Lowering AIDS infections will be lengthy battle

SAN FRANCISCO – It may be possible to battle AIDS into a low rate of infection, but it will take a long time and elimination of the disease seems unlikely, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease said Saturday.

It’s a disease transmitted by sexual activity, which is a fundamental component of human behavior, “so it isn’t going to be easy to shut it off,” Fauci said at the annual meeting of the American Association for the Advancement of Science.

A quarter century after doctors first began recording cases of the illness, AIDS gets fewer headlines now that drugs are available to help those infected, but the drugs don’t eliminate the virus.

Currently, there are 40,000 new infections in the United States each year with HIV – the virus that causes AIDS – and 4.3 million new infections around the world, he said.

Fauci, a longtime AIDS researcher and the government’s point man on the disease, estimated that one in four Americans with HIV don’t know they are infected.

Public fatigue in reading and hearing about AIDS can become a problem, he added, because “once you take it off the radar screen it’s hard to get out the message of prevention.”

It’s important for infected people to get diagnosed and treated, he said, because people who know they have the disease are less likely to spread it to others. And while current triple-drug treatments can’t eliminate the disease, they can reduce the amount of virus in the system sharply, also helping prevent spread.

Modern three-drug treatment is now being used in parts of Africa and infected people there are using the drugs as prescribed, Fauci said. Starting the treatment in Africa with the triple-drug dose reduces the speed with which the disease can build resistance, he said, rather than starting with a single- or two-drug regimen.

But, Fauci said, resistance to drugs develops sooner or later.

There are several new drugs in the pipeline, many of them promising, for use as second treatments in patients whose disease develops resistance to current therapy. Among the approaches, he said, are drugs to block fusion of the virus with human immune cells and others that may prevent the virus from maturing, he said.