Dream of Conquering AIDS, Leave It All to `Cocktail`

Human Immunodeficiency Virus (HIV), a.k.a. AIDS virus, goes through endless mutation. Therefore, if an infected falls ill, there is no other way but to lengthen the life of the patient for one or two years at the most with current therapies. There is a long way ahead to developing cures, too.

This is how the issue was covered by some press this year. However, the truth is not so. Currently, AIDS is right before a moment of being ‘completely conquered,’ and only ignorance, superstition, and prejudice of the people are hindering the curing. The reason why can be simply understood while reading how HIV works and how the cure counteracts.

How HIV works = HIV penetrates into CD-4 cell that works as ‘Conductor of the Orchestra’ in the immune system and turns it into a factory of its own growth. Simultaneously, it decreases CD-4 cells and crashes immune functions.

The process is as follows. Firstly, HIV opens up the lock at the cell wall of CD-4 cell and inserts its RNA inside the cell. RNA, after going through a process called ‘retro-transcription’ to become DNA, moves into the cell’s nucleus and forces its way to settle among the human DNA. After producing protein and sending them outside the nucleus, the long protein is cut and bound together by a protein-dissolving enzyme outside and then sent out of the cell in the forms of HIV. The broods of HIV produced in such a manner get out of the cell and hunt other CD-4 cells.

Blanket-bomb HIV = As the mechanism becomes largely clarified, medical scientists are developing medicines that respectively obstruct an enzyme that helps the HIV’s RNA to DNA and the protein-dissolving enzyme. For the present, there are ten kinds of obstructive medicine for retro-transcription enzyme and six kinds for the protein-dissolving enzyme. ‘Cocktail Therapy’ which is taking three or four medicines among them simultaneously is known to have surprising effects as a cure.

13 research groups in Europe and the U.S. executed clinical experiments to 12,754 people, and they found out that people who were treated with the cocktail therapy at a proper timing showed only 3.4% of the chance to arrive at the last stage within three years and to die. However, half of those who were not treated at the proper timing died. If one is treated with the cocktail therapy upon falling ill, body weight, physical strength, and immunity of the patient get better in all.

Easy to take = Many people know that the medicines do not work because HIV mutates endlessly, but the truth is not so. There are more cases in which they grow tolerant to the medicines since they do not take them steadily.

Generally, there are many cases that AIDS patients stop taking medicine out of the difficulty of taking so many medicines simultaneously. Especially in Korea, the difficulty is more so that one has to take 20 pills at one time because patients often find out about the disease too late.

There was a new medicine that combines the obstructive effects for two retro-transcription enzymes coming out in Korea, but it was not acknowledged as part of the health insurance by the government and is still ‘Pie in the sky.’ Patients take two pills of ‘Trizivir’ abroad, but it is still a distant story to Korean patients. In addition, there is a new medicine called ‘Atazanavir’ that resolves the problems of increasing fat density in the blood with a problem in fat absorption after taking cocktail for a long period time.

Frequently Arriving New Medicines = Other medicines of new type that can be added to ‘Cocktail’ are following the suite.

Scientists has found out that HIV goes through a ‘deliquescence process’ that converges the cell membranes when it enters CD-4 cell after opening up its lock with a ‘special key’ and have introduced a medicine that prevents this process. ‘Fuzeon’ that was recognized to be sold in the market by the Food and Drug Administration (FDA) in the U.S. early this year has shown its high effectiveness in curing patients that do not have any specific betterment with any other therapies. It is expected that this medicine will amplify the curing effects if it is added to an existing cocktail.

With the current cocktail therapy, there is no way to detect and destroy HIV’s RNA that turned into DNA while being dormant and not growing among the human DNA.

Recently, there is a medicine being developed in the U.S. that prevents HIV’s DNA to settle among the human DNA from the beginning. Some have a big hope for a curing vaccine. With the curing vaccine, a part of HIV’s DNA or RNA, not the whole virus, is inserted into a human body to induce vaccination effects. However, a ‘first-generation vaccine’ in which the antibody tried to kill HIV floating outside of CD-4 cell after recognizing them turned out to be a failure after huge-scale clinical experiments. Many research groups including one led by Doctor Seong Young-chol of Pohang University of Science and Technology is currently executing clinical experiments to develop a ‘second-generation vaccine’ that kills infected cells

Being infected with AIDS is no longer being sentenced with a death penalty. Even now, one can live without much difficulty if one carefully follows the medical staff’s instruction, and with the advent of these new medicines, ‘conquering AIDS’ will come soon into our reality.

(Reference = Professor Oh Myeong-don at Department of Infectious Disease, Seoul National University Hospital, Professor Oh Won-sup at Department of Infectious Disease, Seongkyunkwan University)

Seong-Ju Lee stein33@donga.com