Man Free of HIV After Stem Cell Transplant

Dr. Gero Hutter

By Jacquelyne FroeberWEDNESDAY Feb. 11, 2009 (Health.com) — A 42-year-old HIV patient with leukemia appears to have no detectable HIV in his blood and no symptoms after a stem cell transplant from a donor carrying a gene mutation that confers natural resistance to the virus that causes AIDS, according to a report published Wednesday in the New England Journal of Medicine.

“The patient is fine,” says Gero Hutter, MD, of Charite Universitatsmedizin Berlin in Germany. “Today, two years after his transplantation, he is still without any signs of HIV disease and without antiretroviral medication.”

The case was first reported in November, and the new report is the first official publication of the case in a medical journal. Dr. Hutter and a team of medical professionals performed the stem cell transplant on the patient, an American living in Germany, to treat the man’s leukemia, not the HIV itself.

However, the team deliberately chose a compatible donor who has a naturally occurring gene mutation that confers resistance to HIV. The mutation cripples a  receptor known as CCR5, which is normally found on the surface of T cells, the type of immune system cells attacked by HIV.

The mutation is known as CCR5 delta32 and is found in 1% to 3% of white populations of European descent.

HIV uses the CCR5 as a co-receptor (in addition to CD4 receptors) to latch on to and ultimately destroy immune system cells. Since the virus can’t gain a foothold on cells that lack CCR5, people who have the mutation have natural protection. (There are other, less common HIV strains that use different co-receptors.)

People who inherit one copy of CCR5 delta32 take longer to get sick or develop AIDS if infected with HIV; people with two copies (one from each parent) may not become infected at all. The stem cell donor had two copies.

Next: Why the treatment isn’t an option for most people with HIV

While promising, the treatment is unlikely to help the vast majority of people infected with HIV, says Jay Levy, MD, a professor at the University of California San Francisco, who wrote an editorial accompanying the study. A stem cell transplant is too extreme and too dangerous to be used as a routine treatment, he says.

“About a third of the people die [during such transplants], so it’s just too much of a risk,” Dr. Levy says. To perform a stem cell transplant, doctors intentionally destroy a patient’s immune system, leaving the patient vulnerable to infection, and then reintroduce a donor’s stem cells (which are from either bone marrow or blood) in an effort to establish a new, healthy immune system.

Dr. Levy also says it’s unlikely that the transplant truly cured the patient in this study. HIV can infect many other types of cells and may be hiding out in the patient’s body to resurface at a later time, he says.

“This type of virus can infect macrophages (another type of white blood cell that expresses CCR5) and other cells, like the brain cells, and it could live a lifetime. But if it can’t spread, you never see it—but it’s there and it could do some damage,” he says. “It’s not the kind of approach that you could say, ‘I’ve cured you.’ I’ve eliminated the virus from your body.”

Before undergoing the transplant, the patient was also found to be infected with low levels of a type of  HIV known as X4, which does not use the CCR5 receptor to infect cells. So it would seem that this virus would still be able to grow and damage immune cells in his body. However, following the transplant, signs of leukemia and HIV were absent.

“There is no really conclusive explanation why we didn’t observe any rebound of HIV,” Dr. Hutter says. “This finding is very surprising.”

Dr. Hutter notes that one year ago, the patient had a relapse of leukemia and a second transplant from the same donor. The patient experienced complications from the procedure, including temporary liver problems and kidney failure, but they were not unusual and may occur in HIV-negative patients, he says.

Researchers including Dr. Hutter agree that the technique should not be used to treat HIV alone. “Some people may say, ‘I want to do it,’” says Dr. Levy. A more logical—and potentially safer—approach would be to develop some type of CCR5-disabling gene therapy or treatment that could be directly injected into the body, says Dr. Levy.

Less invasive options to alter CCR5 could be on the horizon within the next five years, according to Dr. Levy. “It’s definitely the wave of the future,” he says. “As we continue to follow this one patient, we will learn a lot.”

Next: One drug on the market blocks CCR5

One drug that’s currently on the market that blocks CCR5 is called maraviroc (Selzentry). It was first approved in 2007 and is used in combination with other antiretroviral drugs.

In 2007, an estimated 2 million people died from AIDS, and 2.7 million people contracted HIV. More than 15 million women are infected worldwide. HIV/AIDS can be transmitted through sexual intercourse, sharing needles, pregnancy, breast-feeding, and/or blood transfusions with an infected person.

“For HIV patients, this report is an important flicker of hope that antiretroviral therapy like HAART [highly active antiretroviral therapy] is not the endpoint of medical research,” Dr. Hutter says.


Related Links:What Should I Do if the Condom Breaks?10 Questions to Ask a New Partner Before Having SexWho’s Most at Risk for STDs?What Is Safer Sex?

Circumcision Reduces Risk of Herpes, HPV Infection

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Disease, which funded one of the trials.Niaid.nih.gov

By Amanda MacMillanWEDNESDAY, March 25, 2009 (Health.com) — Men who are circumcised are less likely to get sexually transmitted infections such as genital herpes and human papillomavirus (HPV), but not syphilis, according to a study of adult African men published Wednesday in the New England Journal of Medicine.

The finding adds to the evidence that there are health benefits to circumcision. It was already known that circumcision can reduce the risk of penile cancer, a relatively rare disease. In a previous study, the same research team found that adult circumcision could reduce the risk of HIV infection.

Efforts to increase the practice of male circumcision in areas with high rates of sexually transmitted infections, including Africa, could have a tremendous benefit, say the study’s authors. Genital herpes has been associated with an increased risk of HIV, and HPV can cause genital warts as well as a higher risk of anal, cervical (in women), and penile cancers.

In the United States, infant circumcision is declining. About 64% of American male infants were circumcised in 1995, down from more than 90% in the 1970s. Rates tend to be higher in whites (81%) than in blacks (65%) or Hispanics (54%).

Some opponents say the removal of the foreskin is an unnecessary surgical procedure that may reduce sexual sensitivity in adulthood. In Jewish and Muslim cultures, young or infant boys are routinely circumcised for religious reasons. Circumcision rates have traditionally been higher in the U.S. than in Europe, but the American Academy of Pediatrics currently says that the medical benefits are insufficient to recommend circumcision for all baby boys.

Next page: How the study was conducted

In the new study, a research team at the Rakai Health Sciences Program in Uganda—in collaboration with researchers from the Johns Hopkins University Bloomberg School of Public Health in Baltimore and Makerere University in Uganda—conducted two clinical trials involving 3,393 uncircumcised men ages 15 to 49. All the men were negative for HIV and genital herpes (also known as herpes simplex virus type 2); a subgroup of men also tested negative for HPV.

Roughly half of the men underwent medically supervised circumcision at the start of the trial, while the other half were circumcised two years later.

Overall, circumcision reduced the men’s risk of genital herpes by 28% (10.3% of uncircumcised men; 7.8% of circumcised men) and HPV infection by 35% (27.8% of uncircumcised men; 18% of circumcised men).

Circumcision did not, however, protect against syphilis. (About 2% of men in both groups contracted syphilis.)

Study coauthor Thomas C. Quinn, MD, professor of global health at Johns Hopkins University, says that choosing circumcision, whether it’s the parents of an infant or an adult male for himself, is and should remain an individual decision.

“But the critics need to really look at the benefits versus the risks,” he adds. “By now a large body of evidence has shown that the health benefits clearly outweigh the minor risk associated with the surgery. In our study, we didn’t see any adverse effects or mutilation. We’re recommending supervised, safe, sterile environments—not circumcision out in an open field with rusty instruments.”

Increasing circumcision rates in Africa may not only help men, but would likely protect women too, possibly lowering the rates of female cervical cancer, the authors say. Ronald H. Gray, MD, professor of public health at Johns Hopkins University and study coauthor, says that the researchers plan to look at whether male circumcision reduces the transmission of HPV to female sexual partners.

Next page: Are the findings relevant outside Africa?

Even in the United States, this study has relevance, says Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (which funded one of the trials).

“In this country, circumcision for infant boys remains a personal decision for the parents,” he says. “This makes us rethink whether doctors should be more aggressive in recommending that it at least be considered. If parents say no just because generations before them have said no, they should learn more about the significant health benefits before making that choice.”

Roughly three-quarters of U.S. adults have had at least one HPV infection, according to an editorial by Matthew R. Golden, MD, and Judith N. Wasserheit, MD, both of the University of Washington. Although vaccines against some of the most dangerous HPV strains have been approved for girls ages 13 to 26, the vaccines are expensive and routine Pap tests are still necessary to pick up cervical cancers.

Dr. Golden and Dr. Wasserheit note that “rates of circumcision are declining and are lowest among black and Hispanic patients, groups in whom rates of HIV, herpes, and cervical cancer are disproportionately high.” Medicaid, which insures many low-income patients in these populations, does not pay for routine infant circumcision in 16 states.

The study authors hope that this growing evidence in favor of circumcision will persuade policy-making bodies, both in the United States and in other countries, to officially recommend the procedure—which could make patient education and insurance coverage more likely.

It’s not clear why circumcision may affect infection rates. But the study authors suggest that penile foreskin may provide a moist, favorable environment for herpes and HPV to survive and enter cells on the skin’s surface. Once the foreskin is surgically removed, the risk of infection may be reduced.

They also note, however, that male circumcision is not completely effective in preventing sexually transmitted infections. Safe sex practices, including consistent condom use, are still necessary to provide the best protection.


Related Links:I Was Ashamed of My Herpes Until I Found Out How to Treat ItShocking HPV Statistics: Liz Lange Speaks Out on Cervical CancerNeed Help Telling Exes You Have an STD?Getting Genital Herpes Was Upsetting at First

Gum Disease May Reactivate AIDS Virus

FRIDAY, April 3 (HealthDay News) — Good dental health may help prevent AIDS, say Japanese researchers.

The link, they say, could be periodontal, or gum, disease.

The researchers found that periodontitis-causing P. gingivalis bacteria can trigger a pathway that causes reactivation of latent HIV-1, the virus that causes AIDS. P. gingivalis is among the most widely existent bacteria worldwide.

The findings were to be presented April 3 in Miami at a meeting of the International & American Association for Dental Research.

The results suggest that periodontal disease might contribute to the systemic dissemination of HIV and emphasize the essential role of maintaining oral hygiene and controlling oral diseases to help prevent AIDS, according to background information in a news release from the association.

More information

The U.S. Centers for Disease Control and Prevention has more about HIV/AIDS.

— Robert Preidt

SOURCE: International & American Association for Dental Research, news release, April 3, 2009

Last Updated: April 03, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Cancer

Remember the good ol’ days of PB&J the way mom used to make it—cut into triangles, no crust? Good thing we’re all grown up now: New research shows that an antioxidant naturally found in bread may help prevent cancer, and there’s eight times more of it in the outer layer! [NY Daily News]

Doctors are warning about a newly discovered form of HIV transmission: Three infants contracted the virus from eating food that had been pre-chewed for them by HIV-infected caregivers, researchers reported Monday. They ruled out other ways of transmission before concluding that the virus was most likely spread due to bleeding in the caregivers’ mouths. [Reuters]

We know all too well how contact lenses can dry out eyes—and how eye drops are messy, inconvenient, and inefficient: As little as 1% to 7% actually gets absorbed by the eye! Scientists are hard at work on a quick fix: contact lenses that dispense medication. [Wired]

A 19-year-old from Boulder, Colo., died Tuesday morning after drinking poppy pod tea with his brother. Purchasing poppy pods (usually over the Internet) is not illegal, but certain uses of the opiate can be. Drinking tea made from poppy seeds or pods is dangerous, and in some cases, fatal. The death is Boulder’s second related to poppy tea in only five months. [The Denver Channel]

We’re a little uneasy about the latest Hollywood anti-aging secret: It comes in an IV. Often used to care for burns and other skin wounds, ozone therapy—which pumps extra oxygen into the blood—has been around for a while. But with stars like Michael Jackson rumored to have used it, this bizarre Tinseltown trick is coming back into fashion. [MomLogic]

4 Success Stories in the Fight Against AIDS in 2013

It’s been 32 years since the first mysterious cases of what turned out to be acquired immunodeficiency syndrome or AIDS first began to appear. Since then, the epidemic has killed 25 million people, almost 700,000 of those in the U.S. alone.

But this Sunday, as people across the globe come together to commemorate the 26th annual World AIDS Day, there are hopeful signs in the fight against this killer. Transmission rates have slowed and a diagnosis of HIV or AIDS is no longer the death sentence it once was. In fact, people who get proper treatment may never develop symptoms at all. (Health.com: 16 Signs You May Have HIV)

The year 2013 brought several successes in the fight against AIDS, progress which will hopefully mean still fewer infections and fewer deaths in the years to come. Here’s a look back at the most recent developments in the field.

More people are candidates for testingIn April, the U.S. Preventive Services Task Force issued long-awaited guidelines recommending routine HIV screening for all adolescents and adults aged 15 to 65. The 2005 guidelines recommended testing only for high-risk adults and adolescents as well as pregnant women.

Hopefully, as the new recommendations are adopted, testing rates will go up, transmission rates will go down and more people will get into treatment early enough to save their lives. Currently, 46% of U.S. adults have never been tested for HIV and nearly 20% of Americans don’t know they have the virus because they haven’t been screened.

Obviously, if you don’t know you have the virus, you can’t get proper treatment. In the United States, National HIV Testing Day is observed on June 27, but World AIDS Day also features free testing and counseling events around the world.

The AIDS mortality rate continues to dropMore and better drugs means the mortality rates from AIDS continues to decline. An estimated 15,529 people with AIDS died in 2010, down from 21,601 in 2009. Although a five-figure death rate is still shocking (and not in a good way), this is a big improvement from an all-time high of 50,877 in 1995.

Among the drugs approved this year is Tivicay, one of a class of medications called integrase inhibitors.

“It’s once a day and free of any important drug interactions and it’s the most potent drug we’ve had so far,” says Leonard Berkowitz, MD, medical director of the Program for AIDS Treatment and Health and chief of infectious diseases at The Brooklyn Hospital Center in New York City.

And drug regimens continue to get simpler, with fewer pills at a time and fewer doses needed each day.

“This makes adherence to regimens better,” says Berkowitz. “Treating HIV patients is all about adherence. If they take their medications, they do well.”

Affordable health care is more likelyThanks to Obamacare, insurance companies can no longer refuse healthcare coverage to people with pre-existing conditions. That means people with HIV/AIDS should be able to get coverage, at least they should once all the wrinkles are ironed out.

“Full implementation of the Affordable Care Act is getting HIV-positive patients onto the exchanges,” says Michael Horberg, MD, director of HIV/AIDS at Kaiser Permanente and immediate past chair of the HIV Medicine Association.

Only 17% of people living with HIV have private insurance and about 30% don’t have any coverage at all, not even government-sponsored insurance.

And while the cost of HIV/AIDS drugs is coming down, treatment can run $10,000 or more a year. Tivicay will cost an estimated $14,000 a year.

The first “functional cure” seen in an HIV+ babyIn March, researchers reported the first “functional cure” of HIV in a baby born two-and-a-half years ago in Mississippi. The so-called Mississippi Baby–no one knows if it is a boy or a girl–was treated for HIV unusually early in life, within 30 hours of birth. Medication yet was later stopped, but the virus is only detectable with super-sensitive tests and, importantly, is not replicating.

Other hopeful stories have trickled in during the year. Two HIV patients who received bone marrow transplants for blood cancer also have no detectable HIV even after discontinuing antiretroviral therapies. And 14 French patients who started HIV therapy within two months of becoming infected also discontinued medications without–so far–a rebound in virus levels.

“If you can catch HIV early enough in the infection by giving medication, there’s some data suggesting that early intervention makes a difference in the disease course,” says Michael Kolber, MD, PhD, professor of medicine and director of the Comprehensive AIDS Program at the University of Miami Miller School of Medicine.

So much has happened over the past few years, in fact, that HIV/AIDS experts are cautiously whispering the word “cure.”

“There is a lot of talk about a cure which is a word we’ve very rarely ever used in this field,” Dr. Berkowitz says. “It’s a bit premature and overly optimistic, but there have been some very exciting turns leading to this optimism.”

Too Few Gay Teens Get HIV Tests, Study Finds

WEDNESDAY, Aug. 26, 2015 (HealthDay News) — Gay teen boys are much less likely to get tested for HIV than older gay males, researchers report.

The researchers surveyed more than 300 gay and bisexual male teens between the ages of 14 and 18 from across the United States. Only one in five had ever been tested for HIV, a rate significantly lower than among older gay and bisexual men, the researchers noted.

For example, a 2008 U.S. Centers for Disease Control and Prevention-sponsored study of gay men found that 75 percent of those aged 18 to 19 had been tested for HIV.

Major barriers to gay teens getting tested for HIV are not knowing where to go for a test, concerns about being recognized at a testing location, and believing they won’t get infected, the Northwestern University researchers said.

“Understanding the barriers to testing provides critical information for intervening, so we can help young men get tested,” study first author Gregory Phillips II, a research assistant professor of medical social sciences at the Feinberg School of Medicine at Northwestern University in Chicago, said in a university news release. He is also an investigator in the school’s IMPACT LGBT Health and Development Program.

The incidence of new HIV infections is rising among young gay and bisexual men, study principal investigator Brian Mustanski, an associate professor of medical social sciences and director of IMPACT, pointed out in the news release.

“Testing is critical because it can help those who are positive receive lifesaving medical care. Effective treatment can also help prevent them from transmitting the virus to others,” he added.

HIV testing among gay and bisexual teen males can be increased by making it easy for them to find testing sites through text messaging or online programs and by having testing sites in high schools, the researchers added.

“Providing in-school testing would normalize the process,” Phillips said. “If there is a constant presence of on-site testing at schools, testing would seem less stigmatized. It would also increase knowledge about the testing process and make it less scary.”

The study was published Aug. 26 in the Journal of Adolescent Health.

More information

The U.S. Centers for Disease Control and Prevention has more about HIV testing.


Charlie Sheen Will Reportedly Announce He's HIV

MONDAY, Nov. 16, 2015 (HealthDay News) — Actor Charlie Sheen is reportedly HIV-positive and will discuss the diagnosis Tuesday morning on NBC’s Today show, according to multiple published reports.

People magazine reported Monday afternoon that individuals close to Sheen approached Hollywood publicist and crisis manager Howard Bragman six months ago on ways to deal with the matter, but Bragman said he never dealt directly with Sheen.

“The interview could open up a lot of sympathy for him, but he has to be concerned about a fear of litigation from former sexual partners. You don’t take that lightly,” Bragman told the magazine. He added that the 50-year-old Sheen “is getting treatment, and a lot of people in his life know about it.”

Sheen has a history of substance abuse and has admitted to soliciting prostitutes in the past, People reported.

“It’s been going on for quite a while. He’s not necessarily comfortable talking about it. It was very hard to get up the courage for him to talk about it (HIV),” Bragman said.

Sheen’s diagnosis was first reported by the National Enquirer.

In a press release issued Monday, NBC said Sheen is set to make a “revealing personal announcement” on the Today show with co-host Matt Lauer.

Sheen’s ex-wife, actress Denise Richards, has known about his HIV infection for a “number of years,” according to Access Hollywood.

Richards, who has two daughters with Sheen, is not infected. Sheen reportedly contracted HIV — the virus that causes AIDS — after the couple’s divorce in 2006, Access Hollywood reported.

Dr. David Rosenthal is medical director of the Center for Young Adult, Adolescent and Pediatric HIV atNorth Shore-LIJ Health System in Great Neck, N.Y. He said: “Today, patients with HIV can live almost normal lives, but they have to take their HIV medication daily and follow up with their physician on a regular basis.”

Rosenthal said many of the HIV treatments — called “combined antiretroviral therapy” — are one pill taken once a day. These pills combine multiple different medications into one pill.

“Since one person in seven in the U.S.A. that have HIV do not know that they have HIV, it is essential that patients get routine HIV testing as part of their regular medical care. The earlier we can diagnose a patient as being HIV positive, the less chance that patient can spread HIV to others, and the better chance that the person can start medications early and live a long, healthy life,” Rosenthal said.

Sheen, the son of actor Martin Sheen, starred in a series of hit movies in the 1980s and ’90s, including Platoon, Ferris Bueller’s Day Off and Wall Street.

In the 2000s, he starred in a series of TV shows, most notably Two and a Half Men, from which he was fired in 2011.

More information

To learn more about HIV, visit the U.S. Centers for Disease Control and Prevention.


7 Myths About HIV and the Facts You Need to Know

When the National Enquirer broke the news of Charlie Sheen’s HIV diagnosis, the story was already misleading: “Charlie Sheen AIDS Cover-Up,” blared the headline.

Sheen responded with an exclusive TODAY show interview, where he revealed his HIV-positive diagnosis. Note: Sheen has HIV (human immunodeficiency virus), not AIDS (acquired immunodeficiency syndrome). AIDS is the last stage of HIV infection (characterized by a weakened immune system), and not everyone with the virus will develop it.

That’s just one of the misconceptions people have about HIV, which affects more than 1.2 million people in the United States, according to the Centers for Disease Control and Prevention.

“A lot of the myths that are still out there are the ones that were there in the 1980s,” says James Kublin, MD, the executive director of the HIV Vaccine Trials Network (HVTN), based at Fred Hutchinson Cancer Research Center in Seattle. Here are seven things you should know about HIV.

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MYTH: Very few people in the U.S. get HIV anymore

The number of people in the U.S. who get HIV each year is surprisingly high, and that rate is by no means plummeting. In fact, the number of people who are infected annually with the virus has remained relatively stable—at about 50,000—for the past decade. (In 2009, the CDC estimated that 17.4 people per 100,000 were infected with HIV; in 2013, that number was 15 in 100,000.)

RELATED: Most HIV Infections Come From Undiagnosed or Untreated People: Study

MYTH: HIV/AIDS awareness is high

Our awareness of it actually might be at one of its lower points. One possible explanation: There’s been a lot of progress with how we treat HIV. Since the discovery of the virus and its link to AIDS in the 1980s, people with HIV are living longer, healthier lives.

Thirty years ago, acquiring the virus could have been fatal within a year, says Larry Corey, MD, a principal investigator for the HIV Vaccine Trials Network at the Fred Hutchinson Cancer Research Center. Now people can live with it for 40 or 50 years. One 2013 study in the journal PLOS ONE found that an HIV-positive 20-year-old in the U.S. or Canada on antiretroviral therapy can expect to live into their early 70s—almost as high as the rest of the population.

But that success might be having an unintended side effect: We’re not as aware of it as we once were. Dr. Kublin did an internship in the 1980s at St. Vincent’s Hospital, referred to as the epicenter of New York City’s AIDs epidemic. “In New York City in the late ‘80s, [these deaths] were on the front pages of the newspapers,” he says. Now, only 14% of Americans have seen, heard, or read “a lot” about the problem of AIDS in the United States in 2013, down from 34% in 2004, according to a Kaiser Family Foundation poll. (Plus, 15% of Americans haven’t heard anything about AIDS in the U.S. in the past year; 41% said they only heard “a little.”)

MYTH: Most people with HIV get diagnosed right away

Here’s an alarming stat: 1 in 8 people who have HIV don’t realize it, according to the CDC. And people aged 13 to 24 make up about 26% of all new HIV infections in the U.S. (Young gay and bisexual men are especially at risk: They make up about 19% of all new HIV infections, and 72% of youth HIV infections.) But 44% of young adults (aged 18-29) say they aren’t personally concerned about being infected with HIV, according to the Kaiser Family Foundation poll, while another 28% say they aren’t “too concerned.” And despite all the advances in HIV treatments—antiretroviral drugs, condoms, behavioral therapy—if people don’t know they have the virus, they can transmit it to others, says Dr. Corey.

RELATED: 16 HIV Symptoms

MYTH: You can get HIV from a mosquito bite

This longstanding myth is one that won’t seem to go away. According to the CDC, there’s no evidence that it’s possible to contract HIV from a mosquito. “The virus doesn’t survive in the mosquito, and doesn’t live in the spit,” says Dr. Kublin.

MYTH: You can catch HIV from sharing a drinking glass

About 1 in 4 Americans believe that you can contract HIV by sharing a glass—a number that’s barely changed since 1987, according to the Kaiser Family Foundation poll. Another 17% believed you can get HIV from touching a toilet seat (also false); that’s another percentage that hasn’t fallen since the late 1980s.

For the record: HIV is mainly spread through sex (anal sex has the highest risk, and vaginal sex has the second-highest) or sharing needles, according to the CDC. 

RELATED: 20 New Facts You Need to Know About HIV

MYTH: HIV is a man’s disease

Women make up about 1 in 5 new HIV infections each year. Men who have sex with men account for about 63% of all new infections—but 84% of women who get HIV are thought to get it by having sex with men, while another 16% will acquire it from sharing a needle for drug use. African-American women have a higher risk: About 5,300 black heterosexual women were estimated to get HIV in 2010 compared to 1,300 white heterosexual women and 1,200 heterosexual Hispanic or Latino women.

MYTH: If you get HIV/AIDS, it’s your own fault

Sad but true: 32% of people in the Kaiser Family Foundation poll say that if a person gets AIDS, that’s on them. And 21% say that they think AIDS is a punishment for our falling moral standards. Fewer people think that way than they did in years past, but the numbers haven’t fallen as drastically as you might think.

“There’s a misconception that [if you get HIV], you did something wrong,” says Dr. Corey. “But all infections are created by some contact with another person.”

Having more than one sexual partner is a risk factor for HIV, but it’s possible to get the virus by sleeping with just one person. And, as Dr. Corey says: Sure, you could never have sex again, but sex is a part of life.

Dr. Corey and Dr. Kublin are both working at the Fred Hutchinson Cancer Research Center to develop an HIV vaccine—the clinical trial, called HVTN 100, has been launched in South Africa.

“Solving this is important for our country, it’s important for our humanity,” says Corey.

 

There's a Pill That Prevents HIV, So Why Aren't People Taking It?

A highly effective once-a-day pill for preventing HIV has been available in the United States since 2012—but you’ve probably never heard of it.

That’s because just 1% of people who could benefit from the medication are actually taking it, and a third of primary care doctors and nurses don’t know about it, according to the U.S. Centers for Disease Control and Prevention (CDC).

The medication, Truvada, is a “huge” step in the fight against AIDS, according to Susan Buchbinder, MD, the director of Bridge HIV, an arm of the San Francisco Department of Public Health dedicated to HIV prevention, research, and education.

RELATED: 16 Signs You May Have HIV

“It’s a highly effective tool and we really do need to get it out to the people who most need it,” Dr. Buchbinder says. Here are the facts about this breakthrough drug.

How does Truvada work?

Truvada is a combination of two HIV drugs, emtricitabine and tenofovir, which block an enzyme that the virus needs to make copies of itself. Taking the medication daily will flood the mucosal membranes with these HIV-fighting molecules, preventing the virus from spreading through sexual contact.

Researchers are looking into whether other approaches to dosing are equally effective. A brand new study in the New England Journal of Medicine suggests that taking Truvada before and after sex might be equally effective. The researchers enrolled 400 men at high-risk of contracting HIV to the trial, randomly assigning half of them to a placebo group. Each participant was instructed to take the medicine 2-24 hours before sex, and then again within 48 hours after sex. (All were also told to use condoms and practice safe sex). In the end, the men who took Truvada were 86 percent less likely to contract HIV than those in the placebo group.*

Who should be taking it?

The drug is an option for people with a very high risk of HIV infection due to their sexual activity or drug use. For example, a person with an HIV-positive partner or someone who uses injection drugs can reduce their risk of contracting the virus by 70% to 90% if they take Truvada daily. The CDC reckons that one in four sexually active men who have sex with men, one in five injection drug users, and one in 200 sexually active heterosexual adults are candidates for the treatment, also known as pre-exposure prophylaxis (PrEP).

Are there any risks?

“We talk about PrEP not being a lifelong preventive approach, but rather it’s used during what we call ‘seasons of risk,’” like when you’re dating an HIV-positive person, or perhaps you’re newly single, Dr. Buchbinder explains. People who are on Truvada need to visit their health care provider every three months, in part so that they can be tested for HIV. An HIV-positive person should not be on Truvada, because taking the drug can lead to resistance. It’s also recommended that people also use other HIV prevention methods, including condoms, while taking the drug.

“The other big concern with this drug is really about kidney function,” Dr. Buchbinder explains. “It can’t be taken by people who have pretty severely impaired kidney function, and also kidney function needs to be monitored over time.”

RELATED: 20 New Things You Need to Know About HIV

How much does it cost?

A year’s worth of Truvada costs about $10,000, and expenses for the required quarterly medical visits and lab tests also add up—another part of the reason why few people take it.  But many insurers help cover these costs, and Gilead (the company that manufactures the drug) offers a patient assistance program to help people who can’t afford the medication.

Many experts say the expense is worth it if you have high risks. “We know if we prevent an infection, it saves $350,000 over a lifetime for a person in health costs, so it’s definitely an economically sound approach,” Anthony Fauci, MD, the director of the National Institute on Allergy and Infectious Diseases, told Time earlier this year.

As Dr. Buchbinder put it, at the end of the day, what’s most important is “for people to know that if they’re at-risk now we have something that’s very highly effective and that they should talk to their provider or doctor about.”

RELATED: Top 10 Myths About Safe Sex and Sexual Health

*This information has been updated.

New HIV Treatment Shows Promise in Early Research

By Randy DotingaHealthDay Reporter

WEDNESDAY, Dec. 23, 2015 (HealthDay News) — Preliminary new research raises the prospect that a recently discovered antibody—an important component of the immune system—could be enlisted to boost the body’s response to HIV, the virus that causes AIDS.

A single injection of the antibody, currently dubbed VRC01, dramatically reduced the level of HIV in the blood of people who hadn’t yet been given antiretroviral drug treatment (ART). ART is the current standard treatment for managing HIV infections, according to the study’s authors from the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases in Bethesda, Md.

But in people who’d already been treated with ART, the antibody injection had no effect on HIV levels, presumably because the ART therapy had already reduced the levels of HIV virus in their blood, the researchers said.

And the researchers were quick to note that the study was small and even patients who respond may not be completely rid of HIV.

Still, “this offers a potential alternative to antiretroviral therapy,” said Julian Ma, director of the Institute for Infection and Immunity at St. George’s Hospital Medical School in London. “We desperately need them given our dependence on a relatively small number of antiretroviral therapy drugs.”

Eventually, this new approach could be combined with other treatments aimed at lowering levels of HIV in the body and preventing dangerous strains from emerging, Ma said. He wasn’t part of the research but was familiar with the study findings.

But many questions still remain. The study was small, and at this stage, little is known about the side effects, benefits and potential cost of the treatment. Still, experts are hopeful about the early results that suggest patients can tolerate treatment with the antibody well.

The study appears in the Dec. 23 issue of Science Translational Medicine.

The new research included 14 people with HIV. Six were already receiving ART therapy.

Those six who were already being treated received two infusions of the new antibody treatment, but didn’t have a significant response to the treatment, the study showed.

People who hadn’t yet received HIV treatment — eight patients — were given a single infusion of the drug, the study said.

Levels of the virus in the blood dropped or even vanished in six out of the eight HIV patients who hadn’t been taking ART. That doesn’t mean they were cured of HIV. The virus still remains in the body, just at undetectable levels. Those who didn’t respond to the treatment had strains of HIV that were resistant to the treatment, the study authors said.

The researchers didn’t see signs of side effects. However, the research is in the early stages, representing only the first of three stages of research needed before drugs are typically approved in the United States. Future studies need to look in greater detail at how the drugs work in people who have varying levels of the virus, and what concentration of the antibody is most effective at suppressing the virus, the study authors noted.

The treatment’s costs are unknown, although Ma said these kinds of drugs are generally expensive, which potentially limits their use in poor countries.

Dr. James Crowe, director of the Vanderbilt Vaccine Center in Nashville, Tenn., said the study is impressive and promising. But he cautioned that the effects of single doses of the antibody treatment are “relatively minor and temporary,” and some patients quickly developed immunity to it. As a result, the antibody on its own isn’t likely to work as a long-term treatment, he said.

Ma praised the study but also cautioned about the challenge of HIV strains that are immune to the treatment. “This points to the need to combine this antibody with other antibodies or drugs,” he said.

Going forward, he said, the treatment could be used in conjunction with existing medications, or in cases when those drugs don’t work. Or, Ma said, it could help HIV-infected pregnant women avoid transmitting the virus to their unborn children.

More information

For an overview of HIV treatments, try AIDS.gov.