Researchers into HIV must focus their efforts on known prevention, a leading Aids clinician has urged.
Professor Nancy Padian, University of California, Berkeley, USA, who has the Office of the US Global AIDS Coordinator within the US Government, said disappointing clinical trials into finding a cure mean the challenge should shift to effective prevention strategies.
Writing in The Lancet’s HIV special edition, Prof Padian and fellow authors, say: “The past year marked the end of the steady stream of disappointing results [in HIV prevention], and a concomitant change is evident in public perception and the opinions of policy makers.
“The discourse on HIV prevention now includes the possibility that the epidemic can be stopped.
“Our challenge is to carefully select a group of effective interventions that together have an increased chance of success by complementing each other to achieve the elusive goal of changing the course of the HIV epidemic."
The Review reveals that a new class of cancer drugs, which has entered clinical trials, could force the so-called latent pool of HIV-infected cells that hide in the body to replicate, exposing them to the effects of traditional ART therapy that usually cannot reach these cells.
A trial earlier this year demonstrated that a vaginal gel containing an ART drug reduced new infections in women by 39 per cent, and a second trial reported that when ART was given to an HIV-infected heterosexual person, it reduced by 96 per cent the chances of HIV transmission to that person’s partner.
Meanwhile, a study has found that it is the number of sexual partners, rather than if they are concurrent, that increases risk of HIV transmission in a typical high prevalence African population.
And two large international randomised trials suggest that a once-daily dose of rilpivirine, the latest antiretroviral drug against HIV-1 infection, is a valuable additional treatment for patients with HIV who have not yet started antiretroviral therapy. It is a safe and effective alternative to the widely-used efavirenz, they conclude.
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