Success Covid-19 vaccines creates renewed interest in HIV cure search

The villains of yesteryears have for the last 30 years been looked upon to save the world and humanity in efforts to find a cure for HIV and Aids.

But the wait continues and the saviours drop off one by one due to different factors.

The cure for HIV and Aids is as elusive as it was in 1982.

The Saturday Standard traced some of the sex workers from Majengo who participated in the research for the HIV vaccine.

The idea that a group that had been vilified for many years for spreading HIV had the possibility of saving the word was intriguing and ironic.

The eyes of the world were on Majengo, an estate in Nairobi mostly known as an abode for sex workers in their twilight years.

Researchers focused their equipment on tiny rooms that had just a bed frame and thin mattress. Something mysterious, “a medical wonder”, as doctors called it, was happening.

There was a group of sex workers who appeared to be immune to HIV. The search for any form of intervention that would stop the spread of the condition that was ravaging nations became intense. Hopelessness was beginning to descend until they got a lead in Majengo.

If indeed the workers were immune, scientists could extract whatever their body was producing and use it in making a vaccine.

So, researchers flocked the estate. From overseas and within, each of them hoped to unravel what was happening inside these women’s bodies.

“Every day, we would get visitors. So many tests were done on us. We gave blood, saliva... Some of us were taken to South Africa to be studied further,” said one of the sex workers last month.

Now, with campaigns for people to go for Covid-19 vaccine, she is reminded of a time when hopes for an HIV vaccine were on them.

Talia, whose identity we have concealed as her family has no idea about her trade, has been in the sex work for half a century.

She recalls the time when colleagues got coughs, grew thin, lost hair and died within a short time. 

She was among those who remained uninfected.

In between, she got gonorrhea and genital herpes, but never HIV. She became part of the group of 100 women picked for the study.  

Dr Omu Anzala who was the project manager of the Kenyan Aids Vaccine Initiative (Kavi) at the time, spoke with optimism about the possibility of Kenya breaking the over-dependence on HIV interventions from developed countries.

The solution, scientists speculated, seemed to be in the bodies of the sex workers. 

It started when Frank Plummer, director of Canada’s Centre for Infectious Disease Prevention and Control, came to Nairobi in early 1980s on a project about a sexually transmitted infection called chancroid.

He tracked down sex workers in Majengo and tested them for sexually transmitted infections, including HIV and something stood out in a good number of them. 

“They are simply not getting infected. They are basically immune,” said Plummer in previous interviews.

After years of research on a disease that had been listed as impenetrable and mysterious, the discovery on Majengo sex workers was huge.

More researchers came, and the conclusion was the same.

More than luck

“It was more than them being lucky. These women were having multiple sexual partners but were not getting infected for the many years that we tested them,” says Joshua Kimani, an epidemiologist and senior researcher who is still involved in the study.

Surveys indicated that a quarter of the men who frequented the area, some of whom admitted to have had sexual relations with the Majengo women, contracted.

Good nutrition was dismissed as a reason for immunity. Most of the women survived on food from the nearby kiosks.

The fact that they got other sexually transmitted infections ruled out the idea that their bodies were just hardy. There was something else happening - and doctors were racking their brains to find out what it was.

The mystery deepened when researchers found that immunity was hinged on how long the women had been having unprotected sex.

The longer they had done it, the more likely they were staying negative.

“It was also odd that the ones who stopped prostitution got it soon after. It was as if they were only staying negative as long as they were doing prostitution,” says Kimani.

There were two possibilities: the virus was possibly not able to penetrate their cells, or they were producing antibodies that would clear the virus.

Another study found that if cells were taken outside their bodies and exposed to HIV in a lab, the cells got infected.

Focus turned to the sex workers’ immunity. The researchers realised that with this immune group, HIV could attach to their cells, but, their bodies had a mechanism to clear it.

The hopes of getting a HIV vaccine was seemingly so close. Oxford University embarked on working on a vaccine using cells that were believed to be triggering immunity among the prostitutes.

It got into an anticlimax when the vaccine did not cause other people to develop immunity.

The search continued on the group of 100 sex workers who had been found to be immune. Their genomes were analysed, mucus membranes in their genitals sampled far and wide, blood samples observed closely, habits monitored, but the mystery remained. Nobody could put a finger on what made the cohort unique.

Soon, the urgency to control the devastating effect of the virus overshadowed the research. Media turned off their cameras and left. Researchers focused on finding antiviruses. Donors channeled their money to behaviour change. The sex workers continued with their trade. Most of them, Kimani says, are still immune.

Another woman, Gracia, who was also a subject of studies, says the attention was interesting yet horrifying. She loved the possibility of providing something that the world was desperately looking for.

“After being ignored and knowing people were only looking for one thing; and suddenly, you are told you had something else that nobody has…that was exciting,” she says.

What she does not miss are the many tests and threats they faced. She says there were days they feared stepping out because there were rumours that their blood was so precious that people were looking to kidnap them and “steal their blood”.

She says even though a lot of time was spent studying them, they never got compensated as well as they felt they deserved. “As you can see, we still live in the same old single-room houses in Majengo. We are now old, but our story never changed,” she says.

morengo@standardmedia.co.ke