By Anthony SS Fauci 8 January
Anthony SS Fauci is director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.
In the summer of 1981, the world became aware of a mysterious new disease that was first seen among a relatively small group of gay men in the United States and was soon shown was If a virus causing human immunodeficiency. Fast forward more than thirty years and the whole world is struggling with one of the most devastating pandemics in history.More than 70 Millions of infections occurred primarily among heterosexuals in the developing world, resulting in over thirty million deaths. Despite these terrible statistics, advances in prevention and treatment of HIV transformed the lives of those people infected with HIV who have access to health care, and gave us highly effective methods of preventing HIV infection.
Why is this global pandemic still claiming lives and ruining families? Not because they lack the medical advances and interventions to end the pandemic. It is that our proven tools were not implemented properly or uniformly.
Anti-HIV therapy combination became available in the mid-90, and although the treatment regimens were highly effective in suppressing the virus to undetectable levels is allowed patients to live healthier lives, some questioned whether the cumulative toxicity of pharmacological treatment long term; It would negate the beneficial effects over time. Controlled clinical trials have since the resting place concern showing that most of the management of toxicities therapy measures against HIV contrary are far less harmful than the continuous replication of HIV in the absence of therapy.
Then a revolutionary study showed that early treatment of HIV-infected individuals sooner than later dramatically reduced the likelihood that they would infect their sexual partners. The benefit to public health, from treatment to prevention of later transmission was clear. Still, some have argued that the health benefit to the infected person has been proven, putting doctors in an unenviable position: they knew that individuals infected with viruses could infect others in uncontrollable ways, but they were not able to take the treatment accordingly we strongly recommend to all patients. A study published last year Would put an end to this dilemma showing that treating a person as soon as possible after the diagnosis was far more beneficial to wait until the person's immune system has been damaged completely (or almost). With these studies hinge, there is now no excuse for delay; to all people infected with HIV should be offered antiviral drugs at diagnosis.
But this requires looking for people at risk for infection and testing them; linking infected individuals to medical care; work to keep them in business; and providing anti-HIV drugs. It also requires careful attention avoiding barriers to care, such as poverty, substance abuse, and the question of housing and food insecurity. Globally and domestically did not achieve these goals.
Most of this refers to those who are already infected with the HIV virus. However, 2 million of new infections occur globally each year, including 50.000 In the United States; the last number remained stable for almost two decades. The frustrating fact is that we know exactly who infects who. Of the approximately 1,2 million people living with HIV in the United States, 13 percent who do not know they are infected are responsible for transmitting about thirty percent of new infections per year. Even more surprising, more than sixty percent of new HIV infections are transmitted by people who are aware that they are carrying HIV but are not receiving adequate care. Thus, if we identified all the infected people in the country and continuously, with effective care, including anti-HIV treatment, we could avoid more than 90 percent of new infections each year.
For uninfected individuals, at risk individuals, various forms of prevention are available. An important recent advance comes from a number of clinical trials that have convincingly demonstrated that regularly taking a single pill containing two anti-HIV drugs can reduce an individual's risk of contracting HIV by more than 90 percent. Unfortunately, this prevention strategy - called pre-exposure prophylaxis, or PrEP - is immensely underused. The Centers for Disease Control and Prevention of Opportunistic diseases. That more than 1,2 million people in the United States are at great risk of HIV infection and could benefit from PrEP; however, less than 5 percent of these people are receiving this treatment. To make matters worse, one-third of primary care providers and nurses are aware of the health and potential earning potential that PrEP offers. This situation has to change.
Even in the absence of an effective HIV vaccine, which would be the final nail in the coffin pandemic, we have the tools to end the epidemic of HIV / AIDS in the US and worldwide. We can save the lives of infected people and prevent them from infecting others by having them click on treatment programs and their maintenance. Furthermore, we can effectively prevent HIV infection in at risk populations of a number of means including the use of highly effective Prep.
It is often said that were slow to recognize the severity of the HIV pandemic emerging during the early. At the moment, our ability to combat the spread was scarce. Today we have the tools to end this modern plague. We should not waste the opportunity. History will judge us harshly if we fail.
Translated by Claudio Souza's original No more excuses. We have the tools to end the HIV / AIDS pandemic.