HIV: The Forgotten Illness Is Still a Big Deal

Ask anyone if HIV is a problem in this country and the likely answer you’ll get is something along the lines of, ‘No. There are effective drugs to treat it now.’  Or maybe, ‘Sure, HIV is a major problem in places like South Africa, but here?… not the devastating problem it was once.’

HIV is a forgotten illness.

Once the developed world perfected oral drugs to treat individuals infected with HIV, it became the forgotten disease. With treatment being widely available, normal lifespans, and less fear of developing AIDS, one can live with the disease. And without the mainstream media’s focused attention on the ‘AIDS Epidemic,’ the public lost interest.

HIV and AIDS just doesn’t seem to be a big deal any more.

HIV is Still a Big Deal 

However, HIV is still a big deal to the 50,000 Americans who are newly diagnosed every year. And that number has not changed for the past 20 years.

While HIV is not the death sentence it was once, individuals with the infection still deal with a multitude of financial, social, and emotional issues that come with the diagnosis. They are faced with a lifetime of taking costly daily medications; stop the drugs, and the virus comes right back. They are faced with the unpleasant side effects of taking the drug: headaches, nausea, diarrhea, fatigue, and skin rash, to name just a few. They are faced with social misconceptions and other stigma. They are faced with productivity and job loss. They are often ostracized by family and friends.

Yes, HIV is still a big deal to those people.

HIV is also a big deal to the U.S. taxpayer – most of us just don’t know it. In this country, the cost for HIV medications can easily climb to over $1,000 per month, and it has been estimated that an individual infected with HIV will consume $500,000 in healthcare-related services over their lifetime.

Much of that cost is borne by the taxpayer, with an estimated annual cost of $7.5 billion funded through Medicaid, $4.5 billion through Medicare, and $4.1 billion through the Ryan White Act. Additionally, it has been estimated that the aforementioned loss in annual productivity associated with new HIV infections tops $29 billion.

Yes, HIV is still a big deal.

Why Haven’t Infection Rates Declined?

One may ask the question: With an arsenal of effective oral drugs available to treat individuals infected with HIV, coupled with educational campaigns intended to prevent the spread of the disease, why hasn’t the incidence of new infections declined?

With all of the education, clinics, and financial support for HIV medications, in the US, we have maintained an incidence rate of 50,000 new cases of HIV every year for the past 20 years.

The reason becomes obvious when you study the facts. In the US, out of the 1.1 million individuals who are known or suspected of being infected with HIV, only 25% remain in viral control while using the medications. That leaves the other 75% as carriers with the potential to spread the disease.

The reasons for the failure include an individual’s lack of knowledge about their HIV status and noncompliance with drug treatment regimens.

HIV in the Developing World

HIV is an even bigger deal to the 34 million people worldwide who are infected.

The vast majority of them reside in Sub-Saharan Africa, including 88% of the world’s children who carry the virus. In that region, during 2012 alone, there were 1.6 million new HIV infections and 1.2 million deaths from AIDS. Despite preventive education programs and efforts to distribute life-saving antiretroviral medications to developing nations, HIV continues to be the world’s 5th leading cause of death.

Yes, HIV is still a big deal.

Shortages of resources in the developing world leave the challenge of finding a solution to the drug discovery capabilities in North America and Western Europe. In those regions, it has fallen on the government to take a leading role to find (and fund) a solution to the problem.

A Vaccine is the World’s Best Hope

Since the discovery of HIV as the virus that causes AIDS over 30 years ago, researchers have tried to develop vaccines either to prevent acquisition or to treat those already infected. Efforts to discover a vaccine have been frustrating with little evidence of success.

But an effective vaccine is still the world’s best hope to defeat HIV, similar to how smallpox and polio were previously eradicated.

In developing vaccines, the U.S. National Institutes of Health (NIH) takes the leading role. To alleviate the billions HIV is costing the agency every year, the NIH not only supports innovative research, but it uniquely supports promising clinical trials.

Through the HIV Vaccine Trials Network (HVTN), with support from the NIH, more than ninety phase 1 human safety trials have tested a variety of ideas focused on preventing the acquisition of HIV. Out of this number, only five vaccine candidates were worthy of progressing to phase 2 or phase 3 human efficacy trials.

Of those five, only two vaccines continue in clinical trials – one in this country and one in South Africa.

Not Everyone Has Forgotten about HIV

While the NIH and private institutions such as The Bill and Melinda Gates Foundation have not forgotten about HIV, our press has, perhaps, not from disinterest in the disease itself, but the lack of progress.

Plenty of effort has refined the science; so the solution could be close for a preventive vaccine. The new war on treatment options consists of combination therapies of antiretroviral drugs plus vaccines to look for a cure.

We know the standard of care drugs perform well to control the virus, but the virus will remain forever with us without an effective vaccine solution.

HIV is still a very big deal.

But it can be defeated, which is indeed a goal worth supporting.

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