The theme of this year's World AIDS Day (December 1) is "Shared Responsibility: Strengthening Results for an AIDS-Free Generation," a sentiment supported by research, awareness, and education on HIV and AIDS.
Many new treatments and procedures are helping people living with HIV and AIDS, and last week a new hurdle was cleared, ushering in a new era of research on a disease that affects some 33.4 million people worldwide.
HOPE Act Signed
The National Organ Transplant Act was written in 1984—a time of HIV/AIDS panic. A 1988 amendment specifically prohibited the donation and transfer of HIV-infected organs. Without any cure or treatment available back then, it was decided that the potential risks outweighed the potential gains.
“Basically, every case was a potential spread,” Dr. Michael Horberg, director of HIV/AIDS for Kaiser Permanente and immediate past chair of the HIV Medicine Association, told Healthline.
Nearly 30 years later, HIV is no longer an absolute death sentence. It’s a treatable condition, and many patients may now have longer, healthier lives, thanks in part to the signing of one piece of legislation.
Last week, Pres. Barack Obama signed the HIV Organ Policy Equity Act, or HOPE Act, ending a decades-long ban on the transfer of HIV-positive organs to HIV patients. The legislation directs the Department of Health and Human Services (HHS) and the Organ Procurement and Transplantation Network (OPTN) to develop standards to make these transplants possible.
“For decades, these organ transplants have been illegal. It was even illegal to study whether they could be safe and effective,” Obama said. “But as our understanding of HIV and effective treatments have grown, that policy has become outdated. The potential for successful organ transplants between people living with HIV has become more of a possibility.”
The Need for More Research
Now that the research door is open, Horberg said, researchers and specialists can begin to actively work on HIV-infected organ donations.
“There needs to be a mechanism where patients can donate an organ to another HIV patient where the risk of transmission is minimized,” he said. “Without a legal mechanism, we could not come up with answers to these questions.”
Kidney failure and liver failure are common in people who have had HIV/AIDS for many years. This is because of the destructive nature of the virus, co-infections, and the side-effects of certain medications. With the HOPE Act signed, it is estimated that up to 1,000 HIV patients' lives can be saved a year.
In order to undergo an organ transplant, a patient's HIV must be under control (something that wasn't possible when the procedure was first banned)—the same way a common cold would delay an otherwise healthy person from donation or receiving an organ.
Dying of Old Age, Not AIDS
The HOPE Act is a major victory in HIV and AIDS research, and it gives hope to many that those infected today will die naturally of old age rather than because of the disease.
Hoberg says that with proper treatment, the life expectancy of someone with HIV is the same as someone of the same age and gender who isn’t infected. As such, the same health issues facing the aging U.S. population now apply to HIV patients as well: immunizations, cancer screenings, and controlling risk factors for longer-term problems.
While treatment is key, researchers are continuing to focus on HIV prevention and the word “cure” is percolating through the research field. Until that day, Hoberg says that those living with HIV or those who are newly diagnosed will have many questions, some of which now have simple answers.
“The answer is that it’s serious and with these medications we can keep the virus under control and keep you living a long, healthy, and active life,” he said. “It’s going to require adherence though.”