AIDS at 30
When the federal government reported on June 5, 1981, that "5 young men, all active homosexuals" had been diagnosed with
Pneumocystis carinii pneumonia in Los Angeles, no one yet knew that these were the country's first reported cases of AIDS. Since then, medicine has come a long way in understanding, treating and even
... preventing HIV. Following are the key medical advances and failures that have marked the past three decades of the battle against AIDS — milestones that elucidate how much we still need to learn.
Next: A Mysterious Illness Emerges MORE
First Cases Reported, 1981
In the spring and summer of 1981, young gay men from California and New York are reported to have a form of pneumonia and a rare type of skin cancer, which typically only struck people with crippled immune systems.
At first, the cases seemed unrelated. On June 5, the Centers for Disease Control and Prevention issued its
... href="http://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm">first report on the California cluster: "5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at 3 different hospitals in Los Angeles, California."
Two of the patients died. All five patients had also been diagnosed with cytomegalovirus, a contagious infection. No one knew it yet, but these were the first reports of AIDS.
On July 3, the New York Times runs its first article about the rare skin cancer, Kaposi's sarcoma, diagnosed in 41 homosexual men in New York and California. Doctors said they didn't know what caused the outbreak, and there was yet no evidence of contagion. Many of these patients had also been treated for viral infections, such as herpes, cytomegalovirus and hepatitis B.
Researchers would eventually realize that many of the men had severely compromised immune systems, and that the illness connecting the various cases was a sexually transmitted infection that wrecked the immune system and exposed the body to opportunistic disease. For many months — until December, when similar symptoms first appear in injecting drug users — doctors say the disease is apparently not contagious among non-homosexuals.
—Meredith Melnick
Next: AIDS Gets Its Name MORE
AIDS Gets Its Name, 1982
The emerging new disease is initially referred to by several names, including GRID for "gay-related immune deficiency" or, more informally, "gay cancer."
In May 1982, a San Francisco
Chronicle reporter, Randy Shilts, writes a comprehensive
feature about the medical mystery of GRID:
Even more mysterious than the fact that
... these diseases are attacking a group with few if any common genetic physical or racial characteristics is the fact that the geographic regions where GRID victims have been found are so isolated. About half come from New York, with another quarter split almost evenly between Los Angeles and San Francisco. The remaining quarter is scattered throughout smaller centers of gay populations around the country.
Public health officials also are worried that so far they have seen only the "tip of the iceberg" because of the increase in frequency with which the diseases are being reported. About 86 percent of the GRID victims have been reported since January and the federal Centers for Disease Control now average one new case a day.
And yet many patients with "GRID" aren't gay. In July, the acronym AIDS, for "acquired immune deficiency syndrome," is proposed: "acquired" because it is contracted rather than inherited, and "syndrome" because it comprises a constellation of symptoms and ailments, rather than one central disease. By August, newspaper articles and scientific journals are using that name. The Centers for Disease Control and Prevention (CDC) first defines AIDS properly in September.
In 1987, Shilts would publish And the Band Played On, which is now considered the seminal work on the history of AIDS.
—Meredith Melnick
Next: Evidence that AIDS Is Transmitted by Blood MORE
Evidence that AIDS Is Transmitted by Blood, 1982
In December, the CDC reports that a 20-month-old infant from the San Francisco area developed unexplained cellular immunodeficiency and opportunistic infection. The baby became ill after receiving multiple blood transfusions, including a transfusion of platelets derived from the blood of man subsequently found to have AIDS.
...
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The CDC reports:
The etiology of AIDS remains unknown, but its reported occurrence among homosexual men, intravenous drug abusers, and persons with hemophilia A (1) suggests it may be caused by an infectious agent transmitted sexually or through exposure to blood or blood products. If the infant's illness described in this report is AIDS, its occurrence following receipt of blood products from a known AIDS case adds support to the infectious-agent hypothesis.
In the same month, the CDC reports six infant deaths from AIDS-associated Pneumocystis carinii pneumonia and other mysterious immunodeficiencies. Most are the children of intravenous drug users or prostitutes. Although the child cases are officially classified as "unexplained," this is early evidence that the disease can be transmitted from mother to child. The report notes: "Transmission of an 'AIDS agent' from mother to child, either in utero or shortly after birth, could account for the early onset of immunodeficiency in these infants."
"When it began turning up in children and transfusion recipients, that was a turning point in terms of public perception," epidemiologist Harold W. Jaffe of the CDC would later tell Newsweek. "Up until then it was entirely a gay epidemic, and it was easy for the average person to say 'So what?' Now everyone could relate."
—Meredith Melnick
Next: The AIDS Virus Is Isolated MORE
The AIDS Virus Is Isolated, 1983
Esteemed researchers Luc Montagnier and Francoise Barré-Sinoussi at Institute Pasteur isolate a new virus that penetrates white blood cells and appears to cause AIDS. They present
their findings in the journal
Science in May, writing:
A retrovirus belonging to the family of recently discovered human T-cell leukemia viruses
... (HTLV), but clearly distinct from each previous isolate, has been isolated from a Caucasian patient with signs and symptoms that often precede the acquired immune deficiency syndrome (AIDS) … From these studies it is concluded that this virus as well as the previous HTLV isolates belong to a general family of T-lymphotropic retroviruses that are horizontally transmitted in humans and may be involved in several pathological syndromes, including AIDS.
The team sends a sample of the virus to the CDC where it is named lymphadenopathy-associated virus (LAV), in reference to the swollen glands that commonly affect AIDS patients; the CDC sends a sample of LAV to the National Cancer Institute (NCI).
A year later Dr. Robert Gallo from the NCI announces that he has discovered the virus that causes AIDS, but testing reveals that Gallo's virus, called HTLV-3, is the same as LAV.
—Meredith Melnick
Next: Who Was 'Patient Zero'? MORE
'Patient Zero' Identified, 1984
As part of a years-long investigation by the CDC into the factors leading to the AIDS epidemic, public-health officials map out the sexual contacts of men in gay communities in New York City and Los Angeles. Their investigation identifies a man they refer to as "Patient Zero," and his impact is
described in the
American Journal ... of Medicine in March 1984 — the same month Patient Zero dies.
Patient Zero is later revealed in Randy Shilts' And the Band Played On as Gaetan Dugas, a handsome and promiscuous flight attendant from Montreal who frequented bath houses in Los Angeles, San Francisco and New York City. Dugas was directly linked to nine of the first 19 cases of AIDS in Los Angeles, 22 cases in New York City and nine more in other American cities. A total of 40 of the first 248 patients with AIDS in the U.S. had had sex with him.
As Shilts later writes, Dugas was diagnosed with Kaposi's sarcoma in 1980 and went on to knowingly spread the disease until his death. He had unprotected sex with an estimated 250 partners each year. One public-health worker who spoke with him at length reported to Shilts that he had an almost spiteful attitude: if he had to die of "gay cancer," why should his partners get to live?
However, the notion that Dugas was the first or "responsible" AIDS patient has been disavowed. Rather, he was only one of several men who contracted and then spread the disease.
—Meredith Melnick
Next: FDA Approves First Commercial Blood Test MORE
FDA Approves First Commercial Blood Test, 1985
The Food and Drug Administration (FDA) approves the first commercial blood test for AIDS, which picks up antibodies to the AIDS-causing virus. The test was primarily used to remove tainted blood from blood banks and hospitals and to prevent anyone with antibodies in their blood from donating.
Doctors also begin regularly
... testing high-risk patients. Erik Eckholm reports in the New York Times in December:
Many homosexuals who have begun following ''safe sex'' practices are desperate to know whether they were infected in the past. Women who have had intercourse with bisexuals, and men who have visited prostitutes, are seeking to ease their minds about the possible danger to themselves and those with whom they have had sex.
But with the test comes ethical concerns raised by doctors and leaders of patient advocacy organizations who point out that AIDS status is a major source of discrimination. They advocate for consent forms and anonymity. ''I don't think the test should be too easily accessible,'' Dr. Neal Lewin of the New York University School of Medicine tells the Times. ''Obtaining and filling out the forms forces both the patient and doctor to think about what they're doing.''
—Meredith Melnick
Next: Lightning Fast, the FDA Approves the First Anti-HIV Drug, AZT MORE
First Anti-HIV Drug, AZT, Approved, 1987
In March, the FDA approved the first drug to treat AIDS, the antiretroviral drug azidothymidine (AZT), based on the results of clinical trials that demonstrated that it slowed the progress of the AIDS virus (which has by now been
dubbed HIV, for "human immunodeficiency virus," by the International Committee on the Taxonomy of
... Viruses).
AZT is one of the fastest drug development stories in history. In a commentary in the Journal of Infectious Diseases, Dr. Martin S. Hirsch of Massachusetts General Hospital and Harvard Medical School wrote:
Never in the history of medical virology has an antiviral agent been developed, licensed, and marketed so rapidly as AZT … Three years from the time that AIDS was associated definitively with the human immunodeficiency virus type 1 (HIV-1), AZT was licensed for use in this disorder. Within three years of demonstrating AZT's activity against HIV-1 in vitro, it has been administered to [more than] 20,000 individuals throughout the world.
AZT was initially developed in 1964 as a cancer therapy, but was proven ineffective. It is found to be active against HIV-1 infection, managing but not curing it.
—Meredith Melnick
Next: AZT Reduces Mother-to-Child Transmission MORE
AZT Reduces Mother-to-Child HIV Transmission, 1994
A federally funded study finds that AZT is effective in preventing the transmission of HIV from mother to child without causing birth defects or health problems for the fetus. The data shows that HIV-positive mothers who took AZT in pregnancy were two-thirds less likely to pass HIV to their babies than mothers not taking the
... drug — a major accomplishment in stemming rising HIV infection rates.
"It is the first indication that mother-to-child transmission of HIV can be at least decreased, if not prevented," Harold W. Jaffe, an epidemiologist at the CDC, tells the New York Times. "And it will provide a real impetus for identifying more HIV-infected women during pregnancies so that they could consider the benefit of AZT treatment to themselves and their children."
—Meredith Melnick
Next: Why Are Some People HIV-Positive but AIDS-Free? MORE
HIV-Positive but AIDS-Free, mid-1990s
Researchers begin to take seriously reports of some people who are infected with HIV but never develop the symptoms or the potentially life-threatening syndromes associated with full-blown AIDS. Initial reports are of commercial sex workers in Africa, and scientists begin to study their blood and tissues in an effort to find
... protective factors or genetic differences that could become the basis for new, more effective treatments or even a vaccine against the disease.
—Alice Park
Next: The 'Monkey Man': Baboon Bone Marrow as AIDS Cure? MORE
The Monkey Man, 1995
A year before the idea of using potent anti-HIV drug cocktails would revolutionize AIDS treatment, a San Francisco-based AIDS activist decides to take drastic measures to try to treat the disease that had nearly killed him: Jeff Getty volunteers to become the first patient to receive a bone marrow transplant from a baboon.
... Baboons don't get infected with HIV or sick from AIDS as humans do, and it is a gamble to see if the protection inherent in the primate's cells will transfer to Getty. It doesn't. Getty rejects the baboon cells almost immediately. (In 2006, he dies of complications from AIDS-related cancer.)
But the experiment opens the door to thinking of innovative ways to thwart HIV, and researchers continue to study primates for insight into how human immune systems might be taught to dispatch the virus as effectively as theirs do.
—Alice Park
Next: FDA Approves First Protease Inhibitor MORE
FDA Approves the First Protease Inhibitor, 1995
The FDA approves Invirase (saquinavir), the first of a new class of anti-HIV drugs called protease inhibitors. It is offered free to patients with advanced AIDS. Protease inhibitors interfere with enzymes the virus needs to replicate, stopping its progress through the body. With fewer side effects than previous drugs and better
... clinical results in reducing viral load in HIV-positive and AIDS patients, protease inhibitors are soon considered the best drug on the market. However, many patients grew resistant to them quickly. As the FDA approves Invirase, made by Hoffmann-La Roche, 12 other companies are creating their own protease inhibitors.
—Meredith Melnick
Next: A Scientists Predicts Early Treatment Can Eliminate AIDS MORE
The Dawn of HAART, 1996
At the 11th International Conference on AIDS in Vancouver in July, researchers Dr. David Ho of the Aaron Diamond AIDS Research Center in New York City and Dr. George Shaw of the University of Alabama at Birmingham School of Medicine present data showing that HIV produces not thousands, not millions, but
billions of copies of
... itself in the body each day — even during the early years of infection, when researchers originally thought the virus laid dormant. That discovery, they said, highlighted the fact that HIV was an active viral infection from the start, and needed aggressive antiviral treatment.
Indeed, researchers had already begun using a triple combination of powerful anti-HIV drugs — the newly available protease inhibitors, along with the old standby AZT and a third drug called 3TC — to reduce drug-resistance and suppress the virus in people with AIDS. In a 1996 cover story TIME reports:
For once in the history of HIV, a strategy that ought to work seemed in fact to succeed. Within weeks of starting combination therapy, 7 out of 10 men and women with AIDS begin to get better. Blood tests show that in many of them, the viral load has dropped below detectable levels. Relieved of the burden of fighting HIV, their long-suffering immune systems can finally tackle the deadly fungal and bacterial infections that have taken hold in their lungs, intestines and brains. Fevers break; lesions disappear; energy returns.
But Ho tells the conference in Vancouver that doctors shouldn't wait until AIDS progresses to begin highly active (triple-drug) antiretroviral therapy, or HAART. He reports that he has successfully initiated treatment in patients in the first few weeks of infection, a strategy that he predicts (wrongly, it turns out) can potentially eliminate the virus in two to three years.
From that point, the triple-drug cocktail is quickly incorporated into clinical practice. A study in 1998 shows that it reduces rates of AIDS, death and hospitalization by 60% to 80%.
—Sora Song
Next: AIDS Deaths Decline for the First Time MORE
AIDS Deaths Decline for the First Time, 1997
For the first time since the AIDS epidemic began in 1981, deaths from the disease drop "substantially" across the country, the CDC
reports in February.
The overall national decline was 12% — from 24,900 deaths in the first six months of 1995 to 22,000 in the first half of 1996 — with regional declines ranging from as
... high as 16% in the West to 8% in the South. The month before the CDC figures are released, New York City health officials are the first in the country to report a drop in AIDS deaths: a 30% decrease in 1996.
Federal health officials attribute the declines to better treatments that delay the progression of HIV disease and prevent opportunistic infections, along with efforts to prevent infection, increase access to care and slow the epidemic. Drug-combination therapies had shown benefits even before the advent of the widely publicized new protease inhibitors.
The CDC finds that trends in AIDS incidence and deaths vary by risk group, gender and race: both AIDS incidence and AIDS deaths continue to increase among women — who now account for 20% of all AIDS cases — and among people infected through heterosexual sex. While AIDS deaths declined among all racial and ethnic groups, declines were much greater among whites (21%) than among blacks (2%) or Hispanics (10%), the government reports.
—Sora Song
Next: The Prediction that HAART Could Cure AIDS? Dashed MORE
Hopes for HAART as a Cure Are Dashed, 1998
Two studies in the journal
Science and another in the
Proceedings of the National Academy of Sciences report the same finding: that hidden reservoirs of HIV in the body can evade aggressive drug treatment and cause rebound infections when medications are stopped. The virus is found to lurk dormant in the so-called memory T
... cells of the immune system, even after it has been cleared from the bloodstream, and can trigger infection years or even decades later.
"The bad news is we can't yet get rid of the virus," Dr. Robert Siliciano of Johns Hopkins Medical School, who led one of the studies, tells TIME. "The good news is that as long as people infected with HIV keep taking the triple-drug cocktail, they have an excellent chance of surviving the infection for a long time."
—Sora Song
Next: The First Chimpanzee MORE
The First Chimpanzee, 1999
Working with frozen tissue samples from a chimp called Marilyn that was known to have tested positive for HIV (she died in 1985), scientists at the University of Alabama find that her virus is substantially different, genetically speaking, than the three types of known SIV (simian immunodeficiency virus). A check of Marilyn's
... own genetic makeup also shows that she belongs to a different subspecies of chimp than those that carry the other SIV strains.
More important, Marilyn's virus, unlike the other simian viruses, closely matches the three major types of HIV-1 strains that are largely responsible for the human AIDS epidemic. The findings suggest that the simian virus mutated and crossed over into humans on at least three separate occasions, probably when hunters were exposed to infected blood while butchering chimps for food. "As it happens," TIME reports, "the first documented case of AIDS goes back to 1959, when a man living in Kinshasa, just across the Congo River from Gabon, home of Marilyn's kin, died of the disease."
—Sora Song
Next: HIV Vaccine Trials Fail MORE
VaxGen's HIV Vaccine Trials Fail, 2003
In February, Brisbane, Calif.-based VaxGen reports that its AIDS vaccine failed overall in a trial of 5,400 participants. But the company says the data suggest the vaccine may provide some protection in a subset of 500 non-Hispanic minorities, including blacks and Asians. Independent scientists and AIDS activists criticize the
... company for overstating findings based on such a small group of patients.
In November, the same vaccine fails to protect people from HIV infection in a three-year trial of more than 2,500 high-risk intravenous drug users in Thailand.
—Sora Song
Next: A New Era of Prevention: Male Circumcision MORE
Male Circumcision Reduces HIV Transmission, 2006
In December, the National Institutes of Health halts two randomized clinical trials of male circumcision after an early review of the data shows that the intervention significantly reduced transmission of HIV.
In early 2007 the details of the trials are published in the medical journal
Lancet: in one study involving 2,784
... men in Kenya, circumcision reduced men's risk of acquiring HIV during sex with women by 53%. In the second trial of 4,996 men in Uganda, circumcised men were 51% less likely than uncircumcised men to become infected with HIV. The findings are hailed as ushering in a new era for HIV prevention, and the World Health Organization recommends promotion of male circumcision in areas with severe HIV epidemics.
It is not known whether circumcision affects women's risk of acquiring HIV during sex, but any prevention method that lowers the rate of HIV infection in men will naturally reduce women's exposure.
—Sora Song
Next: Yet Another Disappointing AIDS Vaccine Failure MORE
Another Disappointing AIDS Vaccine Failure, 2007
In September, trials of a promising Merck AIDS vaccine are halted after initial data show the drug fails to prevent HIV infection. In a study involving 3,000 uninfected volunteers — high-risk sex workers largely in the U.S. and Latin America — the experimental vaccine neither prevented HIV infection nor reduced the severity
... of infection in people who acquired HIV during the trial. In fact, the vaccine may have even increased people's chances of infection. Another large trial in South Africa is simultaneously halted.
The much-heralded Merck vaccine was the first of a new class of AIDS vaccine to get this far in human trials. Unlike a previously tested vaccine that worked by stimulating the immune system to produce antibodies, the Merck drug was designed to boost the immune system's T-cell response, by ferrying three synthetic HIV genes into the body via a common cold virus.
The trials' failure is described by Dr. Gary Nabel, director of the National Institutes of Health's Vaccine Research Center, as "a big blow to the field."
—Sora Song
Next: Patients with Undetectable Viral Load Are Not Infectious? MORE
Swiss Experts Say Patients With Undetectable Virus Are Not Infectious, 2008
In January, the Swiss Federal Commission for HIV/AIDS publishes a consensus statement finding that, based on a review of the medical literature, people who have HIV and take effective antiretroviral therapy are not sexually infectious. The commission's statement says that as long as HIV-positive people adhere to their drugs,
... maintain an undetectable viral load for at least six months and have no other sexually transmitted infections, they cannot transmit the virus through unprotected sex. Although it is not possible to prove conclusively that transmission is impossible, the commission says that scientific evidence suggests the risk is "negligibly small."
The Swiss statement is immediately criticized by scientists and AIDS advocacy groups over concerns that the research did not include data on non-heterosexual couples, and world health groups remind people that condoms are the best protection against the spread of HIV.
—Sora Song
Next: First AIDS Patient to Be 'Cured' MORE
Berlin Patient 'Cured' of AIDS, 2008
Timothy Ray Brown, otherwise known as the "Berlin Patient," is said to be the first person cured of AIDS. He has no detectable trace of HIV in his blood, which in itself isn't that unusual, since most HIV patients on antiretroviral drugs achieve the same status. What makes Brown unique, however, is that he remains apparently
... HIV-free four years after he stopped taking the medications.
Is he cured? That's one of the most hotly debated questions in the AIDS research community today. Brown was diagnosed with leukemia after he acquired HIV, and underwent a bone marrow transplant to treat his cancer. Taking advantage of emerging evidence that some people with certain genetic mutations appear to be able to fend off HIV infection, Brown's doctor transplanted bone marrow from one such donor to Brown — twice. Ever since, his HIV seems to have disappeared. A bone-marrow transplant isn't a realistic treatment for every AIDS patient, but Brown's case has prompted studies of the relevant genetic mutation, which might one day help shut down HIV.
—Alice Park
Next: Nobel Prize Awarded for Discovery of HIV MORE
Nobel Prize Awarded for Discovery of HIV, 2008
Francoise Barré-Sinoussi and Luc Montagnier are awarded the Nobel Prize in Physiology and Medicine for their work in identifying HIV, the human immunodeficiency virus, which is responsible for causing AIDS. The team isolated the virus from the lymph nodes and blood of infected patients. Unlike other viruses, HIV is unique in
... its ability to infect and fuse with healthy immune cells, which is how it wreaks its devastating effect on the body's ability to defend against pathogens.
—Alice Park
Next: Thai Vaccine Trial Offers Glimmer of Hope MORE
Thai Vaccine Trial Offers Glimmer of Hope, 2009
A much-anticipated vaccine trial involving 16,400 volunteers in Thailand shows that a combination of two existing vaccines may not be of much benefit in protecting people from HIV infection. However, the data suggest that the experimental combo vaccine may be slightly more protective among low- or average-HIV-risk participants
... than among high-risk individuals, like sex workers or intravenous drug users, though its effect appears to wane after the first year.
Some experts say that that small benefit may eventually help scientists develop a workable AIDS vaccine — a goal that has eluded them for more than two decades. "Having this signal — even if it's weak and even if we're debating whether it's a real signal or not — is a source of great hope," Nicole Frahm, an HIV specialist at the Fred Hutchinson Cancer Research Center in Seattle, tells TIME. "Up until now, we've had nothing. This holds the promise of a start."
—Alice Park
Next: Vaginal Anti-HIV Gel Shows Promise MORE
Vaginal Gel Shows Promise Against HIV, 2010
For the first time, AIDS researchers report success with an HIV-prevention tool that can be controlled by women: a vaginal gel containing the antiretroviral drug tenofovir. Although women account for nearly half of all new HIV infections each year, they have few options for protection. The best strategies — using condoms or
... practicing abstinence — require cooperation from often unwilling partners.
In a preliminary study of 889 women in South Africa, those who used the antimicrobial gel, which contains 1% tenofovir, before and after sex for 2½ years reduced HIV infection by 39%, compared with women who used placebo. Among women who used the gel most faithfully as directed, infections were cut by 54%. What's more, the gel halved the chances of contracting the genital-herpes virus, another risk factor for HIV.
The gel isn't the first of its kind. But unlike previous, failed versions of vaginal microbicides, which attempted to either neutralize HIV on contact or create a physical barrier between the virus and healthy cells, the new formulation incorporates a potent anti-HIV drug that appears to block infection more effectively.
In 2011, scientists hoping to expand on these promising results, tested the gel against rectal transmission of HIV as well. In a small study in which volunteers provided biopsied tissue cultures after regularly applying the gel or a placebo to the rectum for a week, researchers found that cells from people who used the gel were better able to withstand HIV infection in a lab dish than those from people who used placebo.
—Alice Park
Next: A Clue to AIDS Immunity MORE
A Clue to AIDS Immunity, 2010
People who are infected with HIV but never go on to develop AIDS represent the Holy Grail of AIDS research. If scientists could replicate whatever these individuals are doing to fend off the virus, they might have the foundation for an effective treatment or even a vaccine.
In November, Bruce Walker and colleagues at Harvard
... Medical School and Massachusetts General Hospital studying these so-called long-term non-progressors report the discovery of a handful of genetic aberrations that may explain why these patients are able to remain healthy. These individuals possess variants in the protein that controls how certain immune cells called CD4s, which HIV likes to infect, display bits and pieces of viral protein on their outer shell — making them visible to the body's immune system. In people who have the genetic variants, HIV-infected CD4 cells look especially attractive to the body's naturally circulating killer immune cells, which will target and destroy infected cells before they release more virus.
—Alice Park
Next: Can We Use Treatments as Prevention? MORE
Study: Treatment as Prevention, 2010
Truvada Fails to Protect Healthy Women, 2011
As excited as AIDS experts were by the findings in November that antiretroviral drugs could prevent new HIV infections in healthy gay men, they were disappointed by the results of a follow-up trial among high-risk women. In April, that arm of the trial was halted when it became clear that the same combination drug, Truvada, did
... not protect uninfected women. The study involved a group of commercial sex workers in Africa, among whom the drug did not significantly lower the risk of acquiring HIV, compared with placebo. Researchers still can't explain why the pill failed, but some point to the fact that the women may not have been taking their medications as faithfully as they should have, which could have skewed the results.
—Alice Park
Next: Anti-HIV Drugs Prevent Transmission Between Couples MORE
Anti-HIV Drugs Prevent Transmission Between Couples, 2011
Researchers report yet more tantalizing data that the antiretroviral drugs doctors currently use to treat HIV infection could also be effective in preventing transmission of the virus.
In a large randomized trial involving more than 1,700 heterosexual couples — in which one person was HIV-positive and the other was not —
... infected people who took the anti-HIV drugs reduced their risk of transmitting the virus to their partners by 96%, compared with those who did not immediately start treatment.
The results were so stark that Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), which sponsored the trial, elected to release them early and stop the global study four years before its scheduled end. All study participants are now being offered antiretroviral therapy.
It's further evidence that there may be effective ways of controlling the epidemic, particularly in the developing world where the number of new infections, especially among couples, continues to rise. Read more about the findings here.
—Alice Park
Next: Edurant, the New Drug on the Block MORE
Edurant: New Drug on the Block, 2011
In May, the FDA
approves rilpivirine, or Edurant, the first new anti-HIV drug to be approved in three years. The medication, made by an arm of Johnson & Johnson, is designed to be used in combination with other antiretroviral drugs, such as Truvada. Once-a-day rilpivirine is a non-nucleoside reverse transcriptase inhibitor,
... which works by blocking the virus's ability to translate its genetic code into the proteins that it needs to survive, similar to the widely used efavirenz (Sustiva) and nevirapine (Viramine). In clinical trials of more than 1,300 adults with HIV, comparing rilpivirine to efavirenz, the drugs were equally effective, reducing HIV to undetectable levels in the blood in about 80% of patients over 48 weeks. The studies found that rilpivirine appeared to work better in those who had lower levels of virus in their blood to start than in those with high viral load.
—Alice Park MORE
