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HIV Treatment as Prevention: The 2011 Breakthrough of the Year

HIV Treatment as Prevention: The 2011 Breakthrough of the Year

Could treatment for HIV, if given at an earlier enough point in time, prevent it? Science Magazine‘s “2011 Breakthrough of the Year” suggests that HIV treatment could mean prevention.  The study in question appeared in the August 11 New England Journal of Medicine (NEJM) and showed that giving antiviral medicines to HIV-infected people when their immune systems are still relatively healthy made them 96 percent less likely to transmit the virus to uninfected partners.

1,763 heterosexual couples from nine different countries (Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, the United States and Zimbabwe) were enrolled in the study, which is summarized in Science Daily:

Each couple included one partner with HIV infection. The investigators randomly assigned each couple to either one of two study groups. In the first group, the HIV-infected partner immediately began taking a combination of three antiretroviral drugs. The participants infected with HIV were extensively counseled on the need to consistently take the medications as directed. Outstanding compliance resulted in the nearly complete suppression of HIV in the blood (viral load) of the treated study participants in group one. my emphasis

In the second group (the deferred group), the HIV-infected partners began antiretroviral therapy when their CD4+ T-cell levels — a key measure of immune system health — fell below 250 cells per cubic millimeter or an AIDS-related event occurred. The HIV-infected participants also were counseled on the need to strictly adhere to the treatment regimen.

While the NEJM study was originally set to end in 2015, an independent data review by the independent data and safety monitoring board (DSMB) discovered that, only one out of a total 28 cases of HIV infection among the previously uninfected partners had occurred among those couples in which the HIV-infected partner had begun immediate antiretroviral therapy. The DSMB accordingly decided to call for an immediate release of the study’s findings.

Myron Cohen, M.D., director of the Institute for Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill, led the study, which is also known as the HPTN 052 clinical trial.

Science Magazine chose the NEJM study as the “breakthrough of the year” because of its “profound implications for the future response to the AIDS epidemic.” The study was sponsored by the National Institute of Allergy and Infectious Diseases (NIAID); its director, Dr. Anthony S. Fauci, M.D., noted that, while “treatment as prevention is not going to solve the global HIV/AIDS problem,” it can “make a significant impact on the HIV/AIDS pandemic,” when used in combination with a number of other tools and strategies, namely,

“…knowing one’s HIV status through routine testing, proper and consistent condom use, behavioral modification, needle and syringe exchange programs for injection drug users, voluntary, medically supervised adult male circumcision, preventing mother-to-child transmission, and, under some circumstances, antiretroviral use among HIV-negative individuals.”

Dr. Fauci also said that these “proven prevention methods,” along with continued research to create a preventive HIV vaccine and female-controlled HIV prevention, could lead to something before thought unimaginable, “an AIDS-free generation.”

The complete list of 2011 breakthroughs can be found at Science Magazine. Runners-up include a new malaria vaccine, ancient DNA in modern humans and alien solar systems.

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57 comments

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4:21AM PST on Jan 22, 2012

Noted.

8:43AM PST on Dec 30, 2011

wow

10:59AM PST on Dec 29, 2011

One of the awful things about AIDS is people having sex with their partners when they know they have it and stand a high chance of passing it on. That's human love for you, sex before responsibility, and the reason it's so rife in Africa, especially.

6:41AM PST on Dec 28, 2011

Wiletta S, I agree with you. They test on animals just like cancer research. Animals suffer and what do they end up with another synthetic medicine that doesn't cure anything and causes horrific side effects. If they want to do any research that is to benefit people they should research on people. If they want to cure aids they should take that research money and spend it educating people about condoms, which hello would also lower human population growth. Everyone knows where aids comes from and with the exception of rape it is completely preventable.

10:38PM PST on Dec 27, 2011

This article is very exciting because so many people do have this illness/disease and need to know there's a spark of hope for others. It's so important to regularly be tested and that's something that should emphasized more in general and when one of the doctor's said, "preventive HIV vaccine and female-controlled HIV prevention, could lead to something before thought unimaginable, “an AIDS-free generation,” I felt so proud of modern medicine and science because if this is in fact a real possibility, it would have a huge, positive impact on our world which right now is needed.

7:05PM PST on Dec 27, 2011

Looking forward to its application for those who need it.

6:17PM PST on Dec 27, 2011

Thanks.

1:23PM PST on Dec 27, 2011

Let's hope a cure isn't too much further behind. Thanks.

11:41AM PST on Dec 27, 2011

THEY EXPERIMENT ON ANIMALS FOR THIS THEY GIVE THE ANIMAL THE HIV AND THEN TRY AND FIND A CURE BY INJECTING THE ANIMAL ... THAT TO ME IS A SICK WAY AND THEN TO HAVE HUMANS ABUSE ANIMALS, WHAT WOULD THESE SICK HUMANS DO IF THERE WERE NO ANIMALS, I WOULD NEVER WANT AN ANIMAL TO DIE IN ORDER TO SAVE MY LIFE, IF ITS MENT FOR ME TO DIE THEN SO BE IT, I DON'T EVEN AN ASPRIN FOR HEADACHE'S I JUST SUFFER AND GO ON THING POSITIVE AND USING HERBS, THATS ONE GOOD THING I CAN BE PROUD OF " NO ANIMAL SUFFERS OVER ME !!!!

11:39AM PST on Dec 27, 2011

thanks

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Kristina Chew Kristina Chew teaches ancient Greek, Latin and Classics at Saint Peter's University in New Jersey.... more
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