Nearly There?

DW-WORLD.DE: More than 25 years after the emergence of the AIDS epidemic what are the chances of finding a cure to what has largely become a treatable disease?

Dr. Hans Jaeger: We can say that at the beginning we were working with a disease that was not treatable at all, and the majority of patients died relatively quickly. Then starting in the middle of the 90s -- due to a variety of improvements such as a better recognition of how the virus spreads and the ability to measure the virus in the blood but particularly thanks to new medicines to develop treatments -- the disease became more treatable.

Our next goal is a cure -- the medical word for it would be eradication. That means having the ability to remove the virus from the body or to suppress it to the point where it can no long do any damage. That is our main goal at the moment.

I personally believe we will reach this goal because the progress we are making against HIV is much larger than in other comparable serious diseases. At the moment we have medicines that are better than ever at treating patients and possibly even healing them.

Why do you think a cure could be reached soon?

When we look at the progress of the last four to six years and use it to extrapolate the future then we can imagine a cure. At the moment it's only a small step away. In 80 percent to 90 percent of the patients we treat with today's medicines, we do not see the virus, though when the treatment stops the virus comes back.

In recent years there have been more medicines approved initially for very advanced patients. When we use these medicines with other standard medicines very soon after a patient has been infected then I think we have a good chance of developing a treatment that approaches a cure within seven to eight years. Data gathered in the past few years supports this with admittedly small sample groups showing that what used to be completely unimaginable is fundamentally possible.

Does the incubation time for HIV infection play a role in determining how well patients can be treated?

There is a theory that the patients who are very recently infected are the best to treat. There is also data showing that it is not always necessary and that it does not always lead to success.

We presented a large study at a conference last year where we showed that regardless of how early you start, after one to two years of treatment with today's medicines there is no major difference in results. That leads me to believe that we should not only try to treat newly-infected patients but also include patients suffering chronically from the disease in our research projects and trials. These are also the patients who make up the majority of people infected.

You are going to the annual international AIDS conference in Mexico City. What projects are you presenting there?

We have been asked to make presentations on about 10 research projects. Let me tell you about two of the most interesting.

One project of interest around the world has to do with a homeopathic medicine: It was originally developed in Brazil and then very heavily used in South Africa, but it was one in which we did not think much could be done with. We conducted a pilot study and found that patients who did not show satisfactory improvement to their immune systems when treated with our regular medicines did, in fact, improve when they received this homeopathic medicine for a period of several months.

This shows the closing of a circle. A medicine from Brazil travels to South Africa, is then researched and tested by us in a Western country. We were very skeptical about the project and can show in Mexico that this relatively inexpensive homeopathic substance can lead to improvements of the immune system.

Another very important point deals with older HIV patients. In 10 years the vast majority of patients will be over 50. That used to be unfathomable because patients were 20 years old and didn't live to be older than 32. Now we are dealing with more and more patients who are up to 70 or 80 years old and who are, of course, suffering from other diseases. We can show that older patients can fight the HIV virus with medicine just as well as younger patients but do not show the same improvements to the immune system as younger patients.

What are the new challenges facing HIV research?

There are many challenges. One major challenge is a vaccine -- I do not think we're going to have a vaccine we will be able to use worldwide in the next 10 years though it is desperately needed. Major vaccination studies have been stopped over the past few weeks and we, unfortunately, do not expect to find a vaccine. But it remains a very important goal to prevent new infections.

But there are other possibilities in the biological and medical fields to prevent new infections. We know, for example, that people who do have any detectable viruses because they are successfully treated hardly ever infect others because the virus has been suppressed. These people then no longer pose a danger as far as new infections are concerned. The Swiss have conducted important research projects in this area. The conference in Mexico City will certainly discuss this in detail.

But the major challenge -- and the thing my patients continually ask me -- is when are we going to have a cure for this disease. Some of my colleagues are of a different opinion, but I think finding a cure is a realistic expectation.

When do you think we will see a cure?

I think we will be close to a cure in the next eight years or so and will have also cured the first patient.