NEWSFLASH: WORLD HEALTH ORGANIZATION RECOMMENDS EARLIER TREATMENT FOR HIV PATIENTS

According to a statement issued by the World Health Organization (WHO) on Monday, HIV patients should begin treatment sooner than currently recommended. The new guidance issued advises doctors to begin giving patients AIDS medication a year or two earlier than usual. However, should all doctors take heed of this new advice, this would double the number of individuals globally who qualify for treatment, adding an incremental 3-5 million patients to the staggering 5 million already awaiting AIDS treatment.

Specifically, the guidance advises doctors to begin treatment when the level of their patients' CD4 cells reaches 350. Previously, the recommendation was to begin treatment when the CD4 level reached 200. But several studies have shown that when patients began treatment earlier, they had a much better chance of surviving. In fact, doctors in most Western countries begin treatment when their patients' CD4 cell level reaches 500.

One of the key benefits of beginning treatment earlier is the possibility of fending off opportunistic infections (OIs). According to David Ross, an AIDS expert at the London School of Hygiene and Tropical Medicine said the following:

......there is compelling evidence HIV patients should start treatment sooner. People with HIV who aren't on AIDS drugs are more likely to catch a potentially fatal disease like tuberculosis or develop other complications when they do start the drugs.

However, there are some reservations about this new guidance. One of the main questions centers on how countries will be able to cover the costs for this extended treatment. Currently 4 million people are receiving AIDS medication worldwide, and as mentioned previously, there are another 5 million patients waiting in line, and this new guidance could tack on another 3-5 million patients to the waiting list.

In fact, many AIDS programs in Africa are already stretched thin, and Africa is home to most of the world's HIV+ patients. Mr. Ross also added that there were reports of African clinics turning away new patients eligible for treatment due to a lack of available drugs.

Another drawback to this guidance is that putting HIV patients on medication for a longer period of time may also lead to drug resistance in the immune system.



Source: MSNBC

TREAT: WHAT ARE ANTIRETROVIRALS (ARV)?

In some of our previous posts, you've heard me refer to HIV medication as antiretrovirals or ARVs. Some of you may be wondering exactly what they are and how they help treat the HIV infection. Well, let's take a look:



What are ARVs? As defined by the World Health Organization (WHO), antiretroviral drugs or antiretrovirals inhibit the replication of HIV. The aim of this drug treatment is to keep the HIV in an infected person's body at a low level. Unfortunately, ARV treatment is not a cure, and the drugs must be taken everyday for life in order to maintain the effectiveness.

How do they work? Usually ARVs are taken in combination, or more than one at a time. The reason is HIV is a persistent virus, and if only one drug was taken as treatment, the virus would quickly build up resistance and render the drug useless. Note: Taking three or more ARVs at a time can also be referred to as Highly Active Antiretroviral Therapy (HAART). With a combination of ARVs, the rate that the HIV resistance would develop is drastically reduced. This delays the HIV replication of itself, and in turn, the immune system deterioration. Effective ARV treatment helps to prolong the life of an infected individual, slowing the illness and allowing a better quality of life and health.

How many different types of ARVs are there? According to the AIDS charity AVERT, there are now more than 20 approved antiretroviral drugs, and 5 different classes into which the ARVs are grouped.

ARVs has been able to sustain millions of lives around the world, however there are still millions more who are in desperate need of this life-saving medication.

For further information on the different types of ARVs and how they work, be sure to check out http://www.avert.org/treatment.htm.

Sources: AVERT, WHO

NEWSFLASH: POTENTIAL CURE FOR AIDS?

On Friday, November 7, 2008, an article entitled "A Doctor, a Mutation, and a Potential Cure for AIDS" was published in the Wall Street Journal, discussing the possibility of a cure.

A 42-year old AIDS patient living in Berlin recently underwent a bone marrow transplant to treat leukemia, and the results were hopeful. According to the article, his doctor, Gero Hutter, specifically replaced the patient's bone marrow cells with those of a donor who has a naturally occurring genetic mutation that renders his cells immune to almost all strains of HIV. Even though the patient is still recovering, his doctors have been unable to detect HIV in his blood for over 600 days! This is especially remarkable because he has stopped taking all conventional types of AIDS medication. Usually, when someone stops taking their AIDS medication, the virus once again charges through the body within days or weeks.

Even though this case may be just a chance occurrence, it does provide hope that gene-therapy approaches to a cure may be on the right track. However, gene-therapy is seen as being on the far edges of AIDS research, and can prove to be too expensive to roll out globally. Most gene therapy is characterized by removing cells, genetically modifying them outside of the body, and then transfusing them back in. In addition, gene-therapy has unfortunately seen its share of failures. In 1999, an 18-year old patient died in a gene therapy trial. Even as gene therapy was able to cure children of severe combined immunodeficiency disease, aka "bubble boy" disease, it also caused patients to develop leukemia.

Nonetheless, the article explains that current AIDS medication may prove to be unsustainable, especially since anti-retrovirals must be taken for life and are expensive for developing countries where the disease is heavily concentrated. Now the search for a cure has taken on a new sense of urgency. Furthermore, gene therapy is expected to eventually play a substantial role in modern medicine, and researchers are hopeful that this latest case in Berlin is a sign of good things yet to come, and a cure for AIDS may be on the horizon.

For the full article, check out http://online.wsj.com/article/SB122602394113507555.html

EDUCATE: HOW BAD IS THE GLOBAL AIDS CRISIS?

Some of you may be asking, "Just how bad is the global AIDS crisis?" As mentioned in the first post, AIDS has taken the lives of more than 25 million people since it was first recognized as a health issue in 1981. Overall, there are currently 33 million people living with HIV/AIDS, 1 million of which are in the United States. In 2007 alone, an estimated 2.7 million became newly infected with HIV with 68% of that being in sub-Saharan Africa. Globally, another estimated 2.1 million died of HIV/AIDS-related causes.

Africa, by itself, has an estimated 11.6 million orphans who lost their parents to AIDS-related illnesses. There are 15 million AIDS orphans globally. To put things further into perspective for you, women accounted for 50% of all adults living with HIV worldwide (59% in sub-Saharan Africa) at the end of 2007, and young people (those under the age of 25) accounted for 50% (yes, half!) of all new HIV infections worldwide. In subsequent posts, we will be looking at further HIV data, breaking it down by gender, age, and region.

In terms of treatment, there are 9.7 million people in developing and transitional countries who are in desperate need of life-saving AIDS medication. Tragically, only 2.99 million of these people are actually receiving the medication.

The most unfortunate part of reading the above statistics is the fact that the numbers primarily reflect only people who have been diagnosed, or at least tested, and their status reported. No one knows the total number of individuals worldwide who may be infected, unaware of their HIV status or unable to get any assistance or resources, and their infection not reported. Even though there is progress being made in order to increase the access of HIV-infected persons worldwide to anti-retroviral (ARV) medication (the main treatment for HIV/AIDS), as well as funding for researching a cure, there is still so much work left to be done.

*Sources: www.avert.org, www.who.int/hiv/en/index.html