While a part of the scientific community
continues to chase the elusive HIV vaccine, some others are frantically
stepping up ART (antiretroviral therapy) to save several lives from succumbing to
AIDS and to help persons with HIV/AIDS lead a normal life.
CART 2012 (Chennai Antiretroviral therapy
symposium), a two-day meet packed with scientific sessions presented by
international experts involved in HIV care, discussing HIV/AIDS diagnosis,
treatment and research concluded on Sunday evening in Chennai, South India. The
symposium was arranged to provide the latest clinical update on HIV management,
to inform practicing clinicians about current antiretroviral therapeutics and
to discuss newer drugs, resistance and toxicities.
Scientific Sessions on HIV/AIDS
Discussing newer methods to detect AHI (Acute
HIV Infection), Dr. Charles Carpenter Professor of Medicine, Brown Medical School and
Director, Lifespan/Tufts/Brown Center for AIDS Research (CFAR), NIH since 1998, presented updates on some principles of ART such
as When to start? What drugs to start with? When to change? What drugs to
change to? Speaking on the vast improvement in the efficacy of ART drugs in his
paper Goal of Art and When to Start - New Evidence, Dr. Carpenter
observed that until 2003 only patients with CD4 count less than 200 were given
ART because of the toxicity of available ART drugs then. Now even patients with
CD4 count below 500 are given antiretroviral therapy.
the question hour that followed her paper on Pathogenesis and Acute
Infection, Dr. Susan Little, from University of California who conducts
translational research and clinical trials to understand the biology and
epidemiology of HIV transmission, said that it was a big challenge to find and
enroll volunteers with varying levels of HIV infection willing to participate
in clinical trials.
Treatment as Prevention - Breakthrough of the Year 2011
Myron S. Cohen, Professor of Medicine, Microbiology and Immunology and Public
Health at the University of North Carolina said the probability of HIV
transmission risk estimated at 1/1000 contacts is a serious underestimation.
The actual transmission risk is much, much higher. He explained the
success of the HPTN052, first major randomized clinical trials in which many
countries participated. The study showed an earlier intervention of ART drugs
led to a 96% reduction in HIV transmission to an uninfected partner. The
HPTN052 continues and there are questions to be answered, Do these results
apply to MSM (men who have sex with men) and others who have anal sex?
of CART 2012
N. Kumaraswamy, Chief Medical Officer at YRG CARE and Organizing Chair of CART
2012 said, "The Chennai ART symposium has successfully created a venue
for physicians involved in HIV care and for research experts involved in HIV
drug discovery to meet and exchange ideas on the efficacy of antiretroviral
symposium explored a whole gamut of current updates on Drug Resistance, New
Drugs and Targets, HIV and TB, HBV, HCV co-infection, HIV and HPV, HIV and
ageing, ART in Pregnancy, Antiretrovirals in Prevention and Vaccine, Cost
Effectiveness of ART and Lab Diagnosis of HIV infection. The speakers said that
it was very necessary to make a vaccine to prevent HIV, to diagnose and give
drugs to treat HIV as soon as infection sets in and to counsel HIV patients to
adhere to medication so they can lead a quality life with family and kids.
The current economic upheaval all over the world
is pushing up costs and making HIV medicine less affordable to sufferers.
Medical experts at the symposium agreed that it was a major challenge to
translate science into opportunities for prevention and treatment. With limited
funding it was important to prioritize expenditure in HIV research, prevention
and treatment. Currently two thirds is spent on HIV/AIDS prevention and one
third on treatment. In India 90% of the funding comes from public sector and
10% from private funding.
We can treat people with HIV/AIDS effectively with
very few side effects if medicines cost less and if patients strictly adhere to
the drug regimen. The virulence of HIV and the killer nature of the AIDS
epidemic require international health experts and researchers to work together
on a war footing to eliminate the disease, and until that happens, to devise
newer means to treat HIV and prevent HIV transmission.