The world has finally reached “the beginning of the end” of the AIDS pandemic that has infected and killed millions in the past 30 years, according to HIV campaign group.
The number of people newly infected with HIV over the last year was lower than the number of HIV-positive people who joined those getting access to the medicines they need to take for life to keep AIDS at bay.
But in a report to mark the recent World AIDS Day on Dec. 1, the ONE campaign, an advocacy group working to end poverty and preventable disease in Africa, warned that reaching this milestone did not mean the end of AIDS was around the corner.
“We’ve passed the tipping point in the AIDS fight at the global level, but not all countries are there yet, and the gains made can easily stall or unravel,” says Erin Hohlfelder, ONE’s director of global health policy.
The human immunodeficiency virus (HIV) that causes AIDS is spread via blood, semen and breast milk. There is no cure for the infection, but AIDS can be kept at bay for many years with cocktails of antiretroviral drugs.
United Nations data show that in 2013, 35 million people were living with HIV, 2.1 million people were newly infected with the virus and some 1.5 million people died of AIDS. By far the greatest part of the HIV/AIDS burden is in sub-Saharan Africa.
The AIDS pandemic began more than 30 years ago and has killed up to 40 million people worldwide.
The United Nations AIDS agency, UNAIDS, says that, by June 2014, some 13.6 million people globally had access to AIDS drugs, a dramatic improvement on the 5 million who were getting treatment in 2010.
“Despite the good news, we should not take a victory lap yet,” says Hohlfelder.
She highlighted several threats to current progress, including a $3 billion shortfall in the funds needed each year to control HIV around the world.
“We want to see bold new funding from a more diversified base, including more from African domestic budgets,” she says.
ONE also noted that HIV is increasingly concentrated among hard-to-reach populations such as injecting drug users, gay men and sex workers – groups who are often stigmatised and have trouble accessing treatment and prevention services.
AIDS is weakening over time, study finds
Rapid evolution of HIV, the human immunodeficiency virus, is slowing its ability to cause AIDS, according to a study of more than 2,000 women in Africa.
Scientists said the research suggests a less virulent HIV could be one of several factors contributing to a turning of the deadly pandemic, eventually leading to the end of AIDS.
“Overall we are bringing down the ability of HIV to cause AIDS so quickly,” says Philip Goulder, a professor at Oxford University who led the study.
“But it would be overstating it to say HIV has lost its potency – it’s still a virus you wouldn’t want to have.”
Some 35 million people currently have HIV and AIDS has killed around 40 million people since it began spreading 30 years ago.
But campaigners noted on Monday that for the first time in the epidemic’s history, the annual number of new HIV infections is lower than the number of HIV positive people being added to those receiving treatment, meaning a crucial tipping point has been reached in reducing deaths from AIDS.
Goulder’s team conducted their study in Botswana and South Africa – two countries badly hit by AIDS – where they enrolled more than 2,000 women with HIV.
First they looked at whether the interaction between the body’s natural immune response and HIV leads to the virus becoming less virulent or able to cause disease.
Previous research on HIV has shown that people with a gene known as HLA-B*57 can benefit from a protective effect against HIV and progress more slowly than usual to AIDS.
The scientists found that in Botswana, HIV has evolved to adapt to HLA-B*57 more than in South Africa, so patients no longer benefited from the protective effect. But they also found the cost of this adaptation for HIV is a reduced ability to replicate — making it less virulent.
The scientists then analysed the impact on HIV virulence of the wide use of AIDS drugs. Using a mathematical model, they found that treating the sickest HIV patients — whose immune systems have been weakened by the infection — accelerates the evolution of variants of HIV with a weaker ability to replicate.
“HIV adaptation to the most effective immune responses we can make against it comes at a significant cost to its ability to replicate,” Goulder says. “Anything we can do to increase the pressure on HIV in this way may allow scientists to reduce the destructive power of HIV over time.”
The study was published on Monday in the journal Proceedings of the National Academy of Sciences (PNAS). – Reuters