Breakthrough hailed as study shows circumcision can halve HIV risk
Found this interesting articles in The Guardian while searching for some information on AIDS. Will be having lesson about Retrovirus, the causative agent for AIDS. So need some extra information on it.... and i stumble onto this. Great information for scientist and medical practice though ...· Trial outcome could mean huge cut in infection rates
· Aids campaign group says results are a milestone
Sarah Boseley, health editor
Thursday December 14, 2006
The Guardian
Circumcision can halve the risk of a man picking up the HIV infection which leads to Aids, scientists in the United States said last night. Two major trials, in Kenya and Uganda, have confirmed what doctors and campaigners have suspected and hoped for several years. The results have major implications for the fight against the Aids pandemic raging in Africa and Asia.
Yesterday Kevin de Cock, head of the World Health Organisation's HIV/Aids department, said it could cut the numbers of infected men by "many tens of thousands, many hundreds of thousands and maybe millions over coming years".
The two trials should have gone on into next year but were called to an abrupt halt yesterday by the funder, the National Institute of Allergies and Infectious Diseases, after an interim review of the data showed a halving of the risk of infection among those circumcised. Now that the point is proven to the satisfaction of scientists it would be unethical to continue. All the uncircumcised participants will now be offered the medical procedure.
With a vaccine still decades away, the circumcision results are the best news in a long while out of the Aids pandemic. But there are major questions still unanswered and a lot of work still to do.
Anthony Fauci, director of NIAID, said last night that the 48% reduction among men in the Rakai, Uganda, trial and 53% reduction among those in Kisumu, Kenya, "could be negated by small reductions in condom use or the addition of additional sexual partners".
It was vital, he warned, that people understood the need to continue to protect themselves by condom use and safe sex. Circumcision dramatically cuts the risk of HIV infection, but Mr de Cock said: "It is not a magic bullet."
There was no sign that the 2,784 men in the Kenyan trial and the 4,996 men taking part in Uganda had become reckless in their sexual practices, said Dr Fauci, "but now the announcement is out we are cognizant that there could be [an effect]".
Mitchell Warren, executive director of the Aids Vaccine Advocacy Coalition, said the results were "a milestone in the history of the Aids epidemic" but urged that circumcision be rolled out only in the context of other prevention measures.
There are other serious issues. Circumcision was carried out by skilled medical professionals in the trials and all those involved had aftercare in case of complications. The WHO intends to tell governments they should ensure circumcision is carried out in a similar hygienic and skilled fashion. But that will necessitate setting up clinics and giving staff the skills to carry out the surgical procedure and follow patients up. It is likely that now the good news is out a booming trade in adult male circumcision may develop among those who have no medical qualifications, with potentially harmful consequences.
There are also cultural obstacles to overcome, because for some groups circumcision is not normal practice. In India Muslims are circumcised while Hindus are not. At the International Aids Conference in Toronto in August Bill Clinton warned that if the trial results went the way they have: "We will have a big job to do. It is important that as we leave here we all be prepared for a green light that could have a staggering impact on the male population but that will be frankly a lot of trouble to get done."
Scientists say there are several biological reasons why circumcision may decrease the transmissibility of HIV. The mucosal surface of the foreskin contains large numbers of a group of cells particularly susceptible to being targeted by the virus and the area under the foreskin is moist.
Participants in the trials were randomly selected either to be circumcised or not. In the Kenya trial there were 69 infections among the 2,784 participants, 22 of whom were in the circumcision group and 47 of whom were not. In Uganda 65 men out of 4,996 were infected with HIV, 22 of whom were in the circumcised group and 43 in the uncircumcised group.
All participants were counselled on other HIV prevention methods. A further study continues, investigating whether women whose partners are circumcised are less likely to become infected.
At a glance
· 38.6 million people were living with HIV last year, of whom 24.5 million men, women and children were in sub-Saharan Africa. In some countries more than a third of the population are infected.
· 4.1 million became infected with the virus during the course of the year - 2.7 million in sub-Saharan Africa. UN agencies are calling for more efforts on prevention.
· 2.8 million people died of Aids-related illnesses in 2005.
· Around 8.3 million people in Asia are HIV infected, two-thirds in India.
"Islam is always and forever and ever the best way of life, believe it or not..."
Source : The Guardian
posted by Balqis @ 10:48 AM
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