TAB: HIV/AIDS, Hope on the Horizon? Dr. Cohen Speaks Out.

20 Feb TAB: HIV/AIDS, Hope on the Horizon? Dr. Cohen Speaks Out.

The Telluride AIDS Benefit began Friday, February 19, 6-9 p.m. with the Student Fashion Show at Telluride’s Palm Theater. Go here for the event overview.

Can’t attend the gala fashion show? There is yet another opportunity to watch the action. The Town of Mountain Village plans to air Saturday’s fashion show live on Mountain Village Cable Channel 15 and online at townofmountainvillage.com/video, 2/27, 8 p.m.

Please scroll down to listen to my interview with Dr. Myron Cohen, whose research has long focused on the transmission and prevention of HIV.

Dr. Myron Cohen

On June 5, 1981, the U.S. Centers for Disease Control and Prevention put out a report about “five young, previously healthy, gay men in Los Angeles” suffering from strange infections that had already killed two of them.

Throughout that summer, doctors across the United States trumpeted similar cases of “GRID” (Gay-Related Immune Deficiency). The New York Times went on to talk about a “deadly cancer” affecting about 40 gay men in New York and California.

The next year, the CDC named the new plague AIDS and gay men in San Francisco and New York City began the first community-based efforts to eradicate its cause, human immunodeficiency virus or HIV. At the time, condoms were the only reliable defense.

Thirty-five years after the first frightening pronouncements – wrath of God said national leaders like Pat Buchanan and Jerry Falwell – HIV/AIDS is no longer associated with the gay community alone and the infection is no longer a death sentence.

For years now, doctors have treated the virus with a combination of powerful and effective drugs that keep the disease in check, a prime example is an an ovoid-shaped blue pill, brand name Truvada, which has been used for about a decade to treat HIV and was recently discovered to be variably effective in preventing HIV-negative people from contracting the virus. Truvada is now indicated (in combination with safer sex practices) for pre-exposure prophylaxis or PrEp to reduce the risk of sexually acquired HIV-1 infections in adults at high risk.

Again, Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV, but who are at substantial risk of getting the disease, to prevent HIV infection by taking a pill every day. Truvada contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV.

Truvada may be the hope du jour, but at least a corner of blue sky in the dark world of HIV/AIDS twins with name Dr. Myron Cohen, who has been on the forefront of “treatment as prevention” for decades.

Not long after the first FDA-approved drug treatment for HIV/AIDS, AZT, appeared in 1987, Cohen began studying the effect of this and later drugs on the amount of virus in genital secretions. That work led to the idea that people taking these drugs might be less contagious.

In 2005, Cohen launched a clinical study, known as HPTN 052, of 1763 couples, where only one person was HIV-infected. The results indicated that early antiviral therapy reduced sexual transmission by at least a whopping 96 percent.

The then executive director of UNAIDS called Cohen’s findings a “game-changer.”

The Economist speculated on “The End of AIDS,” and “treatment as prevention” became a central part of global HIV/AIDS prevention strategy.

In December 2011, Science magazine, named “treatment as prevention” and Cohen’s HPTN 052 the scientific “Breakthrough of the Year.”

PrEp, antiretrovirals, 15 million HIV-positive people worldwide now on treatment, AIDS-related deaths have declined by 35% since 2005 to 1.2 million in 2014 – all good news. So should we be stashing our red ribbons at the back of the drawer?

Cohen – Associate Vice Chancellor for Global Heath; Chief, Division of Infectious Disease; Director, Institute for Global Health and Infectious Diseases – weighs in.

More about Dr. Myron Cohen:

Myron S. Cohen is the Yeargan-Bate Eminent Professor of Medicine, Microbiology and Immunology and Epidemiology at the University of North Carolina at Chapel Hill.

Dr. Cohen received his BS degree, Magna Cum Laude, from the University of Illinois, Champaign-Urbana. He earned an MD degree from Rush Medical College, Chicago Illinois. He completed training in internal medicine at the University of Michigan and training in infectious diseases at Yale University.

Dr. Cohen is a Fellow of the American College of Physicians and the Infectious Disease Society of America and a member of the Institute of Medicine, the American Society of Clinical Investigation and the American Association of Physicians. He serves as the Director of the UNC Division of Infectious Disease and the UNC Institute for Global Health and Infectious Disease, and as Associate Vice Chancellor for Global Health. Dr. Cohen works as the co-principal investigator of the NIH HIV Prevention Trials Network (HPTN).

Dr. Cohen received the Distinguished Alumnus Award from Rush Medical College in 2000. He received the Distinguished Career Award for lifetime achievement in STD/HIV research from the American Sexually Transmitted Diseases Association in 2005. In 2008, Dr. Cohen was granted the O. Max Gardner Award, the highest honor in the University of North Carolina System. In 2013, Dr. Cohen received the Smadel Award from the Infectious Disease Society in recognition of his work in public health.

Dr. Cohen is the author of more than 500 publications and one book. He has written extensively about the prevention of HIV infection. Much of Dr. Cohen’s research has been conducted over the past three decades in resource-constrained countries, especially in Malawi and in the People’s Republic of China.