|
 Modern drugs for HIV, the virus that causes AIDS, can often achieve
viral suppression, meaning levels of the virus have been reduced to
undetectable levels in the blood.
This week, the AIDS United Public Policy Committee issued a
statement that said virally suppressed people on treatment can't
pass HIV to others, and it recommended that healthcare providers and
educators share this message with the public.
"We feel that the science is very strong on this and felt
comfortable making that statement," said Ronald Johnson, AIDS
United's vice president of policy and advocacy in Washington, D.C.
An expert not involved in the coalition told Reuters Health she
didn't completely agree - but she did say the risk of transmission
in such cases would be "negligible."
People who start treatment for HIV with so-called antiretroviral
therapy (ART) can be virally suppressed within 12 to 24 weeks,
according to the U.S. Department of Health and Human Services (HHS).
Viral suppression can be lifelong if people stay on their medicine.
Over 1.2 million people in the U.S. are currently living with HIV,
according to the Centers for Disease Control and Prevention. Of
those, 86 percent are aware of their diagnosis, 37 percent are on
treatment to stop the virus from replicating and 30 percent are
virally suppressed.
A study published last year in the Journal of the American Medical
Association examined the risk of transmission between a person
living with well-controlled HIV and their HIV-negative partner.
Among 548 opposite-sex and 340 same-sex couples having unprotected
sex, only 11 of the HIV-negative partners became positive over about
a year and a half of follow up. None of the new infections could be
traced back to the partners with HIV. (See Reuters Health story of
July 12, 2016 here: http://reut.rs/2aMSuE9.)
Those researchers and others, however, did not go so far as to say
the risk of transmission is zero. They emphasized that more data is
needed - particularly for condomless anal sex.
"We felt looking at these studies, there is substantial evidence
that we can come to the conclusion that people living with HIV that
have sustained and undetectable viral load cannot transmit HIV,"
Johnson told Reuters Health.
[to top of second column] |
Dr. Michelle Cespedes, associate professor of infectious disease at
Icahn School of Medicine at Mount Sinai in New York, said it's
impossible to say transmission would never occur with condomless
sex.
"To say there is absolutely no risk is maybe a little overstating
it, but based on the evidence to date it’s a reasonable conclusion,"
said Cespedes, who was not involved with the AIDS United statement
but described the risk as negligible.
She said she always recommends condoms and she offers pre-exposure
prophylaxis (PrEP) to HIV-negative patients, which also
significantly reduces their risk of contracting the virus.
The new statement calls for the HHS Antiretroviral Guidelines
Committee to examine the issue and update its language. It also
calls for laws and policies regarding HIV in the U.S. to be
modernized to reflect current science.
Johnson said such changes, along with public knowledge that people
living with HIV can't transmit the infection while on treatment and
virally suppressed, will reduce stigma.
AIDS United also endorsed a consensus statement last year issued by
the Prevention Access Campaign that made a similar determination
about the risk of HIV transmission when the virus is suppressed.
SOURCE: http://bit.ly/2lEOxtg AIDS United, online March 6, 2017.
[© 2017 Thomson Reuters. All rights
reserved.] Copyright 2017 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
