The Future of Infectious Disease Treatment

The infectious disease landscape has been evolving, largely due to advancements in treatment and technology. The CDC estimates that more than 1.2 million Americans are living with HIV. In the hepatitis C virus (HCV), between 130 and 150 million individuals worldwide have chronic HCV, of whom, approximately 700,000 will die each year from HCV-related liver diseases.

In part four of a 4-part exclusive interview with Specialty Pharmacy Times, Ron Nahass, MD, MHCM, FACP, FIDSA, discusses the impact of antiretrovirals and new blockbuster HCV drugs, challenges in the field, patient adherence, telehealth, and more.

Dr Nahass has been conducting infectious disease medicine for almost 30 years. He has had a long career in clinical research, and education in the area of chronic viral diseases, including HCV, hepatitis B, and HIV. He currently serves on the American Association for the Study of Liver Disease (AASLD) panel HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C.

Click here to read part three of this 4-part interview.

SPT: What advancements do you hope to see within the infectious disease landscape in the future?

Dr Nahass: What’s really exciting is that we are starting to do work and see work on curing what’s called integrated viruses. To me, it would be the greatest excitement to take HIV and cure it right now. We need get to a point where we actually cure people of the virus [instead of just manage it] and work is now being done in that area, we’re starting a project in our office on that.

It’s a pretty exciting thing to think about, that in my lifetime I might actually see the development of the technology, or the road forward to curing integrated viruses. That would include the herpes viruses, so people who get cold sores actually figuring out a way to cure that virus. The hepatitis B virus is another example. It is pretty exciting to think that they’re developing techniques to be able to look at that.

SPT: Could you tell me about the project your office is currently working on?

Dr Nahass: It’s a project that takes people who have been long-term survivors of HIV and [who] have non-measurable virus, and you harvest their white blood cells. I’m just providing the specimens, but scientists then take those cells and try to apply treatments to those cells to see if they can get the virus out of those cells. They call it latently infected or resting cells, that’s the real challenge. They have a number of drugs that they’re looking at. The study’s just starting, but it’s exciting to think that is something that one, we’re participating in, and two, that may be something that will happen.

SPT: Do you have any concerns with the aging HIV population?

Dr Nahass: We published a paper on that about 4 or 5 years ago. I see it as an interesting group. We have about 40 or 50 people with HIV who are over 70, and that’s really quite remarkable when you think about where we’ve come. We have a number of people over 80, I don’t have anybody that I’m aware of that’s over 90 in the practice. Aging with HIV is a big deal, and learning about how aging with HIV affects people is important. I have a whole lot of people who are over 60 with HIV and there will be more and more people that are over 70. I think it’s important to get further insight and understanding into the implications of aging with HIV; we’re still learning about that. It certainly seems like there’s some unique features of that group of individuals that relates to aging with HIV, but we have way more to learn.

Early reports on aging with HIV concentrated on people over 55. I’m not as interested in over 55 as I am in over 70 because, to me, it’s remarkable to be thinking about people 70 and older and aging with HIV. It is an area of great interest.