HIV could be eliminated in a decade
The virus that causes AIDS could theoretically be eliminated in a decade if all people living in countries with high infection rates are regularly tested and treated, according to a new mathematical model.
It is an intriguing solution to end the AIDS epidemic. But it is based on assumptions rather than data, and is riddled with logistical problems. The research was published online Tuesday in the medical journal, The Lancet.
"It's quite a startling result," said Charlie Gilks, an AIDS treatment expert at the World Health Organization and one of the paper's authors. "In a relatively short amount of time, we could potentially knock the epidemic on its head."
Gilks and colleagues used data from South Africa and Malawi. In their model, people were voluntarily tested each year and immediately given drugs if they tested positive for HIV, regardless of whether they were sick.
Within 10 years, HIV infections dropped by 95 percent. Other initiatives like safe sex education and male circumcision were also used.
The strategy would cut the estimated number of AIDS deaths between 2008 and 2050 by about half, from about 8.7 million to 3.9 million, leaving only sporadic HIV cases.
Experts think the strategy's cost would peak at about $3.4 billion a year, though expenses would fall after an initial investment.
"This is certainly beyond the bounds of the current infrastructure for many countries, but that is not a reason not to think big," said Myron Cohen, of the University of North Carolina, who has done similar research. He was not involved in the WHO study.
Only 3 million people are currently on AIDS drugs. Nearly 7 million people are still awaiting treatment, and about 3 million more people were infected last year. Worldwide, WHO guesses that about 33 million people have HIV.
Increasing access to testing and drugs would stretch already weak health systems in Africa, which has most of the world's HIV cases.
"This is not like giving someone a Tylenol," said Jennifer Kates, director of HIV policy for the Kaiser Family Foundation in Washington, DC. Once people start AIDS drugs, they must continue indefinitely. "The idea should be explored, but it's a huge leap," Kates said.
Handing out AIDS drugs to everyone who tests positive could also worsen drug resistance.
In addition, doctors don't know if it's safe to take AIDS drugs for decades; the oldest drug combinations have only been around for about a dozen years.
Other experts questioned whether the strategy might infringe on patient's rights. Once people test positive for HIV, they would be advised to start treatment, even if they weren't sick.
That would benefit the community, but not necessarily the patients themselves. AIDS drugs come with side effects including vomiting, liver failure, and heart attacks.
WHO emphasized that the study findings do not signal a policy change. "This is only a theoretical exercise," said Dr. Kevin De Cock, director of WHO's HIV/AIDS department. He said WHO would hold a meeting next year to study the idea more closely.
Actor Corey Haim died from pneumonia complicated by an enlarged heart, bad lungs and narrowed blood vessels, while drugs found in his system played no role in his death, the Los Angeles County coroner said Tuesday (See our Article R.I.P. Corey Haim).
Haim, 38, died of natural causes from "community-acquired pneumonia" along with lung, heart and blood vessel problems, according to an autopsy report.
Low levels of eight drugs, including both prescription and over-the-counter medications, were found in his system along with marijuana, coroner's spokesman Craig Harvey said.
"But nothing was at a level that would have contributed to his death," Harvey said. They included common cold and flu medications, such as ibuprofen and a cough-suppressant, he said.
Haim, who had struggled with drug problems throughout his life, died March 10 after collapsing in his mother's apartment. Haim was ill with flulike symptoms before his death, and police said he was taking over-the-counter and prescription medications.
"The pneumonia is what killed him," Harvey said.
Mark Heaslip, the actor's agent, did not return a phone message seeking comment Tuesday.
California Attorney General Jerry Brown said in April that Haim employed "doctor shopping" to obtain 553 prescription pills in the two months before his death. Brown called Haim - the star of 1980s films such as "The Lost Boys" and "License to Drive" - a poster child for prescription drug abuse. He said Haim obtained powerful sedatives such as Valium and Xanax and painkillers such as Vicodin and Oxycontin.
However, no Oxycontin was found in his body, Harvey said. He noted that Haim's heart was abnormally large and factored in his death.
"His heart was 530 grams. The average normal heart weighs 300 grams," Harvey said.
Haim also had damaged lungs and arteriosclerosis of his coronary arteries, with some vessels 50-percent and even 75-percent blocked.
Harvey said it was unclear how long Haim had suffered from the medical problems or the pneumonia or whether earlier treatment might have saved him.
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Two years after enrolment into the study, new samples were taken and tested. The situation was unchanged for almost all serodiscordant partners (although one man’s saliva showed neutralising capacity for the first time, and another man lost this ability). Moreover, they all remained HIV-negative. 
