Van­cou­ver HIV-AIDS meet­ing a step to­wards goal of end­ing pan­demic by 2030

Cape Breton Post - - HEALTH / ADVICE - BY SH­ERYL UBELACKER

More than 6,000 in­ter­na­tional ex­perts on HIV-AIDS will gather in Van­cou­ver this week­end to share the latest sci­en­tific ad­vances in the fight to erad­i­cate the dis­ease, which first emerged al­most 35 years ago and ex­ploded into a global pan­demic.

The 8th In­ter­na­tional AIDS So­ci­ety (IAS) Con­fer­ence on HIV Patho­gen­e­sis, Treat­ment and Preven­tion will bring to­gether re­searchers, clin­i­cians, com­mu­nity lead­ers and public health ex­perts from around the world. It’s the sec­ond time that Van­cou­ver has hosted an IAS meet­ing in the last 20 years.

“This con­fer­ence re­ally is a fo­cal point for the ex­change of sci­en­tific in­for­ma­tion re­gard­ing HIV and AIDS,” said Dr. Julio Mon­taner, di­rec­tor of the B.C. Cen­tre for Ex­cel­lence in HIVAIDS, which is co-host­ing the meet­ing.

The sci­en­tific gath­er­ing comes at a crit­i­cal point in global ef­forts to con­trol the pan­demic, which has dev­as­tated pop­u­la­tions in sev­eral de­vel­op­ing na­tions, par­tic­u­larly in Africa, said Mon­taner.

On Tues­day, UN Sec­re­taryGen­eral Ban Ki-moon an­nounced that the goal of hav­ing 15 mil­lion HIV-pos­i­tive peo­ple on an­tiretro­vi­ral ther­apy by the end of 2015 - the so-called 15 by 15 strat­egy - had been achieved in March, nine months early.

New HIV in­fec­tions have fallen by 35 per cent and AIDS-re­lated deaths by 41 per cent since the goal was set in 2000, pri­mar­ily be­cause of an­tiretro­vi­ral drugs, which sup­press the abil­ity of the hu­man im­mun­od­e­fi­ciency virus (HIV) to repli­cate and in­fect cells. The triple-drug cock­tail stops the in­fec­tion from pro­gress­ing to AIDS.

It was at the 1996 AIDS con­fer­ence in Van­cou­ver that re­searchers first heard about the ef­fec­tive­ness of an­tiretro­vi­ral ther­apy, or ART, which has turned HIV in­fec­tion from an au­to­matic death sen­tence into a chronic but man­age­able dis­ease.

Mon­taner, whose team has been among those at the fore­front of ART re­search, pre­sented data at the 2006 IAS meet­ing in Toronto sug­gest­ing that the drugs could not only pre­vent HIV from de­vel­op­ing into AIDS, but also stop trans­mis­sion to oth­ers by sig­nif­i­cantly re­duc­ing vi­ral lev­els in the body.

The UN pro­gram on HIVAIDS, or UNAIDS, at­tributes the suc­cess of its “15 by 15” goal to the roll-out of an­tiretro­vi­ral ther­apy, and led Ban to pro­claim this week that the world is now “on the way to a gen­er­a­tion free of AIDS” - a tar­get hoped to be achieved by 2030.

The latest re­search to be pre­sented in Van­cou­ver will show how close sci­en­tists ac­tu­ally are to that ob­jec­tive.

IAS pres­i­dent Dr. Chris Beyrer, a co-prin­ci­pal in­ves­ti­ga­tor of the Johns Hop­kins Cen­ter for AIDS Re­search in Bal­ti­more, said the con­fer­ence will fo­cus on four broad themes: ear­lier an­tiretro­vi­ral treat­ment; pre­ven­tive treat­ment, known as PREP; re­search on a po­ten­tial cure; and treat­ing peo­ple co-in­fected with HIV and hep­ati­tis C.

Among the key pre­sen­ta­tions is one on the im­pli­ca­tions of the START study, a ran­dom­ized con­trolled trial of 5,000 HIV-pos­i­tive peo­ple in 35 coun­tries. The START trial was halted early when in­terim re­sults showed that be­gin­ning an­tiretro­vi­ral treat­ment soon af­ter di­ag­no­sis cut the risk of se­ri­ous ill­ness or death in half, com­pared with de­fer­ring treat­ment un­til the virus’ ef­fects on the im­mune sys­tem had reached a cer­tain level.

While many coun­tries ad­vo­cate early treat­ment, some like the U.K. fol­low a de­ferred treat­ment reg­i­men, so dis­sem­i­nat­ing the study re­sults is im­por­tant, he said.

Got­tfried Hirn­schall, head of the World Health Or­ga­ni­za­tion’s HIV di­vi­sion, is sched­uled on Mon­day to ad­dress the find­ings and what they might mean for the agency’s treat­ment guide­lines, which cur­rently don’t rec­om­mend start­ing an­tiretro­vi­rals im­me­di­ately af­ter di­ag­no­sis.

Mon­taner, long a pro­po­nent of early ther­apy both for treat­ment and the spread of HIV, said the next goal to tackle is the “90-9090” strat­egy un­veiled last year and en­dorsed by the UN, which aims to end AIDS glob­ally by 2030.

CP PHOTO

Dr. Julio Mon­taner, Di­rec­tor of the Bri­tish Columbia Cen­tre for Ex­cel­lence in HIV/AIDS, is shown in a hand­out photo.

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