HIV ‘Treatment as Prevention’

The finding that HIV treatment with antiretroviral drugs (ARVs) can actually prevent transmission of the virus from an infected person to his or her uninfected partner has been named “Breakthrough of the Year” for 2011 by the journal Science.

The eye-opening HIV clinical study, known as HPTN 052, demonstrated that early initiation of ARV therapy in people infected with HIV reduces transmission of the virus to their partners by 96 percent. The findings end a longstanding debate over whether ARV treatment of HIV-infected individuals can provide a double benefit by treating the virus in individual patients while at the same time cutting transmission rates, according to the journal. It’s now clear that ARV treatment can also reduce HIV transmission.

The results were called “astounding” by Anthony Fauci, the top U.S. HIV researcher. Others have called them a “game changer” because of the near 100 percent efficacy of the intervention.

The editors at Science, the flagship publication of the American Academy for the Advancement of Science, said in their announcement that “In combination with other promising clinical trials, the results have galvanized efforts to end the world’s AIDS epidemic in a way that would been inconceivable even a year ago.

The HPTN 052 study is proof of a concept more than 20 years in the making.

“From the time the first AIDS drugs were developed in the mid-1990s, researchers have been working on the idea that antiretrovirals might make people less contagious,” said Dr. Myron Cohen, who led the study.

Cohen and his research team thought it was time to try and prove it. Eventually nearly 2000 couples at 13 sites in nine countries joined HPTN 052.

In May of this year, four years before the study’s scheduled completion, an outside monitoring board requested that the results be released immediately, because they were so overwhelmingly positive.

“Prevention of HIV-1 Infection with Early Antiretroviral Therapy” was published in August of 2011 in the New England Journal of Medicine.

Jon Cohen, a writer for Science, said in an article about the breakthrough, “HPTN 052 has made imaginations race about the what-ifs like never before, spotlighting the scientifically probable rather than the possible.”

Since their release, the study results have been reverberating throughout the policy community. U.S. and international organizations such as the World Health Organization, the President’s Emergency Plan for AIDS Relief, and the Joint United Nations Programme on HIV/AIDS, have incorporated or soon will incorporate “treatment as prevention”–the strategy proved by HPTN 052–into their policy guidelines for battling the AIDS epidemic.

“While I am obviously thrilled to have this research recognized as the Science breakthrough of the year,” Dr. Cohen said, “witnessing the translation of this scientific discovery on a global scale truly is the best reward.”

The HPTN 052 study was funded by the U.S. National Institutes of Health. The complete list of top 10 scientific breakthroughs of the year are published online at news.sciencemag.org.

Courtesy of Healthy Living News