The last couple of years haven’t been a rich source of good news, so perhaps inspired by the improbable heroics of my team Liverpool in reaching the final of the Champions League, I thought I would try to bring you some.
Fortunately, I didn’t have too far to look. An observational study of 1000 gay couples in the Lancet showed that HIV-positive patients treated with antiretroviral therapy (ART), reduced their risk of passing the virus on to zero.
It was a significant place for the story to break because it was the Lancet, back in 1981, which published a paper about the unusual incidence of Kaposi’s sarcoma, a rare form of cancer, amongst a cohort of young gay men in New York. It was the first clue in a trail with led to the discovery of the HIV/AIDS pandemic which has killed 35 million people worldwide in the last 38 years.
We’ve known something of the power of ART for a while now. A couple of years ago, a doctor confided to me that he would rather be HIV-positive than have Type 2 diabetes because he would have more confidence in controlling the comorbidities. But there is something startling about the conclusion that we could end HIV less than 40 years after its discovery. It is a triumph both of medical research and patient activism (indeed some of the advances we have made in breast cancer can be traced to women inspired by the ACT-UP campaign of gay activists against indifference to HIV).
Of course, challenges remain, particularly in sub-Saharan Africa, where infection rates are still high, and ART out of reach. But it shows what can be achieved when researchers, clinicians and an engaged public are all on the same page. Lessons for today perhaps?