Expert: Using antiretroviral drugs early may curb HIV/AIDS spread

By Elizabeth Landau, CNNFebruary 20, 2010 8:49 p.m. EST


The ideas of early HIV/AIDS testing and use of antiretroviral drugs have been gaining support worldwide.

Use of antiretroviral drugs in early stages "an important goal" but needs work, professor says

"We could effectively stop transmission within five years," epidemiologist says

Operational research still needs to be done to gauge results, epidemiologist says

San Diego, California (CNN) -- Antiretroviral drugs that are being used to prolong the lives of patients infected with HIV/AIDS could also be greatly effective in slowing its spread, epidemiologist Brian Williams said.

The concentration of the virus drops by a factor of 10,000 with antiretroviral treatment, resulting in 25 times the reduction of infectiousness, said Williams, formerly of the World Health Organization and now at the South African Centre for Epidemiological Modelling and Analysis. That means that if more people with HIV received this therapy early, there would be fewer new cases of the disease, he said Saturday at the annual meeting of the American Association for the Advancement of Science.

"We could effectively stop transmission within five years," Williams said.

About 33 million people are living with HIV, according to 2008 estimates by the World Health Organization and UNAIDS. That year, 2 million people died of AIDS and 2.7 became newly infected.

Because people who have HIV are living longer, and because in some parts of the world behaviors that facilitate transmission have not decreased, there are more new infections every year than deaths, and the epidemic continues to grow, said Dr. Kenneth Mayer, professor of medicine and community health at Brown University.

In a 2009 article in The Lancet, Williams and his colleagues at the World Health Organization advocated for broader use of antiretroviral drugs, proposing that everyone over age 15 should be tested annually for HIV, and that anyone who tests positive should begin antiretroviral treatment immediately.

The need [for treatment] will continue to go up over the next few years ... can we keep up with the pace of the need?

--Dr. Kenneth Mayer, professor of medicine and community health at Brown University

World Health Organization

HIV and AIDS

Contagious and Infectious Diseases

These ideas have been gaining support worldwide, Williams said. The National Institute of Allergy and Infectious Diseases plans to start a pilot study in New York and Washington, he said. The International Aid Society is doing something similar in British Columbia, and another trial in South Africa will be funded by the French AIDS Research Agency.

Using antiretroviral drugs early to curb transmission is "an important goal" but will take many years to get right in different settings, Mayer said. Beyond the expanded use of medicine, the details of how to get enough people tested and to change their behaviors is "a whole package that needs to be worked out," he said.

Williams agreed that much operational research still needs to be done to determine if people agree to take the drugs and comply with them, and to see if it leads to the predicted stemming of transmission, Williams said.

Offering testing in communities is one way to get at it, he said. One intervention done in Botswana gave HIV tests to anyone who came to a clinic for any reason, resulting in about one test per person each year.

The proposal is expensive -- the cost in South Africa alone would be $3 billion to $4 billion per year, he said. But the plan would save money from the first day because of all of the people today who have to be hospitalized, and because of all of the young people who die in the prime of their lives, he said.

"If you factor all of the costs, the cost of the drugs would be more than balanced by the cost of treating people for all of these other diseases and then letting them die," he said.

But this should not be seen as an alternative to vaccine research and other activities to curb the pandemic, he said. Toward the end of last year the AIDS research community had a burst of optimism with the results of a controversial trial from Thailand, said Dennis Burton of the Scripps Research Institute. Although the validity of the results is still in question, the news was a "very welcome development," Burton said.

"It's important to realize that the HIV vaccine problem is not one of development," Burton said. There are still many discovery steps that need to be made, and if an effective vaccine could be designed, that would revolutionize the entire study of vaccines for infectious diseases, he said.

In the United States, 20 to 25 percent of Americans living with HIV are unaware of their status, Mayer said. When people are unaware, there are more likely to have unprotected sex and engage in other risky behaviors, increasing the risk of transmission, he said. About 1 million Americans have HIV, he said.

Some people are at high risk for getting AIDS by virtue of where they live, he said. A black male in Washington has about a 1 in 15 or 1 in 16 chance of being infected with HIV, and the probability for a black woman is 1 in 30, Mayer said. This is similar to Detroit, Michigan, and other urban centers. Transmission also is relatively high in gay communities where people who do not engage in risky behavior have risky partners.

"The need [for treatment] will continue to go up over the next few years, and the question is, can we keep up with the pace of the need?" Mayer said.

Herpes Drug Might Also Slow HIV Progression

But acyclovir is not a replacement for HIV-specific drugs, researchers say

Feb. 15 (HealthDay News) -- New research suggests that people who are infected with both HIV-1, a strain of the AIDS virus, and herpes simplex virus type 2 could benefit in more than one way by taking a herpes drug called acyclovir. In addition to treating herpes, the medication appears to also slow the progression of HIV.

"While the HIV-disease ameliorating effect we have observed is modest, it could add one more tool to help people with HIV infection stay healthy for longer," study co-author Dr. Jairam Lingappa, of the University of Washington, said in a news release from The Lancet.

The study, published online in the journal, analyzed what happened to almost 3,400 people in Africa who were infected with both diseases.

Half were assigned to take 400 milligrams of acyclovir twice a day, and the others took a placebo. Researchers tracked their progress for up to 24 months.

The risk of HIV progression was reduced by 16 percent in those who took acyclovir, the study found.

However, other research has suggested that acyclovir does not prevent transmission of HIV to heterosexual partners by people who take the drug, the scientists said.

The researchers said that other AIDS drugs would have a greater impact on the progression of HIV in those who were infected. But , acyclovir could be an option for people who had not progressed far enough to need antiretroviral therapy, they said.

The first annual HIV/AIDS Oregon Zoo Day

When
Sunday, April 11th, 2010 
11 AM - 6 PM   Annual Oregon Zoo Day for People living with HIV/AIDS

The first annual HIV/AIDS Zoo Day is happening April 11 and is sponsored by the PSA.
Other partners in the Zoo Day are Cascade AIDS Project. Other Organization can contact us to become a sponsor and part of the event.

Who Can Attend?
Anyone can attend and show their support for people who are living and struggling with HIV/AIDS.

No Cost Admissions Available to all HIV Positive Clients.
We have received a grant of free adult admissions that can be used for people who have HIV/AIDS, their Spouse, Partner and up to 4 family immediate members on a first come, first served basis. You must be placed on the RSVP list to receive free admissions.

Even if you don't get the free tickets, please come and support HIV/AIDS Awareness by coming to the zoo.

What should we wear?
While there is no requirement, Marc Peterson, PSA Director and Michael Kaplan, CAP Director have both suggested that participants wear their AIDSWalk or Positive Force or Screw Stigma shirts, pins or stickers to show awareness of the HIV/AIDS epidemic.

How to get Free Admission Tickets
Free admission tickets are available to actual clients who are living with HIV/AIDS. Additional free admission tickets are available to the clients Partner, Spouse or Caretaker. Clients who have children are encouraged to reserve tickets as well. Please limit the total number of tickets to (4) four admissions, so that actual Positive Clients receive the free admission benefit.

If you are interested in coming to this event and receive free admission tickets, you must RSVP with Marc Peterson at the PSA as soon as possible. Email oregonevents@gmail.com
or call (503) 278-8992 (please leave a voicemail and a number to call you back if we are away from the office).

Is there a RSVP deadline?
Yes, the deadline to get signed up for free admission passes is Monday, April 5th, 2010. Free passes will go fast, so RSVP quickly.

Where do I pick up my Admission Passes?
Pickup your passes at the Zoo entrance area. The PSA or CAP will have a table (or other representative) available between the hours of 11 AM until 1 PM only.

Passes will be handed out to those who are the RVSP list. Any extra guests should be prepared to purchase a regular zoo admission. At 1 PM, if there are any extra free passes, they will be handed out on a first come, first served basis.

Once you are inside, have a blast and enjoy yourselves. Make sure you stop and say hello to anyone who is wearing HIV/AIDS awareness shirts, pins or stickers.

Zoo Location & Admission Rates
(if you don't get on the RSVP free admission list first)

General Admission (12-64) $10.50
Seniors (65 and over) $9.00
Youth (3-11) $7.50
Children (2 and under) are always free

RSVP Admission does NOT include the normal Parking of $2 per car

Ride MAX and Get $1.50 Off regular Admission!

The zoo accepts the following payments at the entrance:

VISA, MasterCard, American Express, Discover and Cash
Please, no personal checks or money orders.

Oregon Zoo Phone 503-226-1561

Oregon Zoo Address
4001 SW Canyon Road
Portland, Oregon 97221

 Directions
The zoo is located five minutes west of downtown Portland on Highway 26. Watch for the signs. The zoo is the first exit from this highway. more info

Parking & Transportation
$2 per vehicle. 960 spaces, 17 disabled person spaces. A shuttle runs from the next freeway exit on busy days. Or take the TriMet Light Rail Service (MAX) which stops at the Washington Park station approximately every ten minutes.

PSA Event HIV/AIDS Symposium at Lewis & Clark University

Wednesday, March 11, 2010
11 AM -2 PM    PSA HIV/AIDS Talk Presentation

Several members of the PSA have been invited to speak at the 29th Annual Lewis & Clark College Gender Studies Symposium. The presentation will include talks by people living with HIV/AIDS. An open question & answer session will also occur after the talks.

When
The presentation will occur on Wednesday, March 11, 2010 from 11 AM - 2 PM.

The presenting speakers will present the topic of
"Living with HIV/AIDS: Stories of Courage in the Face of Fear and Stigma"

Where
The Gender Studies Symposium is located at Stamm Hall, Templeton Student Center
615 S.W. Palatine Hill Road, Portland.

About the Symposium
The public is welcome to attend, please click the picture or this link to go view the entire 2 day program of this wonderful event.