Antiretroviral treatment greatly reduces the risk of transmitting HIV. Several very large studies have now shown that people with undetectable viral load do not pass on HIV to their sexual partners. However, there is still a possibility that HIV might be passed on during the period between starting treatment and viral load becoming detectable, which may take up to six months, or if viral load rebounds due to treatment failure.
A review of a large PrEP study conducted in couples where one partner had HIV and the other did not, has shown that when the partners with HIV became eligible to start antiretroviral treatment for their own health, there was still a risk that HIV could be passed on before they reached an undetectable viral load.
A major conference on hepatitis treatment heard lots more good news about the new drugs for hepatitis C. For example, a single pill combining sofosbuvir with the new drug velpatasvir cured 95% of people living with hepatitis C and HIV co-infection. Results were similar regardless of hepatitis C genotype (1 to 4), the presence or absence of cirrhosis, and whether people had taken hepatitis treatment before or not.
But how many people in the UK will be able to access this new medicine and others like it? The situation is better in Scotland, but NHS England’s guidelines are so restrictive that the new generation of hepatitis C drugs are often only available to people who are already seriously ill with hepatitis C.