2011 Breakthrough of the Year – HIV Treatment as Prevention

2011 will be remembered as the year the game changed forever in the battle against HIV/AIDS. A breakthrough study known as HPTN 052 found that treatment as prevention can reduce the risk of HIV transmission.  The news is a long time coming – it has been thirty years since the contagion was first discovered and it has killed more than 30 million people worldwide so far. U.S. Secretary of State Hillary Rodham Clinton noted that for the first time in three decades, it is now possible to imagine a future “AIDS-free generation,” in her November 8, 2011 speech at the National Institutes of Health.

World AIDS Day: Treatment as Prevention janelangille.com

The journal Science named HPTN 052 the 2011 Breakthrough of the Year and said, “The results have galvanized efforts to end the world’s AIDS epidemic in a way that would have been inconceivable even a year ago.”  The study results, published in The New England Journal of Medicine, were released years ahead of schedule because the results were so compelling: treating HIV-infected people with immediate antiretroviral therapy (ART) reduces the risk of transmission by an astounding 96%.

The treatment-as-prevention strategy has the potential for a one-two punch: keeping infected people healthy and helping keep their partners HIV-free. Dr. Julio Montaner says, “Study HPTN 052 conclusively shows that when an infected person receives ART, the ability of the virus to replicate is shut down immediately. At that point, the virus becomes almost undetectable in the blood, and as immunity recovers, the person leads a near-normal life and both AIDS and death are potentially prevented.” Dr. Montaner is Director of the British Columbia Centre for Excellence in HIV/AIDS and Past-President of the International AIDS Society.

The large-scale randomized clinical trial measured the impact of HIV treatment in 1,763 couples (where one partner was HIV positive) in 13 sites across nine countries including Asia, Africa, and the United States. Originally designed to measure the difference between early and delayed ART, the study was halted years ahead of schedule after results showed that early treatment was cutting the transmission rate so dramatically.  Myron S. Cohen, MD of the University of North Carolina at Chapel Hill, Institute for Global Health and Infectious Diseases led the study, which was funded by the National Institutes of Health and conducted by the HIV Prevention Trials Network.

Right now there are 34 million people around the world who are living with AIDS – 27 million are located in Sub-Saharan Africa and South and South-East Asia. Yet only about 6.65 million are currently receiving treatment.

The tide has turned in the war against HIV/AIDS. The conclusive evidence from HPTN 052 gives the world an extraordinary opportunity to move forward and work on eradicating the disease for good. In his editorial comment in The Lancet, Dr. Montaner stated, “The evidence is in: treatment is prevention. Treatment dramatically prevents morbidity and mortality, HIV transmission, and tuberculosis. The challenge remains to optimize the impact of this valuable intervention. Failure to do so is not an option.”

CONNECT THE DOTS

Read our earlier post about study HPTN 052, “World AIDS Day: Treatment as Prevention to Halt HIV/AIDS Epidemic.” Watch a video where U.S. Secretary of State Hillary Rodham Clinton speaks about “Creating an AIDS-Free Generation.

Originally published on GE Healthy Outlook, January 20, 2011.

 

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