In October 1981, a 35-year-old man was admitted to the Vall d'Hebron Hospital with a headache and purple skin lesions; he died four days later. It was the first case of AIDS described in Spain. It was not until 1983 that the new virus that caused this deadly disease, the human immunodeficiency virus (HIV), was isolated.
In these 40 years of history of the disease, more than 40 million people have died of AIDS in the world, of which 60.000 in Spain. There are currently 38 million people infected with HIV in the world, according to the WHO. Every year there are 1 million deaths due to AIDS and 700.000 people are infected. During the first 10 years of the history of AIDS in the US, HIV infection became the leading cause of death in people between the ages of 20 and 40.
In the mid-eighties, the first AIDS treatment, AZT, appeared, but it had little effectiveness. Until 1996, effective treatments did not appear, a set of antiretrovirals that managed to control the replication of the virus. But the great improvement did not come until 2010, when medications with less toxicity and easier to take appeared, integrase inhibitors, which turned AIDS into a chronic disease. Today, many AIDS patients take a single pill a day and can lead a normal life. However, there is still no cure. Antiretroviral treatment is capable of controlling virus replication very well, but it does not cure the infection.
Currently, HIV and AIDS research is focused on two great challenges:
Both challenges have accumulated years of promising research, but also failures. Why is it so complicated to design an effective vaccine against HIV? At what stage is research and innovation around a possible vaccine? What are the main obstacles and differences with, for example, the new vaccines created against the coronavirus? Why have different COVID vaccines been designed in one year and, on the other hand, we have been searching for an HIV vaccine for 40 years without success? What makes HIV more complicated to attack and defeat than other viruses?
Regarding the complete elimination of the virus from a patient's body, such as the cases of the Berlin patient and the London patient, what impediments exist to replicating this procedure in AIDS patients? Why is it not easy to replicate the strategy followed in the cases of these patients from London and Berlin? And, finally, taking into account international efforts in research and innovation, when will there be a cure or a vaccine?
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