In the 2010s, the number of new infections with the human immunodeficiency virus (HIV) fell by a fifth across the world, according to a vast report published Tuesday, November 226 in the Lancet HIV.
Deaths, generally caused by opportunistic diseases when AIDS occurs at the last stage of infection, have fallen by around 40% to fall well below the threshold of one million per year.
This trend is primarily fueled by a clear improvement in sub-Saharan Africa, by far the region of the world most exposed to the AIDS epidemic.
The picture nevertheless remains mixed since infections are rebounding in other regions, such as Eastern Europe or the Middle East. We are far from the objectives of the UN which would like to virtually eradicate the epidemic by 2030.
Effective tools
There is consensus among HIV experts on one point: preventive treatments, known as PrEP, have become crucial in the fight against the epidemic.
Taken by people who are not infected but engage in behaviors considered risky, they work very well to avoid infection.
Specialists are therefore pushing for their expansion. Thus, in France, health authorities have just made this the highlight of new recommendations: PrEP should no longer be reserved for men having homosexual relations.
« It is something that can be used by anyone who needs it at some point in their sex life », Underlined infectious disease specialist Pierre Delobel during a press conference organized by the ANRS institute, which co-signed these recommendations.
People who are already infected have treatments that are increasingly effective and practical, particularly because they need to be taken much less frequently.
Obstacles remain
However, the deployment of treatments – preventive or not – still faces numerous obstacles. This is particularly the case in poor countries, such as in Africa, where the cost of medicines remains a problem.
A case has fueled controversy in recent months. The Gilead laboratory offers a drug, lenacapavir, which promises unprecedented effectiveness, whether in prevention or treatment.
Experts say it could be a game-changer, but its cost is astronomical – $40,000 per person per year.
Under pressure from those involved in the fight against AIDS, Gilead announced at the beginning of October that it would allow the production of its treatment at reduced cost by several generic laboratories, intended for the poorest countries.
However, the barriers are not only financial, particularly for preventive treatments. We must also make people accept the idea of taking them without fear of being stigmatized, while behavior such as homosexuality remains, in fact, unacceptable in many countries.
« The deployment of PrEP in Africa faces a major challenge: that people at high risk realize and recognize that they are at risk », summarized in 2021 an article from the Lancet Global Health.
The problem is the same for screening, which is particularly important since many infections are detected at a well-advanced stage, complicating their treatment.
What about vaccines?
Finally, certain points are the subject of media attention which may appear disproportionate. Thus, research on vaccines which has not yet yielded any convincing results.
With the effectiveness of preventive treatments, “Don’t we finally almost have a vaccine? “, asked infectious disease specialist Yazdan Yazdanpanah, head of the ANRS – a pioneering French institute in the fight against AIDS – at a press conference in mid-October, admitting that ” vaccine research must not stop ».
https://www.whatsupdoc-lemag.fr/article/les-chiffres-du-sida-sont-plutot-bons-en-2023-dans-le-monde-ca-pourrait-etre-encore
Another development that should not be highlighted is the few cases of remission observed in recent years: less than ten in total. Certainly spectacular, they are the consequence of stem cell transplants, risky operations which are only possible in very specific cases.
With AFP
