HIV Treatment Developer Wins 21st Yomiuri Award

By Yamada, Satoshi | The Daily Yomiuri (Toyko, Japan), November 6, 2014 | Go to article overview

HIV Treatment Developer Wins 21st Yomiuri Award


Yamada, Satoshi, The Daily Yomiuri (Toyko, Japan)


Kumamoto University Prof. Hiroaki Mitsuya, 64, who is committed to saving the lives of poor people in developing countries by developing drugs for HIV/AIDS, will be awarded the 21st Yomiuri International Cooperation Prize. Special prizes will go to three organizations -- the Japan Overseas Cooperation Volunteers (JOCV), which has conducted volunteer activities in developing countries for nearly half a century, and two other organizations that have supported members of JOCV activities -- the Supporting Organization of JOCV and the Japan Overseas Cooperative Association.

"I'll discover medicine that makes you and other people live longer."

Mitsuya says this was his childhood promise to his mother, Makiko, who was prone to illness. His mother died in 1990.

Mitsuya became a physician specializing in hematology and clinical immunology at Kumamoto University and went to the United States in 1982 to study at the U.S. National Cancer Institute.

Around that time, a new, mysterious disease called acquired immune deficiency syndrome (AIDS) was spreading in the United States. About 90 percent of AIDS patients died within two years once they developed full-blown AIDS, mainly due to pneumonia and other infections as their immunity systems rapidly deteriorated.

In 1983, the virus that causes AIDS, called human immunodeficiency virus (HIV), was discovered by French researchers. At that time, Mitsuya was leading the world in research on leukemia-causing viruses, which infect human immune cells. It was then learned that HIV also infects immune cells.

The stage for challenging the mysterious disease opened in front of Mitsuya.

He thought: "There are many patients who need medicine in the world. This is the job I should take up."

When a cell is infected by HIV, reverse transcriptase copies its genetic information from RNA to DNA and incorporates it into the DNA of human immune cells. Mitsuya thought if the reverse transcriptase was stopped, the virus would stop replicating. He intensively searched for drugs that would do this.

His lab assistant, who was afraid of infection, refused to help in his experiment, and a colleague said he would quit if Mitsuya used the same laboratory. Mitsuya continued to conduct his experiments alone around midnight and in the early morning. When his experiments continued into the morning, arguments would break out with one of his colleagues, who came to work in the morning. Even under such an intense situation, Mitsuya's resolve to seek medicine that would help patients live longer was not shaken.

Potential agents identified

In 1985, Mitsuya published in a prestigious U.S. science journal the effects of a drug called zidovudine (AZT), which became a candidate to be the first AIDS medicine. The U.S. Food and Drug Administration, in 1987, gave approval to AZT, which became the world's first anti-HIV drug based on clinical trials initiated by Mitsuya's data, at an unprecedented speed.

Although AZT was successfully developed as the medicine patients all over the world were waiting for, the pharmaceutical company that provided Mitsuya with the chemical used its patent to push the cost of the drug to as high as 1.5 million yen a year.

With such a high price, low-income people and patients in developing countries, where AIDS was rapidly spreading, were unable to get treatment.

"Patients still could not live long, even though there was effective medicine available," Mitsuya said. "I was overwhelmed with indignation."

He developed two new medications in a row -- didanosine (ddI), which had fewer side effects, in 1991 and dideoxycytidine (ddC) in 1992, thus significantly lowering the cost of treating AIDS. However, the virus mutated, and patients received no benefit from the medications.

Pessimism that medical science might not be able to beat AIDS spread. However, soon a combination of chemotherapy using multiple classes of antiviral agents was developed -- a result of Mitsuya's pioneering accomplishments. …

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