Is the End of AIDS in Sight?

Reality Check: Is the End of AIDS in Sight?

Dr Francois Dabis from the Bordeaux School of Public  Health at the University of  Bordeaux (Segalen, France) gave an excellent talk today at CROI-2013 that is easily understood by any lay person who wants to know how far we have come in HIV and the challenges ahead

CLICK HERE TO WATCH PRESENTATION

Successful treatment is "as effective as consistent condom use" in reducing HIV transmission

At least, for vaginal sex...(no data on anal sex!)

The statement notes that there is now conclusive randomised clinical trial evidence, from the HPTN 052 trial, to show that transmission of HIV through vaginal sex is significantly reduced when an HIV-positive person is taking effective antiretroviral therapy (ART). In this trial, early treatment reduced HIV transmission to an uninfected partner by 96%.


Position statement on the use of antiretroviral therapy to reduce HIV transmission January 2013. The British HIV Association (BHIVA) and the Expert Advisory Group on AIDS

Undetectable HIV Viral Load in the Blood? Not Necessarily in Semen, Boston HIV Study Finds

Can someone with no detectable HIV virus in their blood due to successful HIV treatment infect someone?




"Undetectable viral loads in blood is not a guarantee that HIV is also undetectable in semen, according to a new study involving 101 HIV-positive men who have sex with men (MSM) conducted in Boston and published online ahead of print by the journal AIDS. Of the 83 men with undetectable virus in blood samples, roughly a quarter of them—21 MSM in total—had semen with detectable HIV."

"Eighty-three of the 101 MSM (men that have sex with men) had undetectable levels of HIV in their blood samples. Though most also had undetectable HIV in their semen samples, 21 (25 percent) had detectable seminal viral loads"

How long had these 21 MSM guys been on HIV meds? What was the rate of other active sexually transmitted infections in this sub group?

"..the average free-floating viral load was 4,438 copies among those with detectable blood-based HIV levels, it was 51 copies among those with undetectable blood-based HIV levels. "

Are these 51 viruses enough to infect someone?

Previous studies that looked at this found a rate of around 8 percent. And some researchers say that these viral particles may consist mostly of pro-virus and not active "infectious" virus.

I wish they had measured blood and intra-cellular levels of anti-retrovirals to see if they correlate with semen's HIV viral load.

Read this great article by Tim Horn:

http://www.aidsmeds.com/articles/hiv_semen_transmission_1667_22190.shtml