How Much Would it Cost to End AIDS?

via Bloomberg, by Simeon Bennet

Michel Kazatchkine and Eric Goosby may be able to halt the spread of HIV. They just need the money.

The two men control the funds that buy drugs for most of the world’s AIDS patients. Studies in July provided the strongest evidence yet that medicines used since 1994 to treat HIV can almost eliminate the chance an infected person will pass the virus to a sex partner. Given to healthy people, the treatments can also protect against infection, offering the potential to end a pandemic that has killed 30 million people in 30 years.

Governments are now planning projects to assess whether those findings can be replicated in the real world, and what that might cost. Getting the drugs just to those patients who should be treated under existing guidelines would cost another $6 billion a year, according to the United Nations. Treating all those infected, in some of the world’s poorest countries, would cost tens of billions more.

Finding more money will be difficult with economic growth stalling and nations including the U.S., the biggest donor to the AIDS fight worldwide, trying to curtail overall spending to rein in debt. Funding for AIDS in poorer nations fell 10 percent to $6.9 billion in 2010 from 2009 levels, according to the UN.

“We may well be able to overcome AIDS,” Kazatchkine, the director of the Geneva-based Global Fund to Fight AIDS, Tuberculosis and Malaria, said in an interview. Still, “the gap between what the science is telling us we can achieve and what we would be able to achieve is at risk of increasing.”

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Infection-resistant monkeys could be crucial in the fight against HIV

Via Io9, by Alasdair Wilkins.

Sooty mangabeys are a monkey species found on the western coast of central Africa. Their unique immunity to SIV, a relative of HIV, has intrigued medical researchers for decades. Now we know just how their immunity works.

SIV and HIV function in much the same way - the viruses find two molecules on the surface of the cell, which are known as co-receptors. These molecules function much like gates. One of these molecules is CD4, which is found on immune cells known as T cells. The immune response triggered by the appearance of the virus stimulates these T cells, which boost the level of the other co-receptor, CCR5, which in turn facilitates the deadly infection.

But sooty mangabeys are able to avoid that chain of events, thanks to a unique type of T cell called a central memory T cell. When this particular type of T cell responds to the virus, it does so without activating CCR5. This helps the T cells survive the SIV infection, and it's a crucial reason why these monkeys are able to avoid the onset of AIDS. Best of all, central memory T cells are long-lived in the body, and their positioning in the lymph nodes makes them particularly effective in stopping the spread of SIV.

Emory University researcher Mirko Paiardini explains what this means:

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Starting HIV treatment when CD4 cell count dips below 500 improves AIDS-free survival

Via aidsmap, by Michael Carter

Patients who start antiretroviral therapy when their CD4 cell count dipped below 500 cells/mm3 are less likely to develop an AIDS-defining illness than individuals who start treatment with a CD4 cell count of 350 cells/mm3, an international team of investigators report in the Annals of Internal Medicine. However, initiating HIV treatment with a CD4 cell count of approximately 500 cells/mm3 did not reduce the risk of all-cause mortality.

“If the goal is to prevent AIDS-defining illness or death, our findings support cART [combination antiretroviral therapy] initiation once the CD4 cell count decreases below 500 cells/mm3,” comment the investigators.

Nevertheless, results of the study will undoubtedly inform the debate about the best time to start antiretroviral therapy.Treatment guidelines in Europe currently recommend that AIDS-free patients should start therapy when their CD4 cell count is in the region of 350 cells/mm3. However, US guidelines advocate treatment when an individual’s CD4 cell count falls under 500 cells/mm3.

Large randomised trials are currently underway to try and determine the optimum time to start HIV therapy. However, their results are not expected for several years. Because of this continuing uncertainty investigators from the HIV-CAUSAL Collaboration undertook a prospective observational study involving approximately 21,000 adult patients enrolled in cohorts in Europe and the US.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]