By Stephen Spotswood
ATLANTA — Raymond Schinazi, PhD, Hon DSc, still remembers how the patients lined the corridors. They were all too thin, too pale and much too weak.
“They looked one foot away from death,” he said. “It was very, very sad.”
This was in 1985 at the Atlanta VA Medical Center. Schinazi was a junior investigator working on HIV. He had been paired with a clinician whose office was right next to his.
“Every day, I’d look out my office and see these patients lined up. The virus was basically eating them up from within,” he said. “We felt we had a duty to do something for these people.”
Over the next 30 years, Schinazi would have a hand in developing some of the most widely-used HIV treatments. He currently holds 90 U.S. patents, and the drugs he’s helped create are estimated to be in use by over 90% of HIV-infected individuals worldwide.
Schinazi started off studying organic chemistry in the UK and jokes that he turned to biology out of boredom.
“The action and glory were in biology,” he said. “Chemists are pretty boring except to other chemists.”
He began studying biology, then went to Yale for a post-doctorate in pharmacology. Eventually he moved to Emory University to become a post-doc research fellow studying the herpes virus.
All this made him the right person with the right background in the right place and time when HIV began to enter the public consciousness in 1983. Schinazi was a researcher knowledgeable in chemistry, biology and pharmacology and was studying sexually-transmitted viruses. So, when the Atlanta VA began looking to build up its anemic research programs, Schinazi was an easy choice to recruit.
He began digging into the structure of the HIV virus, eventually focusing on the mechanism that copies HIV RNA into new viral DNA. In the early 1990s, his research team at Emory developed two drugs — FTC, now sold as Emtriva and 3TC, now sold as Epivir. Both antiretrovirals were in a class of drugs known today as nucleoside reverse transcriptase inhibitors. Both drugs inhibited the reproduction of the HIV virus and kept already-infected patients from getting sicker.
This new class of drugs became a safe, effective cornerstone of anti-virology for HIV. This work helped pave the way for turning what was once a fatal illness into a manageable chronic disease — one that does not require a back-breaking drug regimen
“Prophylaxis, prevention, stopping mother-to-child transmission — all of these things are [being developed] because of the discoveries we made,” Schinazi said.
Three decades after starting research into HIV, Schinazi explained, “We did not develop a cure for HIV, but we basically stopped the bleeding. And we did it very quickly.”
Now he’s taking what he’s learned with HIV and turning his attention to hepatitis C (HCV) and hepatitis B (HBV), both of which are commonly seen in HIV patients.
A cure for HCV was released last year, but its cost — more than $90,000 for a full 12-week course in some situations — can be prohibitive for patients. Schinazi is studying ways to shorten the duration of the regimen, which will save patients money and increase adherence to the drug.
He also is seeking to develop regimens with fewer side effects, which would also increase adherence. One-third of HIV patients are infected with HCV, and the latter infection accelerates the former.
He’s also examining a potential pathway to a cure for HBV, which affects approximately 450 million people worldwide.
“These people have to take drugs for the rest of their lives, so if we can find a cure, it’ll be great,” he said.
The HCV cure has been particularly inspiring for Schinazi, suggesting to him that any virus can be cured, if researchers can just find the right path.
“All of this accumulated knowledge [on HIV and HCV] can translate to other viruses,” he said. “We’re at the forefront of this new era. I hope we can have a big impact on all of the important pathogens affecting humans.”