HIV-AIDS

RECENT POSTS

Big AIDS meeting few care about opens in Rome, and GOOD map on AIDS pandemic

The International AIDS Society is holding its meeting in Rome this week. I’ll be doing a round-up of the meeting as soon as something newsworthy comes out of it. So far it’s mostly been folks giving their perspectives on the news already reported or calling for more funding to expand treatment:

AIDS conference organizers say their meeting is important milestone

Question: Why isn’t the media interested?

Answer: Maybe because of the gecko AIDS treatment story

Meanwhile, GOOD has created this cool-looking (but somewhat confusing?) infographic and map of the global state of affairs in the HIV/AIDS pandemic:

GOOD

Studies provide proof of powerful new HIV/AIDS prevention strategy

Gilead

Two clinical studies done in Africa, the largest done by Seattle scientists involving nearly 10,000 people in Uganda and Kenya, have shown that the same drugs used to treat HIV infection can be used to prevent the infection.

“This is huge news because of the impact it could have on prevention worldwide,” said Jared Baeton, one of the leading researchers at the University of Washington on the study, which was funded by the Bill & Melinda Gates Foundation.

“These results are tremendously exciting and confirm we are at a pivotal period in the AIDS epidemic,” said Mitchell Warren, a leading voice on HIV-AIDS prevention matters and director of the AIDS Vaccine Advocacy Coalition.

A number of earlier studies have shown that getting people who are HIV infected on anti-HIV drugs significantly reduces the risk of spreading the virus. Now, Warren said, it seems clear that people who are at high risk for HIV can also be protected if they take the drugs prior to being exposed to the virus.

The approach is known as pre-exposure prophylaxis, or PrEP. The other study cited today as demonstrating PrEP’s potential was done by the U.S. Centers for Disease Control and Prevention in Botswana involving more than 1,200 volunteers.

Connie Celum

“This study demonstrates that anti-retrovirals (anti-HIV drugs) are a highly potent and fundamental cornerstone for HIV prevention and should become an integral part of global efforts for HIV prevention,’ said Celum, who was among the first to show the power of these drugs to prevent infection.

The UW study in Uganda and Kenya was of 4,758 “discordant” couples (in which one partner has HIV and the other does not) was called Partners PrEP and led by Celum and Baeten. On Sunday, scientific advisers monitoring the UW study ordered the placebo arm halted and the results released early.

Earlier studies of PrEP strategies had shown conflicting results, some effective and some not, but many experts say these new studies will resolve the uncertainty.

The UW study, which compared a single anti-HIV drug regimen vs a combo drug regimen, found that giving non-infected partners these drugs reduced the risk of infection by 62-73 percent (depending on if it was the single or combo drug).

But, as AIDS prevention advocate Warren noted in his statement heralding these results, science is one thing and implementing treatment or prevention programs in the real world is another.

Many millions of HIV-infected people living in poor countries and who right now need access to these drugs to save their lives are not getting them. Programs such as the Global Fund to Fight AIDS, TB and Malaria have not been fully funded by donors and governments.

 

Botswana: An African success story in the fight against AIDS

The southern African nation of Botswana has one of the world’s highest rates of HIV infection and yet is also widely considered one of the big success stories in the fight against AIDS.

On Tuesday, at a Seattle event sponsored by the World Affairs Council, former Botswanan President Festus Gontebanye Mogae spoke and took questions from an audience of several hundred people at the Bell Harbor International Conference Center.

Tom Paulson

Former President of Botswana Festus Mogae

Mogae began his remarks by recalling when AIDS was first recognized in some central African countries and was largely ignored as another one of those “mysterious diseases” that afflict or kill a few people, attract some scientists and media attention and then just as mysteriously ebb away.

Not this time.

Botswana would soon have (and still does have) one of the highest rates of HIV infection in the world. At the peak of the pandemic, nearly 40 percent of Botswana’a adult population was infected. That’s come down some, but today still one of every four Botswanans between the ages of 15-49 is estimated to carry HIV.

“We didn’t know what hit us,” Mogae said. “We were faced with the possibility of extinction.”

Continue reading

Recharting the world’s response to the AIDS pandemic

For only the second time in a decade, the United Nations is holding a “high-level” General Assembly meeting to reach consensus — and commitment — from the international community on how to respond to AIDS.

Starting today and running through Friday, those meeting at the UN headquarters in New York City face a daunting task due to a number of factors:

  1. The virus continues to spread, newly infecting thousands of people every day.
  2. In the developing world, many more people are on anti-HIV treatment (more than 6 million) than was the case a decade ago, but many more (9 million) who need the drugs aren’t yet getting them.
  3. Donors and governments are reluctant to increase funding (or even meet previously committed funding targets) to various efforts in the global AIDS response due to the economic turndown.
  4. New evidence that supports the claim that anti-HIV treatment can almost completely stop those infected from spreading the disease has caused many advocacy organizations and others to press even harder for expanding AIDS treatment — as a means to save lives but also stop the spread of the disease.

The meeting is just starting but here a few stories or op-eds out of it:

VOA: UN holding conference on global AIDS response

AFP: UN summit to set treatment target for AIDS sufferers

CNN: Don’t let up on AIDS research

NOTE: At the same time, in South Africa where HIV and AIDS has been massive, another AIDS meeting is taking place and strikes a “positive note.”

Seattle’s Julie McElrath leading in the search for an effective AIDS vaccine

WHO

Map of the AIDS pandemic

Thirty years ago, Julie McElrath was a medical resident in Charleston, South Carolina, seeing young patients with rare illnesses, unusual forms of pneumonia or cancer, typically only seen in the elderly with weakened immune systems.

“We were trying to care for these people but we didn’t know what they had,” McElrath said. What they had was AIDS. The epidemic had emerged.

Three decades later, McElrath is one of the world’s leading scientists searching for what many believe is the best, perhaps only, hope of ending the pandemic. A vaccine.

“I do think a vaccine is what we will ultimately need,” she said. Recent studies that have shown that treatment can prevent spreading the infection to others is tremendous news, she said, but the logistics and expense of making that happen are daunting.

HIV Trials Network, Fred Hutchinson

Julie McElrath

Today, in her Seattle lab, the HIV Trials Network operated by the Fred Hutchinson Cancer Research Center, she and her colleagues will open precious vials containing white blood cells collected from thousands of Thai research volunteers.

Not that long ago, many had given up on ever finding a vaccine against HIV.

Then, in late 2009, the Thai Prime-Boost vaccine trial (technically known as RV 144) stunned the skeptics, well, okay, almost everybody, by demonstrating that a vaccine could prevent infection. It wasn’t enough protection, but it was protection.

“It gave us hope that this was possible,” McElrath said. Continue reading

Scientists discover (again): AIDS treatment prevents infection

Flickr, Benny Sølz

As MSNBC, the Wall Street Journal, New York Times and many other media report today:

People infected with the virus that causes AIDS are far less likely to infect their sexual partners if they are put on treatment immediately instead of waiting until their immune systems begin to deteriorate, scientists report.

The study, begun in 2005, was done by the National Institutes of Health and had such dramatically positive results it was ended five years early. As the Wall Street Journal’s Mark Schoofs writes:

The results were so overwhelming that an independent panel monitoring the research recommended the results be released four years before the large, multi-country study had been scheduled to end.

Connie Celum

What may be even more surprising is that a Seattle-based AIDS expert, Connie Celum, as well as some Swiss scientists had already discovered this!

Here’s my post on Celum’s findings last July, UW Study shows AIDS Treatment IS Prevention. As Celum and her team reported back then in The Lancet:

“We found a 92 percent reduction in transmission among those who went on (anti-HIV drug therapy),” said Celum.

The New York Times said the NIH study was convincing because it is the first time this was shown in a major randomized clinical trial and earlier studies had only “implied” this. That’s a little misleading and certainly ignores the power of what Celum and her colleagues showed. Continue reading

UW global health researchers dodge political turmoil in Uganda

Wikipedia

Uganda

A week ago, the UW’s Amy Hagopian, Peter House and Bert Stover headed to Uganda to coordinate a study aimed at resolving a fierce debate in global health.

Since arriving in Uganda, the UW researchers and their co-workers have had to deal with escalating violence which most observers blame on the government’s attempt to quell public protests and calls for political reform.

As the BBC reports, eight people have been killed and about 250 people injured so far. Continue reading

Signs of regress in the global AIDS fight

IRIN, Allan Gichigi

Condom dispenser, Kenya

Okay, this is an incredibly disturbing story that should scare the bejeebers out of everyone.

IRIN News reports, kind of matter-of-factly, that in Kenya “Condom recycling highlights gap in HIV prevention programming.” The story tells about men in rural northern Kenya:

“… washing condoms and hanging them out to dry; the men said the price of condoms meant they could not afford to use them just once. Other men in the village said when they had no access to condoms, they used polythene bags and even cloth rags when having sex.”

Remember when we were celebrating (last week, I think) how many more people with HIV are receiving treatment with anti-AIDS drugs?

If we can get malaria-preventing bed nets out to almost everyone who needs them, how is it we are still failing to make sure everyone has access to something so cheap and basic as a condom?