“Many think AIDS is no longer a problem, but the virus is still there”

With its red ribbon logo, Sidaction is known to all. Just like its vice president, Line Renaud, who is one of the favorite personalities of the French and has been involved in the fight against AIDS for many years. On the other hand, the mechanisms of this disease, its management and research challenges are much less clear to the general public.

“Many think that AIDS has become a chronic disease like any other, but if the treatments are effective, it remains a virus that cannot be cured”, insists Françoise Barré-Sinoussi, president of Sidaction. On Tuesday, International AIDS Day, the virologist, co-discoverer of HIV and Nobel Prize for Medicine in 2008, will attend a special evening on France 3 on Monday evening, including 20 minutes is a partner. After the film was shown 120 beats per minute a debate will be organized at 21:05. The opportunity for you to ask for remobilization. “There are many sources of hope as research continues to develop new therapeutic approaches. But all this is possible only if public opinion intervenes against HIV-AIDS ”.

Since the creation of Sidaction in 1994, research has made significant progress. How have treatments evolved to improve the quality of life of people living with HIV?

Since the arrival of triple therapies in 1996, therapeutic management has evolved a lot and improved over the years, in particular to eliminate the toxicity of these treatments. In the late 1990s, patients had to take dozens of tablets every day. Today one tablet a day is enough. It is even estimated that a treatment initiated soon after being exposed to the virus can have a life expectancy identical to that of a person who is not infected with HIV.

Furthermore, the performance of these drugs is such that they cause an undetectable viral load, which means that patients no longer transmit the virus. We can therefore see the individual and collective benefit of triple therapy.

There has also been the development of PrEP, a preventative treatment. However, the research does not stop. What are the new therapeutic avenues explored?

With triple therapy it is possible to live with HIV. This is obviously a positive point, but it is a lifelong treatment. The virus remains in the body. If the patient stops treatment, the virus starts again, it can progress to AIDS and the risk of transmission reappears. The patient may also develop resistance to resuming treatment and may pass on a resistant virus to others. However, patients say it is difficult to adhere to this treatment for life.

Today we have a better understanding of the virus, its reservoirs and mechanisms. And one of the priorities is to develop treatments that can induce remission. Treatments to be used for a set period of time and after which the virus would be controlled for the rest of life.

Research also focuses on the development of a very slow-acting antiretroviral therapy. It consists of an injection that allows people to be treated for 3-6 months and is already showing interesting results. The other advantage of this “long-acting treatment” by injection is that it can be used for prevention, such as PrEP. Evidence has shown its effectiveness in women in Africa, who have difficulty protecting themselves from HIV infection. It is a great source of hope. Because the treatments of the future are also based on prevention.

All this progress shows the importance of research, and we can see it with Covid-19: deploying colossal resources allows us to quickly obtain important results …

Research funding is the very essence of Sidaction! You should know that there are no longer any sources of funding in France: the research is funded by the National AIDS Research Agency (ANRS) and Sidaction.

When we work on HIV-AIDS, we try to understand the mechanisms, the persistence of the virus in the body being treated. And we learn a lot, especially that there are inflammatory phenomena that play an important role. However, we know that SARS-CoV2 infection causes inflammation. We must not believe that there are totally closed barriers between researchers working on HIV and those working on Covid-19, because there are similarities, similarities, which show the importance of working together. Additionally, many AIDS researchers have started working on this coronavirus.

And if we make the analogy with Covid-19, one of the lessons we have learned from AIDS research is the importance of all working together. Whatever the discipline, competence is much stronger when combined with others.

Is there any specific research on the effects of Covid-19 in people with HIV infection?

This health crisis makes us fear an impact of the coronavirus on people living with HIV, particularly on screening and prevention. Studies have been published and others are underway, notably in France, where a cohort of people infected with HIV and Covid-19 has been worked on. For now, the results are still preliminary, but it appears that people with HIV and who contract Covid-19 do not develop a more severe form due to their HIV-positive status, provided they do not. they have no other comorbidities such as cancer, diabetes or cardiovascular disease.

In this particular pandemic context, what do you expect from this International AIDS Day 2020? Aren’t you afraid of a form of competition from Covid-19?

People don’t feel worried, they are no longer aware of the danger. There is a demobilization of the general public, but it existed before Covid-19.

Through Sidaction, we strive to support research and young researchers. And the associations, which bring a lot to the people affected by the infection, to these most vulnerable and precarious populations, in particular sex workers and migrants, also populations strongly affected by the Covid crisis. The work of the associations is fundamental and can only continue with the support of the general public.

So, for this year, we hope for a re-mobilization of civil society against HIV-AIDS, because we must not forget: HIV is still there!

However, even today, public opinion remains rather poorly informed. What are the consequences of this misinformation?

New cases of contagion in France affect young people, but also people over 50. If they get infected, it is because they no longer take precautions, but why? Paradoxically it is linked to the progress of research. Many believe that AIDS is no longer a problem, since there are treatments. Our latest annual survey shows that 23% of young people feel misinformed and even think we are cured of AIDS, but we cannot cure it! This misinformation also shows how much communication and information about HIV needs to be updated.

To date, there are still 38 million infected people worldwide and only 67% of them are in treatment. AIDS is not a “solved case”. Away from there.

Can the solution come from vaccination? Where is the research on an AIDS vaccine?

We are beginning to better understand all the immune responses a vaccine must induce to gain protection. It is the basic research upstream that is needed to develop effective vaccines.

And there is enormous progress in this field: the discovery of powerful antibodies constitutes a new line of research launched in the last decade, to try to find a vaccine candidate capable of inducing the production of these antibodies in the body. . And right now, vaccine candidates are being studied.

The search for future treatments continues, which is why I remain extremely optimistic about developing a vaccine. I don’t know how long it will take, but we should get there. However, success is based on the mobilization of everyone and thanks to donations.