25 years of AIDS and cure remains elusive

HIV drug treatments and tests have improved over 20-plus years, but vaccine is still the Holy Grail.

By Aaron Smith, CNNMoney.com staff writer

NEW YORK (CNNMoney.com) -- Twenty-five years and 25 million deaths after the first AIDS diagnosis in San Francisco, drug companies are still looking for the Holy Grail in HIV research: a vaccine that would prevent infection.

Researchers from the drug companies Merck (up $0.55 to $45.06, Charts), Sanofi-Aventis, VaxGen (down $0.03 to $1.66, Charts), GlaxoSmithKline (up $0.60 to $53.73, Charts) and Wyeth (up $0.22 to $48.50, Charts) are trying to discover the elusive vaccine. The 40 million people who are currently living with HIV would not benefit from a vaccine, but it would help guard against the spread of new infections, estimated at three million a year.

Researchers are still seeking a cure for the AIDS virus responsible for 25 million deaths 25 years after the first diagnosis.

After more than 20 years of research, condoms - not vaccines - are still the most effective way of preventing the spread of HIV among sexually active people.

"It has been an enormous problem to try and develop an effective AIDS vaccine," said Dr. Paul Maddon, founder and CEO of Progenics (up $0.46 to $27.84, Charts), a company testing HIV-blocking drugs. "It's certainly been a Holy Grail for most of us in HIV research. The conventional approaches that have worked on other viruses have been tried without success" on HIV.

Today is World AIDS Day and church bells from Washington, D.C. to India and Nigeria are ringing every eight seconds to hammer home the universal impact of this killer virus. The awareness program, "For Whom the Bell Tolls," calls for a bell to toll for every death and every new infection.

And while a vaccine or a cure for the constantly-mutating virus is still lacking, drug companies and biotechs have made substantial improvements in recent years for treatments (called anti-virals) and tests.

In one of the more recent developments, the Food and Drug Administration approved Atripla in July, a once-a-day combination HIV treatment from Bristol-Myers Squibb (up $0.01 to $24.84, Charts), Merck and Gilead Sciences (down $0.74 to $65.22, Charts) that consolidates and simplifies the often-complex AIDS drug regimens. And before the end of 2006, Pfizer (up $0.37 to $27.86, Charts) plans to file its experimental AIDS drug Maraviroc with the FDA, which could be used to halt or slow the viral spread.

The market for AIDS drugs - estimated at $4 billion a year - is not a major money-maker for drug companies. Unlike heart disease, cancer and diabetes, which have an enormous impact on relatively affluent markets like the United States and Europe, two-thirds of the people infected with AIDS live in sub-Saharan Africa, a comparatively impoverished region.

Leaders in the AIDS drug industry, like GlaxoSmithKline and Bristol-Myers Squibb, often sell the products at reduced prices, or simply give them away in impoverished regions like sub-Saharan Africa. While this puts a cap on prospective drug sales, some argue it gives drug companies a way to improve their reputation with the public while the companies maintain altruistic motives.

Glaxo is heavily promoting World AIDS Day on its web site, and Wyeth's vaccine research executive Dr. Emilio Emini moderated an industry panel discussion hosted by the Nasdaq market site in New York with CEOs from HIV industry players including Polydex (down $0.04 to $7.27, Charts), which is experimenting with an HIV preventative, Insmed (down $0.06 to $1.65, Charts), a company testing treatments for weight loss associated with HIV treatments, OraSure Technologies, (down $0.03 to $8.58, Charts) maker of a rapid oral HIV test, and Progenics.

Polydex chief executive George Usher said his company is conducting late-stage testing on women in Africa and India with a vaginal-applied treatment called Ushercell, to see if it protects women who have sexual intercourse with infected men.

Ushercell is a "microbicide," a class of drugs that has attracted $40 million in funding from the Bill and Melinda Gates Foundation, said Dr. Henry Gabelnick, executive director of Conrad, a research entity from the Eastern Virginia Medical School that partners with Polydex on Ushercell testing. Dr. Gabelnick said that if Ushercell tests are successful, it might be ready to file for review by regulators by 2009 or 2010.

Have you taken your AIDS test?

More than one million Americans are living with AIDS, according to the Centers for Disease Control. The virus is usually spread through unprotected sexual activity or the use of infected needles by drug users. The CDC has previously recommended routine testing for high-risk groups like sexually active gay men and heroin addicts.

But on Sept. 21, the CDC recommended routine HIV testing for all Americans between the ages of 13 and 64, sending up OraSure's stock price more than 20 percent on that day. The stock price has climbed another 5 percent since then, and chief executive Douglas Michels said he plans to sell up to three million OraQuick kits in 2006.

What's next for OraSure? The OraQuick tests are currently conducted in doctor's offices and medical clinics, but Michels told CNNMoney.com that the kits are being tested to see if they can be used at home. This would require "consumer friendly packaging" and approval from the FDA. Michels wouldn't say when he plans to file the home test kits with regulators, but he said clinical trials should last through much of 2007.

Michels said detection of the virus is not necessarily a death knell. He said early detection, combined with the improvements in HIV treatment, allows infected patients to live on for decades.

"Despite the fact that there's no vaccine and there's no cure, there are highly effective anti-viral drugs that allow people with HIV to live very productive lives," said Michels. "Now, more than at any time in the past, people who know they're HIV positive can go on therapy and live indefinitely. Monitored and put on therapy at an appropriate time before they can develop full-blown AIDS, they can take steps to avoid spreading the infection."

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