If the entire planet is grappling with the coronavirus, there is an epidemic not to be forgotten: that of AIDS. The rapid progress in the fight against Covid impress and challenge us, unlike those against HIV, who skate after clear improvements in treatment. ” Faced with AIDS, we started from nothing, would like to remind Morgane Bomsel, virologist at the Cochin Institute. There, we were already familiar with the coronaviruses due to the two previous epidemics, SARS and Mers. »
Although both are RNA viruses, the mechanisms of infection – and of course the symptoms – of HIV and SARS-Cov-2 have nothing to do with it. The retrovirus responsible for AIDS integrates into the nucleus of cells, unlike the coronavirus. It is therefore much more difficult to fight it, stop it, or even target it.
As a result also, HIV induces chronic disease, where SARS-Cov-2 is only occasional. ” In an acute viral infection, it appears more important to get vaccines quickly, while for a chronic disease, treatment will be preferred. », Recalls Brigitte Autran, from the center of immunology and infectious diseases. In other words, it is quite normal to have vaccines against Covid-19, the outcome of which is decided in a few weeks, and treatments against AIDS, with which you have to live your whole life.
HIV is a much more complex virus
However, vaccines against the coronavirus have greatly benefited from research against AIDS. “Unable to develop a vaccine against HIV with traditional methods, we began to imagine vaccines with recombinant vectors”, says Brigitte Autran. A technique that can be found in some products against Covid, such as the Russian Sputnik V or that of AstraZeneca. Since 1is In January, the Inserm Reacting consortium, very mobilized against Covid, and the national research agency on AIDS and viral hepatitis were merged into a single entity.
So why do coronavirus vaccines come before HIV vaccines? Quite simply because HIV is a much more complex virus to pin down, and which mutates far too quickly. ” HIV has extremely strong immune system escape mechanisms, confirms Brigitte Autran. An HIV-infected patient produces about a billion mutants per day, which is as many as the number of influenza mutants on the planet in a year. “ Knowing that we already change flu shots every year …
Good news, however, has come from research on the coronavirus: the technological flexibility and rapidity of development of RNA vaccines, such as Pfizer. ” It won’t work any miracles and the specific problems of an HIV vaccine will not change, but maybe we will go faster in the tests. “, Wants to believe the specialist. ” Developing vaccines for the respiratory tract to prevent the transmission of the coronavirus would also be a good step forward for possible vaccines against HIV, to block the transmission of the virus in the genital mucous membranes. », Adds Morgane Bomsel.
Barrier actions and protection against AIDS
Beyond medical discoveries, the AIDS epidemic has provided experiences on the logistics of deployment and access to drugs, especially in the poorest countries. Experiences that can be used to avoid, perhaps, “hiccups” with anti-Covid vaccines.
Infectious disease specialists also hope that the discourse on barrier gestures, well anchored in practices with the coronavirus epidemic, will make it possible to relaunch communication around protective measures against AIDS.