Friday, May 13, 2011
Breakthrough in AIDS fight: Drugs radically reduce transmission of virus
More Media Rhetoric / choice of wording.
READ the text.
There is NO Break though.
The 11 Drugs do not reduce Transmission.
Deal in FACTS:
-read the LA Times article and then New York Times (below) the choice of words:
"...can reduce the transmission of the virus to spouses and partners by 96%"
-everything is based on CD4 level.
Can you name which country define AIDS with a low CD4 level?
-Try to think of this the other way around.
What if these people in the test would have never gotten the HIV virus in the 1st place. Was that taking into consideration? NOPE.
-Why are more people NOT taking about Dr. Nancy Padian 10 years study?
The Study “We followed up 175 HIV-discordant couples [one partner tests positive, one negative] over time, for a total of approximately 282 couple-years of follow up… No transmission [of HIV] occurred among the 25% of couples who did not use their condoms consistently, nor among the 47 couples who intermittently practiced unsafe sex during the entire duration of follow-up…”
“We observed no seroconversions after entry into the study [nobody became HIV positive]…This evidence argues for low infectivity in the absence of either needle sharing and/or other cofactors.”
How about this fact it's cost 73 million dollars to study 1763 couples. That's 41,406.70 per couples. To give them Free Drugs. Just think about that? long distance calls? Shipping? Salaries?
Stop accepting "FACTS" for a drug pusher like Dr. Anthony Fauci
May 12, 2011
In what is being hailed as a landmark breakthrough in HIV prevention, a new study has shown that giving anti-AIDS drugs to HIV-positive people can reduce the transmission of the virus to spouses and partners by 96%, U.S. researchers said Thursday.
Though some uncontrolled studies of populations had previously suggested that treatment of patients with antiretroviral drugs could slow transmission of the virus, the new results announced by the National Institute of Allergy and Infectious Diseases represent the first large clinical trial to confirm those suggestions — and they showed that the drugs are unexpectedly effective.
In fact, the results of the study of nearly 1,800 couples in the United States and southern Africa were so dramatic that the study's sponsors decided to terminate it prematurely — four years before its scheduled completion in 2015.
The study shows that not only does early treatment of HIV infections benefit the patient's own health, but also "there is clearly a benefit of a profound decrease in the probability of … transmission to his or her own partner," Dr. Anthony S. Fauci, director of NIAID, said in a news conference.
Antiretroviral treatment "can definitely decrease rates of transmission, and we can get this disease under control," said Dr. Kathleen Squires, chairwoman of the HIV Medicine Assn. and director of the division of infectious diseases at Thomas Jefferson University Hospital in Philadelphia. "This is scientific proof that this is true," said Squires, who was not involved in the study.
The clinical trial, begun in April 2005, was conducted at 13 sites in nine countries. Although the United States was one of the countries, there were only two couples who participated here, presumably because few people wanted to run the risk of deferring treatment.
The trial enrolled 1,763 couples in which only one partner was infected: Those infected included 890 men and 873 women; 97% of the couples were heterosexual. All the infected patients had CD4 counts — a measure of the severity of the infection — between 350 and 550 at the beginning of the study. U.S. treatment guidelines now call for antiretroviral treatment to begin when CD4 counts fall below 500, but international guidelines typically require a wait until counts drop below 350.
For half the couples — selected randomly — the infected member began receiving a cocktail of anti-AIDS drugs immediately, and half had treatment deferred until the patient's CD4 count fell below 350 or he or she developed an AIDS-defining complication, such as pneumocystis pneumonia. All the subjects received counseling on safe sex, free condoms and treatment for any sexually transmitted diseases that occurred during the study.
When the monitoring committee examined the interim results last month, they found 39 new HIV infections. Twenty-eight of the infections clearly came from the person's partner based on genetic analysis of the virus, seven were thought to have arisen from other sources, and four probably came from other sources but the researchers were not sure yet.
Among the 28 partners who developed new infections that clearly seemed to come from their partner, 27 were in the group where treatment with antiretroviral drugs was deferred.
"We were very, very surprised" by the magnitude of the reduction, said Dr. Myron Cohen of the University of North Carolina at Chapel Hill, who led the study.
The preliminary results also showed some benefit for the patients themselves. The team observed 17 cases of disseminated tuberculosis (TB that has spread beyond the lungs) in the deferred-treatment group and only three in the immediate-treatment group. TB is a leading killer of HIV-positive people.
There were 23 deaths in the study, 10 in the immediate-treatment arm and 13 in the other arm. The difference was not statistically significant, and the researchers have not yet analyzed the causes.
"This is amazing news," said Michael Sidibe, executive director of the Joint United Nations Programme on HIV/AIDS. "Prevention can be a reality. The science is strong — so strong that we must use it."
The $73-million study was funded by NIAID. The 11 different drugs used by participants were provided free of charge by the companies that make them. The cost of the drugs in the developing countries would normally be "a few hundred dollars per year," Fauci said.
All patients in the study will now receive the drugs for at least another year as Cohen and his colleagues monitor them to determine whether the findings "are durable."
Published: May 12, 2011
People infected with the virus that causes AIDS are far less likely to infect their sexual partners if they are put on treatment immediately instead of waiting until their immune systems begin to deteriorate, according to preliminary results from a large clinical trial released Thursday.
Patients with H.I.V. were 96 percent less likely to pass on the infection if they were taking antiretroviral drugs — a finding that is so overwhelming that it is likely to change the way American AIDS doctors treat patients and what treatment policies are adopted by the World Health Organization and other countries, said Dr. Anthony S. Fauci, head of the National Institute of Allergy and Infectious Diseases, which paid for the trial.
The data was so convincing that the trial, scheduled to last until 2015, is effectively being ended early.
There have been previous studies, notably among drug abusers in San Francisco and Vancouver, British Columbia, that concluded that starting patients on drugs immediately would stop them from infecting others.
Those studies led Unaids, the United Nations AIDS-fighting agency, to adopt “test and treat” as its goal last year; the policy encourages doctors to start people on treatment as soon as they test positive for H.I.V. However, this is the first evidence from a randomized clinical trial, the gold standard in medical research.
AIDS prevention specialists not connected to the trial were enthusiastic.
“These results are phenomenal,” said Thomas J. Coates, director of the global health program at the University of California, Los Angeles, and the founder of the Center for AIDS Prevention Studies in San Francisco. “It was a tough study to do, and I’m thrilled it came out this way.”
Dr. Julio Montaner, an AIDS specialist at the University of British Columbia whose work among Vancouver heroin addicts helped lead to the Unaids policy, called the result of 96 percent protection “as good as it gets.”
“This is consistent with what we’ve been saying and doing in British Columbia for close to a decade,” he said. “How much more evidence do we need before we implement what we know works?”
The $73 million trial, known as HPTN 052, involved 1,763 couples in 13 cities on four continents. One member of each couple was infected with H.I.V.; the other was not. In half the couples, chosen at random, the infected partner was put on antiretroviral drugs as soon as he or she tested positive for the virus.
In the other half, the infected person started treatment only when his or her CD4 count — a measure of the immune system’s strength — dropped below 250 per cubic millimeter.
In 28 of the couples, the uninfected person became infected with the partner’s strain of the virus. Twenty-seven of those 28 infections took place in couples in which the partner who was infected first was not yet getting treatment.
On Thursday, Dr. Fauci and Dr. Myron Cohen, an AIDS specialist from the University of North Carolina at Chapel Hill and the study’s director, announced that the data collected since the study began in 2005 had been “unblinded” to an independent safety review panel, which is standard procedure in clinical trials. When the panel realized how much protection early treatment afforded, it recommended that drug regimens be offered to all participants. Although participants will still be followed, the trial is effectively over because it will no longer be a comparison between two groups on different regimens.
The results carry moral implications for doctors in the United States. Although medical associations like the Infectious Diseases Society of America advocate starting patients on AIDS drugs early, the decision is made by the doctor and patient. Some patients fear the reported side effects of AIDS drugs and want to delay taking the drugs until they get obviously sick or until their CD4 counts fall, and some doctors go along with that, Dr. Fauci said, especially as long as their patients’ CD4 counts remain above 350.
But that means the patient may infect others during the delay. Of the 27 people in the study who became infected while their partners were not yet taking the drugs, 17 had partners whose CD4 counts were still above 350.
Asked if it could now be considered immoral for a doctor to accede to a patient’s request to delay starting drugs, Dr. Fauci said: “I’m not going to go there. I’m not going to say it’s immoral. But there is more and more data showing the advantages of starting as early as you can.”
Dr. Coates of U.C.L.A. said he hoped that treatment delays would fade away because the newest antiretroviral drugs had few side effects.
Although the evidence suggests that it would be good public health policy to lower infection rates by starting everyone on drugs as soon as they are infected, that is impossible in much of the world. For lack of money, clinics in Africa are turning away patients who are not just infected but close to death. And in some American states where money provided by the Ryan White Care Act has run out, poor uninsured people are on waiting lists.
Although the trial was relatively large, there are some limitations on interpreting the data.
More than 90 percent of the couples in the trial, who lived in Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, the United States and Zimbabwe, were heterosexual.
“We would have liked to have a substantial number of men as potential study subjects, but they just weren’t interested,” Dr. Cohen said.
Although common sense suggests the results would be similar in the contexts of homosexual sex and sex between people who are not couples, strictly speaking, the results apply only to the type of people studied, Dr. Fauci said.