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EPIDEMICS
Setback for cure overshadows AIDS council of war
by Staff Writers
Paris (AFP) July 17, 2014


New HIV cases in Australia at 20-year high
Sydney (AFP) July 17, 2014 - The number of new HIV cases in Australia remains at the highest level in 20 years, according to data Thursday which reveals many people are not being detected early enough.

The Annual HIV Surveillance report from the University of New South Wales' Kirby Institute found 1,235 new cases of the virus were diagnosed in 2013. There were 1,253 new infections in 2012.

"These are the highest levels we've had in 20 years," the institute's associate professor David Wilson said.

While the rates for the past two years have been stable, the 2013 figure represents a 70 percent rise since 1999, when diagnoses were at their lowest.

Wilson said the evidence suggested that the rise in cases was not due to more testing, but more likely a rise in unprotected sex, particularly among gay men.

The report estimated the number of people living with HIV in Australia at 26,800, but said that about one in seven of these do not know they carry the virus which causes AIDS.

Wilson said people were being diagnosed too late in the process, with about 30 percent detected well after they should have begun treatment to restore their damaged immune system.

"In some cases, people are living for several years without knowing they are HIV-positive," he said.

"This is a double concern: for their own health and that they could be passing the virus on to others.

"If people wait a long time before getting diagnosed, or if they do not start treatment once diagnosed, it is not as easy to recover."

The good news was that people with HIV were living longer, and the treatment rates for patients in Australia were among the world's best.

In Australia, about 60 percent of people living with HIV were on treatment in 2013 which suppressed the virus and reduced the risk of transmission.

"This is higher than almost anywhere else in the world and a great achievement," said Wilson. "In comparison, around 25 percent of people with HIV in the United States are on suppressive therapy."

Factfile on AIDS ahead of the 20th International AIDS Conference
in Melbourne, Australia on July 20-25.

- Since 1981, around 78 million people have been infected by the human immunodeficiency virus (HIV) that causes AIDS. Thirty-nine million have died from AIDS-related illnesses.

- In 2013, around 35 million people, in an estimated range of 33.2-37.2 million, were living with the virus, nearly 71 percent of them in sub-Saharan Africa. In 2001, the total was just under 30 million.

- The toll of infected people is rising mainly because antiretroviral drugs are enabling millions to survive.

- Around 2.1 million people contracted the AIDS virus in 2013, a fall of 38 percent from 2001, while 240,000 children became newly infected, 58 percent down from 2001.

- In 2013, 1.5 million people died from AIDS-related disease, a fall of more than a third since 2005, the pandemic's peak year. In the past three years, mortality from AIDS has fallen by nearly a fifth.

- TB remains the leading single cause of mortality, accounting for around 320,000 of AIDS-related deaths in 2012. Even so, the tally has fallen by more than a third since 2004.

- Since 1995, antiretroviral therapy has averted 7.6 million deaths, 4.8 million in sub-Sahara.

- 12.9 million people in low- and middle-income countries, the bulk of those infected, had access to HIV drugs last year, compared to only 1.3 million in 2005.

- The UN has set a goal of reaching 15 million people by 2015. But 28 million are already eligible under WHO guidelines issued last year.

- Money spent fighting AIDS in poor and middle-income countries last year was $19.1 billion (14.01 billion euros), an increase of around $200 million over 2012. Of this, $9.65 billion came from domestic sources.

For more than three decades, AIDS and those fighting it have been locked in a tango whose steps have gone sideways, backwards or forwards with the lives of millions at stake.

The 20th International AIDS Conference, opening in Melbourne, Australia, on Sunday will have plenty of opportunity to mull the strange dance with this complex, deadly disease.

For several years now, the news has been sunny, a tale of declining mortality and fewer infections -- the outcome of gruelling lab work and billions of dollars in health investment.

Among the greatest pharmaceutical inventions of all time, drugs to repress HIV are more and more reaching those in need, and ways are being explored to use them to prevent infection by the AIDS virus, not just treat it.

Added to this is a campaign under way in sub-Saharan Africa to promote male circumcision, which has been found to be remarkably effective in shielding men from sexually-transmitted HIV.

"It is easy to forget where we were 30 years ago -- overcrowded AIDS wards, little funding for and even less understanding of HIV," Michel Sidibe, chief of the UN's specialist programme UNAIDS, told AFP.

"The AIDS epidemic devastated families, communities and had a major impact on countries where the epidemic took hold. But over the last 15 years, there has been remarkable progress and we have moved from despair to hope."

But, true to AIDS' unpredictable tango, the buoyant mood has been jolted by a sharp disappointment.

A path that seemed to lead to the glittering goal of a cure for HIV now seems to point to a dead end.

The hopes had been sparked by an infant in the United States, known anonymously as "the Mississippi Baby," who was born with HIV to an infected, untreated mother.

She was given a strong dose of drugs immediately at birth and the treatment continued for 18 months, when physicians lost track of her.

When doctors next checked her five months later, they could find no sign of the virus -- an astonishing discovery, given that the human immunodeficiency virus (HIV) invariably rebounds less than a month after treatment is stopped.

Last week, though, it was discovered that after the child had lived 27 months without HIV and drugs, the virus had bounced back.

Far from being cured, the "Mississippi Baby" has been put on drugs, a daily regimen that -- in the present state of things -- may prove to be lifelong.

"The announcement... is of course disappointing for all of us in the field," said Sharon Lewin, a leading cure researcher and professor at Melbourne's Monash University, who will co-chair the six-day conference.

"The case has reminded us that finding a cure for HIV -- or a way to put the virus in long-term remission -- is going to be a tough task."

"Why the virus stayed under control for so long and why it rebounded after two years off ART (antiretroviral therapy) will be key questions we must understand."

- Homophobia and eastern Europe -

Held every two years, the International AIDS Conference also is a forum for campaigners to highlight grassroots and financing problems.

The 12,000 participants will be joined this year by a couple of superstar activists -- former US president Bill Clinton and rock singer and poverty activist Bob Geldof.

The conference will also channel anger about laws in Africa that stigmatise homosexuality and in the former Soviet Union that punish intravenous drug users -- a crackdown now extended to Russian-annexed Crimea.

Evidence shows that whenever people with HIV become outcasts, the disease spreads, said Chris Beyrer, a professor at the Johns Hopkins Bloomberg School of Public Health.

"Despite all our scientific advances, the story in 2014 in many, many countries is a wave of new repressive laws and policies... and restrictions on evidence-based HIV policies," Beyrer said in a pre-conference briefing.

Nobel laureate Francoise Barre-Sinoussi, who co-discovered HIV, said, "We are all very concerned about homophobia, repressive measures, lack of political willingness regarding access to care and treatment."

"We have to make pressures as much as we can on the decision makers in those countries... we have to make those countries respect human rights."

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EPIDEMICS
AIDS could be wiped out by 2030: UN
Geneva (AFP) July 16, 2014
Global AIDS-related deaths and new HIV infections have fallen by over a third in a decade, raising hopes of beating the killer disease by 2030, the United Nations said Wednesday. With more than half of the 35 million people living with HIV unaware they are infected, the battle is far from over however, said Michel Sidibe, head of UNAIDS. "If we are smart and scale up fast by 2020, we'll ... read more


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