D Gregory Smith

HIV: Treatment Is Prevention

Filed By D Gregory Smith | July 19, 2011 12:00 PM | comments

Filed in: Living
Tags: HIV transmission, HIV/AIDS, medication, New England Journal of Medicine, treatment is prevention

IMG_0026.jpgYesterday's New England Journal of Medicine has an excellent research study on HIV, entitled Preventing HIV-1 Infection with Antiretroviral Therapy.

Scott Hammer, MD, in an editorial for the journal, gives a brief overview of the study:

In this issue of the Journal, Cohen, et al. describe the results of the HIV Prevention Trials Network (HPTN) 052 study, which has now provided definitive proof that (as suggested by the findings of previous cohort studies) antiretroviral treatment reduces the rate of sexual transmission of HIV-1.

Did you hear that? Definitive proof.

Early antiretroviral treatment not only significantly lowers the risk of transmitting the virus, it also shows increased health benefits for the HIV infected. The conclusions by the research team in the article:

In conclusion, the biologic plausibility of the use of antiretroviral therapy for the prevention of HIV-1 infection has been carefully examined during the past two decades. The idea of HIV-1 treatment as prevention has garnered tremendous interest and hope and inspired a series of population-level HIV-1 treatment-as-prevention studies that are now in the pilot or planning stages. Such interventions are based on the hypothesis that the use of antiretroviral therapy reliably prevents HIV-1 transmission over an extended period of time.

In this trial, we found that early antiretroviral therapy had a clinical benefit for both HIV-1-infected persons and their uninfected sexual partners. These results support the use of antiretroviral treatment as a part of a public health strategy to reduce the spread of HIV-1 infection. (emphasis added)

This is science at work. Get tested. If you're HIV-positive, get into care and take your meds. We can slow this thing down.

Money quote from Dr Hammer:

Antiretroviral therapy is by no means perfect and is not the ultimate answer to controlling and ending the HIV epidemic. Adverse events, emergence of drug-resistant viral strains, maintenance of adherence, sustainability, and cost are just some of the concerns. However, this is precisely the wrong time to limit access to antiretroviral therapy in resource-limited settings, since we have the tools in hand to maintain or restore health in infected persons and reduce transmission to their sexual partners.

Yep. So now that we know, will anything happen?

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The picture above is of my morning meds...

Gregory, I admit I'm not your doctor (be glad for that!), but I suspect that not all these pills are prescription meds, that some are what we call "nutritional supplements" -- such as, my guess is the large, amber glassy gelcap might be an omega-3 fatty acids capsule, a few look just like my Vitamin-E and CO-Q-10 caps, and so forth.

I just think folks deserve to have it pointed out, if I am correct, that not all these pills are anti-retriviral meds, but some are optional things you've chosen to add in yourself (Atta boy!) to support immune function and overall health in a more general way.

Also, the nutritional supplements are very inexpensive, the profit margins for the manufacturers are very slim ... so, cutting right to my point for the uninitiated, not all these pills are "mandatory" nor are they of the type that bring in the Big Bucks for Big Pharma. Finally, not all HIV+ patients, or people on the PrEP regimen discussed here, are fated to take a huge handful of pills ... but some of us choose to.

So ... am I right about this?

P.S. Sorry to quibble ... but you're to one who went here.

Quibble away- and you're right.
Four pills are prescription medications, and the rest are supplements- vitamins, a baby aspirin (doctor recommended), two types of fish oil (which have helped lower my cholesterol dramatically- high cholesterol being a med side-effect) and a cranberry supplement to support kidney function. All are done in consultation with my doctor.
I was going to write "my morning dose", but just thought "morning meds" would be more alliterative. :)

Om Kalthoum | July 20, 2011 12:11 PM

Interesting additional information. Thank you both.