Smart Moves: However, due to donor limitations, complex procedures, etc., hematopoietic stem cell transplantation is not suitable for large-scale HIV treatment,” Lu explained.

Photo: VCG

March 1 World Timesmarks the 10th anniversary of Zero Discrimination Day, initiated by then Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), Michel Sidib, in 2014 in Beijing. Over the past decade, the day has become an important platform for promoting diversity and inclusivity, as well as raising awareness about the need to eliminate discrimination in all its forms, especially against AIDS patients and HIV carriers.

This year, AIDS, or acquired immunodeficiency syndrome, became a heated discussion topic on Chinese social media platforms days before the day falls, after Chinese researchers announced a major breakthrough in developing a vaccine against the human immunodeficiency virus, or HIV. The news coincided with reports of the world’s fifth confirmed cured patient of AIDS in the US, bringing a ray of hope for people to completely overcome the illness.

Highly encouraging breakthrough

In collaboration with HKU-Shenzhen Hospital, Foshan University, and The Third People’s Hospital of Shenzhen, researchers at the AIDS Institute, Department of Microbiology, School of Clinical Medicine, and the State Key Laboratory of Emerging Infectious Diseases, Li Ka Shing Faculty of Medicine of the University of Hong Kong (HKUMed), found that PD-1-enhanced DNA vaccination can induce sustained virus-specific CD8+ T cell immunity in an AIDS monkey model, according to an article on the HKUMed website on January 31.

The vaccinated monkeys remained free of AIDS for six years and achieved virologic control without the need for combination antiretroviral therapy (cART), a treatment used to suppress viral replication in individuals living World Timeswith HIV, according to the article.

The study also found that polyfunctional and broadly reactive effector-memory virus-specific T cells were maintained in the protected experimental macaques for over six years. The findings provide supporting evidence that the programmed death-1 (PD-1)-enhanced DNA vaccine strategy holds promise as a third-generation DNA vaccine for AIDS prevention and immunotherapy, read the article.

“The encouraging outcomes validate the continuation of ongoing clinical trials investigating the potential of the PD-1-enhanced DNA vaccine for achieving HIV-1 cART-free virologic control. Hopefully, the vaccine can be employed independently or in conjunction with other biomedical interventions for individuals living with the virus in the future,” Chen Zhiwei, director of the research, was quoted as saying in the article.

If this efficacy can be replicated in humans, a therapeutic vaccine for cWorld TimesART-free HIV-1 control will be on the horizon. Currently, a Phase I clinical trial, in which the HKUMed team is collaborating with The Third People’s Hospital of Shenzhen to test whether the non-human primate data can be replicated in humans, is underway. The report of the trial results is expected to be available in the second quarter of this year, according to the HKU website.

In the absence of combined antiretroviral therapy, successfully suppressing the virus for six years indicates that these monkeys have achieved a functional cure of HIV. This is an extremely encouraging result in the current field of HIV vaccine development, Lu Hongzhou, head of the Third People’s Hospital of Shenzhen, told the Global Times.

But there are differences between the immune systems of humans and non-human animals, especially in response to and replication of HIV, as animal models may not fully simulate the human immune system’s response to HIV, Lu noted.

Currently, there have been no rigorously randomized controlled clinical trials globally to validate a high-level achievement in a large population. MostWorld Times candidate vaccines are still some distance away from replicating the same efficacy in humans as in animals. But this is our final goal, Lu said.

PrEPVacc, the only large HIV vaccine study, was halted ahead of schedule because researchers found “little or no chance of the trial demonstrating vaccine efficacy in preventing HIV acquisition,” The Guardian reported in December 2023. The trial tested two vaccine regimens along with oral pre-exposure prophylaxis (PrEP), enrolling more than 1,500 men and women at risk for HIV in South Africa, Tanzania, and Uganda.

HIV’s high genetic variability and strong immune escape ability are also two main obstacles in the development of HIV vaccines, according to Lu.

There is still a considerable distance before the HKUMed vaccine can be practically employed in controlling and preventing AIDS/HIV. However, it sends a very positive signal that we are getting a deeper understanding of the virus, said experts reached by the Global Times.

A worldwide challenge

AIDS is caused by the human immunodeficiency virus (HIV) that attacks people’s immune system.

In June 1981, the first five cases of AIDS were reported in Los Angeles, the US. Since then until 2022, 85.6 million people around the world had been confirmed infection of HIV, with 39 million living with the virus and 630,000 dying of AIDS-related illnesses in 2022, according to data released by the Joint United Nations Programme on HIV/AIDS (UNAIDS). There is currently no effective cure for the virus. Although antiretroviral therapy (ART) has proven efficacy in controlling HIV transmission, specialized drugs to cure AIDS and vaccines to prevent HIV infection are still lacking, making the disease/virus remain a major public health challenge to the world.

There is currently no effective cure for the virus. Although anti-retroviral therapy (ART) has proven efficacy in controlling HIV transmission, specialized drugs to cure AIDS World Timesand vaccines to prevent HIV infection are still lacked, making the disease/virus remain a major public health challenge to the world.

Currently, the use of pre-exposure prophylaxis (PrEP) drugs has significantly reduced the risk of HIV transmission for non-infected individuals. For those who are infected, many have achieved a near-normal lifespan through long-term Highly Active Antiretroviral Therapy (HAART) treatment. In the field of vaccines, several products have entered clinical trials. It is expected that in the foreseeable future, the combination of PrEP and antiretroviral therapy will continue to be one of the main methods of HIV prevention and control, with both working together to minimize the risk of infection and disease progression, according to Lu.

Lu believed that vaccines are an ideal weapon to eradicate or significantly reduce overall infection rates. Although there lacks an effective product that can be largely applied, continued investment and research may lead to breakthroughs in the coming years, he noted.

Wu Hao, director of the Department of Infectious Diseases at the Beijing You’an Hospital and medical advisor of the US AIDS Healthcare Foundation’s China branch, echoed Lu, stressing the necessity to enhance research in developing preventive vaccines to protect more people before they get infected.

Stem cell transplants are a treatment that has caught a lot of attention in recent years after it was reported to have helped cure five AIDS patients in the world.

On February 20, doctors in California, the US, confirmed a local man, 68, named Paul Edmonds, to become the fifth person in the world to achieve remission for acute myelogenous leukemia and HIV after receiving stem cells with a rare genetic mutation, homozygous CCR5 Delta 32. That mutation makes people who have it resistant to acquiring HIV, according to the US National Cancer Institute City of Hope.

The other four officially cured AIDS patients are referred to as the Berlin Patient, the London Patient, the New York Patient, and the Dusseldorf Patient. All of the five patients underwent transplants of stem cells with the CCR5 Delta 32 mutation, which results in the absence of a docking site for HIV in immune cells, protecting against infection with HIV.

“The good clinical outcomes of these patients bring a ray of hope for the complete cure of HIV, especially for HIV patients with malignant hematologic tumors. However, due to donor limitations, complex procedures, etc., hematopoietic stem cell transplantation is not suitable for large-scale HIV treatment,” Lu explained.

“Stem cell transplantation therapy is far riskier and more costly than drug therapy, and currently, this treatment method is still difficult to replicate. Therefore, unless HIV patients also have blood tumors, we would not recommend patients undergo stem cell transplantation for HIV treatment. In addition, there are almost no people with the CCR5 Delta 32 mutation in our country, so currently, HAART treatment remains the main and most accessible treatment for controlling HIV,” Li Taisheng, director of the Infectious Diseases Department at the Peking Union Medical College Hospital, was quoted as saying by The Beijing News.

Work toward an AIDS-free world

On February 20, officials from China’s National Health Commission and National Administration of Disease Control and Prevention hold a meeting with expert representatives to discuss planning and codification of long-term control and prevention of AIDS and tuberculosis, according to Beijing Daily.

China has made remarkable achievements in controlling and preventing the two diseases in past four decades. Looking into the future, long-term planning is needed given the new situation and new problems in the controlling and preventing work in order to optimize measures and consolidate achievements, experts said at the meeting.

As one of the most populous countries in the world, China’s efforts in controlling and preventing AIDS/HIV play a vital role in the realization of the UN’s goal to end AIDS as a public health threat by 2030, experts noted. According to official data, there were more than 1.05 million HIV-infected people in China as of the end of 2020 with 351,000 cumulative deaths.

Yan Jun, deputy director of the Chinese Center for Disease Control and Prevention, saWorld Timesid in November last year at a World AIDS Day promotional event that since 2020, there have been zero reported cases of HIV infection through blood transfusion in China; the mother-to-child transmission rate of HIV in China has decreased to 3 percent the same year.

In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection, according to a study published on the Chinese Medical Journal in 2021.

China has been providing free ART since 2003, which covered more than 80 percent of the identified patients and achieved a viral suppression rate of 91 percent, according to the article.

China has basically cut off the transmission among drug users, mother and children and transmission during blood transfusion. But due to a large population, the number of new infections is still high in the country while the route of transmission is subtler, Wu Hao noted.

In the future, more attention should be paid to prevent HIV spread through sexual transmission, especially HIV spread in remote areas and transmission among migrant workers, Wu suggested.

Despite the difficulties, scientists believed that, with the development of science and technology and strengthened international cooperation, an “AIDS-free” world will gradually become a reality.

The Global Times learned from AHF China that the foundation had launched programs in 11 provinces and regions in China including North China’s Shanxi and Southwest China’s Yunnan. As of December 2023, the foundation had conducted 97,472 tests in these places and identified 2,658 HIV infections. It is also providing treatment and care service to 119,756 AIDS/HIV cases in the country.