This week in The Lancet:

This week’s issue focuses on HIV/AIDS in the lead up to the XVII International AIDS conference being held August 3-8^th.

The editorial addresses HIV/AIDS in Latin America and the Caribbean, as Mexico City is hosting this year’s International AIDS Conference.

A comment linked to this week’s editorial looks at how the annual AIDS conference themes serve as milestones in the global response to HIV and show how progress has, or has not, been made in controlling the epidemic.  There are also three comments that are linked to articles in the issue, as well as discussions on HIV/AIDS in children and HIV counselling and testing.

There is a world report on the President’s Emergency Plan for AIDS Relief (PEPFAR) bill that was just passed by the US Senate; another reports on how discrimination may continue to hamper HIV prevention and treatment efforts in the Middle East and North Africa, though religious leaders could play a key role in addressing this issue.

An important article in this week’s issue presents the results of the Antiretroviral Therapy Cohort Collaboration, a multinational collaboration of HIV cohort studies in Europe and North America.  The study found that HIV-infected patients treated with combination antiretroviral therapy have increased life expectancy, and that an individual receiving treatment from the age of 20-years will live an average of 43 more years, or 2/3 that of the general population.  There were, however, differences across population sub-groups.

Infants born to HIV-infected mothers who are not breastfed and where safe and affordable feeding alternatives are not available are at very high risk for mortality and morbidity, even exceeding the potential risk of HIV transmission.  A study of three trials in Ethiopia, Uganda and India found that providing infants (who were breastfed by HIV-infected mothers) with a six week extended dose of nevirapine resulted in a reduced risk of HIV transmission at 6 weeks when compared to a single dose of nevirapine.  There was not, however, a reduction in HIV transmission at 6 months, which may indicate that a longer course of daily treatment may be more effective.

An article on the risk of HIV transmission between serodiscordant couples, where the HIV-infected partner is effecitvely treated, shows that - contrary to the consensus statement released by the Swiss Federal Commission for HIV/AIDS - there is a risk of HIV transmission.  Although the risk of infection between heterosexual partners is low, it is not non-zero, and the risk between male homosexual partners is comparatively higher.

A health policy paper discusses the resources required to fight HIV/AIDS globally, and weaknesses in the UNAIDS estimates in particular.

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