Important note: Information in this article was accurate in November 2002. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; November 18, 2002
Michael Greer, Senior Medical Writer
"Current combination antiretroviral therapies (ARV) are widely used to treat HIV," according to J. X. Velasco-Hernandez and colleagues at the Free Metropolitan University of Iztapalapa and Mexican Institute of Oil in Atepehuacan, Mexico, Harvard Medical School in Boston, and the University of California at Los Angeles. "However, drug-resistant strains of HIV have quickly evolved, and the level of risky behaviour has increased in certain communities."
Despite these phenomena, mathematical infection models show that widespread ARV use could lead to the eradication of HIV, Velasco-Hernandez and coauthors reported.
Using data from the HIV epidemic in San Francisco, the researchers determined the basic reproduction number (R0) for HIV infection in the context of ARV availability. This variable represents the number of new cases generated over the lifetime of one patient, they said, with a value close to 1 indicating a nonzero chance of disease eradication.
A steady decline in the prevalence of high-risk sexual behavior combined with a high rate of ARV usage produced a median R0 of 0.90, and an 85% chance of HIV eradication, study data showed. With no change in behavior patterns, the chance of eradication dropped to 50% as the median R0 rose to 1.0.
Surprisingly, this model showed that HIV eradication could be achieved even if high-risk sex becomes increasingly common although the likelihood drops to about 13% (Could widespread use of combination antiretroviral therapy eradicate HIV epidemics? Lancet Infect Dis 2002 Aug;2(8):487-93.
These results led Velasco-Hernandez and colleagues to concluded that "ARV can function as an effective HIV-prevention tool, even with high levels of drug resistance and risky sex. Furthermore, even a high-prevalence HIV epidemic could be eradicated using current ARV."
The corresponding author for this report is S.M. Blower, University of California at Los Angeles, School of Medicine, Dept. of Biomathematics, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA. E-mail: sblower@biomath.ucla.edu.
A search at www.NewsRx.net using the search term "AIDS and HIV therapy" yielded 1193 articles in 29 specialized reports.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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