Ending the global HIV/AIDS pandemic may be possible by implementing a multifaceted global effort that expands testing,treatment,and prevention programs,as well as meets the scientific challenges of developing an HIV vaccine and possibly a cure,say researchers.
Anthony S. Fauci,M.D.,Director,National Institute of Allergy and Infectious Diseases (NIAID),Bethesda,Md.,made the recommendation at a JAMA media briefing at the International AIDS Conference.
Among the most important interventions is combination antiretroviral therapy,which significantly improves the health and longevity of individuals infected with HIV.
Since the advent of antiretroviral therapy,the annual number of deaths due to AIDS has decreased by two-thirds in the United States. Globally,an estimated 700,000 lives were saved in 2010 alone due to the increased availability of antiretroviral therapy in low- and middle-income countries, Dr. Fauci and Gregory K. Folkers,M.S.,M.P.H.,also of the NIAID,wrote.
Important challenges remainnotably finding the resources and developing the infrastructure to provide antiretroviral therapy to the estimated 8 million individuals with HIV infection who need these drugs but are not receiving them, they noted.
The researchers added that antiretroviral therapy could also prevent HIV infection by reducing the amount of virus in an infected person”s blood and other body fluids,making it less likely that the virus will be transmitted to others. Also,antiretroviral therapy is highly effective in blocking mother-to-child HIV transmission.
Other important interventions include medical male circumcision,which offers a highly effective and durable way to protect heterosexual men from HIV infection; and potentially,pre-exposure prophylaxis with antiretroviral medications,which have shown promise in reducing an individual”s risk of acquiring HIV infection.
Each of these treatment and prevention strategies has a strong evidence base; with further refinement and scale-up and also when used in combination,they could have an extraordinary effect on decreasing the trajectory of the HIV pandemic, they said.
They said researchers are maintaining focus on 2 key scientific challenges that remain: the development of a vaccine and a cure. They wrote that modest success in a large-scale clinical trial of an HIV vaccine,promising results in animal models,and advances in structure-based vaccine design suggest that an HIV vaccine is feasible. The prospect of an HIV cure remains challenging.
The researchers concluded that ending the global HIV/AIDS pandemic will require a global commitment of resources involving additional donor countries,strengthening health care systems overall,and fostering greater ownership by host countries of HIV/AIDS effort,including investing more in the health of their people. With collective and resolute action now and a steadfast commitment for years to come,an AIDS-free generation is indeed within reach.
Their recommendation appeared in the latest issue of JAMA,a theme issue on HIV/AIDS.