Breakthrough of the Year: Antiretroviral drugs treat & prevent HIV

When given to people infected with the virus, the drugs not only help the patient, but they also reduce the risk of transmission to their partners. By up to 96%!

The editors and news staff over at Science have chosen their Breakthrough of the Year, and the winner is… HIV treatment as prevention!

When given to people infected with the virus, the antiretroviral drugs (ARVs) not only help the patient, they ALSO reduce the risk of transmission to their partners. By up to 96%!

The discovery that treatment for HIV doubles as prevention was such a game changer that the findings were made public 4 years before the study’s official end date.

In 2007, Myron Cohen from the University of North Carolina, Chapel Hill, and an international team of colleagues from the HIV Prevention Trials Network kicked off the study – called HPTN 052.

  1. They enrolled 1,763 heterosexual couples from 9 different countries: Brazil, India, Thailand, the US, Botswana, Kenya, Malawi, South Africa, and Zimbabwe. Each couple included one partner with an HIV infection.
  2. ARVs were administered to half of those HIV-infected individuals immediately. As for the other half, the researchers waited for them to develop immune CD4 cell counts below 250 (severe immune damage) before offering them treatment.

But this year, the effects of early ARV treatment on HIV transmission rates were so dramatic – a near-100% efficacy – that an independent monitoring board decided that all the infected participants should receive ARVs at once, well before the study was scheduled to end. Post haste!

Combined with 3 other major biomedical preventions that've proven their worth in large clinical studies since 2005, many researchers now believe it’s possible to break the back of the epidemic in specific locales with the right package of interventions, according to Science’s Jon Cohen, who wrote about the trial back in May.

But some 52% of the people who need ARVs immediately for their own health right now have no access. That's 7.6 million people. (Not to mention infrastructure and pricing obstacles.)

The US National Institute of Allergy and Infectious Diseases spent $73 million on the trial.

The findings of HPTN 052 were first announced in May, and then presented at the International AIDS Society meeting in Rome back in July. The study was published in the 11 August issue of the New England Journal of Medicine. See also coverage from SmartPlanet’s Larry Dignan and Laura Shin .

Via Science/AAAS.

Image: HIV viruses on an infected cell surface / Thomas Deerinck, Kathleen Fitzpatrick, John Guatelli, and Mark Ellisman, NCMIR, UCSD/Visuals Unlimited, Inc.

This post was originally published on Smartplanet.com

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