The other day Mitchel criticized me, Marc Cooper and Doug Henwood for our
attitudes on the current Pacifica battles. The news below provides further
evidence that by featuring AIDS denialist Gary Null so prominently in its
programming, something that Mitchel enthusiastically supports, WBAI is
dealing in death.

By the way, that's an attack on Mitchel's misguided politics, not him as a
person. I have never met him but fully assume that he means well.


May 12, 2011
Early H.I.V. Therapy Sharply Curbs Transmission By DONALD G. McNEIL

People infected with the virus that causes
far less likely to infect their sexual partners if they are put on treatment
immediately instead of waiting until their immune systems begin to
deteriorate, according to preliminary results from a large clinical trial
released Thursday.

Patients with H.I.V.<>
 were 96 percent less likely to pass on the
they were taking antiretroviral drugs — a finding that is so overwhelming
that it is likely to change the way American AIDS doctors treat patients and
what treatment policies are adopted by the World Health Organization and
other countries, said Dr. Anthony S.
head of the National Institute of Allergy and Infectious Diseases, which
paid for the trial.

The data was so convincing that the trial, scheduled to last until 2015, is
effectively being ended early.

There have been previous studies, notably among drug abusers in San
Francisco and Vancouver, British Columbia, that concluded that starting
patients on drugs immediately would stop them from infecting others.

Those studies led Unaids, the United Nations AIDS-fighting agency, to adopt
“test and treat” as its goal last year; the policy encourages doctors to
start people on treatment as soon as they test positive for H.I.V. However,
this is the first evidence from a randomized clinical trial, the gold
standard in medical research.

AIDS prevention specialists not connected to the trial were enthusiastic.

“These results are phenomenal,” said Thomas J. Coates, director of the
global health program at the University of California, Los Angeles, and the
founder of the Center for AIDS Prevention Studies in San Francisco. “It was
a tough study to do, and I’m thrilled it came out this way.”

Dr. Julio Montaner, an AIDS specialist at the University of British Columbia
whose work among Vancouver heroin addicts helped lead to the Unaids policy,
called the result of 96 percent protection “as good as it gets.”

“This is consistent with what we’ve been saying and doing in British
Columbia for close to a decade,” he said. “How much more evidence do we need
before we implement what we know works?”

The $73 million trial, known as HPTN 052, involved 1,763 couples in 13
cities on four continents. One member of each couple was infected with
H.I.V.; the other was not. In half the couples, chosen at random, the
infected partner was put on antiretroviral drugs as soon as he or she tested
positive for the virus.

In the other half, the infected person started treatment only when his or
her CD4 count — a measure of the immune system’s strength — dropped below
250 per cubic millimeter.

In 28 of the couples, the uninfected person became infected with the
partner’s strain of the virus. Twenty-seven of those 28 infections took
place in couples in which the partner who was infected first was not yet
getting treatment.

On Thursday, Dr. Fauci and Dr. Myron Cohen, an AIDS specialist from the
University of North Carolina at Chapel Hill and the study’s director,
announced that the data collected since the study began in 2005 had been
“unblinded” to an independent safety review panel, which is standard
procedure in clinical trials. When the panel realized how much protection
early treatment afforded, it recommended that drug regimens be offered to
all participants. Although participants will still be followed, the trial is
effectively over because it will no longer be a comparison between two
groups on different regimens.

The results carry moral implications for doctors in the United States.
Although medical associations like the Infectious Diseases Society of
America advocate starting patients on AIDS drugs early, the decision is made
by the doctor and patient. Some patients fear the reported side effects of
AIDS drugs and want to delay taking the drugs until they get obviously sick
or until their CD4 counts fall, and some doctors go along with that, Dr.
Fauci said, especially as long as their patients’ CD4 counts remain above

But that means the patient may infect others during the delay. Of the 27
people in the study who became infected while their partners were not yet
taking the drugs, 17 had partners whose CD4 counts were still above 350.

Asked if it could now be considered immoral for a doctor to accede to a
patient’s request to delay starting drugs, Dr. Fauci said: “I’m not going to
go there. I’m not going to say it’s immoral. But there is more and more data
showing the advantages of starting as early as you can.”

Dr. Coates of U.C.L.A. said he hoped that treatment delays would fade away
because the newest antiretroviral drugs had few side effects.

Although the evidence suggests that it would be good public health policy to
lower infection rates by starting everyone on drugs as soon as they are
infected, that is impossible in much of the world. For lack of money,
clinics in Africa are turning away patients who are not just infected but
close to death. And in some American states where money provided by the Ryan
White Care Act has run out, poor uninsured people are on waiting lists.

Although the trial was relatively large, there are some limitations on
interpreting the data.

More than 90 percent of the couples in the trial, who lived in Botswana,
Brazil, India, Kenya, Malawi, South Africa, Thailand, the United States and
Zimbabwe, were heterosexual.

“We would have liked to have a substantial number of men as potential study
subjects, but they just weren’t interested,” Dr. Cohen said.

Although common sense suggests the results would be similar in the contexts
of homosexual sex and sex between people who are not couples, strictly
speaking, the results apply only to the type of people studied, Dr. Fauci

Michael Balter
Contributing Correspondent, Science
Adjunct Professor of Journalism,
New York University

Email:  [log in to unmask]

"When I give food to the poor, they call me a saint. When I ask why the poor
have no food, they call me a Communist." -- Hélder Pessoa Câmara