A snapshot of Prof. Luc Montagnier’s * scientific career

1972	At 40 years of age, became Head of the Viral Oncology Unit at the Institut Pasteur, where he taught, then Research Director at the CNRS (National Center for Scientific Research)
1977	Focused his research on human retroviruses
1983	Identified HIV, the virus that causes AIDS, with his team at the Institut Pasteur
1986	Isolated HIV-2, more frequent in Western Africa
1991-1997	Appointed Director of the AIDS and Retrovirus Department at the Institut Pasteur
1993	Set up and ran the World Foundation for AIDS Research and Prevention in Paris
1996	Elected member of the French Science Academy (Human Biology and Medical Sciences section)
1997-2001	Nominated Distinguished Professor at the City University of New York and Director of a Center of Molecular Biology
Depuis 2002	Has set up and run several Biotechnology Research laboratories in France, USA and Africa.

The latest statistics published by UNAIDS and WHO in their joint report entitled "The global AIDS epidemic – December 2007" remain worrying, even though they have fallen. Twenty-five years after the discovery of the HIV virus, this disease remains incurable.

Professor, what do you think of the research on HIV/AIDS?
Triple therapies have enabled patients to live with the virus without being cured. International aid and a significant price reduction granted by the pharmaceutical industry to the developing world have helped provide this type of treatment to a greater number of people infected with HIV, particularly in the most affected countries of Africa and Asia. However, biological and virological follow-up tests are still too expensive, while they are essential in determining whether the treatment has been effective. It is therefore imperative that we continue our research in order to achieve functional eradication of the infection.

What do you mean by functional eradication?
This means ensuring that, after a short antiretroviral treatment which considerably decreases the virus replication, the immune system of the infected patient is sufficiently restored to control the residual virus at a non-pathological level. This is what I call functional eradication of the infection. This situation already exists in a small number of HIV-positive people who never actually develop the illness.

What do you suggest?
I suggest triple therapy over a 6-month period to reduce the viral load as much as possible, then a non-specific immune stimulation and antioxidant treatment to neutralize the oxidative stress that leads to infections and virus mutation. Stimulation is followed by specific immunotherapy (vaccinotherapy) using viral proteins. Triple therapy is then stopped and, if the viral load does not increase, it can be considered that the vaccination has been effective and that the immune system is controlling viral replication. If, on the other hand, the virus reappears, triple therapy will be required again along with another cycle of vaccination. In case of success, this therapeutic vaccine could be transformed into a preventive vaccine. Naturally, all latent co-infections will also need to be treated, especially mycoplasma infections that may render the virus invisible to the immune system.



You often talk about "oxidative stress" and "antioxidants", particularly in your last book, “Les Combats de la vie” (Life’s struggles), published by Jean Claude Latès. What are their roles?
Oxidative stress is a biochemical imbalance caused by an excess of highly oxidant molecules – called free radicals - compared with our body's antioxidant defenses, created by some of its products as well as by a diet rich in vitamins. Oxidative stress attacks membrane proteins and lipids, damaging their functions, and also DNA thus inducing mutations. At body level, it causes a depression of the immune system. In the case of HIV, the virus has a protein producing oxidative stress, which in return increases the virus capacity to mutate, and protects it against immune responses and therapies. It is thus necessary, in the case of infection with HIV and many other infections, to suppress this oxidative stress through the use of food supplements, bearing in mind that triple therapies can also have an oxidizing effect due to their influence on mitochondria. Such supplements are not necessarily expensive as they can be produced by fruits and vegetables that abound in tropical countries.

Why is the scientific community so discreet about oxidative stress and antioxidants?
The solutions I have suggested are well known to biochemists and nutritionists but not to AIDS specialists. As for pharmaceutical research, it is mainly focused on developing new antiretroviral drugs that will work on viruses which have become resistant to first generation antiretroviral drugs.

What role can African pharmacopoeia play in the fight against HIV?
Africa has a very strong tradition of plant pharmacopoeia, but these plants are of no interest to the pharmaceutical industry because they cannot be patented as their effect depends on a complex mixture and not on a single active ingredient. The preparation of these plants must therefore be well-defined. They must also fulfill the same criteria in terms of efficacy and toxicity as commercialized pharmaceutical products, and, in particular, be studied in controlled clinical trials.

Don't you feel that interest in the fight against HIV has reached saturation point in Africa, and that worldwide attention is shifting over to China or India?
It is true that, in Africa, results have been slow to come for various reasons: the HIV epidemic is huge, prevention is only just starting to bear fruit in the countries which were the first to take up the fight, and access to healthcare and treatment, although it has improved thanks to the disbursement of international funds and the decentralization of healthcare, is still not widespread. There are not enough healthcare professionals trained in HIV/AIDS. Governments often have other priorities than treating HIV. Access to basic nutrition and improved hygiene is far from optimal. As for India and China, they are densely populated countries and, even though the proportion of infected people is still low, it represents a large number of patients.

Are medical students still interested in AIDS?
The study of HIV/AIDS must be undertaken along with that of other infectious diseases. The infection must not be seen as a simple chronic disease that can be drug-treated for life, since the drugs have intolerable side effects when used in the long-term. It is absolutely essential that doctors in badly affected countries in the south are trained in this specialty via North-South partnerships.

In your opinion, which priority actions should be taken to have a greater impact on the disease?
The priority must always be prevention by educating young people in schools, encouraging the use of condoms when no cultural barriers prevent it, teaching personal hygiene precautions to women, including during labor and informing them of the danger of sharing breastfeeding with a relative or a neighbor infected with HIV, treating genital co-infections, and increasing women's economic independence so that they do not turn to prostitution. As far as treatment is concerned, we should be rethinking the system of tenders, which puts the patients' life at risk because, when drugs are out of stock, treatments are frequently modified. The risk of cross-resistance emergence should outweigh the advantages of price discount. The cost of biological tests should also be reduced to improve the patient's follow-up.

You share your time between France and the USA. What are your plans for 2008?
The World Foundation for AIDS Research and Prevention that I created in Paris in partnership with UNESCO, helped me set up Research and Prevention Centers in Africa. These centers combine clinical research with training and transfer of technologies. After the creation of CIRBA (Integrated Center for Biological Research in Abidjan) in Côte d’Ivoire inaugurated in 1996, we supported the launch of CIRCB (Chantal Biya International Reference Center) in February 2006. Other centers should soon be opening in Africa and Central America. Since 2005, I have been applying the knowledge I acquired in oncology and HIV/AIDS to other chronic pathologies whose infectious origins are unknown, such as rheumatoid arthritis, Parkinson’s disease, Alzheimer’s disease, and Multiple Sclerosis. Strangely, by applying a new technology, we managed to detect the presence of bacterial infections in these diseases. Confirming these observations, long-term antibiotic treatments sometimes lead to a certain improvement or stabilization of the disease. Herein lie the seeds of new and highly promising therapeutic paths.

Utopian for some, precursor for others, Prof. Montagnier is not yet ready to give up his microscope. He still has more than one trick up his sleeve to surprise us!

* The views expressed in this article reflect the own experience and opinion of the interviewee.

Interview conducted by Sophie d'Aurelle de Paladines. Pictures by Prof. L. Montagnier.