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amfAR H1N1 Briefing: Interview with Dr. Susan J. Blumenthal

Michelle Samplin-Salgado: This is Michelle Samplin-Salgado with AIDS.gov. Recently, I had the opportunity to sit down with Susan Blumenthal from amfAR. Susan, could you please introduce yourself and your role at amfAR?

Dr. Susan Blumenthal: I’m Dr. Susan Blumenthal, and I serve as the Senior Policy and Medical Advisor at amfAR, the Foundation for AIDS Research, and also was formerly Assistant Surgeon General of the United States, and have been working on this disease since the very beginning of the epidemic in the early '80s.

AmfAR is a pioneering AIDS organization that has provided leadership in ending epidemics, through innovative research and evidence-based public policies. It was established at the very beginning of the epidemic, over 24 years ago, and provides global leadership by supporting cutting-edge research, prevention, treatment education, and evidence-based public policies.

MSS: Thanks, Susan. Could you tell us about the purpose of amfAR’s congressional briefing on H1N1 and HIV/AIDS held on December 11, 2009?

Dr. Susan Blumenthal: The purpose of the briefing was to explore what happens when two major global pandemics converge. What do we know from the science? AIDS is one of the most devastating public health crises in the history of humankind and the most serious pandemic of modern times. More than 60 million people have been infected since it was first reported in 1981, and half of them have died.

The novel H1N1 influenza virus is a new virus to which humans currently have little or no immunity. Since the emergence of this pandemic last spring, about 15 million Americans—that’s one-sixth of the U.S. population—have been infected. About 200,000 people have been hospitalized, and nearly 10,000 have died, and millions more have been infected globally as well.

H1N1 is highly contagious. So far it does not appear highly lethal, but what’s worrisome is that it’s affecting young people and pregnant women and people who have underlying medical conditions, such as HIV/AIDS. That’s what the briefing was all about. Was to really explore what we know about the course of H1N1 flu in people who are HIV-positive and have AIDS? Are there differences in the treatment approaches? And, will the vaccine work as well in people who HIV-positive? Then, finally, we wanted to explore what are the future research needs and policy implications?

MSS: And can you tell us about some of the key messages you took away from the briefing?

Dr. Susan Blumenthal: Two major pandemics of modern times, HIV/AIDS and H1N1 influenza, have infected millions of people worldwide; yet there is currently a paucity of data concerning the health implications of H1N1 flu in people with HIV/AIDS. Limited data suggests, however, that HIV infection does not appear to significantly increase risk of influenza acquisition. However, HIV infection may increase the risk of more severe influenza illness and death among people with low CD4 cell counts or who have AIDS.

Prevention is the cornerstone of pandemic preparedness, and research is now underway to determine the dosage of H1N1 vaccine that will be most effective to prevent H1N1 infection in HIV-positive infants, youth, pregnant women, and other adults.

Additionally, given the initial shortage of H1N1 vaccine, it has become evident that decades-old technology should be enhanced with new methods of vaccine production, such as cell-based technologies. With the threat of pandemics and other emerging diseases, the rapid manufacturing of safe and effective vaccines is essential. But for now, people with HIV/AIDS should continue taking their antiretroviral therapy as prescribed, and get those seasonal and H1N1 flu shots.

But more research is clearly needed on the convergence of these two pandemics, as well as the implications for public policies in both the industrialized and the developing world. Preparedness is the cornerstone; complacency is the enemy of preparedness. Infectious diseases have been major killers of people throughout our history, and we must remain vigilant against them.

MSS: That’s excellent.Where can someone go to learn more about the briefing?

Dr. Susan Blumenthal: At the Capitol health briefing we had several health experts speak, and their slides of their presentations will be available at amfAR.org, as well as a fact sheet that amfAR has prepared on this issue, “What You Need to Know About the Convergence of H1N1 Flu and HIV/AIDS.”

MSS: Thanks Susan. Afain, that website is amfAR that’s A-M-F-A-R.org. This is Michelle Samplin-Salgado for AIDS.gov