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As HIV investigators work to control and eradicate the virus worldwide, certain myths and misconceptions about the disease have been embraced, while other concepts with merit have been left relatively unexplored, argues American HIV/AIDS pioneer Dr. He shares his views and recommendations in a commentary published today in the journal . Levy calls on fellow researchers to continue questioning and not to lose sight of alternative strategies that could ultimately lead to a sustainable, long-term solution to HIV infection. Levy was one of the first researchers to isolate the AIDS virus and is Director of the Laboratory for Tumor and AIDS Virus Research at the University of California, San Francisco.
A cure of HIV infection, which is exemplified in the “Berlin patient,” has stimulated approaches to achieving this goal for all infected people.
This person received a stem cell transplant from a donor who was genetically resistant to HIV. Levy argues that some of the directions chosen to effect a cure "are not based on well-established experimental facts," and eliminating a virus that has integrated itself into the genes of a cell requires a better understanding of the challenge. Levy says he appreciates the pilot studies involving genetic editing that could mimic the treatment used for the "Berlin patient" and believes that the most immediate chance of success is one directed at enhancing the anti-HIV response of the immune system.
Levy writes: Researchers need to examine the basis of their observations and consider whether what they are seeing is really the answer or is part of what’s really there.
We have to ask whether we are disregarding or missing what might be a much better answer because we’re grabbing at something that looks good today.
There is no denying the success antiretroviral medications have had in lowering viral loads, reducing transmission, and helping people live a relatively normal life with HIV.
Doctors often prescribe these drugs upon diagnosis, but Levy questions whether the long-term side effects, which include kidney and liver disorders, are worth it if a patient is asymptomatic.Because this immune response handles all HIV types, it would be important in approaches aimed at enhancing immune antiviral responses and in the development of a vaccine.Importantly, both activities of the CD8 T cell need to be appreciated.On the basis of preclinical work, he believes that there are missed opportunities to invest in basic science and study other vaccine strategies, such as enhancing the antiviral responses of immune cells, particularly those of the innate immune system.He also advocates further studies of individuals who have been highly exposed to HIV but are not infected and the evaluation of killed-virus vaccines.While recognizing the important success of ART, Levy calls on his colleagues to give more attention to drug toxicities and the potential emergence of drug-resistant viruses.“It seems misguided to just look at the short-term benefit," he says. Levy argues that one of the greatest weaknesses of existing HIV-vaccine clinical trials — most reporting limited, if any, success — is that they are mainly looking to find a better antibody to neutralize the virus.This paper may be controversial, but people need to know the other side of the story The train left the station and no one is stopping to see whether we did the right thing or not.I’m asking anyone who is involved with HIV/AIDS to pause and focus on some research and clinical areas that need more attention.As Media Relations Manager, he works closely with the media and public information officers to share the scientific breakthroughs published in Cell Press's 31 journals.He is a graduate of Sarah Lawrence College in New York and received his MS in Science and Medical Journalism from Boston University.