A new breakthrough by Dr. Myron Cohen from the University of North Carolina and his extensive team from across the globe has brought forth new hope to help stem the HIV epidemic plaguing Africa and the wider world.
Human Immunodeficiency Virus (HIV) can severely compromise a person’s immune system, leaving him or her open to opportunistic infections that can significantly affect his or her health. When the virus weakens the body to the point where it cannot fight off infections, the disease becomes known as Acquired Immunodeficiency Syndrome (AIDS).
In 2009, it was estimated that over 33 million people worldwide were living with HIV, with an additional 2.6 million people being newly infected with the disease. Over 20 million of these people were living in Sub-Saharan Africa, which also accounted for approximately 75 per cent of the total number of people infected with HIV that year (approximately 2 million people).
The disease is spread to a person through the introduction of the virus into the bloodstream from an infected person, generally though unprotected sexual intercourse or needle sharing. While becoming infected with the disease is fairly preventable through condom use (which is almost 100 per cent effective with proper use), there are still social, religious, and cultural barriers inhibiting their use. Other factors include lack of knowledge about safe and effective use of condoms, sexual preference for not using a condom, and the desire have a child. In Sub-Saharan Africa, where the HIV epidemic is the most pronounced, many of these problems are ever-present, contributing in part to the continued spread of the disease.
To help address this large-scale health problem, Dr. Cohen and his team examined past research on HIV treatments and found that the standard treatment for HIV (the combination antiretroviral therapy) not only slows the progression of HIV, but also significantly reduces the concentration of HIV found in the blood and genital tract. As antiretroviral therapy has traditionally only been administered to HIV patients once their disease has progressed far enough to cause a high concentration of HIV in the blood, and as high concentration of HIV in the blood is largely associated with the transmission of HIV to another uninfected person, Dr. Cohen and his team were interested in evaluating whether early antiretroviral therapy could help prevent the spread of HIV to uninfected people by keeping the concentration of HIV low in the infected person.
To do this, Dr. Cohen and his team recruited 1763 sexually active long-term couples with one partner HIV positive and the other HIV negative and randomly selected the HIV patient to either traditional antiretroviral therapy or early antiretroviral therapy. Half of the couples came from Africa, and they were followed over time starting in April 2005.
As of February 2011, a total of 39 people were infected over the course of the study. The remarkable result of the study was that only four of the 39 infections were from the early antiretroviral group, indicating that the early antiretroviral therapy played a substantial role in preventing the spread of HIV.
Given that over 2 million people are diagnosed with HIV per year in Sub-Saharan Africa, this breakthrough could change the tide in the battle against the HIV epidemic. While barriers still exist preventing the large scale administration of early antiretroviral drugs to HIV patients in Africa (including logistics and costs), the future is looking much more hopeful.
