In Reviewing The Year, Good News On Possible AIDS ‘Tipping Point’

People walk inside an 82-foot condom during an AIDS awareness event marking the World AIDS Day in Budapest, Hungary .

Somebody stop me before I do another year-end round-up. But just a brief note about what I found myself saying yesterday as part of Radio Boston’s year-in-health review: The decision by the journal “Science” to call an HIV-drug study its “Breakthrough of the Year” brought greater attention to some very encouraging news about AIDS.

‘A tipping point in the fight against AIDS, 30 years after the epidemic first surfaced.’

Today’s story by NPR’s Dick Knox — on the study and the questions it raises about ramping up the fight against AIDS — is here.

And here are the basics from the New York Daily News:

The lead story of the year was an international trial, coined HPTN 052, which showed that people taking anti-retroviral drugs reduced the risk of heterosexual transmission to partners by 96 percent.
The breakthrough was described by some experts as a tipping point in the fight against AIDS, 30 years after the epidemic first surfaced.
“People were interested in the idea of treatment as prevention, but it created a hurricane-force wind behind the strategy,” said lead investigator Myron Cohen of the University of North Carolina’s School of Medicine.

And from bio-ethicist Art Caplan on

When the study on the benefits of antiretroviral therapy ran last August in the New England Journal of Medicine, it did not really get the attention it deserved. Continue reading

100% Prevention And A Cure For HIV/AIDS: On The Horizon?

Dr. Fauci speaking recently at Holy Cross

As promised in my previous post, here’s more from Dr. Anthony Fauci, a leading expert on HIV/AIDS and director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. I asked him for a summary of new findings and advances in preventing the spread of HIV/AIDS and finding a cure for those infected.

Since my interview with Dr. Fauci, another new finding was announced. As reported by the Globe, an international team of researchers has cracked the genetic code of the “controllers,” a mystifying group of individuals infected with HIV who are virtually free of symptoms and the need for medication. The researchers discovered five amino acids that distinguish controllers from their HIV counterparts facing less fortunate fates.

An excerpt from the Globe:

“HIV is slowly revealing its secrets,’’ said Dr. Bruce Walker, one of the leaders of the international consortium and director of the Ragon Institute, an AIDS-vaccine research center affiliated with Massachusetts General Hospital, Harvard University, and MIT.

“We’ve now been able to go from a haystack down to a needle and see that this is really the key place where we need to focus our effort,’’ he said.

Have there been any breakthroughs or developments in HIV/AIDS research?

Dr. Anthony Fauci: The first is in the arena of vaccine. We have been trying for over 20 years to develop a safe and effective vaccine, with nothing but unfortunate and discouraging failures. But a year and a half ago, in a trial that the NIH and the Department of Defense sponsored in Thailand among 16,000 people, it was the first indication of a modest, positive effect of preventing acquisition of HIV infection. It is not good enough to be ready for primetime by any means, but it’s the first positive step to prove the concept that a vaccine is at least feasible.

Also, this past year we’ve had some very encouraging results of studies that were conducted in South Africa using a topical microbicide — a vaginal gel which is inserted before and after intercourse — that prevented infection in, again, a modest number of individuals, about 39 percent compared to placebo. It was strongly related to whether or not the individuals actually used the gel. But this is again another important proof of concept. We have to improve upon the results, but at least it’s proved that this approach to prevention can work. So in the areas of microbicides and vaccine, [it’s] not quite yet where we want to be, but certainly going in the right direction.

Another important area that is being pursued is what’s called pre-exposure prophylaxis: mainly getting people who are at high risk and practicing high risk behavior – for example, discordant couples, commercial sex workers, injection drug users and others — and giving them a drug, every day, an anti-viral drug that is known to be safe, to prevent them from getting infected. The results of that study should be forthcoming in the next month or so.

What are the timelines for the development of such prevention methods and vaccines?
Continue reading

HIV/AIDS In The U.S. 'Worse Than Most Perceive'

More than 1 million people live with it in the U.S., and one in five don’t know they have it. While the annual numbers of new HIV infections have remained stable, more than 56,000 Americans are newly infected with the virus each year, according to the Centers for Disease Control.

In a recent survey, more than 60 percent of Americans said advancements in HIV/AIDS have received too little coverage. I spoke with an infectious disease doctor and expert to find out where we stand in combating HIV/AIDS. Dr. Anthony Fauci is the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.

What is the state of HIV/AIDS in the U.S. today?

Dr. Anthony Fauci: The state of HIV/AIDS in the United States is clearly worse than I believe most people perceive, because we’ve reached somewhat of a plateau — but at an unacceptable level — and there has been a degree of complacency about that.

I believe the perception of HIV/AIDS in the general population, is [that people don’t] perceive it as serious a situation as it is. The people who are involved with it every day, like I and my colleagues are, we see that right up front, just looking us square in the face. But for the ordinary person who has so many other things on their mind, they’re really not thinking about this as a big problem in the United States, when in fact it still is.

What is being done in terms of funding and outreach for HIV/AIDS?

There’s always a need for robust funding for HIV/AIDS research, but there have been enough major advances, particularly in the arena of therapy, where we really need to implement the things that we have done, as much as, or more than, getting new things.

This is really a low-tech public health/sociological issue, where you’ve got to get into the population, particularly people at risk, and you need to seek them out in a voluntary way, get them tested and get them into care. Continue reading