Major randomized studies of the impact of antiretroviral treatment expansion on new infections are getting underway, and should provide important evidence to guide further implementation, researchers reported at the International Association of Physicians in AIDS Care summit, controlling the HIV epidemic with antiretrovirals, in London this week.
However, some delegates attending the meeting, which comprised physicians, community advocates, donors and program managers, argued that expansion of antiretroviral treatment in order to achieve an impact on new infections should not be held back by the need to conduct further research.
Prof. Julio Montaner of the University of British Columbia, Canada, a long-time advocate of the use of antiretrovirals for prevention purposes, argued passionately that the available evidence obliged donors, program managers and physicians to move swiftly to make treatment more widely available.
“People have been talking about [another] 1996 moment. Please remember what 1996 was like. We had early results from two clinical trials, we didn’t have clinical endpoints, viral load hadn’t been validated, [but] we put it all together and flew by the seat of our pants. Morbidity and mortality declined by 90% within a year. My concern is, we have the evidence today – what are we going to do to expand treatment to everyone who is eligible?”
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