The rate at which HIV is progressing to AIDS is slowing, and the new pace could be a result of the virus’ evolution in response to advanced treatments, according to a recent study published in the Proceedings of the National Academy of Sciences of the United States of America. These findings could mean huge advancements in the 30-year battle with HIV, which has already caused around 40 million deaths worldwide.
Led by Prof. Phillip Goulder, researchers from Oxford University collected data from 2,000 women living with HIV in South Africa and Botswana—two of the countries hardest hit by the pandemic. The scientists studied how the women’s immune responses impacted the virus’ ability to advance into AIDS to determine the virus’ virulence.
Specifically studying blood proteins, which allow the immune system to distinguish between harmful proteins and healthy proteins, the researchers found a new evolution in the virus which could be its downfall. HLA-B*57 is a blood protein expressed in the genes of some people that is known to have a protective effect against the virus’ virulence, but the research revealed that in some cases—particularly in Botswana—the virus has become resistant to HLA-B*57’s protective effects.
However, the evolutionary adaptation the virus underwent in order to undermine the protein’s protection also impaired the virus’ ability to replicate, slowing its progression from HIV to AIDS. The researchers believe the virus’ adaptive flaw could help to give medicine the upper hand in the eradication of HIV over time. The study found that an increase in the effectiveness and regularity of antiretroviral treatment (ART) is a factor in forcing the virus to adapt at great risk to its virulence.
ART is a combination of three or more antiretroviral drugs (ARV) proven to significantly lower the amount of HIV in the body, reducing the risk of spreading infection and promoting the health and longevity of HIV sufferers. According to the National Institutes of Health, ART can reduce HIV levels to undetectable amounts, but strict adherence to therapy is necessary and the infection can still be transmitted.
Access to treatment is rapidly increasing, especially in low- and middle-income countries, according to the World Health Organization (WHO). An estimated 35 million people in low- and middle- income countries are living with HIV and roughly 2 million people living with the virus enrolled in ART in 2013, representing the largest annual increase in sufferers receiving ART. In fact, 2013 was the first year the number of people enrolled in therapy surpassed the number of new reported infections since the outbreak began in the early 1980s.
The WHO reports that in 2013, 67 percent of pregnant women with HIV in low- and middle-income countries received medicine to prevent transmission of the virus to the baby. Though the rate of treatment is increasing globally, certain demographics still lack access to necessary treatments. Only 23 percent of children in need of ART received it in 2013, while 37 percent of adults were enrolled in ART, illuminating a disparity between services for adults and children. The WHO also found that the regions with less progress in ART enrollment in 2013 were those in which the virus is concentrated in populations with limited access to health services, such as gay men, sex workers and injecting drug users.
By Sree Aatmaa Khalsa