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The Latest Trends in HIV Treatment And Care

HIV/AIDS
A Conversation with Dr. Itzchak Levy, Director of the HIV/AIDS Center at Sheba Medical Center.

Dr. Itzchak Levy, Director and Founder of the HIV/AIDS Center at Sheba Medical Center, is one of Israel’s top HIV clinicians, and specializes in infectious diseases.

Dr. Levy established the first and only Israeli AIDS hospice in the early 1990s. When the prognosis of HIV improved after the development of new treatments, he opened an outpatient clinic and turned the hospice into a rehabilitation center for AIDS patients. However, during the early 2000s, the rehabilitation center closed after Dr. Levy realized that HIV patients could be treated in general rehabilitation centers.

Apart from his work at Sheba, Dr. Levy also volunteered as a medical advisor at the Israel AIDS Task Force NGO In 2000, established the Israeli Society of HIV Physicians, and served as its director for eight years. Throughout his career, he has been deeply involved in HIV research and published over 50 papers on the subject.

Recent Developments in HIV Treatment

In recent years, research has focused on finding a cure, developing vaccines, and improving patient outcomes. With better treatment options now available to HIV patients, which can help them achieve a normal life expectancy, it has become essential to develop therapies that contribute to maintaining a high quality of life, and preventing comorbidities. 

For example, treating HIV patients with injectable therapies, which can be administered once every few months, may significantly enhance the quality of life compared to previous, more intensive therapeutic regimes. A cure and vaccination are closer than ever, and much research focuses on this area. In particular, mRNA vaccines are being tested to overcome the obstacles of vaccination against HIV by allowing the body to build a good immunological response against a virus that constantly changes and requires a wide range of antibodies to overcome. “As a clinician,” Dr. Levy explains, “the introduction of injections that only need to be administered once every other month is a great advancement in simplifying treatment. There has been a lot of progress in understanding the reservoir of the virus in the body, which is vitally important for developing a cure. Each generation of drugs introduced is safer and more effective.”

Moreover, Dr. Levy emphasizes that “biologically, the biggest game-changer in the last two decades was the introduction of integrase inhibitors, which make the anti-retroviral therapy much more effective, safer, and more tolerable than what we had before. I am sure that the introduction of this drug family contributed greatly to the normal life expectancy and high quality of life we now see. Sociologically, I think the biggest game-changer was the results of a study that showed that undetectable viral load is untransmittable, and the introduction of preexposure prophylaxis, a preventive medication for people at risk of HIV infection. Those two things contributed to stigma reduction, which is crucial in fighting this epidemic.”

The importance of HIV studies today

According to Dr. Levy, there are currently many co-epidemics of interest. COVID-19 plus HIV, for one. It is now well established that PLWH (people living with HIV) who have a healthy immune system will respond to COVID-19 similarly to people without HIV. However, those who suffer from immunosuppression are at higher risk for complications and death. HIV patients have also been shown to have similar immune responses to vaccination (immunogenicity), although their immune systems may weaken faster.

Sheba Medical Center was the first to conduct a COVID-19 vaccine trial among PLWH, which showed good reactogenicity, and continues to monitor PLWH patients. “We see a lot of STDs (sexually transmitted diseases) among patients receiving preexposure prophylaxis,” says Dr. Levy, “and try to figure out what is the best way to decrease their rates. We are doing a lot of research concerning STDs and Mycoplasma genitalium resistance studies.”

Under the leadership of Dr. Levy, Sheba is committed to remaining at the forefront of HIV research and treatment.

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