Giving AIDS drugs to people infected with HIV can protect their uninfected spouses and other sexual partners, U.S. researchers reported on Thursday.
The study, done in 13 countries, could have implications for policymakers trying to decide the best way to try to control the AIDS pandemic. It found that HIV patients taking drug cocktails were 96 percent less likely to infect someone else.
“This breakthrough is a serious game-changer and will drive the prevention revolution forward. It makes HIV treatment a new priority prevention option,” said Michel Sidibe, who heads the Joint United Nations Program on HIV/AIDS (UNAIDS).
U.S. AIDS actiivists said they would use the findings to fight for better funding for U.S. programs. “With our nation’s AIDS Drug Assistance Programs facing the most serious funding crisis in their history, and some in Washington calling for major cuts to Medicare and Medicaid, this study makes clear the importance of ensuring access to (HIV drugs) for all Americans living with HIV," said said Daniel Montoya of the National Minority AIDS Council.
"These medications not only safeguard the health of individuals living with HIV, they are extremely valuable as a method of prevention."
The results fit in with those of other studies that have found that HIV patients who choose to take drugs are less likely to infect others – but the kind of people who chose to take drugs may have done other things to protect their partners, too. This study, done in more than 1,700 couples, was randomized, meaning people were assigned to either take drugs right away or wait until showing signs that the fatal and incurable virus had damaged their immune systems.
“We think that these results will be important to help improve both HIV treatment and prevention,” said Dr. Myron Cohen of the University of North Carolina, who led the trial sponsored by the National Institute of Allergy and Infectious Diseases.
The study was supposed to last until 2015, but an interim analysis showed 39 of the previously uninfected people in the trial had become infected, and further checks showed virtually all of them were sexual partners of patients who were not taking the AIDS drugs.
“The findings of this study strongly indicate that treating an HIV-infected individual with antiretrovirals (HIV drugs) sooner rather later can have a major impact,” NIAID Director Anthony Fauci told reporters in a conference call.
"This is a crucial development, because we know that sexual transmission accounts for about 80 percent of all new infections," said World Health Organization Director-General Margaret Chan.
Only about half of the Americans who know they have HIV and should be getting treatment actually receive it, but more than 20 percent of the 1 million Americans infected with the virus do not even know it, the Centers for Disease Control and Prevention estimates. Globally, only about a third of patients who need HIV treatment get it.
“With these results, we should redouble our efforts to diagnose individuals with HIV earlier,” Dr. Kathleen Squires, chair of the HIV Medicine Association, said in a statement.
“The U.S. federal treatment guidelines were modified recently to recommend earlier treatment for people with HIV infection to improve health outcomes for this patient population. We now have further evidence that effective treatment not only benefits the individual but also will help reduce the spread of this disease.”
AIDS has killed 25 million people globally since it first was discovered 30 years ago, and 33 million people are infected. The CDC estimates that more than 56,000 Americans become infected with the disease each year and that 18,000 die of it. There is no cure and no vaccine, but condoms can protect against sexual transmission and cocktails of HIV drugs can keep patients healthy.
The President’s Emergency Plan for AIDS Relief, or PEPFAR, initiated by former President George W. Bush, is the single biggest government program aimed at one disease. President Obama has wrapped it into his Global Health Initiative and it is slated to get an estimated $51 billion over six years. Some AIDS activists say Obama has broken a campaign promise to spread this international AIDS cash over just five years.
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