Julià Blanco, researcher: “We are having a hard time getting good drugs for covid-19”

Why have different vaccines against coronavirus been designed in a year and, instead, has not yet been achieved? against HIV? How do the treatments for both diseases work? These are some of the questions answered by the IrsiCaixa researcher Julià Blanco in conversation with El Periódico de España. Blanco has been researching a virus for 27 years – the human immunodeficiency virus (HIV) – which, he clarifies, is very different from SARS-CoV-2. “In AIDS it has been achieved an excellent therapyIt does not cure the infection, but it works very well and the patients have a normal life expectancy at the moment, but we do not have a vaccine. In covid-19, we have gotten a vaccine very quickly, very effectively, but what is costing us more is having good drugs to control the virus. “

Doctor in Biochemistry from the University of Barcelona since 1994, Blanco leads the Virology and Cellular Immunology group of IrsiCaixa. On the occasion of World AIDS Day, which is held this December 1, talks with this newspaper about the complications that researchers face in order to overcome the disease forty years after the first cases described.

“In 94 there was no antiretroviral therapy – the treatment of people infected with HIV – and mortality became the leading cause of death in young people in the United States. The social impact of the disease was very high,” says the researcher when he looks back at the moment when he began to work on an ailment that, although with less impact in rich countries – “It is practically not spoken and it is not like that, we cannot forget it”, he says – it still exists and wreaks havoc in africa.

A good quality of life

In Spain, a total of 151,387 people they live with VIH, according to the latest estimate published by the National Plan on the Page. However, the researcher points out, their life expectancy is high and their quality of life is great: “In HIV, the drugs that we have are highly effective: 100% in some cases and, in addition, their administration is very comfortable Orally, one pill a day. “

Nothing to do, recalls the doctor, with those first antiretroviral treatments involving “very complex pill combinations.” There were patients who had to take up to ten drugs a day. Also, with long-term side effects: as lto lipodystrophy, a medical term that refers to alterations in the distribution of body fat. “All of that has changed enormously. At the moment the therapy is very safe, it does not cause side effects and it is very comfortable for the patient “, points out Julià Blanco.

The vaccine, a pending issue

However, the researcher admits that, despite so many years of study, it has not yet been achieved an effective vaccine against the disease. Curious, he admits, when he stops the coronavirus, a new disease, you already have an antigen. The head of the Virology and Cellular Immunology group of IrsiCaixa highlight the differences associated with the biology of each virus at a time when countries are still on alert for the new variant of covid detected for the first time in South Africa and that it has already spread to at least 44 countries, including Spain. Ómicron, as it has been called, has turned on the alarm light just a month from the start of Christmas.

HIV and SARS-CoV-2, White abounds, they are very different viruses. “The main difference is the variability that each virus has. In the case of the coronavirus, the variability is limited and, even if it is limited, it is already giving us problems, that is why it is what worries us most at the moment.”

As for HIV, he continues, this variability “it’s even worse and huge”. That makes the classic vaccine approach not working against the virus. “That is why the way to design this vaccine must be completely changed. What has been worked in these years is to try to identify which are the regions of HIV which are constant. The virus mutates a lot, it has many variants, but it has to have regions that are constant because otherwise it would not be able to infect us “, adds the researcher.

“This is an enormously difficult problem because even if we vaccinate with the protein, the antibodies that are generated are not good neutralizers of the virus. We have to modify the vaccination guidelines, to design new immunogens and new strategies to generate this type of antibodies “, he continues. The solution, he says, may be closer and closer:” We have identified these regions very well and there are different studies in progress but we are not yet at the point of have the perfect vaccine. “

Classic vaccine technology

If you talk about coronavirus, the biochemist assures that they have been lucky because the classic vaccine technology “has worked very well. Virtually all infected people generate neutralizing antibodies against SARS-CoV-2, something that, he clarifies, does not happen in the case of HIV: “Patients generate many antibodies but they are not effective against the virus and that is the big problem: their extraordinary variability. “

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Regarding the new anticovid pills, Julià Blanco indicates that they are drugs “that have good efficacy, they are reducing hospitalization in mild patients, but they are not perfect yet. There is room for improvement in finding antivirals that are more effective. So far, neither of the two – from the pharmaceutical companies MSD and Pfizer – has demonstrated 100% efficacy. The vaccines are not working at 90% in severe infection either, “he says.

In fact, the drug against covid-19 developed by the North American laboratory Merck-MSD (molnupiravir) is less effective than what was announced a month ago. This has been confirmed by the company in an update of the data of the 1,433 participants in the MOVe-OUT study on the drug: it has an efficacy of 30% against hospitalization or death, compared to 50% previously verified. Precisely this Wednesday, another pharmacist, in this case the Swiss Roche, presents in Spain a new therapy against the disease.