India cannot become complacent: HIV/AIDS expert
Dr Salim Abdool Karim, a clinical infectious diseases epidemiologist and a global authority on AIDS, said the low incidence of the disease could lull India into complacency which would be dangerous.health Updated: Dec 01, 2017 15:05 IST
Salim Abdool Karim and his wife, Quarraisha Abdool Karim, have dedicated almost three decades of their lives to HIV research. They were recently awarded the Institute for Human Virology (IHV) Lifetime Achievement award. Dr Karim is the director of the Centre for the Aids Programme of Research in South Africa (CAPRISA) and Dr Quarraisha Abdool Karim is its associate scientific director. The couple divides their time between the US and South Africa.
AIDS (acquired immunodeficiency syndrome) is caused by infection by an HIV (human immunodeficiency virus). The disease attacks the immune system and proves fatal in many cases. Currently there is no vaccine available for HIV.
In a telephonic interview to Hindustan Times from Durban ahead of the World Aids Day, Dr Karim spoke about his work and warned India against complacency in the fight against AIDS.
How did you and your wife become involved in HIV research?
My wife and I have been doing AIDS research for almost 29 years. I got a fellowship to study at Columbia University New York in July 1987 and at the end of the year, I came back to South Africa to get married. The next year my wife and I went back to the US. New York was a hotbed of activity around HIV, there were protests and demonstrations. We hadn’t seen much of that in South Africa.
Our research in South Africa showed us that young women had much more HIV infection than young men. HIV prevalence is 4-6 times higher in teenage girls compared to boys. These young women were getting infected by older men. It holds for much of Southern and eastern Africa.
Is this true of India?
I have been coming to India regularly. We haven’t seen the same phenomena in India. I was really concerned 10 years ago that India is going to be the worst hit country in the world, that once HIV spread in the red light of districts of the big cities, it would become uncontrollable.
For some reason, HIV never took off in India. A friend in India, who works exclusively with young girls working as sex workers, told me that India was able to tackle the problem early, so it did not grow to the proportions it did in South Africa. Though small is relative in India, it is one of the top three countries in terms of the number of HIV-infected people which is 2-3 million.
However, It did not do as well as Thailand. If you look at India, South Africa and Thailand in 1990 they had a similar small epidemic. It skyrocketed in South Africa and started growing in India. In Thailand it was nipped in the bud because interventions were put in place to control its spread from vulnerable populations to the mainstream.
Is there still reason to be worried?
When I look at the situation in India, I do worry that India has become complacent about HIV. Because you don’t have a raging epidemic there is high risk of becoming complacent. It just needs a spark. It is how epidemics like measles spread within a matter of a year or two.
Are we any closer to an HIV vaccine?
I am very optimistic about a vaccine right now. The really exciting thing that we are doing right now is developing a broadly neutralising antibody.
When a person gets infected with HIV, the body produces antibodies which can kill only that virus. The HIV virus mutates inside the body and the anti bodies aren’t able to eliminate those. However, there are some rare individuals, who produce an antibody that can kill lots of different HIV.
We have been following a large group of women, over 300 of them, right from the time they were infected. That’s how we found CAPRISA- 256, a woman who had an antibody which could kill a wide range of HIV, almost 400 viri from throughout the world. We cloned the cell that produces the antibody and developed an even more effective antibody.
We then sent it to one of our colleagues at Harvard University, who did a study in 21 monkeys. In 9 of the monkeys who got the sham injection (without the antibody), all of them were infected by the simian version of HIV. None of the 12 monkeys, that received the antibodies, was infected.
We have given ourselves the next 5 years to show that it works in humans. We own the antibody, we will provide it non-profit, we do not believe in profiteering.