HIV Treatment Advances Lower Risk of Unsafe Sex

     (CN) — Viral suppression drugs appear to suppress the HIV virus in individuals with the disease enough that they can have unprotected sex without passing on the virus, according to a new study.
     Researchers from several British universities studied 1,166 serodifferent couples — where one partner is HIV-positive and the other is not — who engage in unprotected sex. Their results were published Tuesday in the Journal of the American Medical Association.
     After following up with 888 of the couples nearly a year and half later, it was determined that the viral suppression regimen prevented HIV transmissions in 877 cases. According to the scientists, infidelity — not failure of the drugs — led to the 11 cases of HIV-negative partners who ultimately became positive for the virus.
     “Although these results cannot directly provide an answer to the question of whether it is safe for serodifferent couples to practice condomless sex, this study provides informative data (especially for heterosexuals) for couples to base their personal acceptability of risk on,” the researchers noted.
     Of the 1,166 couples, 62 percent were heterosexual and 38 percent were homosexual men.
     Researchers from the Harbor-UCLA Medical Center in Torrance, California, described the value of virological suppression in preventing HIV transmissions in an accompanying editorial.
     “For individuals who want to routinely or intermittently not use condoms with an HIV-infected partner, clinicians can indicate that the risk of HIV transmission appears small in the setting of continued viral suppression, emphasizing that the duration the HIV-infected partner needs to be virologically suppressed before achieving optimal protection is unknown.”
     In a separate report, a group of researchers from University Hospital Zurich, Switzerland, and the International Antivriral Society-USA panel provided recommendations for the usage of antiretroviral drugs in the prevention and treatment of HIV infections. Their guidelines were also published Tuesday in the Journal of the American Medical Association.
     The researchers also noted that anal sex and frequent sexual activity without using a condom does increase the risk of HIV transmission, regardless of whether an individual is taking antiretroviral drugs.
     HIV is a retrovirus, a virus that replicates in a host cell through the process of reverse transcription — a process that uses an enzyme to generate complementary DNA from an RNA template.
     Significant advancements in the use of antiretroviral drugs since the previous set of recommendations in 2014 prompted the researchers to release an update.
     The group recommends using antiretroviral therapy for any individuals with HIV infection, regardless of T-cell count — a type of white blood cells that are key to protecting a person from infection.
     “Historians may wonder whether the pace of discovery in the early days of the epidemic could have been accelerated, but no one can doubt the signal accomplishments of biobehavioral research and community engagement in forging a common strategy to deal with this global pandemic, one that continues to pose new challenges,” researchers from Fenway Health, Boston, said in an accompanying editorial.
     While many patients in wealthier nations can afford the treatment, which costs about $10,000 annually, people dealing with HIV infections in poor parts of the world have fewer options.
     Of the 36.7 million people who are HIV-positive, 7 million of them are in South Africa.
     Fewer than 1 million people in South Africa were on antiretroviral drugs to treat HIV infections before 2010. Now there are over 3 million people receiving the treatment.
     Expanded access to these treatments is largely credited with the leap in South Africans’ life expectancy at birth, which jumped from 53.4 years in 2004 to 62.5 in 2015.
     Though the nation’s HIV-positive population is still quite large, South Africa represents a real-life case study of antiretroviral drug’s efficacy in stifling the virus and preventing its prevention.
     “Mother-to-child transmission has fallen from a high of 30 percent in the early 2000s to just 1.5 percent,” Steffanie Strathdee, a professor at the University of San Diego and a headline speaker at South Africa’s upcoming conference on HIV and AIDS, said. “It’s a miraculous achievement that shows the world what can be done.”

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