Analysis of trends among 15 to 24-year-olds in countries with high prevalence of HIV infection indicates a decline HIV rate,said Dr Robert Bollinger,director of Johns Hopkins Centre of Clinical and Global Education,USA while highlighting the top ten developments in HIV prevention and treatment in 2008.
He was addressing a gathering of students,lecturers and academicians at the B J Medical College (BJMC) on Thursday.
Bollinger emphasised that prevention of the disease was the key to curb the spread of the virus. In fact,while there is a decline in HIV infection in certain communities of Africa and India,researchers have realised that they have underestimated the HIV infections in USA. “We do have a large number of infections every year,” says Bollinger.
The academician quoted several studies to showcase how a single drug like nevirapine prevents transmission of HIV from mother to child via breast milk while on the other hand the failure of the STEP vaccine trial has put on hold various initiatives related to anti-HIV vaccine development.
There has been good news and bad news in 2008,Bollinger said. A CHER study on when to start treatment for HIV positive children has led to WHO changing its guidelines on the issue. The study shows that early anti-retroviral treatment (ART) has reduced mortality by 76 per cent in children and hence,regardless of their clinical CD4 count status,therapy is started for children below one year.
There have been several key changes in laying new guidelines for starting treatment for adults who are infected with HIV,says Bollinger. There is concern over the toxicity of drug stavudine,which has not been recommended as a drug for first line treatment in USA,but is used in India and elsewhere.
In his talk,Bollinger also underlined the need to develop alternate methods to diagnose tuberculosis in children infected with HIV apart from undertaking research in alternate systems of medicine for treament of HIV.