After winning the Nobel for helping to discover HIV, Luc Montagnier and Francoise Barre-Sinoussi say they are targeting the "reservoirs" where the AIDS virus lurks after it has been rolled back by drugs.
Montagnier, 78 and Barre-Sinoussi, 63, shared in the 2008 Nobel Prize for Medicine for their work at the Pasteur Institute in isolating the human immunodeficiency virus (HIV).
The French researchers talked about their early role in the AIDS combat and their future goals in separate interviews ahead of the 30th anniversary of when the disease first came to public light, on June 5 1981.
IDENTIFYING HIV
In January 1983, tissue samples arrived at the Pasteur Institute from a patient with a disease that mysteriously wrecked the immune system.
"Two weeks, three weeks later, our culture dishes had the first signs of a virus that looked as if it was the culprit, although much further work of course was needed to show the link between the virus and the disease," said Barre-Sinoussi.
Montagnier recalled "a sense of isolation" as the team battled to make this vital connection.
"The results we had were very good but they were not accepted by the rest of the scientific community for at least another year, until Robert Gallo confirmed our results in the United States.
"It was extremely frustrating, we knew we were right, yet we were banging our heads against a brick wall, in France and abroad."
Said Barre-Sinoussi: "We were in an emergency situation, although we didn't have any concept of the scale and magnitude of the epidemic, which emerged later on.
"We were completely wrapped up in our work. I never had the time to have a 'eureka' moment."
AIDS DRUGS
The advent in 1996 of combination drugs to repress HIV was a turning point in the AIDS pandemic, said Montagnier and Barre-Sinoussi.
"It's quite a rare success in the history of medicine, in the sense that labs usually work separately and in secret -- and on this one they worked together," said Montagnier.
Both referred to a promising new study which has found that when a patient starts taking the drugs early after infection, this almost eliminates the risk of handing on HIV to a non-infected partner.
"It's a very strong argument in favour of what we have been arguing for a number of years, namely to use treatment for (HIV) prevention," said Barre-Sinoussi.
But Montagnier was cautious about using this as a policy tool, saying that the drugs, which have to be taken daily for the rest of one's life, can have toxic side-effects.
With an eye on the 33.3 million people with HIV, he also noted the spiralling costs.
"Treatment cuts transmission, that's clear, but it doesn't eradicate it, and we can't treat all the millions of people."
VIRAL RESERVOIRS
Even when drugs suppress HIV in the blood to below detectable levels, the therapy has to be continued. The virus retreats to bolt-holes in the body and rebounds as soon as treatment is stopped.
Where these "reservoirs" are is fuzzy -- evidence points to lymph nodes, bone marrow and digestive tissue, but there could be other places -- and how to clear them is just as unknown.
Even so, "I am optimistic," said Barre-Sinoussi, who heads a group of scientists on this quest.
"There is a tiny number of patients called elite controllers, amounting to just 0.3 percent of people infected with HIV, who have been infected for the last 10 years, who have never taken antiretrovirals and who control their infection naturally.
"We say that if this situation exists in nature, we as researchers should be able to reproduce it."
Montagnier said his foundation was looking at ways to boost parts of the immune system which are not fully restored after antiretroviral therapy.
Working in Ivory Coast and Cameroon and with South African scientists, his team were investigating "extracts of plants of South African origin" that have antioxidant effects.
"I am very encouraged, very excited by what we're doing," he said.
A small-scale trial had seen signs of an response among five out of seven volunteers and "we envisage a second trial with more patients to see if the response is significant," he said.
The viral refuge is "somewhat my obsession right now," he said.
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