Preventing Mother to Child Transmission of HIV/AIDS

The Kaiser Family Foundation is reporting live from the XVIII International AIDS Conference in Vienna Austria, which is going on now. Below is a video. After an introduction, Bill Gates starts speaking about ‘Building on Success: A Roadmap for HIV Prevention’ at 8:00 minutes.

During his presentation, he speaks about preventing mother to child transmission saying that ‘we can eliminate pediatric AIDS’. The entire video is 48 minutes long and covers lots of different HIV/AIDS topics, so those who are primarily interested in the section of the video regarding pediatric HIV/AIDS and prevention may want to forward the video to start watching at 38:15. At this point is a Q & A with Elizabeth Glaser Pediatric AIDS Foundation president Chip Lyons and Bill & Melinda Gates Foundation co-chair Bill Gates. The highlight: Lyons asked Gates what we could do to step up our efforts to prevent new pediatric infections, and how we could move closer to eliminating altogether HIV and AIDS in children.

“It’s outrageous that we haven’t done better on [eliminating HIV and AIDS in children],” Gates answered. “We need to get countries to set aggressive goals. We need to get the political leaders to recognize the tragedy that this is.”

He added that he was “horrified” that only 45 percent of women currently had access to PMTCT services.

“In terms of cost of the intervention, the impact on the lives involved, that should be something that we have above 90 percent. This is one where, even in the next year, I’d like to see a big change.”

He expressed optimism that this goal was entirely reachable, and acknowledged Elizabeth Glaser Pediatric AIDS Foundation’s pivotal role in making this happen.

A Breakthrough in HIV Vaccine Research

HIV Vaccine Research Developments
This image shows the antibody VRCO1, pictured in blue and green, binding to HIV, colored gray and red.

Los Angeles Times Article

A pair of naturally occurring antibodies are able to kill more than 90% of all strains of HIV, researchers say. The finding could lead to the development of new treatments and a possible vaccine.

An effective vaccine against the AIDS virus may have moved one step closer to reality, researchers said Thursday.

Federal researchers have identified a pair of naturally occurring antibodies that are able to kill more than 90% of all strains of the AIDS virus, a finding they say could lead to the development of new treatments for HIV infections and to the production of the first successful vaccine against the virus.

HIV, the virus that causes AIDS, is notoriously mutable, changing the composition of proteins on its surface with ease to escape pressure from the immune system. This enables it to continue infecting cells even after the appearance of antibodies targeting it — and to avoid the relatively ineffective vaccines developed so far.

Hundreds of variants of the virus are now in circulation around the world, and the identification of so-called broadly neutralizing antibodies that can block the bulk of them has been the holy grail of HIV researchers.

To date, however, the best antibodies — immune system proteins that fight infections — that researchers have found block only 30% to 40% of all HIV strains. The identification of antibodies that can block more than 90% of strains could lead to what some researchers are dubbing a renaissance in AIDS prevention and treatment.

The key to the new antibodies is that they bind to a site on the virus surface that rarely mutates.

“I am more optimistic about an AIDS vaccine at this point in time than I have been probably in the last 10 years,” Dr. Gary Nabel of the National Institute of Allergy and Infectious Diseases told Reuters. He led the research reported Thursday in the online edition of the journal Science.

Continue Reading…

Antiretroviral Therapy Significantly Cuts Risk of HIV Transmission

A while back I had posted about this BBC report which stated that antiretroviral therapy (ARV/ART) medications make HIV positive people become “close to non-infectious”. It also stated that “early detection and treatment would prevent transmission”. This new article Study Confirms That Antiretroviral Therapy Significantly Cuts Risk of HIV Transmission states that HIV positive individuals who used antiretroviral therapy reduced the risk of transmitting HIV to their uninfected partners by 92 percent. I find these studies interesting because it is increasingly clear that medicated individuals  are hardly a risk to people they are engaging in risky behaviors with. Therefore, they are absolutely not a risk to people with whom they are not having sex with, nor sharing needles with. The point is that the people who are spreading HIV are people who do not know they have it (and are therefore not taking medication) and people who unfortunately do not have access to the medication (in resource poor settings).

Infant HIV Testing

HIV can be passed from a birthmother to child during pregnancy, labor, delivery or breastfeeding. Transmission rates are approximately 35% if the mother and child are not treated (this average varies in different parts of the world and twins have a higher transmission rate).  The best way to prevent transmission is for the mother to stay on a course of anti-retroviral therapy(ARV) throughout the pregnancy, and for the newborn baby to receive medicine as well. In this scenario, transmission rates fall to 1%.

All newborn babies carry their birthmother’s antibodies. A baby born to a mother with HIV will test positive to an HIV antibody test, until the mother’s antibodies leave the baby’s bloodstream, which can take up to 18 months. This does not mean that the baby has HIV. The recommended HIV test for babies 18 months or younger is a PCR test which tests the baby’s DNA (not the antibodies).

Negative: HIV infection can reasonably be excluded among HIV exposed children with two or more negative DNA PCR tests performed at age greater than one month and one of those being performed at or greater than four months. Negative DNA PCR tests drawn when the infant is less than 28 days do not exclude HIV infection, particularly if the infant has been exposed to antiretroviral medication in utero or after birth.

Positive: An infant is diagnosed as infected at any age by two positive DNA PCR tests performed on separate specimens.

HIVguidelines.org

UN seeks to eliminate mother-to-child-transmission in Africa

Could this be the last generation of AIDS orphans? From the United Nations News Centre. A wonderful ambitious plan. Here is a short excerpt:

The United Nations is seeking to virtually eliminate mother-to-child transmission of HIV in sub-Saharan Africa, where 390,000 infants became infected with the virus that causes AIDS in 2008, through the use of antiretroviral drugs during and after delivery.

“AIDS has become the leading cause of death among infants and young children in much of sub-Saharan Africa,” Joint UN Programme on HIV/AIDS (UNAIDS) Executive Director Michel Sidibé said…

BBC: ARVs make HIV+ people become close to non-infectious

This BBC report is about using ARVs to stop the spread of AIDS. In it, Dr. Brian Williams, a leading figure in the field of HIV research is sited:

Speaking at at the annual meeting of the American Association for the Advancement of Science (AAAS) in San Diego, he said 30 million people around the world were infected with HIV – with two million dying each year.

“The tragedy is that the disease continues unabated. The only real success story is the development of these extremely effective drugs that keep people alive and reduce their viral load by up to 2,000 times. They become close to non-infectious.

I make note of this because people living with HIV/AIDS in the United States are given ARV meds so that their viral loads become ‘undetectable’. In other words, there is VERY little of the HIV virus in their bloodstream. This report is claiming that an undetectable state is close to a non-infectious state. If you read between the lines, Dr. Williams does not even mention the use of condoms – he mentions the use of ARVs to stop the spread of the virus. [I could go into a discussion about that, but this post is about the article itself.]

This is the second time I have heard the word ‘non-infectious’ being used. The first time being the Swiss study which says that HIV-positive individuals on effective antiretroviral therapy and without sexually transmitted infections (STIs) are sexually non-infectious.

However, separate research (last paragraph) showed that 10% of men with an undetectable blood viral load had “significant” viral load in their semen which they said meant that HIV could be detected, but were unable to say if potentially infectious quantities of the virus were present.

South Africa to Treat All HIV Positive Babies

According to this article, South Africa will begin ARV treatment for all babies born to HIV positive women. All pregnant women who seek treatment, will also receive anti-retroviral medication. This is very big news and will save hundreds of thousands of babies’ lives. Pregnant women and newborn babies receiving treatment brings down the chance of the child being infected to less than 2%. Under the new policy, which will take affect in April, all children under 1 year of age will receive treatment.

Kurt Firnhaber, who runs Right to Care, one of the largest private providers of AIDS treatment, counseling and testing in South Africa, said Zuma outlined “steps that aren’t rhetoric – if they’re implemented.”

He said the burden would now be on the government and foreign donors to find the money to meet Zuma’s ambitious goals.

On Tuesday, in response to a plea from Zuma, the United States announced it was giving South Africa $120 million over the next two years for AIDS treatment drugs. That is in addition to $560 million the U.S. has already pledged to give South Africa in 2010 for fighting AIDS.

World AIDS Day

In honor of World AIDS Day, I would like to bring attention to some very important help for HIV positive orphans around the World.

AHOPE for Children is in need of 15 new sponsors to save the lives of 15 HIV positive orphans in Addis Ababa, Ethiopia. Cost of sponsorship is $35 per month. There are more than 1 million HIV+ children in Ethiopia. AHOPE now has room to accept 15 more orphans into its care homes. The funds go to basic necessities such as food, medication, education and holistic care.

agapeFrom HIV To Home’s Five For Five Campaign: Donate $5 per day for 5 days to help HIV positive orphans. Today’s donations go to Agape Children’s Home in Thailand.

dsc07917The Heart of the Matter is advocating for a family for an HIV+ orphaned sibling group of three: an 8 month old baby boy and his 3 year old and 5 year old siblings. Could you be the missing parents?

ElizabethGlaserPediatricAIDSFoundationElizabeth Glaser Pediatric AIDS Foundation has announced a tireless goal to decrease new pediatric HIV infections by one-half over the next 5 years, preventing nearly a million infections in children. The Foundation, together with its partners, will work to reach 15 million pregnant women with prevention of mother-to-child transmission (PMTCT) services in many of the world’s most vulnerable countries.