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World AIDS Day: Corona pandemic slows down the fight against HIV worldwide


The HIV pandemic began 40 years ago - today more than 37 million people worldwide live with the virus. What the corona crisis means for the fight against AIDS and what treatment options are available.

Enlarge image

HI viruses (orange) infiltrate T lymphocytes (blue): In 2020 around 1.5 million people around the world were newly infected

Photo: KATERYNA KON / Science Photo Library RF / Getty Images

The corona crisis is having a dramatic impact on the containment of the HI virus.

Due to Covid-19, funds actually intended to fight HIV were diverted, prevention programs were compromised and supply chains - also for medicines essential for survival - were interrupted.

This is reported by the UN program Unaids, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the German Aids Aid.

The fight against HIV progressed too slowly worldwide even before the outbreak of the corona pandemic.

However, due to Covid-19, HIV containment suffered another setback, said the managing director of the German Aidshilfe Silke Klumb before World AIDS Day on December 1st.

"Pandemics increase inequality"

According to UN figures, around 80 million people worldwide have become infected with the HIV virus since the first AIDS cases were reported in 1981, and 36.3 million infected people have died. In 2020 around 1.5 million people around the world were newly infected with the virus and 680,000 died. About 37.7 million people are currently living with the infection. Two thirds of all people with HIV live in sub-Saharan Africa.

According to Unaids, people infected with HIV are twice as likely to die of corona disease as the general population.

However, most people with HIV still have no access to corona vaccines: In South Africa, for example, only three percent of the population had received at least one vaccine dose by mid-2021.

"Pandemics increase inequality," said the executive director of the Global Fund, Peter Sands.

"We are in a time of unprecedented challenges."

Unclear origin of the omicron mutant

According to the Global Fund, there has been a more than ten percent decline in HIV testing and HIV prevention measures worldwide over the past year. As a result, many people infected with HIV started treatment late. The corona pandemic also had "catastrophic effects" on the global fight against tuberculosis (TB). The number of HIV-positive TB patients who received both antiretroviral and TB treatment fell by 16 percent in 2020.

Because so many HIV-positive people in South Africa receive neither HIV therapy nor a corona vaccination, various virologists consider it possible that the omicron mutant of the coronavirus originated in an HIV-infected person or a patient with another form of immunodeficiency could be.

In people with a weakened immune system, the virus can multiply over many weeks, said Carsten Watzl, Secretary General of the German Society for Immunology (DGfI).

"During this process, isolated mutations can occur that may not be of any benefit to the virus, but which can continue to multiply due to the lack of control by the immune system."

Declining numbers in Germany

In Germany, slightly fewer people were infected with HIV last year than in 2019, reports the Robert Koch Institute (RKI) in Berlin.

According to one estimate, the number of new infections is 2000 and thus 300 cases lower than in the previous year.

This emerges from an RKI report published on Thursday.

Around 1,100 cases are therefore due to sex between men, and the numbers are declining here too.

The development is reassessed annually by the RKI, as HIV is often only diagnosed years after infection.

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It is not clear what the reason for the decline is. The RKI points out that people may have restricted their sexual contacts in the course of the corona pandemic and that fewer routine tests may have been offered or used. In the group most at risk - men who have sex with men - the decline is not least a result of the success of drug-based HIV prevention (prep), said Robin Rüsenberg, the managing director of the German Association of Resident Doctors in the Care of HIV-Infected People. with.

During prep treatment, HIV-negative people swallow drugs that prevent the HIV virus from multiplying.

If this person then comes into contact with the pathogen, the agent protects against infection.

Taken consistently, according to the German Aidshilfe, the drugs protect against infection as well as a condom.

According to the RKI report, an estimated 9500 people in Germany are unaware of their HIV infection.

"It is very important to find out about the infection at an early stage and to seek treatment," said the spokesman for the German AIDS Federation, Holger Wicht.

You protect your own health, but also sex partners.

How drugs prevent transmission

HIV drugs can prevent HIV from multiplying in the blood until it can no longer be detected.

The virus would then no longer be sexually transmitted, said Wicht.

On the other hand, those who carry off an infection for too long could suffer various consequential damages that cannot be reversed, such as hearing or memory disorders.

Men who have sex with men should therefore have themselves tested once a year, heterosexuals after unprotected sex with new partners.

A doctor can rule out an HIV infection by doing a blood test six weeks after sex, and a rapid test is reliable after twelve weeks.

"When symptoms appear, a lot can have broken down," said Wicht. Early symptoms such as fever, night sweats and diarrhea, however, are not clear. »Even severe immune deficiencies are often not associated with HIV in doctors' offices. We sometimes see people in clinics who are half dead and who have been to many practices before, "said Wicht. General practitioners should also ask their patients about possible risks and offer an HIV test.

A cure for HIV is so far - almost - impossible.

In 2008, however, doctors at the Charité in Berlin had a spectacular success: They treated a patient who was suffering from leukemia and AIDS to treat blood cancer with HIV-resistant stem cells - after which he was HIV-negative.

In 2020 the man died because his leukemia had returned.

A few years later, doctors in London succeeded in freeing the second cancer patient worldwide from the HIV virus by means of a special stem cell donation.

However, because this form of therapy is highly risky, it has so far not been an option for the millions of people infected with HIV.

No vaccination in sight

And there is still no vaccination against HIV. While scientists in the corona pandemic developed various vaccines against Sars-CoV-2 in just a few months, no team of researchers has so far succeeded in developing a vaccine against HIV. The HI viruses are particularly complex and therefore difficult to neutralize. They infected cells of the immune system and integrated their genetic material into their DNA, says Olivier Schwartz from the Pasteur Institute in Paris. In addition, the HIV virus mutates much more easily than the coronavirus, so it is "more difficult to generate antibodies with a broad spectrum that could block the infection."

Several dozen AIDS vaccines are currently being tested. The biotechnology company Moderna is currently conducting a clinical study with an mRNA vaccine against HIV that is based on the same technology as the successful corona vaccines. "The use of this technology opens up new possibilities, and they give hope to viruses like HIV," says Gilles Pialoux, AIDS specialist and head of the Infectious and Tropical Diseases Department at Tenon Hospital in Paris. However, the final results are not expected for a few years.

On the one hand, the corona pandemic made the fight against AIDS more difficult.

"On the other hand, there has never been so much talk about health, infectious diseases and the collective efforts that are necessary to fight a global pandemic," says Serawit Bruck-Landais of the French anti-AIDS campaign Sidaction.

The fight against HIV could also benefit from this.

Because both pandemics have not yet been defeated.

he / dpa / AFP

Source: spiegel

All life articles on 2021-12-01

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