Belgian doctor, researcher and professor, Stéphane De Wit has been with the St Pierre University Hospital in Brussels since 1983. Initially planning to specialize in intensive care, his first internship took him by chance to the infectious diseases department where he encountered his first patients with AIDS, met his mentor, Professor Nathan Clumeck, and found his calling. Nearly four decades on, Professor De Wit continues to tirelessly lead the charge to discover effective vaccines and therapeutics for HIV/AIDs.
While substantial advancements have been made in medical science over the past few decades, particularly with the introduction of antiretroviral therapy (ART), turning what used to be a death sentence in the 1980s and 1990s into a manageable chronic condition, HIV remains one of the world’s most serious public health challenges.
As De Wit laments, “HIV is an extremely complex virus. It not only attacks the immune system but it is also integrated in cells that have a very long memory. This means that cells are [always] ready to be reactivated by any antigenic exposition.” For this reason, he staunchly believes, “the solution to HIV will be multiple, and it will be a combination of solution approaches.” One of the new strategies, known as ‘Kick and Kill’, involves activating the reservoir of dormant HIV cells in patients on ART, and then eliminate them. De Wit indicates, “we have been working on this approach for years now and have a good understanding of the process. We are looking at the right combination to activate and kill those cells.”
In addition to this strategy, another exciting new approach on the horizon is CAR-T technology. While mainly associated with oncology for now, De Wit suggests, “when talking about HIV, we are talking about T-Cells. Since the disease is directly present in T Cells, CAR-T seems very promising.”
Despite the relatively small size of Belgium, the country remains one of the core R&D hubs on the continent. De Wit explains, “this is mainly because of the top quality of clinical research conducted. Big multinational companies consider us a serious partner because of the output and the quality of data that we produce.” However, more generally within the field of infectious diseases, particularly in HIV, he notes, “one of the main unfortunate changes I have observed across the years is the number of companies that have dropped out of the HIV field. In the past, we used to collaborate with five or six companies and today we are left with only two main partners: Gilead and ViiV Healthcare.”
While discouraging news for the sector, De Wit is not deterred. He adds, “we are starting to collaborate with generic companies as some of the latest treatments are coming to market in generic forms. This is obviously a completely new setting, where we try to understand how to increase the usage of generics and control the costs,” emphasizing, “this is very important in a universal healthcare environment.”
Ultimately, he proclaims, “I am a firm believer that the solution will come from a global approach and through a combination of different solutions.”