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EPIDEMICS
Swaziland halves world's highest HIV infection rate
By Mariėtte Le Roux
Paris (AFP) July 24, 2017


Candidate AIDS vaccine passes early test
Paris (AFP) July 24, 2017 - The three-decade-old quest for an AIDS vaccine received a shot of hope Monday when developers announced that a prototype triggered the immune system in an early phase of human trials.

Tested in 393 people in the United States, Rwanda, Uganda, South Africa and Thailand, the drug "raised antibody responses in 100 percent of vaccine recipients," Dan Barouch, a member of the research team, said in Paris.

"These promising... data, together with advances from many other investigators in the field, support a new sense of optimism that development of an HIV vaccine might in fact be possible," he told journalists at an HIV science conference organised by the International AIDS Society (IAS).

A vaccine is widely considered the best way of ending an epidemic that has seen 76.1 million people infected with HIV, the virus that causes AIDS, since the early 1980s.

Some 35 million have died.

Last year alone, 1.8 million people around the world were newly infected, according to UNAIDS, and there were 36.7 million people living with the virus.

Of those, 19.5 million had access to virus-suppressing anti-retroviral treatment (ART).

"The ultimate control of the worldwide HIV epidemic will likely require the development of a safe and effective vaccine," said Barouch, director of the Center for Virology and Vaccine Research at the Beth Israel Deaconess Medical Center in Massachusetts.

"But to date, only four vaccine concepts have been tested for clinical efficacy in the 35-year history of the epidemic."

The team hopes their prototype will get approval for the next trial phase.

The vaccine uses a common cold virus to deliver antigens -- foreign substances that induce the recipient's immune system to produce intruder-fighting antibodies. The vaccine is boosted with a protein that raises antibody levels.

- 'Important news' -

In an earlier trial, the prototype prevented infection in 66 percent of rhesus lab monkeys, said Barouch.

In humans, it has now been shown to be safe and to generate an immune response.

"Of course, we don't know yet whether this vaccine will protect humans," the researcher said.

"However, these data to date support the advancement of this vaccine candidate into a larger... efficacy trial, which we hope will start before the end of this calendar year."

That will depend on additional data to be gathered in the coming months.

IAS president Linda-Gail Bekker described the results as "important news".

Condoms are still at the frontline of efforts to prevent infection -- mainly through sex and blood contact.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) in Maryland, told AFP that developing a vaccine was "going to be very difficult" but "would be really a game changer".

"If in fact we get a very moderately-effective, a 50-60 percent effective vaccine, that will go a long way when you combine it together with other prevention modalities... to really having a major impact on the pandemic," he said ahead of the conference.

Another vaccine candidate, dubbed HVTN 702, is being tested in a major clinical trial in South Africa.

Swaziland, which bears the world's heaviest HIV burden, has almost halved the rate of new infections in five years by boosting access to virus-suppressing drugs, researchers said Monday.

The country -- where one in three adults is infected with the AIDS-causing virus -- has vastly expanded public programmes to test people for HIV infection and put them on life-saving anti-retroviral treatment (ART).

"The rate of new HIV infections has been reduced by half," Velephi Okello of the Swazi health ministry told journalists at an HIV science conference in Paris.

"Remarkable progress has been made... in controlling the HIV epidemic."

In 2011, 31 percent of adults (aged 18-49) out of a total country population of just over 1.2 million were infected with HIV, according to government data.

This made Swaziland the country with the highest national rate of new infections, said the authors of the new study, as well as the highest proportion of people living with HIV.

The latest data, based on blood samples from almost 11,000 people aged 15 and over, showed that about 27 percent of the population was HIV-positive in 2016.

This translated to an infection rate of 1.39 percent among 18- to 49-year-olds, down from 2.58 percent in 2011 -- a 46-percent reduction.

Ninety-five percent of HIV-positive pregnant women last year received drugs to prevent transmission of the virus to their offspring.

"As a result, fewer than 1,000 children became infected with HIV in Swaziland in 2016," said the UN agency.

- 'Great news' -

The infection rate was higher among women than men, according to a survey report to the International AIDS Society conference. The decline was also steeper for men, with 52 percent, than for women (40 percent).

The survey showed that 73 percent of HIV-positive people had achieved suppression of the virus -- meaning it does not replicate to make them ill -- compared to 35 percent in 2011.

The gains were the fruit of a much improved HIV treatment programme, said the researchers. The share of infected people on ART rose from 37 percent in 2011 to 74 percent last year.

ART not only stops HIV from replicating and attacking a patient's immune system, but also curbs its spread to sexual partners.

"Our recipe for success is that we... have been able to scale up a lot of the prevention and treatment services in the country," said Okello.

"We have more than doubled the number of people who have started on anti-retroviral treatment, and we have also almost doubled the number of men who have been circumcised in the country."

According to the World Health Organization, there is "compelling evidence" that male circumcision reduces the risk of heterosexual sexual transmission of HIV by as much as 60 percent in men.

The number of HIV tests conducted in Swaziland more than doubled from 176,000 in 2011 to 367,000 in 2016.

"Basically, we think that that's one of the recipes (for success), and also the government commitment to buying and procuring the ARVs for people in the country so that there is a sustainable response going forward," said Okello.

Despite the "great news", she cautioned much more needs to be done to maintain the downward trend.

"While we do celebrate these findings, we still know that Swaziland is facing a severe HIV epidemic," she said.

"In the end, we would like to see a Swaziland which is free from AIDS."

EPIDEMICS
S.African girl, 9, is third child with HIV remission: study
Paris (AFP) July 24, 2017
A South African girl has become only the third child to beat the AIDS virus into long-term remission - almost nine years and counting - after receiving a drug cocktail in infancy, researchers announced Monday. The child was given a ten-month course of anti-AIDS medicine until she was one year old, then taken off the drugs as part of a medical trial. Eight years and nine months later, t ... read more

Related Links
Epidemics on Earth - Bird Flu, HIV/AIDS, Ebola

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