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If you like David Ho's story, you might also like:
Paul Farmer,
John Gearhart,
Jeong Kim,
Antonia Novello,
Jonas Salk and
Bert Vogelstein

David Ho also appears in the video:
Frontiers of Medicine

Related Links:
Aaron Diamond AIDS Research Center

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David Ho
David Ho
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David Ho Interview (page: 5 / 6)

AIDS Research Pioneer

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  David Ho

What is the role of the CCR5 molecule in the disease cycle?

David Ho Interview Photo
David Ho: This is a very recent discovery made within our institute about two and a half years ago. A susceptible cell has the CD4 molecule on the surface. It turns out that by itself is not enough for HIV to bind to and enter. For a decade or more we knew there was a missing factor, but we didn't know its identity. About two and a half years, ago we realized that CCR5 was that molecule. It took a lot of fancy molecular biology to prove it. HIV has a dual docking system. It needs to bind to CD4, then bind to CCR5, and then it will fuse with the cell and get in. Now armed with this information, we can design inhibitors that will block CCR5. That should be tested in patients sometime next year. That would create a new class of drugs to use against HIV.

Interestingly, it turns out that not everyone's CCR5 is the same. Certain people of Caucasian background are missing more CCR5. If that molecule is not there it's very hard for HIV to infect those individuals. These are the lucky few. There's a lot of variation in CCR5. Certain forms allow the faster disease and other forms the slower disease. We're beginning to understand how genetics affect a disease that is caused by a virus.

That's fascinating. To a lay person, it looks like you've encountered a lot of professional jealousy, especially after the Time Magazine "Man of the Year" story. I'm sure some of this is sincere disagreement in the scientific community, but how do you respond to being criticized by your peers and colleagues?

David Ho: I think genuine scientific disagreement is healthy. That's how we move science forward. And, yes there are certain people who would disagree with me about how, say, the lymphocytes are specifically destroyed by HIV, so the mechanistic issues. It's a very controversial area. I have my views and others don't agree with those views, but each one of us are involved with experiments trying to prove our case or in fact sometimes disproving ourselves. So, that is good and that is what science should be.

[ Key to Success ] Integrity

I think there are other forms of criticisms that are not healthy where it becomes very personal.

I've gotten a lot of recognition, especially by Time magazine. I've never said that I am the representative for the AIDS community. It was Time that, in trying to recognize the achievements in the field, they typically do it through the story of one and I was the chosen one. I fully realize that it's symbolic for the progress made by the field. And, a lot of people deal with that very well and many colleagues have said very nice things to me about that and about how good that is for the field and for science in general. But, there are a lot of big egos in the field and if they're not the one, some of them can be vicious and have been vicious. But, I don't think you would find much in terms of a response from me about such type of criticism. I've said that I'm just going to continue to work and to do my science and advance the field. I don't want to be dragged into the mud into such an unnecessary debate which is harmful to the field, to science, and most importantly, what does that look like from a patient's perspective?

[ Key to Success ] Courage

Do you still use AZT in the anti-AIDS cocktail, or has it been replaced?

David Ho: There are now many different cocktails. We have about twelve drugs against HIV in our armamentarium, and with that you can mix many different combinations. Typically they involve one or two of the protease inhibitors together with several of the older drugs, such as AZT, D14, 3TC. The whole field is trying to learn what the best combinations are. We don't have the final answer, but we know some good combinations.

What is the likelihood that we will see a cure or a vaccine for AIDS in the near future? Do you have any kind of time line in your mind?

David Ho: Those are our objectives. We want to push the therapy from controlling the virus to curing the virus. We are facing several major obstacles. We know now, having controlled the virus for three years, that in a lot of patients there's still a residual pool of virus, and we have to come up with strategies to flush that out. We have to tickle those viruses out of quiescence so they can be attacked by the drugs that we administer. That's going for the cure, but I can't give you any time line. A vaccine is another goal. These therapeutic advances of the past few years are great for American and European patients who can afford it.

How expensive is this treatment?

David Ho: The drugs cost about $15,000 a year. You add on all of the testing and the doctor's fee and the hospital and clinic fees, and it's an enormous cost, which is simply out of the question for the patients in other countries. And that's where the epidemic is, numerically speaking. Over 90 percent of AIDS cases occur in Africa, Asia and in developing countries. Were not going to make an impact on the global epidemic of HIV infection through these drugs, so we have to do it through prevention. Prevention can be tackled through education, but as scientists our responsibility is to develop a vaccine. That has been the most difficult task. If HIV were as easy as polio or Hepatitis B or measles, we would have had a vaccine sometime in the mid to late '80s, but it's a different virus. It changes very quickly. It has this shield which I talked about earlier, and the immune system doesn't see it very well. We need new strategies to come up with a vaccine, so there isn't one now. Even if there was one today, it would take several years to test it and apply it, so a vaccine is still years away. But everyone working in the field realizes in the field how important it is. It's center stage in AIDS research.

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This page last revised on Feb 29, 2008 12:37 EDT
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