HIV has been transformed from a death sentence, to a manageable disease. But there is no cure... Yet.

On April 9, Professor Sharon Lewin will be speaking at Women in Science – Inspiring Tomorrow’s Leaders in Melbourne. In the lead up to the event, she writes for Mamamia about her work researching HIV and AIDS. 

By Professor Sharon Lewin

With the discovery of effective treatment in 1996, HIV was transformed from a death sentence to a manageable chronic disease. But treatment must be lifelong, is not available to all who need it, and there is no cure.

This July, Melbourne will be hosting the 20^th International AIDS Conference (AIDS 2014) and I will be the local co-chair for the conference.  I will be sharing this role with Francoise Barré-Sinoussi, who discovered the HIV virus in 1983 and was awarded the Nobel Prize in Medicine in 2010.  It will be the first time that two women and two laboratory scientists have chaired the conference—both a recognition of the important role that women and science have played in shaping the global response to HIV so far, as well as the leadership that we will continue to show in the future.

Women continue to be important in every aspect of the response to HIV – not only in the laboratory but also in households, families, communities, clinics and political leadership around the world.

I started work on finding a cure for HIV as a young doctor working for Dr David Ho in New York in the late 1990s. David Ho was Time Man of the Year in 1996 for discovering the lifesaving antiviral treatment that people with HIV enjoy today. At the time, we thought that antiviral treatment alone was going to cure HIV – but we were rapidly proved wrong. We learnt that HIV can “hide” from current treatments by infecting certain long lived cells and if we were ever to cure HIV, we would need to know how HIV got into its hiding place and how to lure it out of there. Once back in Melbourne in 1999, I set up a new laboratory to set to work on answering these questions. Over the last 15 years, we have made some very significant progress – but we still have no cure.

What we do know now – and what we didn’t know then – is that a cure for HIV, although extremely rare, is indeed possible. The first and only report of a true cure for HIV was the Berlin patient – an American man Timothy Brown. Timothy is an HIV positive man who was living in Berlin and taking antiviral treatment when he developed a rare blood cancer. He needed a bone marrow transplant for the cancer and his doctor had a brilliant idea to given him a new bone marrow from a donor who was naturally resistant to HIV. About 1% of people are naturally resistant to HIV because they don’t make the protein that HIV needs to enter a cell. After receiving this special transplant, Timothy stopped his antiviral treatment – and the virus never returned. Doctors have looked everywhere – and no virus to be found.

We also now know that if you treat HIV very soon after infection, we can block HIV from going into hiding. The virus is still there – but at very low levels and is under control. This happened in Mississippi, where a baby born to a mother who was living with HIV, received antiviral treatment within hours of being born and stopped treatment at 18 months of age. The infant is now 3 years old and there are only traces of virus found. If we could work out what exactly cured Timothy Brown and the Mississippi baby and some other similar cases, we might find a way to eventually cure the 33 million people currently living with HIV around the world.

Both Francoise and I remain passionate about finding a cure for HIV – or a way to keep the virus under control without the need for long term antiviral therapy. We know a cure is possible. We know it would make a major difference to many people’s lives and a cure would substantially reduce the economic burden of providing lifelong treatment for people living with HIV. However, the science is complex. HIV is a very smart virus – so far it has always been a step or two ahead of us. But if we invest in great ideas and work as a team, together we might find the answers.

AIDS 2014 will see over 14,000 people visiting Melbourne from all around the world, with the world’s pre-eminent scientists, researchers, political leaders, activists and affected populations attending. I sincerely hope that AIDS2014 will be a chance for us to continue the momentum in all aspects of the HIV response which means antiviral treatment for everyone, elimination of new infections, elimination of stigma and discrimination and working together to one day find a cure and truly see an end to HIV.

Professor Sharon Lewin is an infectious diseases physician and basic scientist. She is Director of the Department of Infectious Diseases at The Alfred Hospital and Monash University and co-head of the Centre for Biomedical Research, Burnet Institute, Melbourne, Australia. She completed her medical degree and PhD at Monash University, Melbourne and her post-doctoral fellowship at Rockefeller University, New York with Professor David Ho. Her laboratory focuses on why current treatments don’t cure HIV. In September 2014, she will take up the position of inaugural director of the Doherty Institute for Infection and Immunity, The University of Melbourne. She is the local co-chair for the 20th International AIDS Conference (AIDS2014) which will be held in Melbourne July 2014. The meeting is expected to attract over 14,000 participants. Further details about AIDS 2014 can be found at www.aids2014.org.

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