This year's biggest disease scare is no doubt, the Ebola virus. News outlets and social media have been replete with so much Ebola-related news, ranging from the more sober CDC warnings to fantastical hoaxes on Facebook, where Ebola victims are reported as turning into zombies. However, there is one disease that, so far, is far worse than Ebola and still needs our attention and resources.
We're talking about HIV/AIDS, of course, and this seems as good a time as any to review or find out what we know (or don't yet know) about this illness-for more than three decades this disease has killed millions across continents; while that fact has become easy to take for granted, we must never let our guard down and keep fighting for a cure.
- Don't forget-HIV/AIDS is a global pandemic; Ebola is not
As of 2014, 39 million people all over the world have died from HIV/AIDS. To get some perspective on that, let's see how many people have died from Ebola Virus Disease (EVD): according to the CDC, some 4,951 people have died from that disease. Besides that, the World Health Organization says that as of 2013, 35 million people globally are currently infected with HIV. Contrast that with EVD which, as of October 29, 2014, has a recorded 13,703 cases (WHO data).
So if there's a public health concern right now that we should be more focused, it's obviously how to help those 35 million HIV-positive persons who need urgent treatment. Also, since the Ebola virus has been so far contained in the West African countries where it first spread, there's a greater chance for people to be infected with HIV than EVD.
- HIV/AIDS is deadly but no longer a death sentence
The HIV/AIDS epidemic was officially declared by the CDC in June 5, 1981. From that year until the mid-1990s, getting diagnosed with HIV/AIDS was a death sentence. Thankfully, by 1996, antiretroviral therapy had been invented. It is comprised of a cocktail of drugs that keeps the AIDS virus or HIV from replicating; this same drug treatment also keeps HIV from turning into full-blown AIDS. This turned what was once a fatal disease into a manageable one.
Today, this treatment is known as "highly active anti-retroviral therapy" or HAART. This treatment uses several approved drugs in combination. Usually, three or more types of drugs are combined to keep HIV from developing drug-resistance. Some of the most common drugs used in HAART include:
A class of drugs called "nucleoside/nucleotide reverse transcriptase inhibitors, also called nucleoside analogs, such as abacavir, emtricitabine, and tenofovir; Then there are the nonnucleoside reverse transcriptase inhibitors (NNRTIs), i.e., efavirenz, etravirine, and nevirapine.
The other inhibitor drugs used in HAART include protease inhibitors (PIs) such as atazanavir, darunavir, and ritonavir; entry inhibitors, like enfuvirtide and maraviroc; and integrase inhibitors, such as dolutegravir and raltegravir.
- Scientists discovered a breakthrough HIV treatment-and it's not a drug!
Currently, HAART required HIV-positive persons to take several antiretroviral medications each day. While this vastly improves patients' quality of life and keeps the virus from causing full-blown-and fatal-AIDS, scientists have not stopped looking for even better medication for HIV therapy.
Recently, biotech firm CytoDyn, Inc. (OTCQB: CYDY) has gone into near-completion of Phase 2b clinical trials for its new anti-HIV treatment called PRO 140. Amazingly, PRO 140 is not a drug. Rather it's an antibody that keeps HIV from entering a human cell. In case it is eventually approved for use by the FDA, HIV patients would have an option to take only one therapeutic agent, PRO 140, instead of the usual cocktail of drugs.
PRO 140, belongs to a class of HIV therapies known as entry and fusion inhibitors. These therapies block HIV from entering into and infecting certain cells. PRO 140 has been the subject of one Phase 1 and two Phase 2a trials, each of which demonstrated PRO 140's ability to significantly reduce HIV viral load in human test subjects.
The Phase 2b clinical study was designed to investigate the potential of allowing patients to enjoy treatment interruption from their current HAART regimen concurrent with a monotherapy consisting of weekly injections of PRO 140.
The results from its treatment substitution trial to date have demonstrated 100% success in suppressing the viral load among patients who were administered weekly injections of PRO 140 for 4 weeks of monotherapy (success defined as zero virologic failures).
As of October 13, 2014, there were zero virologic failures among 21 patients who have reached 4 weeks of monotherapy. As of October 13, 2014, 36 patients out of 40 have received at least the first injection of PRO 140.
With this success in the Phase 2B trials, CytoDyn is requesting FDA clearance to conduct a larger similar Phase 3 licensing trial to demonstrate further the efficacy of PRO 140 for 4 weeks of monotherapy with PRO 140.
"We believe PRO 140 is the most advanced experimental monoclonal antibody for HIV treatment in the world. The PRO 140 antibody appears to be a powerful anti-viral agent while not being a drug, which means fewer side effects and less frequent dosing requirements as compared to daily drug therapies currently in use. We believe PRO 140 can be a unique and important entry into the global fight against HIV and serve as a catalyst to shareholder value," said Dr. Nader Pourhassan, President and CEO of CytoDyn.
Since PRO140 is an antibody and not a drug, it has a number of potential benefits to patients. Among these are: having no or only minimal side effects; and a lesser likelihood of viral mutations. PRO140 would also have special application to patients with multi-drug resistant viruses; those who have difficulty adhering to daily drug regimens; and those with intolerance to existing therapies.
- HIV is spread more insidiously than Ebola
The Human Immunodeficiency Virus uses more stealth than the Ebola virus. A person who is infected with HIV can have no symptoms for up to ten years. This means he or she is able to unknowingly infect others within that period. It's only during the late stage of HIV infection that a patient shows symptoms-and even then, these symptoms might be mistaken for other illnesses at first.
In contrast, the Ebola virus has an incubation period of up to 21 days. On the average, it takes 8 to 10 days for an Ebola patient to show symptoms. By comparison, it is more likely for us to spot Ebola and take immediate measures to contain and treat it because the symptoms appear much sooner compared to HIV.
Overall, our concern for EVD is well-placed-but this must not cause us to panic to the point of ignoring the much greater and more serious pandemic that is HIV, that has killed-and continues to kill-millions worldwide. A more balanced, rational perspective on Ebola vis a vis HIV/AIDS is needed now more than ever.