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HIV ‘cure’ in U.S. baby stimulates AIDS research in Africa

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WHEN doctors from the University of Mississippi medical centre, United States (U.S.), announced on March 2, 2013 that a baby had been ‘functionally cured’ of Human Immuno-deficiency Virus (HIV), the world hailed the news as a historical medical breakthrough.

The baby- famously known as the ‘Mississippi baby’- was born with HIV and treated with aggressive antiretroviral drugs 30 hours after birth. Now, more than two years old, doctors confirm that the baby has not taken any medication since the age of 18 months and tests show no sign of re-active HIV (detectable viral load).

From the time that this extraordinary news was announced scientists and researchers have been busy trying to understand how the ‘Mississippi baby’ case could advance future research in preventing mother-to-child transmission of HIV.

More than 20 scientists, researchers, public health practitioners, donors, government authorities, representatives of non-government organisations and civil society came together for a two-day symposium on June 3 and 4 under the theme Scientific advances from ‘Mississippi baby’: Implications for public health programmes on mother-to-child transmission of HIV.

Executive Director of Joint United Nations programme on AIDS (UNAIDS), Michel Sidibé, said: “This meeting is about giving people hope. The Mississippi miracle has to become a Durban miracle, a Bamako miracle, a miracle for all children irrespective of where they are born.”

Organised by UNAIDS and the Centre for the AIDS Programme of Research in South Africa (CAPRISA), the symposium focused on: whether programmes to stop new HIV infections among children need to be reformulated to promote early identification and treatment of babies at risk of HIV infection; and challenges associated with stopping new HIV infections among children and paediatric antiretroviral treatment.

Despite the 24 per cent drop in new HIV infections in children since 2009, some 330 000 children around the globe were born with HIV in 2011. Most children born with HIV (more than 90 per cent) are in sub-Saharan Africa.

Many African countries have made remarkable progress in preventing mother-to-child transmission of HIV by increasing access and integrating HIV prevention, treatment and cares services to mothers and their new-borns.

However, progress in expanding access of antiretroviral therapy to children has been minimal. The percentage of children living with HIV eligible for treatment and who were receiving it in 2011 largely falls below 50 per cent in at least 15 of the 22 priority countries- eight per cent in Chad, 19 per cent in Ethiopia and 29 per cent in Malawi.

United Nation Children’s Fund (UNICEF) Senior Advisor on AIDS, Dr. Chewe Luo, said: “Paediatric treatment and care lags behind; there seems to be a disconnect between investments in programmes to stop new HIV infections in children and for children in need of treatment. Even when the infants are identified they are not successfully linked to care.”

The ‘Mississippi baby’ case was discussed at great length highlighting the need for early infant diagnosis and initiation of treatment. “The relevance of the ‘Mississippi baby’ to the general population remains unclear and more research, including for safe and appropriate neonatal drugs needs to be done before we push for widespread change in policy,” said Dr. Hanna Gay, Associate Professor at University of Mississippi, who treated the ‘Mississippi baby’. “But one thing we can be certain of is that early diagnosis and treatment saves lives.”

At the end of the two-day discussions, participants made several recommendations, including the need for early infant diagnosis, better research and improved medicines for children as well as more efficient funding mechanisms to strengthen mother and child AIDS programmes.

Minister of Health of South Africa, Dr. Aaron Motsoaledi, said: “What we do know is that early diagnosis of HIV and early treatment of infants and children does lead to better outcomes – regardless of the issue of a cure. We should be concerned that we are not diagnosing and treating children early enough. In South Africa only 65 per cent of children who are in need to treatment are on treatment.”

Meanwhile, a new Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) prevention drug should be approved for use by intravenous drug users, United States health experts have said.

The anti-retroviral drug, which has recently been approved for prescription to some other high-risk groups, could soon be given to people who inject heroin and methamphetamine.

After reviewing the results of a study, carried out by U.S. Centres for Disease Control and Prevention (CDC) and the Thai government, health officials recommended that the drug, tenofovir, should be taken daily by drug users.

It has already been approved for use by high-risk gay men and heterosexual couples, CBS News reported.

To conduct the study, scientists followed more than 2,400 drug users at clinics across Bangkok, in Thailand.

Half were given a daily dose of tenofovir, which is sold as Viread, while the other half were given a placebo.

The patients were followed for four years during which time 17 of those taking the preventative drug contracted HIV, while 33 of the people taking the placebo became infected.

Therefore, it was concluded that the drug reduces HIV risk by 50 per cent.

Dr. Jonathan Mermin, director of AIDS prevention for the CDC, told CBS News that ‘this study completes the story’ about how HIV drugs can protect people at highest risk of infection.

Currently, the only HIV prevention drug, which is available for use in the U.S. is Truvada, which is prohibitively expensive at $14,000 a year.

The tenofovir, which was used in the study costs just $360 a year per patient.

According to researcher, Dr. Michael Martin: ‘We now know that pre-exposure prophylaxis can be a potentially vital option for HIV prevention in people at very high risk for infection, whether through sexual transmission or injecting drug use.

‘Adherence was a key factor determining efficacy in our trial among people who inject drugs.’

Scientists are also working on an HIV vaccine but the U.S. government recently stopped trials of the experimental vaccine after an independent review found it did not prevent HIV infection or reduce the amount of HIV in the blood.

The research, started in 2009, it is just the latest in a series of failed attempts to develop a vaccine for the virus.

In the U.S. intravenous drug users account for about one in 13 new HIV infections but in the countries of Eastern Europe and central Asia, they make up 80 per cent of those newly infected.

According to the National AIDS Trust 96,000 people in the UK are currently living with HIV. Of these people, 22,600 are thought to be unaware of their infection.

In 2011, only one per cent of people with HIV in the UK died.

The biggest group of HIV positive people in the UK are men who have sex with men - they account for about 40,000 of the HIV infected population.

Article Credit: Guardian News

Updated 6 Years ago

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