Australian researchers win bumper grant from Bill Gates for HIV research

Australian researchers have won themselves a bumper grant from the Bill & Melinda Gates Foundation to examine the best way of using drugs to treat HIV.

The grant worth $18 million ($U.S.12.42 million) is one of the largest private grants received by the University of NSW (UNSW) and will finance a major project on optimising the drugs used to treat HIV.

The study will be vital in that it will significantly boost efforts to increase the number of HIV sufferers able to access treatment in developing countries.

According to the World Health Organisation (WHO), by the start of 2008 an estimated 33 million people worldwide were living with HIV and 2 million had died of AIDS - but despite advances in treatment and access to drugs, by the end of 2007 only 31% of people who needed HIV treatment had access to it.

The WHO says more than three million of the world's poorest people are now receiving antiretroviral drugs through government and non-government initiatives, and the aim is to increase this to nine million by 2015.

Professor Sean Emery, of the National Centre in HIV Epidemiology and Clinical Research, says the UNSW study will involve almost 700 HIV sufferers from around the world and aims to identify the "buffer" in the drug's effectiveness.

Professor Emery says if lower doses can be proven to be as effective, then millions of extra lives could be saved for the same amount.

Professor Emery says decisions about doses often aim for the maximum tolerated dose rather than the minimum effective dose - the drugs used are supply-constrained - and on that basis it is appropriate to examine whether lower unit doses might be as effective; if this was the case up to 33% more people could be treated at the same cost.

According to Professor Emery as all other avenues to make the drugs cheaper - from chemical make-up through to manufacture and the supply chain - had already been exhausted - this has to be the next step.

The ENCORE (Evaluation of Novel Concepts in Optimisation of antiRetroviral Efficacy) study will begin enrolling patients this year and it is expected to publish its results by mid-2013.

Professor Emery says the large private grant will allow the globally significant work to be carried out in Australia and they are delighted that Bill & Melinda Gates Foundation has entrusted them with a project of such scale and scope.

HIV is transmitted through unprotected sexual intercourse (anal or vaginal), transfusion of contaminated blood, sharing of contaminated needles, and between a mother and her infant during pregnancy, childbirth and breastfeeding.

HIV is a retrovirus that infects cells of the human immune system, destroying or impairing their function, in the early stages of infection, the person has no symptoms, but as the infection progresses, the immune system becomes weaker, and the person becomes more susceptible to so-called opportunistic infections.

The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS) - it can take 10-15 years for an HIV-infected person to develop AIDS; antiretroviral drugs can slow down the process even further.