A long and full life like everyone else. In other words almost “normal”, that is, like that of someone who hasn’t had the misfortune to come across HIV. This is the most important goal achieved after decades of dreaming of creating a vaccine able to prevent or cure AIDS. The vaccine hasn’t arrived yet (an experimentation started at the beginning of 2022) and who knows when it will, but in the meantime the therapies have evolved so much that, if followed properly, the viral load can be lowered, effectively eliminating the chances of develop the disease and infect others. The evolution of therapies have not only led to greater efficacy in the control of HIV, but also to a lesser “invasiveness” of the therapy itself, which also avoids stigma. If previously an HIV-positive person was forced to take over a dozen drugs a day, which later became 2-3, today only 6 injections a year are enough.
A real revolutionary change, on which the famous writer Jonathan Bazzi has recently focused the spotlight, who has just recently started following the so-called long lasting therapy. In practice, they consist of the injection every two months of a drug that contains two active ingredients that inhibit some functions of the HIV virus, an integrase inhibitor and a reverse transcriptase inhibitor. This possibility is accessible only to 50 percent or even less of patients. More precisely to those who have not experienced failures in previous therapies, who have contracted an HIV infection that does not present resistance to long-acting drugs or who have not tested positive for too little time. But it is still a very positive result, above all given that probably, in a short time, the injections could eventually be reduced to even one every 6 months.
But if the news on the therapy front is very good, much less is the news on the circulation of the HIV virus. The “monster” exists and continues to spread and it is essential to remember it, like every year, on the occasion of World AIDS day, which is celebrated on December 1st. Because, even if there is always little talk about HIV, this virus continues to be a threat to global health. According to the United Nations, in 2021 as many as 38.4 million people worldwide were HIV positive, 650,000 died of AIDS-related diseases and 1.5 million people were recently infected. “HIV remains a major public health problem affecting more than 2 million people in the WHO European Region,” the World Health Organization said ahead of World AIDS Day. “In recent years, progress towards HIV targets has stalled, resources have dwindled and many lives are at risk as a result. Unequal access to health services, and in particular to HIV services, and contempt for human rights – he adds – are among the failures that have allowed HIV to become and remain a global health crisis”.
In our country the incidence of infections with three new cases per 100,000 residents is below the European Union average which is 4.3 new cases per 100,000. In total, in 2021 they were registered 1,770 new diagnoses, more frequently in males between 30 and 39 years of age and for over 80 percent of cases the infection occurred through sexual intercourse. However, the most alarming data, released by the AIDS Operations Center of the Higher Institute of Health, is the timeliness with which diagnosis is reached: still too many (63%) discover the infection when it is in an advanced stage. L’covid emergency it could somehow have played an important role in slowing down the infections, but also in a possible underdiagnosis.
The pandemic “has certainly influenced the trend of the spread of the HIV infection,” he says Massimo Galli, former director of the infectious diseases department of the Sacco hospital in Milan. “The Covid period, with restrictions and social distancing, has in fact reduced contacts between people and this has also decreased new infections. However, Covid – he adds – has played a negative role in delaying some diagnoses, with the renunciation of tests ”.
Concerned about late diagnoses too Stephen Vella, professor of global health at the Catholic University of Rome and president of section L (expert researchers on the subject) of the technical-scientific committee for AIDS of the Ministry of Health. “Late diagnoses – dice – they would have no reason to exist today. While the deaths of people with AIDS, although stable at 500 cases a year, remind us that the idea that in rich countries people no longer die from this disease because they have access to specific drugs is a false myth”. The big problem “remains late diagnoses, because when the infection is identified late, the consequences for the patient are worse”, specifies Vella.
Furthermore, it should be remembered that even if the therapies have revolutionized the course of the infection, prevention is still the most important goal to achieve. “It is true that the therapies have represented an epochal step forward”, admits Vella. “But that doesn’t mean that the quality of life of those who fall ill suffers. The fact that we have so many drugs and know much more about the disease should help us not get to the disease itself anymore. And there shouldn’t be any dead. Unfortunately the numbers do not tell us this ”, she concludes.
30science for the Fact