Treating HIV-positive people can keep their uninfected partners from getting the virus, a finding that an Omaha-based researcher said has major implications for stopping the global spread of HIV.

"Can we treat our way out of this epidemic? The answer is basically, 'Yes, but . ' " said Dr. Susan Swindells, medical director of the HIV Clinic at the University of Nebraska Medical Center and one of the authors of a newly published report.

"In theory, yes, we can. But we would have to provide this treatment to everybody that needs it or pretty much everybody that's infected. And that is a tall order."

The study involved more than 1,760 couples in nine countries, with one person HIV-positive and the other HIV-negative. Nearly all — 97 percent — of the couples were heterosexual, and 94 percent were married.

Researchers found that infection of the HIV-negative person can be prevented by giving antiretroviral therapy to the HIV-positive person. The therapy included various combinations of three drugs widely used in treating HIV patients.

The report was published in the Aug. 11 issue of the New England Journal of Medicine.

"The antiretroviral therapy was 96 percent effective in preventing HIV infection in the HIV-negative person," Swindells said. "This is the most effective HIV prevention strategy we have ever seen."

But the high cost of the drugs — an estimated $1,100 per patient per year — is just one hurdle to treating those who could benefit.

"It's a question of the health infrastructure in some of the very poor countries of the world," she said. "People have to have an uninterrupted supply of medicine. They have to be monitored. They have to have specialized laboratory testing."

And the treatment must continue throughout the infected people's lives, she said.

Making this more difficult is a dearth of doctors: Some poor nations have fewer doctors in the entire country than UNMC has on its campus, she said.

"It's a political and economic problem as much as anything else," Swindells said.

An estimated 33.3 million people were living with HIV in 2009, the World Health Organization says. Of the 14.6 million people who were in need of antiretroviral therapy, WHO says, just 5.25 million people had access.

WHO is coming out with new guidelines based on this study, Swindells said.

"It's nice to be able to contribute to something that makes a big difference," she said.

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