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Africa: Daily HIV/Aids Report


 

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Kaisernetwork.org (Washington, DC)

7 August 2008
Posted to the web 7 August 2008

AIDS 2008

Fauci, Piot Discuss Progress in HIV/AIDS Treatments, Prevention

[Aug 07, 2008]

National Institute of Allergy and Infectious Diseases Director Anthony Fauci and UNAIDS Executive Director Peter Piot on Wednesday at the XVII International AIDS Conference in Mexico City discussed progress in HIV/AIDS treatments and prevention efforts and the future of HIV treatment, Bloomberg reports.

According to Fauci, HIV-positive people eventually might be able to stop taking drugs and live without symptoms if they are treated aggressively with newer antiretroviral drugs. Treating patients soon after they are contract HIV could protect the immune system and suppress their viral loads, allowing them to slowly stop taking the drugs.

Fauci said that he believes physicians will someday "be able to ... eradicate HIV microbiologically" in "some patients, not very many," and have a "functional cure" for others. He said such a possibility "will likely require aggressive drug regimens and rely on the timing of initiating therapy." A "cure will likely require early diagnosis and treatment," Fauci said, adding, "Studies need to be done in [the] next few years to determine if very aggressive therapy early on will allow us to get a functional cure." In addition, a vaccine that targets people with a specific genetic makeup could be available within 20 years, Fauci said. Fauci said that while research into an HIV vaccine is ongoing, researchers also are looking into using antiretrovirals to prevent HIV.

Piot said that the pharmaceutical industry needs to continue to invest in the development of new HIV treatments and look into the possibility of using existing antiretrovirals to prevent HIV transmission. "We have to make sure the drug development remains in step with the evolution of the virus and that industry continues to invest," Piot said, adding that there are "worrying signs that that isn't the case, and that is something we have to put on the table."

In addition, effective prevention methods that target men who have sex with men, commercial sex workers and injection drug users need to be scaled up to slow the spread of the virus, Piot said, adding that health workers also must learn how to target prevention messages more effectively. "No company will try to sell soap if they haven't done research for the community they are trying to sell to," Piot said, adding, "It would pay off if we could bring that experience from the business world to our amateur approaches" to HIV prevention campaigns (Pettypiece, Bloomberg, 8/6).

Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference. A webcast on AIDS research featuring Fauci and Piot is available online.

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Efforts To Fight HIV/AIDS Not Reaching Enough Children, Health Workers at Conference Say

[Aug 07, 2008]

Despite significant funding for HIV/AIDS treatment in the developing world and efforts to prevent mother-to-child transmission, the global response to the disease has "short-changed" children, health workers at the XVII International AIDS Conference in Mexico City said Wednesday during the conference's first plenary lecture on children, the New York Times reports. In the past five years, 1.5 million children have died of AIDS-related causes, and 15 million children have lost one or both parents to the disease, according to Michael Sidibe, a UNAIDS official. An estimated two million children younger than age 15 are HIV-positive.

Jim Yong Kim of Harvard University said that about 6% to 10% of children in need of antiretroviral drugs receive them, compared with 30% of adults (Altman, New York Times, 8/7). In addition, fewer than one in 10 infants in low- and middle-income countries were tested for HIV within two months of their birth, despite new evidence that early treatment significantly increases their chances of survival, South Africa's The Star reports (Green, The Star, 8/7).

Linda Richter, a psychologist in South Africa who delivered the lecture, said too little government and donor money reaches children living with HIV/AIDS. What money is allocated toward children with HIV/AIDS generally goes to consultants and overhead costs, according to Richter (New York Times, 8/7). Richter said HIV in children has increased eightfold in sub-Saharan Africa, where 90% of the world's HIV-positive children live. The increase is largely the result of MTCT, as many pregnant women did not know they were HIV-positive or did not have access to prevention services (The Star, 8/7). Too few pregnant women receive the antiretroviral drugs that could prevent transmission of HIV, Richter said.

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Richter said that although the news media have often focused on the experience of AIDS orphans, "children orphaned by AIDS are, sadly, only the tip of the iceberg of HIV-affected children" (New York Times, 8/7). "It is the needs of all children, especially vulnerable children, not whether they meet the definition of orphan, that must be our primary focus," Richter said, adding, "The focus on orphans had individualized the challenge of care and support. It has framed the epidemic's impact on children as individuals rather than a national social problem and has separated assistance to children from efforts to support families and communities" (The Star, 8/7).

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