The light at the end of the tunnel in the fight against the AIDS epidemic seems to be sight after a landmark study found that men with the HIV infection were completely suppressed by antiretroviral drugs and had no chance of infecting their partners. This is being considered a functional cure for now as the drugs suppress the amount of HIV virus in the body to such low levels that it can’t be detected or make you ill – but it would still be present. Reports claim that were the drugs to succeed then it could be possible that people with HIV could live without the stigma of having transferred the infection.
The Guardian reported that in the 1,000 male couples throughout Europe, where one of the partners had HIV, the person receiving treatment to suppress the virus showed no cases of transmitting the infection to their HIV-negative partners during sexual intercourse without a condom.
Even though 15 men were infected with HIV during the eight-year study, DNA testing proved that this happened when they had sex with partners who were not on the treatment. Professor Alison Rodgers from University College London, the co-leader of the paper which was published in the Lancet medical journal, said: "It’s brilliant – fantastic. This very much puts this issue to bed." Earlier studies have also shown that the treatment protects heterosexual couples as well.
She added: "Our findings provide conclusive evidence for gay men that the risk of HIV transmission with suppressive ART [antiretroviral therapy] is zero. Our findings support the message of the international U=U campaign that an undetectable viral load makes HIV untransmittable. This powerful message can help end the HIV pandemic by preventing HIV transmission, and tackling the stigma and discrimination that many people with HIV face."
Prof. Rodgers continued: "Increased efforts must now focus on wider dissemination of this powerful message and ensuring that all HIV-positive people have access to testing, effective treatment, adherence support and linkage to care to help maintain an undetectable viral load."
There were almost 40 million people living worldwide who were diagnosed with HIV in 2017 of whom 21.7 million were on the antiretroviral treatment. An estimated 101,600 people are currently living with HIV in the UK alone and about 7,800 of these are undiagnosed, which means they do not know they are HIV positive. Approximately 1.1 million people in the US are living with HIV today. About 15 percent of them (1 in 7) are unaware they are infected. An estimated 38,700 Americans became newly infected with HIV in 2016.
According to the National Aids Trust, around 97% of the people on the HIV treatment in the UK have an undetectable level of the virus, which means they cannot pass it on to others. Deborah Gold, the trust’s chief executive, said: "Hearing this can be enormously empowering and reassuring to people living with HIV." The latest findings have reinforced the importance of people who take HIV tests regularly, which could lead to an end of transmitting the virus in the future.
New diagnoses have been on the downward curve since they peaked in 2005, with numbers from 2017 showing that there was a 17% drop on 2016 and a 28% fall compared to 2015. Late diagnosis is still a major challenge and still accounts for around 43% of the new HIV diagnoses. This affects certain groups in a disproportionate way, including black African heterosexual men and people who are 65 years and older.
Gold said: "If we don’t reduce late diagnosis, there will always be those who are not aware of their HIV status and who therefore cannot access treatment. We think that the findings from this study could be incredibly powerful in breaking down some of the barriers to testing in communities where there is still a lot of stigma around HIV."
Myron S. Cohen of the UNC Institute for Global Health and Infectious Diseases at Chapel Hill in North Carolina said in a linked comment in the journal that he was optimistic for the future treatment of the disease. He said: "During the course of these studies, antiretroviral drugs have become more effective, reliable, durable, easier to take, well tolerated and much less expensive."
He added: "The results … provide yet one more catalyst for a universal test-and-treat strategy to provide the full benefits of antiretroviral drugs. This and other strategies continue to push us toward the end of AIDS."