Over 40 million people are living with HIV or AIDS world-wide. Acquired Immune Deficiency Syndrome (AIDS) was first reported in the early 1980's and has since become a major world-wide epidemic. AIDS is caused by the human immunodeficiency virus (HIV).

What are HIV and AIDS?
By killing or damaging cells of the immune system, HIV progressively destroys the body's ability to fight infections and certain cancers. Individuals diagnosed with AIDS are susceptible to life-threatening diseases called opportunistic infections, which are caused by microbes that usually do not cause illness in people with healthy immune systems.

The target of HIV is a white blood cell called a CD4 cell. These blood cells are important because they tell other infection-fighting cells when to start working. HIV infection lowers the number of CD4 cells (the CD4 count). When the number of CD4 cells drops to a certain level, the body's immune system weakens. When the CD4 count drops below 200, or when opportunistic infections or cancers occur, a person with HIV infection is said to have AIDS.

How is AIDS transmitted?
HIV is transmitted via body fluids and there are four main ways of contracting HIV. HIV is spread most commonly by sexual contact with an infected partner, as the virus can enter the body during sex. HIV is also spread through contact with infected blood. HIV frequently is spread among injection drug users by the sharing of needles or syringes contaminated with minute quantities of blood of someone infected with the virus. Pregnant women can transmit HIV to their babies during pregnancy or birth. Approximately one-quarter to one-third of all untreated pregnant women infected with HIV will pass the infection to their babies. HIV also can be spread to babies through the breast milk of mothers infected with the virus.

Treatment approach
The goal of HIV therapy is to reduce the level of the virus in the blood to as low a level as possible, for as long as possible. Currently, four different classes of antiretroviral drugs are available and treatment guidelines recommend that a combination of at least three individual drugs be used to form highly active antiretroviral therapy (HAART). Roche is active in the development and marketing of a broad range of anti-HIV/AIDS drugs (see our Product Portfolio, infectious diseases)

Roche Solutions

Diagnostics
Reliable diagnosis and monitoring are essential to ensure appropriate management of HIV infection. Roche is active in the development and marketing of diagnostic tests, such as Polymerase Chain Reaction (PCR) technology, which quantifies levels of HIV in blood. In 1994, Roche's AMPLICOR HIV-1 Monitor™ became the first commercial test accurately and precisely to measure quantities of HIV-1 RNA in the blood ("viral load"). This is still the only test cleared by the FDA for measuring viral load. It is a highly sensitive test, proven to detect viral loads as low as 50 RNA copies per mL, well below the cut-off level of other viral load tests. This degree of accuracy is important to evaluate the success and durability of HIV therapy.

Anti-HIV treatment
Anti-HIV treatment started to change profoundly with the introduction of the first protease inhibitor in 1995. Regimens combining protease inhibitors and inhibitors of reverse transcriptase are the basis of HAART, which has improved survival and reduced AIDS-related illnesses. Roche also developed the reverse transcriptase inhibitor, an antiretroviral that has shown to significantly prolong survival and reduce the onset of opportunistic infections.

Cytomegalovirus
Cytomegalovirus (CMV) is a common infection normally dormant in individuals with healthy immune systems. The virus can become active in people with weakened immune systems and, if it attacks the eye, can quickly result in blindness if not treated. The effectiveness of HAART has reduced the number of people progressing from HIV to AIDS and therefore the incidence of CMV infection. Despite this reduction, the commitment by Roche towards people living with HIV and AIDS is clearly highlighted by the development of further treatment options. In addition, Roche Diagnostics also offers a PCR test for measuring CMV viral load, the AMPLICOR CMV Monitor™ assay.

Roche and the future of HIV research
Roche is continuing to invest significantly into HIV research, with programmes in the areas of novel protease inhibitors, novel non-nucleoside reverse transcriptase inhibitors as well as chemokine receptor inhibitors (agents that attach to specific sites on the CD4 cell and prevent the virus from binding).
Continued Roche investment in molecular diagnostics will enable rapid detection and analysis of HIV virus resistant to medication, allowing for optimised treatment and the best use of available resources for those living with HIV/AIDS. Roche is supporting several Integrated Health Care Solutions initiatives in the area of HIV drug resistance.

Roche is actively involved in programmes run by the WHO, UNAIDS and other international organisations to provide access to HIV treatment in developing countries.

Further Information
To access more detailing information about HIV and AIDS, please view the dedicated portal.

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