HIV Therapy Cuts AIDS Deaths, but Infection Rates Are Rising

2009 polls showed that most Americans think that AIDS is no longer a major problem. They are wrong. AIDS infection rates are continuing to soar, with 31% of new infections in heterosexuals. The number of women being diagnosed with HIV is rising steadily, particularly among non-whites. Over 1 million Americans are currently living with HIV (human immunodeficiency virus), the virus that causes AIDS.

In 1991, AIDS was the leading cause of death in American men between the ages of 25 and 44. In 1996, AIDS researcher Dr. David Ho was named Time Magazine's Man of the Year after he pioneered an AIDS drug cocktail which was able to cut the HIV viral load in AIDS patients down to undetectable levels. Following his discovery, AIDS deaths declined by over 40 percent in the US. By 2006, HIV therapy had extended the life of the average HIV/AIDS patient by 24 years, at a cost of almost $619,000.

But in 2008, we received the bad news that AIDS in America had risen over the last five years, and was much more widespread than expected. HIV positive rates were soaring among bisexual and gay men, in particular black men.  Although blacks compose only 12% of the US population, they represent 45% of modern HIV infections. In 2010, AIDS is the fourteenth leading cause of death for the general population, but the leading cause of death in black males aged 25 to 44.

Most people get the HIV virus by having sex with an HIV positive person, sharing a needle with an HIV positive person, or being born to or drinking the breast milk of an HIV infected mother. Being HIV positive is not the same as having AIDS. HIV destroys a type of white blood cell that helps your body fight disease, weakening your immune system and eventually resulting in AIDS. Without treatment, nearly everyone with HIV will get AIDS. While we now have effective HIV therapy that drastically slows the progression of the disease and allows victims to remain symptom-free for years, we still don’t have a cure.

HIV drugs slow down the multiplication of the virus. The first HIV drugs, reverse transcriptase inhibitors, are still being used today. A second class, non-nucleoside reverse transcriptase inhibitors, hit the market in 1996, around the same time as the groundbreaking third class, protease inhibitors. They were followed by entry or fusion inhibitors in 2003, and integrase inhibitors in 2007. New HIV drugs are currently in development in the existing classes, and new classes are also being researched.

Each class blocks the virus in different ways, so HIV medication guidelines recommend combinations of three or four HIV drugs.  For that reason, many HIV medications combine two or more HIV drugs into one.  For example, the widely prescribed GlaxoSmithKline Trizivir combines Epivar 150 mg with Ziagen 300 mg and Retrovir 300 mg.

It's estimated that nearly half of the Americans who are currently HIV positive don't know it. "We must confront fear," says Dr. Kevin Fenton, PhD, of the Centers for Disease Control and Prevention, "Many men do not get tested and retested because they are afraid of what they might learn. Finding out you have HIV is hard, but not knowing is even worse and puts your life and others' lives at risk."