[Congressional Record (Bound Edition), Volume 151 (2005), Part 2]
[Senate]
[Pages 2734-2735]
[From the U.S. Government Publishing Office, www.gpo.gov]




                  ETHA AND DRUG-RESISTANT HIV STRAINS

  Mr. SMITH. Mr. President, I discuss a rare strain of HIV that is 
highly resistant to most antiretroviral drugs and causes a rapid onset 
of AIDS that was recently discovered in a patient in New York City. The 
strain, identified as 3-DCR HIV, is resistant to 3 of the 4 classes of 
antiretroviral drugs, which means that 19 of the 20 available 
antiretroviral drug combinations would be ineffective for a person with 
this HIV strain.
  Although drug-resistant HIV strains are common in patients who have 
been treated with antiretroviral drugs, multiple-drug-resistant HIV is 
extremely rare in patients who are newly diagnosed and previously 
untreated. Moreover, while HIV infection usually takes about 10 years 
to progress to AIDS, this patient apparently progressed to AIDS in a 
matter of months. Combination of a highly drug resistant HIV infection 
and rapid disease progression has the potential to become a very 
serious public health problem with global health implications.
  The ultimate significance of the new strain is still unknown. Only 
time will tell whether this was an isolated case or part of an outbreak 
of similar cases. It is imperative, however, that we take action to 
identify and halt the spread of aggressive, multiresistant HIV/AIDS 
strains.
  We must continue to build upon and fund existing prevention programs 
and to strengthen our infectious disease monitoring systems. The CDC, 
in collaboration with community, state, national, governmental and 
nongovernmental partners, employs a number of programs designed to 
prevent HIV infection and reduce the incidence of HIV-related illness 
and death. By providing financial and technical support for disease 
surveillance; risk-reduction counseling; street and community outreach; 
school-based education on AIDS; prevention case management; and 
prevention and treatment of other sexually transmitted diseases that 
can increase risks for HIV transmission, such programs have played a 
key role in reducing HIV transmission.
  Stopping the spread of this strain is also critical in order to 
preserve the effectiveness of existing HIV/AIDS therapies. Not only do 
such therapies prolong and improve the quality of life of those 
affected by HIV/AIDS, but they also play a vital role in preventing the 
spread of the disease. A recent study found that HIV therapies reduce 
infectiousness by 60 percent. Consequently, that is why I recently 
reintroduced S. 311, the Early Treatment for HIV Act, ETHA. Supported 
by a bipartisan group of 31 Senators, ETHA redresses a fundamental flaw 
under the current Medicaid system that provides access to care only 
after individuals have developed full blown AIDS.
  ETHA brings Medicaid eligibility rules in line with Federal 
Government guidelines on the standard of care for treating HIV. ETHA 
helps address the fact that increasingly, in many parts of the country, 
there are growing waiting lists for access to life-saving medications 
and limited access to comprehensive health care. Access to HIV 
therapies reduces the amount of HIV virus present in a person's 
bloodstream, viral load, a key factor in curbing infectiousness and 
reducing the ability to transmit HIV.
  Early access to HIV therapies as provided under ETHA would not only 
delay disease progression and increase life expectancy, but it would 
also reduce the need for more expensive treatment and costly hospital 
stays. According to a study conducted by PricewaterhouseCoopers, ETHA 
would reduce gross Medicaid costs by 70 percent, saving the Federal 
Government approximately $1.5 billion over 10

[[Page 2735]]

years. With the administration looking for ways to reduce Medicaid 
costs, passing ETHA would be a good start. It's also the right thing to 
do.

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