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Aids Update: ARV resistance looms as 40% fail to follow regimen

The rising demand for Aids drugs and increasing failure of the 2.7 million South Africans on ARVs to take them properly is leading to new infections among young women.

And dwindling funding threatens the advancements made last year that have brought down the infection rate.
 
"We have made progress but the battle's not won. A fifth of the new infections in the world are taking place in South Africa," said Fareed Abdullah, CEO of the SA National Aids Council.
 
Nearly 40% of people on ARVs don't take them as instructed after three years, amounting to hundreds of thousands of people at risk of drug resistance.
 
Anel Yawa, general secretary at the Treatment Action Campaign, said it is piloting "adherence clubs", and monitors and supports clinics in Khayelitsha and Lusikisiki in the Eastern Cape.
 
Roughly a quarter of the 400000 new infections last year were among women aged 15 to 24.
 
Salim Abdool Karim, director of the Centre for the Aids Programme of Research in SA, said: "South Africa could make a huge impact on its HIV epidemic if it could slow the transmission of HIV in young women."
 
Prevention took a back seat once treatment was introduced said Olive Shisana, CEO of the Human Sciences Research Council.
 
"Treatment is prevention, but we also need to reduce new infections through a combination of social, behavioural and biomedical prevention programmes," she said.
 
People who take the drugs as prescribed and mothers who get ARVs before giving birth are unlikely to infect their partners or newborn babies. South Africa's single biggest achievement is the 90% reduction in babies born with HIV, said Abdullah.
 
Good News
 
Professor Francois Venter, deputy executive director of the Wits Reproductive Health and HIV Institute, highlighted two breakthroughs in the last 12 months.
 
"We have a new class of ARVs which looks safe, is cheap and does not require 95% adherence."
 
The success of PrEP (Pre-exposure prophylaxis) - taking an ARV tablet before a risky exposure - at blocking infection is another advance.
 
Salim Abdul Karim, currently conducting a study on injectable PrEP options, said they could be a "game-changer for young women" if proved safe and effective.
 
"Long-acting injectable antiretrovirals could overcome the challenge [of inserting tenofovir gel at every sex act]. One injection could provide protection against HIV for three months."
 
The Caprisa team and NICD also identified a powerful broadly neutralising antibody against HIV in 2014. They're working with US scientists to test a batch on monkeys. If results show promise, it could lead to human testing of a new vaccine.
 
The first phase of a Thai Aids vaccine tested among South Africans showed encouraging results, released in October. A more powerful version will be tested in a large South African trial.
 
Beating HIV

  •     An estimated 20 million South Africans have been tested for HIV over the past three years;
  •     Nearly 3 million South Africans are on ARVs, 2.7 million of them in the public sector;
  •     About 7000 babies were born HIV-positive last year, down from 70000 in 2004; and
  •     ARVs now cost just R89 a month.

Source: Health Minister Aaron Motsoaledi
Source URL: http://www.timeslive.co.za/thetimes/2015/01/11/aids-update-arv-resistance-looms-as-40-fail-to-follow-regimen

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