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  • The world is getting closer

  • to achieving one of the most important public health goals of our time:

  • eradicating HIV.

  • And to do this, we won't even have to cure the disease.

  • We simply have to stop HIV from being transmitted

  • until eventually it fizzles out.

  • Once, this goal would have seemed impossible.

  • HIV has caused millions of deaths

  • and is one of the most devastating diseases that humanity has ever known.

  • But we're now at a point where new advances

  • such as one-pill, once-a-day medications

  • are helping us tackle HIV in effective ways.

  • HIV is a retrovirus

  • meaning it integrates copies of itself into an infected cell's DNA,

  • allowing it to replicate and infect other cells.

  • HIV has evolved numerous ways to evade the human immune system,

  • which makes it difficult to cure.

  • But by developing ways to block HIV replication,

  • we can stop the spread of HIV itself.

  • That's where antiretrovirals– a.k.a. ARVscome in.

  • ARVs are a group of drugs which work in different ways to combat HIV.

  • Some block HIV's access into immune cells,

  • and others work by stopping the virus itself from replicating.

  • ARVs also work preventatively in people who don't have HIV.

  • This type of approach is called pre-exposure prophylaxis, or PrEP.

  • PrEP works by accumulating in a person's body

  • and preventing HIV from establishing itself.

  • That means an HIV-negative person who may be at risk of contracting the disease

  • can take certain ARVs to protect themselves,

  • before they become exposed.

  • Here's where it gets especially interesting:

  • In people with HIV, ARVs can also dramatically reduce HIV transmission.

  • This is calledTreatment as Prevention.”

  • On a global scale, this has the potential to end the HIV epidemic.

  • It's based on the idea that someone with HIV who takes ARV's

  • can lower the virus level in their bodies until it becomes undetectable.

  • That doesn't mean the virus is gone;

  • it could still be lurking within cells, ready to reactivate if treatment stops.

  • But so long as it's kept dormant with drugs,

  • HIV remains undetectable.

  • And when HIV is undetectable, it's untransmittable, too.

  • In theory this means that by testing everyone who's at risk of HIV

  • and treating those who test positive,

  • we could stop transmission and eventually eradicate HIV.

  • In the real world, however, things are more complex.

  • Many at-risk HIV negative people across the world

  • do not have access to PrEP or ARVs,

  • and those who are HIV positive may experience challenges to taking ARVs.

  • These problems are often greatest in countries

  • where the burden of HIV is highest.

  • Getting these medications depends on access to a functioning healthcare system

  • and this isn't something everyone has.

  • That's part of the reason why stopping the spread of HIV for good

  • will require a significant investment of resources to improve those systems.

  • One study carried out by the UNAIDS

  • estimated that between 20-30 billion dollars per year

  • would be needed to achieve a nearly 90% reduction

  • in new HIV infections by 2030.

  • This investment would ensure more people would get tested in the first place,

  • and more would be able to access and maintain treatment.

  • Achieving this goal and improving healthcare in general

  • is in everyone's best interest,

  • from individual people to society as a whole.

  • We have roadmaps that could allow us

  • to bring the HIV epidemic to an end in the near future,

  • with the possibility of eradicating the disease altogether

  • several generations in the future.

  • In the period from 1996 to 2017

  • we almost halved the number of new HIV infections,

  • and for the millions of people who still live with the virus,

  • ARV treatments enable most to lead long and healthy lives.

  • With continued and increased investments,

  • we can get transmission rates low enough to end HIV once and for all.

  • A world without HIV is no longer inconceivable:

  • it's closer than ever.

The world is getting closer


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HIVの根絶にどれだけ近づいているのか?- フィリップ・A・チャン (How close are we to eradicating HIV? - Philip A. Chan)

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    April Lu に公開 2021 年 01 月 14 日