The evolution of HIV treatment
Wednesday, December 04, 2019
Anti-retroviral drugs (ARVs) in an Exhibition at Kigali Convention Centre on December 4, 2019. Dan Nsengiyumva.

In the early days of HIV/AIDS existence, there were no drugs to either prolong the life of the infected person or lessen their suffering. In simple terms, during that period, contracting HIV was akin to death sentence.

Much later, Anti-retroviral drugs (ARVs) were introduced but people living with HIV had to swallow 38 tablets at a go and these were taken on a daily basis for as long as the person was alive.

The dose has come down to a single pill per day and more revolutionary technologies are upcoming – before an HIV vaccine that has been on clinical trial for 20 years now - gets licensed.

For the last three decades, the epidemic has claimed 35 million lives globally.

In Rwanda, an estimated 5,000 HIV-related deaths were recorded in 2013 according to the Ministry of Health. As if not enough, people are increasingly being infected, with 5,000 HIV transmissions per year.

However, scientists who have been studying the epidemic for decades are now coming up with promising revolutions that will eventually provide an appropriate solution.

In two sessions that were held on sidelines of the ongoing 20th International Conference on AIDs and STIs in Africa taking place in Kigali, various researchers presented what could be the most impressive scientific achievement; HIV vaccine trials and long-acting technology for HIV.

Technologies for HIV treatment

• Injectables: They are long-lasting ARVs. Once taken, an injectable can last for three months.

According to Dr Michelle Kisare, a medical scientist, two injections that have been tried on patients have been successful thus can be used.

She estimates three years until they are on market.

Rwanda joined a Unitaid network that conducts long acting technology researches in 2018.  Dr. Sabin Nsanzimana the Director General of Rwanda Biomedical Centre (RBC) confirmed to The New Times that one of the two injections was tried in Rwanda and has worked.

"It is only a matter of time until it starts being used (on large scale),” he said.

•Implants: For HIV, they exactly look similar to contraceptive implants that are placed in upper arm. Once inserted under one’s skin, they release the ARVs to stop and treat HIV infections in a given period of time.

•Vaginal rings: Usually known as family planning devices, they will be used by female patients. It is placed inside vagina and will release ARVs instead of hormones.

•Microarray patches: A novel technology usually used in vaccine delivery. Once patched to a skin, it releases ARVs just in seconds.

•Lyndra gastric residence system: For it has proven that some patients find it uncomfortable to switch to newly introduced treatment means, Lyndra gastric residence system uses a pill that lasts for a given time in stomach, spiting ARVs in the patient’s body.

An efficacious HIV vaccine trial

Rwanda was involved in one of the four HIV vaccine trials that enrolled with 4, 625 HIV–negative population with majority of young women and LGBTQ+ in 13 countries around the world.

Findings of all the four vaccine trials that are still ongoing will be released in 2022 and 2023.

According to Dr. Azwi Takalani who has been part of HIV Vaccine Trial Network (HVTN), the efficacy will hopefully reach 50 percent, a required percentage for a vaccine to be licensed, in an estimation of two years.

"HVT has been inconsistently efficient in previous years, we are working hard to make it to 50 percent efficient and we are cautiously optimistic that it will not take long,” she told The New Times.

What you need to know about the HIV vaccine

1.     How it works: The vaccine stimulates the body’s immune system to recognize and protect against or create resistance to an infection.

2.   Why HIV vaccine:  According to UNAIDS, over 3 decades, HIV/AIDS have claimed over 35 million lives globally and 34 million are living with the epidemic. 5000 HIV transmissions are recorded every day. It is 75 percent more concentrated in black people and Hispanic with the majority of young women. This, according to HVTN, emphasizes the need for a vaccine as a long-term method to control the alarming growth of the HIV/AIDS pandemic.

3.   Is it safe: Myths that HIV vaccine trial can cause HIV, autism or infertility were scientifically proven wrong. Scientists make careful studies before trying the vaccine. Besides, the institutions involved are charged with ensuring the safety and welfare of people.

4.   How far is the trial? It has been tried in 13 countries globally in mostly sub-Saharan Africa and South America. It has made 80 clinical trials in three phases whose findings will be issued out in the next 3 years.

5.   Who are involved? HIV vaccine trials do not involve necessarily HIV + people only.  4,774 people who were tried in all the HVT phases were uninfected.