It has been more than 30 years since Secretary of Health and Human Services Margaret Heckler made a historic announcement. "The probable cause of AIDS has been found," she began, "a variant of a known human cancer virus." It was 1984, and she stated that a vaccine would be available within two years. It was a statement based in hope rather than in science.
Researchers in France and the United States had discovered what was behind the AIDS epidemic, but it turned out to be more challenging than the medical community first thought. The retrovirus discovered that year, later named HIV, is part of a family of viruses known to camouflage themselves within human DNA. No one knew how to treat them. For most virologists, the end of the epidemic seemed far away.
However, in the time since we discovered HIV, there have been many advances in the diagnosis and treatment of HIV/AIDS, amounting to a revolution in infectious disease. Still, with nearly 50,000 new infections annually in this country, more needs to be done to turn the tide of this disease.
In the United States, we have observed a rise in HIV infections in adolescents and young adults in comparison with other age groups. Of the estimated 1.1 million Americans living with HIV, the Centers for Disease Control and Prevention suggests that 16 percent do not know their HIV status. This number is significantly higher for those aged 13 to 24: Almost 60 percent of these individuals do not know they are infected. This lack of awareness also means that young adults are more likely to receive treatment later in the course of the disease, potentially after the virus has caused irreparable damage to the body. As someone who has been on the forefront of the fight against HIV from the very beginning, I can state that getting tested and knowing one's status are important tools against the spread of this virus.
Fortunately, advanced tests called HIV Combo tests, which test for both antibodies and antigen, are available in the U.S. that can detect the virus sooner after infection than traditional antibody-only tests. HIV antigen is a protein produced by the virus shortly after infection. Antibodies (the body's reaction to the virus as it fights the infection) can take as many as three to four weeks to become detectable.[vii] By detecting both antigen and antibodies, these HIV Combo tests can help identify infected patients who might have been missed if they were only tested with an antibody test. And by knowing their HIV status sooner, they may reduce risky behavior earlier and begin antiretroviral therapy more rapidly.
National HIV Testing Day -- June 27 -- provides us with an opportunity to call for a shift in our approach. To change the course of the HIV epidemic in this country, we must focus on the latest advances in HIV testing technology to provide quicker, more reliable results to help patients get the right treatment faster. Our ability to treat and cure HIV in the future is at stake.
• Dr. Gerald Schochetman is senior director, infectious diseases and diagnostic research, for Abbott.