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SAN DIEGO (California) - Health officials are considering a radical shift in the war against HIV and Aids that would see everyone tested for the virus and put on a lifetime course of drugs if they are found to be positive.
The strategy, which would involve testing most of the world's population for HIV, aims to reduce the transmission of the virus that causes Aids to a level at which it dies out completely over the next 40 years.
Dr Brian Williams, professor of epidemiology at the South African Centre for Epidemiological Modelling and Analysis, said transmission of HIV could effectively be halted within five years with the use of antiretroviral drugs (ARVs).
"The epidemic of HIV is really one of the worst plagues of human history," he told the American Association for the Advancement of Science meeting in San Diego.
"I hope we can get to the starting line in one to two years and get complete coverage of patients in five years. Maybe that's being optimistic, but we're facing Armageddon."
Major trials of the strategy are planned in Africa and the United States and will feed into a final decision on whether to adopt the measure as public health policy in the next two years. In the trials, people will be offered HIV tests once a year, either as routine when they visit their GP, or through mobile clinics in more remote regions.
The move follows research that shows blanket prescribing of ARVs could stop HIV transmission and halve cases of Aids-related tuberculosis within 10 years.
More than 30 million people are infected with HIV globally and two million die of the disease each year. While ARVs have been a huge success in preventing the virus from causing full-blown Aids, scientists estimate only 12 per cent of those living with the infection receive the drugs.
The disease is overwhelmingly prevalent in sub-Saharan Africa, which accounts for a quarter of all HIV/Aids cases globally. Half of these are in South Africa.
In general epidemics, a person with HIV infects between five to 10 others before succumbing to complications of Aids. Treating patients with ARVs within a year of becoming infected can reduce transmission tenfold, enough to cause the epidemic to die out.
Scientists estimate that the cost of implementing the strategy in South Africa alone will be US$3 billion to US$4 billion ($$4.2 billion to $5.6 billion) a year.
The world currently spends US$30 billion a year on Aids research and treatment, a figure that some experts believe will double over the next decade.
From TODAY, Tuesday, 23-Feb-2010
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