Thursday, November 29 2012 21:27

HIV/AIDS in 2012 and Beyond

By  Jill Crank, CRNP, MPH, Family Nurse Practitioner (Chase Brexton Health Services)

This year was the first time the International AIDS Society was able to hold its conference in the U.S. since 1990, following President Barack Obama’s October 2009 announcement that the United States would end entry restrictions on people living with HIV. Scientists continue to share the latest knowledge on keeping each individual living with HIV as healthy as possible, as well as public health efforts to decrease the number of new infections.

Here are some of the major highlights of advances in the HIV/AIDS community in 2012:

Expanding Treatment
Previously, HIV treatment was recommended only to those with certain evidence of immune system impairment. Experts now recommend that antiretroviral treatment be offered to all HIV positive patients, regardless of their health status. This change resulted from research showing that HIV medications improve immune function, decrease AIDS-defined complications, and prolong life. In addition, a prominent study proved that keeping the HIV viral load low can reduce the risk of transmission to HIV negative partners by as much as 96 percent.

“Quad” Pill
In August, Gilead Sciences announced their third one tablet per day HIV regimen, Stribild, which has four medications in it. It is expensive (about $28,000/year, compared to $20,000/year for another popular once-a-day regimen), but Gilead is working with state drug assistance programs to expand its availability. Studies indicate it decreases viral loads quickly, and does not have the same neuropsychiatric effects as some other drugs.

Rapid HIV Test for Home Use
In an effort to increase detection of patients with HIV and connect them to care, the Food and Drug Administration approved an in-home OraQuick HIV test. Patients simply swab the inside of their mouth and wait 20 to 40 minutes for a preliminary result. Any positive result should be followed by a confirmatory blood test. It is important to note that false negatives can occur due to the window period of up to three months for HIV antibodies to develop following infection. The test costs $39.99 and can be ordered online or purchased at a local store.

Truvada for PrEP
In July, the FDA approved an indication for Truvada (an antiretroviral medication) to be taken daily by HIV negative patients for PrEP (Pre-Exposure Prophylaxis, to reduce the chance of getting infected). Patients must be engaged in a comprehensive prevention plan including condom use, counseling, and regular testing for HIV and other sexually transmitted infections. Research trials show effectiveness as high as 92 percent reduction in HIV transmission among heterosexual couples, and up to 42 percent reduction amongst HIV negative men or transgender women who have sex with men.

A cure for HIV?
In July it was announced that two HIV positive men who received bone marrow transplants were found to have no further traces of HIV in their white blood cells. While much further investigation is required, this gives us hope that we are getting closer to understanding how we can develop a cure for HIV.


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