HIV/AIDS: A New Approach anchored on treatment-as-prevention

As the world prepares to mark 2016 World AIDS Day, scientists have applauded a new treatment approach which would prevent HIV globally, saying that there is proof that the therapy could work.
The World Health Organisation (WHO) and the Joint United Nations Programme on HIV/AIDS plan to use the approach called ‘treatment as prevention’ to eliminate the global pandemic, which the WHO said will have occurred when only one person out of 1, 000 becomes infected each year.
The findings are published May 9 in the ‘Lancet Infectious Diseases.’
Also, a nearly two-decade analysis by researchers from University of California, Los Angeles (UCLA) and in Denmark, has yielded the first proof that the approach could work.
The human immunodeficiency virus is a lentivirus that causes HIV infection and over time acquired immunodeficiency syndrome.
HIV is a virus that gradually attacks the immune system, which is our body’s natural defence against illness. If a person becomes infected with HIV, they will find it harder to fight off infections and diseases.
The virus destroys a type of white blood cell called a T-helper cell and makes copies of itself inside them. T-helper cells are also referred to as CD4 cells. Reviewing Danish medical records, the researcher found that the treatment-as-prevention strategy has brought Denmark’s HIV epidemic to the brink of elimination.
The study found that in 2013, the country had only 1.4 new HIV infections per 1,000 men who have sex with men, Denmark’s major risk group.
“The Danes have done what nobody else in the world has been able to do,” said Sally Blower, the study’s senior author and the director of the Center for Biomedical Modeling at UCLA. “They have almost eliminated their HIV epidemic, and they have achieved this simply by providing treatment.”
The paper notes, how-ever, that the treatment programmes in Denmark are exceptional. “Treatment makes people less infectious,” said Justin Okano, the study’s lead author and a statistician in Blower’s research group.
“In Denmark, 98 per cent of patients take all of their HIV medications, which is why treatment as prevention has worked there. Unfortunately, adherence levels are nowhere near as high in other countries.”
According to the researchers, the findings are based on a sophisticated statistical analysis of data from the ongoing Danish HIV Cohort Study, which began in 1995.
That project, which tracks all Danish men who have sex with men, and who have been diagnosed with HIV, was established and is run by Jan Gerstoft and Niels Obel, clinicians and epidemiologists in Denmark, who also are co-authors of the new study.
A co-author of the study, Laurence Palk, said for the treatment-as-prevention approach to eliminate HIV epidemics throughout the world, all countries would need to emulate Denmark’s treatment programmes.
“Even in resource-rich countries, this would take a huge amount of money and effort,” she said. “The goal of elimination through treatment is aspirational, but Denmark has shown that at least, in resource-rich countries, it’s achievable.”