Rising Hope:In the March to a Cure for HIV/AIDS

HKU AIDS Institute Lab. Photo by Jasmine HONG. 

“Hope for AIDS,” “a new drug to eliminate HIV” and “a finding worth the Nobel Prize” (see an example here in Chinese), these were titles the media used to flatter BiIA-SG, a new universal antibody drug against HIV viruses invented by the AIDS Institute at the University of Hong Kong. Ever since its announcement on April 26, BiIA-SG attracted much attention.

“One article received 16 million views in one day, I was shocked!” said Professor Chen Zhiwei, Head of BiIA-SG Research and Director of HKU AIDS Institute. “I never expected such a huge reaction, we have always been holding press releases.”

Although the public might be too quick to celebrate the invention of this new HIV drug, as it is has only been tested on mice for the time being, the ardent responses on social media show how greatly people want to see a breakthrough happen in the battle against HIV.

Kill Two Birds with One Stone

BiIA-SG Explanation Board. Photo by Evelyn YE

The BiIA-SG research team found that the new antibody drug would not only protect people from contracting HIV but also serve as a long-acting treatment for the virus. “It can kill two birds with one stone,” said Professor Chen.

Check the below animation to understand the mechanism and advantages of this new drug!

“It is wonderful to see an HIV drug that is made in Hong Kong, which can also be of help for many other countries,” said Johnny Li Choi Hing, the Senior Programme Manager (Education) at Hong Kong AIDS Foundation. “Although it cannot be applied to humans right away, we look forward to its advent.”

Mounting Challenges

HKU AIDS Institute Lab. Photo by Jasmine HONG.

Despite this kind-willing aspiration, the situation of HIV/AIDS that we are facing is nonetheless challenging. The graph below shows a world map with both the number of people living with HIV and the number of new HIV cases as of 2016, using information compiled by Our World in Data. In terms of both indexes, China ranked 12 out of 177 countries with data.

According to government statistics, Hong Kong had 9,091 cases of HIV at the end of 2017, a number which doubled from that of 2009. Behind the growing cumulative population, the number of new HIV infections has also increased over time, which contributed to an accelerated speed of HIV expansion.

The government website also indicates that homosexual contacts and heterosexual contacts are the most common routes of HIV transmission (39% and 34% respectively among the 9,091 people). In terms of gender, 81% of HIV carriers are male. In fact, according to Professor Chen, men who have sex with men (MSM) are exposed to the highest risks of contracting HIV, no matter in Hong Kong or China.

In Professor Chen’s opinion, Hong Kong government plays an active role in fighting against HIV, including supporting NGOs, introducing new medication once available, and providing free treatment to people when needed. However, even with all the efforts, the number of infections continues to increase.

“The message is clear, antiviral treatment alone, although it deals with the patients’ health conditions, cannot prevent the growth of HIV epidemic in our city very effectively,” said Professor Chen. “We need other alternative preventive measures, like what my team is working on – vaccines and antibodies. We need to come up with some new methods in addition to the treatment, so we can really control HIV.”

Ups and Downs

Niu Mengyue Before Her Research Desk. Photo by Evelyn YE.

Before the public cast attention on Professor Chen’s laboratory, it took the team 8 years to come closer to this possible answer to HIV problem, with three generations of graduate students working on the project.

Niu Mengyue, the major contributor of the new finding and a penultimate Ph.D. candidate at The University of Hong Kong, is the third graduate student working on this project. With no experience with AIDS research before, Niu confessed a lot of difficulties in doing research at HKU.

As HKU AIDS Institute only came into being since 2007, its public recognition is not as sufficient as other famous laboratories worldwide, causing a lack of quality collaborations and experiment resources.

“You have to do all the time-consuming things by yourself, like cultivating the virus, raising the mice, dealing with administrative issues and so on,” said Niu, “In terms of collaboration, we always have to wait a long time before others put us into consideration. But I did learn a lot.”

Professor Chen initially worked in the US with Dr. David Ho, who is the leading expert in the AIDS field and the inventor of the famous cocktail therapy. A visit back to China in 2006, when AIDS exploded in Central China, triggered Professor Chen’s idea of going back to China.

“The HIV epidemic rose very quickly in China. We always want to do something to try to fight this epidemic,” said Professor Chen, “So when the HKU approach us, talking they are going to establish an AIDS institute, I was the person willing to commit 100% of my time working in Hong Kong, and basically, in my opinion, working in Hong Kong is working for China, for the whole country.”

Check out this video featuring three questions answered by Professor Chen and Niu regarding their research.

Future Phases

Professor Chen Zhiwei. Photo by Evelyn YE.

The news around this scientific breakthrough resulted in over-excitement from both the media and the public. “I received so many emails and requests [asking] whether this could be used for patient treatment immediately,” Professor Chen said.

However, Professor Chen emphasized that the drug “is still at the stage of preclinical research, undergoing animal testing.” To ensure safety, there are strict procedures that the drug, as well as every other drug, need to undergo to safely enter the market.

Currently, the tests on primates has begun for the drug. If everything is successful, three phases of clinical tests would follow. The clinical phases for anti-HIV/AIDS drugs takes an average of almost six years, according to the data from FDA.

If there is enough money support, Professor Chen hopes that the drug could smoothly complete the testing procedures in 3-5 years.

Besides the Cure

It might still take some years for an effective HIV vaccine or cure to be available in the market, but there are many things the society could do before any breakthrough take place.

An Awareness Gap

Education is one key area to work on. A simple keyword research of AIDS(艾滋病)on Baidu Index, which reflects the trend of public and media interest for a certain word, will lead to an intriguing picture as below.

 

In the whole year, the search count for HIV is flat, only on December 1st – the World AIDS Day –  it peaks, then drops, and becomes flat again. “What it means is that there is a significant gap in the public education of HIV,” said Professor Chen.

Hidden Aging Problem

The advanced treatment technology extends the life expectancy of people living with HIV, but also gives rise to an aging problem among this population. AIDS Foundation’s Li sees providing good public facilities to aging HIV patients as the main priority of what we should do before finding an HIV cure.

“Many infected people didn’t expect that they would be able live long,” said AIDS Foundation’s Li, “but they survive the disease and live on. Now they are in their 50s, 60s and even 70s, a time when they need the medical care, elderly home and social workers the most, while these organizations are not yet ready to take care of elderly carrying HIV.”

“The more fear the public have towards people with HIV, the less quality life the latter can enjoy especially when they become old. We need to educate people who are reluctant to provide services to them,” added Li.

Money Matters

Seaview Outside HKU AIDS Institute. Photo by Jasmine HONG.

When talking about scientific research, we often ignore the important role that money needs to play – for instance, in 2017, Hong Kong government cut fundings for HIV prevention, as reported by South China Morning Post, but laboratories like the AIDS Institute are still in deep concern of raising money.

“A very critical issue is, a lot of discoveries made in the laboratory actually never get a chance to be tested in humans. After 37 years of efforts, currently only 5 vaccines have been tested for efficacy in the human population. Why? Because such kind of test really costs a lot of money. We also wish to push our discovery into the human trial and benefit the patients, but it requires a large amount of money. It’s quite a challenge for us,” said Professor Chen.

Niu is passionate about working on research investment after her graduation from HKU next year, aiming to connect funds to laboratories.

“The researchers cannot achieve everything on their own. I would like to help. There are a lot of rich people in this world, they want to invest in good projects, but for those laboratories, they don’t know how to sell their findings. They do lack of money. If you only count on the government grants, it’s not enough.”

The Journey Onwards

Niu Mengyue Holding The Explanation Board of BiIA-SG. Photo by Evelyn YE

Since the first confirmed case of AIDS in 1981, the past 37 years witnessed a harsh fight between humans and the disease. Below is a timeline overviewing the major events defining the progress of HIV/AIDS we’ve seen so far.

Recognising the rapid development in the scientific community, Professor Chen is hopeful about the future. He said:

“I’m quite positive for finding something that eventually will end this pandemic. But how long it takes – it’s an issue of how effective the discoveries we make.”

Although there used to be doubts on the point of keeping HKU AIDS Institute, Professor Chen is determined to keep digging in the field. He said:

“People have different views, it’s ok. But for us, we just keep working quietly. Hopefully, we can make something different just like this time.”

At the end of our interview, Professor Chen finished a meeting with the entire research team and Niu also returned to her research desk.

The global march for a cure for HIV/AIDS goes on.

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