The Future of HIV in India: dismal or bright

India and other developing countries of Asia and Africa may see a rise in HIV cases in coming years. In a breakthrough finding by the only research lab in India doing research on HIV C pathogens, which needs to be confirmed with few more rigorous experiments, scientists fear an onslaught of HIV in near future.

The head of the program and emeritus scientist Prof Ranga Udaykumar of JNCASR, Bengaluru, said that the C variety of HIV which is specific to India, China and part of the African population has a natural propensity to change into new variants. The root of the problem of the emerging new variants is identified as the promoter (DNA sequence) in the HIV C family gene. The promoter in C family is quickly changing and getting stronger with capability to make more and more viral proteins that in turn are making them resistant to all medications.

A seemingly super intelligent virus, with some brilliant design strategies, HIV C has unlike other viruses a single promoter that controls an entire range of gene expressions with any important change having an impact on the entire viral pathology. The variant property is also manifested in Tat protein in C virus, which is instrumental in lesser incidents of dementia in HIV infected people in India as compared to that in Caucasian population.

The new discovery has baffled the scientists yet again who have for long battled to understand the genetic code of the HIV C family that is causing more than half of global HIV infections. The study is a collaboration of AIIMS, St John’s medical college Bengaluru, YGRK Chennai, National Aids centre Pune with 800 HIV infected samples from patients who were not administered with any drugs. The study has also added to their puzzle of understanding the software code or virus algorithm responsible for the unique viral transcriptional silencing property by which the virus completely switches off after infecting and activating the immune system.

The unique property of the virus which is more pronounced in C family makes one cell active and keeps itself silent in the other cell. Multiple proteins come together and make daughter virus which inactivates the cell defence machinery by targeting the CD4 white blood cells, before making more of itself. With the emerging new variants this proliferation is much more in C family as compared to other families which the scientists fear to be of extensively drug resistant varieties.  It could then have a direct impact on HIV treatment too. The ART (Antiretroviral therapy) that is currently the only drug available for HIV patients may have to be administered for life.

For aforesaid reasons the focus of research which was till recently on vaccine development worldwide is now shifting slowly to understanding of virus software code and the emerging drug resistant variants.

“The problem in India is of funding. The government funding is too dismal. Where there is all the money and the lab there is no C virus and where there is C virus there is no money. So far, all the research has been focussed in the western world, towards understanding only B variety.  Sadly, in India there is no philanthropy funding too,” laments Prof.Uday kumar who pioneered the research on C virus in India.

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