Looking toward Vienna: Mark Harrington

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Mark Harrington is the Executive Director of the Treatement Action Group.

The International AIDS Conference starts this coming weekend. ScienceSpeaks sat down with Mark Harrington (right), executive director of the Treatment Action Group (TAG), to get his thoughts on the meeting.

TAG is an independent AIDS research and policy think tank fighting for better treatment, a vaccine, and a cure for AIDS. TAG’s programs focus on antiretroviral treatments, HIV basic science and immunology, vaccines and prevention technologies, hepatitis and tuberculosis.

Tell me about the IAS pre-meeting you are attending in Vienna, on potential functional and sterilizing cures to HIV/AIDS?

This 2-day meeting is a collaboration between IAS and TAG which will bring together both scientists as well as some community activists who are interested in the science of HIV.  The pre-meeting will look at both functional and sterilizing cures. A functional cure doesn’t mean you’ve gotten rid of all of the virus in the body, but it does mean long-term absence of detectable virus without therapy, so you wouldn’t have to take medication every day.   We’ll also look at sterilizing cures, which would therapeutically eradicate the virus. The discussion and research are preliminary, and not ready for standardized trials. But there is a need for targeted studies and we will be addressing that.

Why is it a priority for you to attend that meeting?

Part of TAG’s mission is to ensure that research is done to end the epidemic, and that will be through a cure and a vaccine. So it’s natural that we would be a part of this.

Some research recently presented at CROI in February showed that adding the integrase inhibitor raltegravir to an already suppressive triple Highly Active ART (HAART) regimen did not further reduce viral burden. This is because current HAART suppresses all full cellular replication of HIV, so the only HIV expressed during effective HAART is coming out of latently infected CD4 T cells which are reawakening from latency. HAART is fully effective in preventing these new viruses from infecting new cells. This led researchers to reopen the search for therapies which could awake the virus out of latency so they could be killed by HAART, which would be one approach to a cure.

HAART or combination antiretroviral therapy, on the other hand, has set the stage for revival of eradication research. We’ve reached the limits of what we can do with HAART in terms of what it’s able to do about virus population, so new research is needed because HAART does not affect HIV DNA resting in latently infected CD4 T cells.

Anthony Fauci, MD — Director of the National Institute of Allergy and Infectious Diseases at the Department of Health and Human Services — is speaking at the plenary session . What do you think he’ll have to say?

I know that he wants to talk about the potential of treatment as prevention. I bet he’s going to talk about the recent antibody discoveries and the need to continue scaling up HIV programs worldwide in spite of the ongoing recession.

What is the rising concern regarding donor countries backpedaling on their commitment to universal access to HIV treatment and prevention services? Do you see that happening/Do you agree?

There’s no question that’s happening. Rather than admitting that they’re backtracking, donors are talking about “downscaling the scale up.” But they are backpedaling. The goal was for universal access to be achieved by 2010 and that clearly is not going to happen.

What other issues to do you think will come to the forefront at this meeting?

I imagine there’s going to be quite an emphasis on human rights because this conference is taking place in a part of the world where there is a lot of stigma and discrimination. The groups that are most at risk in Eastern Europe – including MSM, sex workers, drug users –  they are all highly discriminated against in that part of the world.

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