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In Conversation with Professor Françoise Barré-Sinoussi

Posted 22 juillet 2014, 07:03 , by Administrator

By Rob Moodie, University of Melbourne

Watch the video of Professor Rob Moodie talking to Professor Françoise Barré-Sinoussi on YouTube.

Françoise Barré-Sinoussi is the director of the Regulation of Retroviral Infections Unit, at the Institut Pasteur in Paris, and was the first author of the 1983 paper that reported the discovery of a retrovirus later named HIV (human immunodeficiency virus).

She shared the 2008 Nobel Prize for Physiology or Medicine for that work and is the current president of the International AIDS Society. She is also the international chair of AIDS2014, the 20th International AIDS Conference being held in Melbourne July 20-25.

Professor of public health at the University of Melbourne, Rob Moodie, spoke to Professor Barré-Sinoussi about her work as a researcher and an advocate on the conference's opening day.



Rob Moodie: Welcome to The Conversation. Today we have the honour of speaking with Professor Françoise Barré-Sinoussi, Nobel Laureate, who's here at the AIDS 2014 Conference. Welcome; terrific to have you in Melbourne.

Just with respect to the tragedy of MH17, what impact do you think that will have on the conference?

Françoise Barré-Sinoussi: First of all, everybody is in shock. We are all think about our colleagues, our friends; we're thinking about all the other passengers. It's a real tragedy.

It was very important for us, thinking about our colleagues, to move on and to show people that we will continue the fight and this is the best tribute I think we can make.

Rob Moodie: To honour that, yes.

Perhaps you could tell us a little about your work (and as a Nobel Laureate): how did that start, what were some of the key moments in your discovery of the virus and, in some ways, how has that impacted on your life?

Françoise Barré-Sinoussi: Of course, the first thing was the contact with the clinician in my country, France, William Bourn. [He] was among the first clinicians [to recognise] patients with this new emerging disease.

It came at Pasteur Institute and [Stewart] Cole, a virologist at Pasteur and especially virologists working with this family of viruses, the retrovirus. It's how we really started to work together with other clinicians as well and virologists at the hospital, developing strategies to try and isolate the virus, if it really was a virus.

And it's how we decided to ask patients… if they will accept lymph node biopsy.

Lymph node biopsies arrived at Pasteur at the beginning of January 1983, and two weeks later we had the first sign in the culture of a virus from that family. We had a surprise, a bad surprise, to see that the cells were dying.

At that time there was a blood bank at Pasteur across the street, first [we took blood from] a donor, and again the virus started to replicate again. We were able to detect, and then it was starting to correct the retrovirus, showing this virus was not similar to the only human retrovirus that was known at the time – and is still known today – HTLV [Human T-lymphotropic virus] family.

Then, to make the link between the virus and the disease itself: by serological/immunological studies, by also trying to isolate the virus from other patients, starting to make diagnostic tests – both for the serological and immunological studies, but also for diagnostics – and starting to study the biology of the virus. What was the target cells? [And] starting to characterise the genome of the virus.

So everything really started.

Rob Moodie: So it was a very exciting, I mean also an intellectually very…

Françoise Barré-Sinoussi: Very busy, very challenging, but also an exciting time because each time you know that we were – as we always do in science, you make a hypothesis, you ask a question, then you test the question, you define an approach to answer the question, and the answer is the one you were expecting.

This is not so for all science, I must say, but that period was wonderful for that!

Rod Moodie: Yes, I mean it must have been awfully, in some ways, energising and draining by virtue of the hours you were working.

Françoise Barré-Sinoussi: But it was also a difficult period because, of course, it was, scientifically speaking, very exciting, but as a human being it was a lot of pressure, because for me, I'm not a doctor, I'm a scientist. That was the first time in my life really to be in direct contact with people affected by this disease. Because they were coming – Pasteur wanted to know about the virus and so on – and that was really dramatic.

Rob Moodie: Yes, that hadn't been in your training. Can you tell us about the time I think in the US when a very sick patient actually asked to see you.

Françoise Barré-Sinoussi: That was in San Francisco. You know, San Francisco was strongly affected, particularly the homosexual population. I was invited to give a talk on the virus, and at the end the clinician Paul Volberding asked me whether I would visit a patient in the emergency room, and I said yes.

And of course it was dramatic because the guy was really dying, he was almost not able to speak. And he took my hands – I still feel that moment he took my hands – and said something I had some difficulty to understand, but reading his lips I found "thank you".

So he said "thank you", and I looked at Paul and I asked "why?", and I asked the guy and he said – I could recognise – "not for me, for the others". And I think that's the moment in my life that I will remember forever.

Rob Moodie: And is that in some ways, still related to your work from then on.

Françoise Barré-Sinoussi: Oh yes, yes, it gives you some strength to say "OK, we have to move on [this] as fast as possible".

And I think the HIV/AIDS community really did quite well, really with mobilisation, solidarity in the 80s which is unprecedented.

Rob Moodie: And people say that in the first decade we learnt more about HIV than we'd learn about other diseases maybe in a century, and even in the last we've learnt more about it maybe than we had before that. Why do you think there is this such dramatic increase and rapidity of scientific knowledge?

Françoise Barré-Sinoussi: It's possible because of this solidarity between the scientists, the clinicians, the health professionals altogether, working together with representatives of the patients.

I think it's this network and partnership between… I mean we call us the HIV/AIDS "community", and I don't think in any other kind of disease you have the same kind of thing.

You have the scientific community [for other diseases], but for us we don't say the scientific community, we say the HIV/AIDS community. So it's just everybody together fighting with the same objective, with the same goal, to try and do the best for the affected population.

Rob Moodie: Now the other thing that seems apparent to me and it seems interesting that [clinician] Willy Rozenbaum would come to you, and clinicians coming to you. You certainly don't seem to be living in an ivory tower; that you're prepared obviously to communicate with clinicians, work with clinicians and with the community at large.

Has that sort of characterised your career? That you like to work with other parts of the system?

Françoise Barré-Sinoussi: Probably, first of all, I made all my career, really at the Pasteur Institute, and this is as far I was educated. For me, this is a mission of the Pasteur Institute, with Pasteur, the spirit of Louis Pasteur, the vision of Louis Pasteur was really to develop science … and to bring benefit to mankind, everywhere in the world.

That's how Louis Pasteur started to make Louis Pasteur institutes in different parts of the world. I was myself educated according to the Pasteur spirit, but I did not, I must confess, I did not realise totally what that means until HIV/AIDS came along.

Rob Moodie: And in the spirit of that, you famously wrote an open letter to Pope Benedict in 2009. Why did you do that and do you think it is part of the scientists' job to be advocating in that way?

Françoise Barré-Sinoussi: Sure, I mean, scientists certainly trying to do their best to make progress in science for the benefit of humanity, but when you see…

When there is scientific evidence, like there was and still is for the condom, and you have a person like the Pope, who could be anybody else, I mean, president of a country or whatsoever…

Rob Moodie: Because we've heard presidents of other countries say the same thing!

Françoise Barré-Sinoussi: Saying just before arriving in the country where it's very sensitive, and the voice of someone like the Pope is very important, saying that the condom is not efficient… you have to do something, because this is not true.

We as scientists, we know condoms are efficient, so it's the reason why I decided with two other colleagues to write a letter to the Pope, saying that "we are sorry, but, maybe you are not aware, but we can provide you all the data and it's very solid – proving that the condom is very efficient."

"So please, it's a mistake we feel when you're arriving in a country like Cameroon to make such statement. So please could you say that statement was not totally right, because it's important for the life of individuals."

Unfortunately he never answered.

Rob Moodie: It did have an important impact, I think, globally.

Françoise Barré-Sinoussi: It had an impact; not so far after his visit, I was myself in Cameroon, and it turned out that some colleagues and people involved in HIV already in Cameroon said "Oh Françoise, you should not have written to the pope, because probably you did not entirely make the right interpretation of what you wanted to say. He did not really say that the condom was not efficient but that we have to consider fidelity," and so on.

No, I understood very well what the Pope said, and you have yourself a responsibility as a professional in your country to explain to the population that the condom is efficient.

Unfortunately in Cameroon and in other countries, I have seen myself, and we all know there are religious people that are [doing] a wonderful job – for reasons that make me furious also, by the way. Because I know some religious people that are distributing condoms, [educating] the population to try and prevent HIV infection. It was very hard; they [did] a wonderful job.

Then they have their boss arriving in the country and destroying, in a few minutes, everything. This is not acceptable.

Rob Moodie: And you've been a very strong proponent of prevention. Despite, or as well as, the major progress in terms of treatment, you remain a strong advocate for prevention.

Françoise Barré-Sinoussi: For prevention, for everything which is for the benefit of the population: prevention, treatment, care. I think, really, it's just a question of respect of life only; life is the most beautiful thing in the world, and should be the thing that we should respect the most.

Rob Moodie: Today you've been at a major symposium towards a cure for HIV. What's been the major news to come out of the symposium?

Françoise Barré-Sinoussi: To tell you the truth, I cannot answer because I'm so busy that I've not been able myself to attend the symposium. I will know during the next few days because my colleagues will tell me, but unfortunately as I said in closing, it's frustrating to be part of the organisation and not be able to really hear what is going on during the symposium.

I know, however, [there have] been some presentations regarding new drugs that are trying to reactivate cells that carry the virus in patients who are on treatment – the reason why we cannot stop the treatment. Of course, it's promising but still preliminary.

Rob Moodie: As we've done for a number of AIDS Conferences.

Françoise Barré-Sinoussi: That's right, but that's science, it's how we progress. It's important we present the data anyway, because also we have to think about combining this approach to others.

I know that [there has been some data presented] regarding vaccine candidates: using cytomegalovirus as a vector of HIV antigens, showing that this vaccine candidate is very efficient in reducing the size of the reservoir in the monkey model. [This is] associated now to antiretroviral treatment, showing that if we treat very early on and associate with vaccines, we can reduce more and more the size of the reservoir.

So I mean, this kind of information, critical for the progress of pure research. The data also on the broadly neutralising antibody, very promising and that might be an approach for the future to associate towards a cure strategy. So it's progress.

Rob Moodie: Well, on behalf of all of us at The Conversation, can I thank you very much for the time you've spent for us, and just to wish you well in your important role in this AIDS 2014 conference. Thank you very much indeed.

Françoise Barré-Sinoussi: Thank you very much indeed, thank you.

The Conversation

Rob Moodie has received funding from Department of Health and Ageing. He is Deputy Chair of the Advisory Council of the Australian National Preventive Health Agency. He is on the GAVI Alliance Evaluation Advisory Committee and his University receives sitting fees. In a voluntary capacity he is a member of the SEATCA Southeast Asia Initiative on Tobacco Tax (a project funded by the Gates Foundation) Steering Committee.

This article was originally published on The Conversation. Read the original article.

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