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August 31, 2009

Stronger Prospects for the President on a Health Care Bill

"Yet other factors suggest that President Obama still has stronger prospects for achieving his health policy goals than surface impressions of the Congressional recess indicate. ...

"For all the political risks of acting, 'Everyone knows the alternative is worse,' said Rahm Emanuel, Mr. Obama’s chief of staff and a veteran of the Clinton White House. 'Failure leads to failure.'"

Read more in New York Times, August 30, 2009.

CDC Publishes New Opportunistic Infection Guidelines for HIV-Positive Children

"Revised guidelines regarding the prevention and treatment of AIDS-related opportunistic infections (OIs) among HIV-infected children were published August 26 online in the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report. A panel of more than 30 government and nongovernment pediatric HIV and infectious disease experts developed the guidelines, which both update and combine a 2002 and 2004 publication on the treatment of opportunistic infections in children."

Read more in POZ, August 31, 2009.

August 30, 2009

National HIV Prevention Conference Delivers Call to Action

"There is great interest and anticipation around the President’s call for the development and implementation of a National HIV Strategy. The three main priorities of this plan include: 1) reducing HIV incidence; 2) improving access to care and optimizing health outcomes for people infected with HIV; and 3) reducing HIV-related health disparities. During the Atlanta conference, Jeff Crowley, the director of the White House Office of National AIDS Policy, spoke of the community forums his office is conducting in 14 U.S. cities most affected by HIV/AIDS to solicit public input on how to form this national strategy"

Read more in, August 28, 2009.

August 29, 2009

Medicines needed (AID for AIDS International)

Due to increased demand in certain medications, AID FOR AIDS International is in greater need of the following medication:
· Aptivus 250mg
· Atripla 600/300/200mg
· Emtriva 200mg
· Epivir 300mg
· Insentress 400mg
· Norvir 100mg
· Prezista 300mg
· Prezista 600mg
· Prezista 400mg
· Retrovir 300mg (Zidovudine 300mg)
· Truvada 300/200mg
· Videx 400mg EC (Didanosine 400mg)
· Viread 300mg
· Zerit 30mg

Special temporary request:
· Emend 80mg
· Metotrexate 40mg

If you or someone you know has excess of these or any other antiretroviral, please click here.

If you want to know where you can drop the medicine off, click here." [Note the mailing instructions, if you are not in the New York metropolitan area, or near the other drop-off points.]

Read more in AIDS for AIDS International, August 2009.

August 28, 2009

siRNA and shRNA screens advance key understanding of host factors required for HIV-1 replication

"A recent RNAi screen used a genome-wide shRNA library to search for cellular factors required for HIV-1 replication. This work complements three other siRNA-based screening studies and potentially opens the door to the discovery of factors that are important for HIV-1 replication in physiological host cells such as T lymphocytes. shRNA screens can be further improved, and they could promise to unravel new pathways and new facets of virus-cell interactions."

Read more in Retrovirology, August 27, 2009.

Comment: This technical article could be important. Both siRNA and shRNA are fairly new techniques for turning off a particular gene -- in this case for research, and potentially some day for treatment.

HIV health problems cause few problems in employment, but discrimination still a reality in UK

"A majority of people with HIV employed in the UK report that HIV has no impact on their working life at present, according to research conducted by City University on behalf of the National AIDS Trust. Although most of those who disclosed their HIV status at work had had a generally positive reaction, stigma and discrimination create more problems at work than ill-health."

Read more in Aidsmap, August 27, 2009.

Comment: This study was in the UK, but the U.S. situation is probably similar, especially in regard to health at work. Discrimination may be more different between the countries.

August 27, 2009

Detectable HIV Levels Don’t Necessarily Increase the Risk of Cognitive Decline

"Having a viral load over 1,000 copies doesn’t necessarily increase the risk for cognitive decline—at least in people with high CD4 counts—according to a study published online August 18 in the Journal of Acquired Immune Deficiency Syndromes."

Read more in POZ, August 25, 2009.

Risk of kidney problems similar for tenofovir and alternative drugs

"Treatment with tenofovir does not involve a greater risk of kidney problems compared to alternative NRTI drugs, US investigators report in the online edition of AIDS. They found that regardless of whether a patient took tenofovir or an alterative drug as part of their initial antiretroviral therapy, there was a modest decline in kidney function, but that this soon stabilised. However, the research did show that taking tenofovir in combination with a ritonavir-boosted protease inhibitor could have an adverse effect on the health of the kidneys."

Read more in Aidsmap, August 25, 2009.

Patients taking HIV treatment need to maintain undetectable viral load to protect kidney function

"Kidney function declines in patients taking antiretroviral therapy if their viral load is not fully suppressed, US investigators report in a study published in the online edition of AIDS. Although kidney function improved once a patient started taking HIV treatment, continued declines were observed in some patients, especially if their viral load “blipped” to detectable levels."

Read more in Aidsmap, August 25, 2009.

August 26, 2009

HVTN 505 HIV Vaccine Study Begins Enrolling Volunteers

"The National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, has opened enrollment in HVTN 505, an exploratory HIV vaccine clinical study examining whether a two-part vaccine regimen can decrease viral load (the amount of HIV in the blood) in study participants who later become infected with HIV. Viral load is an important health indicator in people who are infected with HIV because typically those with less virus remain healthier longer. Further, HIV-infected individuals with reduced levels of virus may be less likely to transmit the virus to other people. ...

HVTN 505 is planned to take place in 12 U.S. cities and is designed to enroll 1,350 HIV-negative men ages 18 to 45 years who have sex with men. Participants must be circumcised and at the time they are enrolling, without Ad5 antibodies resulting from previous exposure to the Ad5 virus. ...

For more information about the HVTN 505 study, see Questions and Answers: The HVTN 505 HIV Vaccine Regimen Study and"

Read more in U.S. NIAID, August 24, 2009.

August 25, 2009

CDC's 2009 HIV Prevention Conference: “Innovation and Action to End the Epidemic”

"The 2009 National HIV Prevention Conference Exit Disclaimer is reaching over 3,500 of our colleagues in Atlanta this week. Thanks to conference organizers, this year’s highlights are shared to those unable to attend via Twitter: CDC NPIN Exit Disclaimer, Exit Disclaimer, and others are tweeting with the hashtag #NHPC09 Exit Disclaimer. CDC also provides conference participants with text message updates Exit Disclaimer, and videotaped many of the presentations to broaden reach (CDC NPIN Exit Disclaimer should have these posted around September 7th).
Miguel Gomez

Miguel Gomez, Director, presents at NHPC09

This morning, Director Miguel Gomezpresented on the plenary panel, “Advances in HIV Prevention Science and Technology.” The presentation Exit Disclaimer focused on how the HIV community can adopt new media tools to further their work. Miguel said, “we have a responsibility to learn about new media—to learn what clients are doing online, what new media is, and how to fit it into our overall HIV prevention planning.”

Read more in, August 25, 2009.

Note: Even if you have never used Twitter and do not have an account, you can click of the Twitter "hashtag" above to read recent "tweets" tagged for this conference.

S. Africa Embraces Study Critical of Health Policy

" Leading South African scientists challenged the governing party on Monday to break with its deeply flawed record on AIDS and public health, spurring the country’s new health minister to say that he and his party shared their diagnosis of systemic problems and were determined to repair them.

"The decision by the health minister, Dr. Aaron Motsoaledi, to embrace the often withering assessment of his party’s failings, laid out in six papers published online Monday by The Lancet, a medical journal based in London, provided a strong signal that the governing party’s new leadership intended to shake up a badly managed health system."

Read more in New York Times, August 24, 2009.

Note: These articles are available to anyone, but free Lancet registration is required. Or you can read an executive summary (PDF download) without registering.

New Intelence Prescribing Information Warns of Severe Rash Risk

"The prescribing information for Intelence (etravirine) has been updated to reflect warnings of rare—but potentially life-threatening—skin reactions, including Stevens-Johnson syndrome. Systemic hypersensitivity reactions have also been reported and are characterized by rash, flulike symptoms and sometimes organ problems, including liver failure. "

Read more in POZ, August 24, 2009.

‘We’re safe from HIV’ claim SA youths

"About 20000 South African users answered the question “do you go for regular HIV tests”, with nearly 7000 claiming they were tested at least once a year.

"Just over 6000 members chose the response: “I don’t believe I’m at risk.”

"Commenting on the results of the survey, Dr Olive Shisana, CEO of the Human Sciences Research Council, said: “Not believing that they are at risk is quite common ... in fact, in the last survey we did, about 50% of the people infected thought they were not at risk of HIV!"

Read more in The Times (South Africa), August 22, 2009.

August 23, 2009

5-Year Survival of Patients with AIDS Receiving Antiretroviral Therapy in Haiti

"This report documents the long-term sustainability of antiretroviral-therapy programs in resource-poor countries, with excellent rates of retention and adherence and a survival rate of 75% at 5 years. The WHO criteria of treatment failure are not sensitive or specific. Waiting to meet these criteria may delay the recognition of virologic failure and result in the accumulation of HIV-1 drug-resistance mutations."

Read more in New England Journal of Medicine, August 2-, 2009.

Activists say poor nations' access to affordable drugs stymied

"Activists in the U.S., as well as Thailand and other developing countries, have accused the Obama administration of blocking greater access to affordable drugs in a bid to win the pharmaceutical companies' support for its healthcare overhaul.

"Organizations such as Doctors Without Borders and Oxfam International -- an anti-poverty group -- said they had hoped President Obama would join them in the fight to make generic drugs available to combat disease in impoverished countries.

"But 'it appears that Obama appointees are continuing to work from the playbook of the last administration,' said Oxfam policy advisor Rohit Malpani. The British-based group had opposed President George W. Bush's trade policies as being detrimental to public health."

Read more in Los Angeles Times, August 20, 2009.

Religious Leaders Absent in the Anti-AIDS Fight

"Though they exert great influence in the communities in which they serve, religious leaders are not doing enough to fight HIV/AIDS, said experts at the recent ninth International Congress on AIDS in Asia and the Pacific, held in Bali, Indonesia. “Many religious groups and leaders are unwilling to address HIV/AIDS and make it a priority. Their commitment level is quite low, particularly when compared to the size of their budget and the amount of work they do,” said Donald Messer of the US-based Center of Church and Global AIDS. “We’ve been talking about HIV/AIDS and the religious groups’ response for three decades now. We’re still talking too much even now,” said Fiji’s Dominica Abo. The “most powerful contribution” religious leaders can make is addressing stigma, discrimination, and biases that put groups like women at high risk for the disease."

Read more in CDC NPIN, August 13, 2009.

August 21, 2009

Ghostwriting documents now fully available on PLoS Medicine Web site

"The documents include internal correspondence, reports, and tracking documents relating to interactions between the pharmaceutical company Wyeth and a medical communications firm, to promote Wyeth's hormone drugs. These documents show in considerable detail a coordinated and carefully monitored campaign of "ghostwriting" by Wyeth and medical writing companies for a number of products marketed by the company.

"Ghostwriting, which involves using medical writers to produce articles that are then nominally authored by an academic not substantially involved in the writing process, has been condemned as an unacceptable practice by medical journals and editors. Nonetheless, the practice appears to persist and by placing all the documents for scrutiny in the public domain, the editors of PLoS Medicine hope that they will help guide the way to identifying reforms that will eventually stamp ghostwriting out. ...

"In an editorial that has been posted on the PLoS Medicine blog, Speaking of Medicine (, the PLoS Medicine editors declare that this is "one of the most compelling expositions ever seen of the systematic manipulation and abuse of scholarly publishing by the pharmaceutical industry and its commercial partners in their attempt to influence the health care decisions of physicians and the general public." The editors go on to call for action to eradicate ghost-writing, including retraction of papers where ghostwriting or inappropriate involvement of medical writers is found, banning of authors found to have put their names to such papers from any subsequent publication in the journal, and rigorous investigation of such misconduct by the researchers' academic institutions."

Read more in EurekAlert!, August 21, 2009.

Research shows why low vitamin D raises heart disease risks in diabetics

"Low levels of vitamin D are known to nearly double the risk of cardiovascular disease in patients with diabetes, and researchers at Washington University School of Medicine in St. Louis now think they know why.

"They have found that diabetics deficient in vitamin D can't process cholesterol normally, so it builds up in their blood vessels, increasing the risk of heart attack and stroke. The new research has identified a mechanism linking low vitamin D levels to heart disease risk and may lead to ways to fix the problem, simply by increasing levels of vitamin D. ...

"Worldwide, approximately one billion people have insufficient vitamin D levels, and in women with type 2 diabetes, the likelihood of low vitamin D is about a third higher than in women of the same age who don't have diabetes.

"The skin manufactures vitamin D in response to ultraviolet light exposure. But in much of the United States, people don't make enough vitamin D during the winter — when the sun's rays are weaker and more time is spent indoors."

Read more in EurekAlert!, August 21, 2009.

President Obama Announces National HIV/AIDS Community Discussions

"First Event, the Atlanta HIV/AIDS Community Discussion, to be Held on August 25th at the 2009 National HIV Prevention Conference Community Discussions will feed into the development of a National HIV/AIDS Strategy

"WASHINGTON – President Obama today announced the launch of the National HIV/AIDS Community Discussions, a series of events to be held across the country. These events, hosted by the White House Office of National AIDS Policy (ONAP) will offer the public a chance to provide input as the White House works to fulfill the President’s pledge to develop a National HIV/AIDS Strategy (NHAS). The first event, the Atlanta HIV/AIDS Community Discussion, will be held on August 25th at the 2009 National HIV Prevention Conference.

"HIV remains an serious challenge to the American people and I am committed to developing an effective National HIV/AIDS Strategy," said President Obama. "The National HIV/AIDS Community Discussions will provide an opportunity for members of the public to give their input on how we can best address this crucial issue. With the insights from communities across the country, we will have a strategy that is focused on the goals of reducing HIV incidence, getting people living with HIV/AIDS into care and improving health outcomes, and reducing HIV-related health disparities."

Read more in The White House, August 21, 2009.

FDA Details Access to 'Investigational' Drugs

"Anything FDA does to promote transparency is good for us," said Lynda Dee, a patient representative for the FDA's Antiviral Drugs Advisory Committee and a founding member of the AIDS Treatment Activist Coalition in Baltimore. "This will go far in helping people who need these new treatments."

Read more in Health Day - U.S. News and World Report, August 12, 2009.

August 20, 2009

CDC Report Shows 10 Percent Drop In Overall HIV-Related Death Rate In 2007

"According to a preliminary report (.pdf) released on Wednesday by CDC's National Center for Health Statistics (NCHS), "U.S. life expectancy has risen to a new high, now standing at nearly 78 years," and "death rates in almost all the leading causes of death" have fallen, the Associated Press/Philadelphia Inquirer reports. According to the report, in 2007, there was a 10 percent drop in the overall HIV-related death rate, the biggest one year decline in HIV-related mortality since 1998. Bob Anderson, chief of the NCHS mortality statistics branch, said, "It was kind of a surprise to see it go down so much," and it is unclear whether the trend will continue (Stobbe, 8/20).

"HIV is the sixth leading cause of death among 25 to 44 year olds," New York Times' Well blog reports (Parker-Pope, 8/19). According to the report, "[a]lthough Human immunodeficiency virus (HIV) disease was not one of the 15 leading causes of death in 2007, it is still of concern" (Xu et al., Deaths: Preliminary Death Data for 2007, 8/19)."

Read more in Kaiser Daily U.S. HIV/AIDS Report, August 20, 2009.

Study Backs Heroin to Treat Addiction

"The safest and most effective treatment for hard-core heroin addicts who fail to control their habit using methadone or other treatments may be their drug of choice, in prescription form, researchers are reporting after the first rigorous test of the approach performed in North America.

"For years, European countries like Switzerland and the Netherlands have allowed doctors to provide some addicts with prescription heroin as an alternative to buying drugs on the street. The treatment is safe and keeps addicts out of trouble, studies have found, but it is controversial — not only because the drug is illegal but also because policy makers worry that treating with heroin may exacerbate the habit."

Read more in New York Times, August 19, 2009.

Obesity and diabetes main underlying health conditions in people dying of swine flu: no evidence that HIV increases mortality risk

"Obesity and diabetes are the principal underlying conditions associated with death in patients with swine flu, a report published in the August 20th edition of Eurosurveillance shows. There is no indication in the report that HIV increases the risk of death from swine flu.

"The authors from the French Institute of Public Health analysed all deaths caused by swine flu before 16th July."

Read more in Aidsmap, August 20, 2009.

August 18, 2009

SHORT SURVEY: Tell Us Your HIV and Health Care Story

"The AIDS Foundation of Chicago is working with a broad coalition of AIDS organizations to collect individual healthcare nightmares from people across the U.S. living with HIV/AIDS. These personal anecdotes help us creatively and effectively appeal to members of Congress and President Obama as well as advocate to lawmakers working on national healthcare reform legislation for the strongest healthcare provisions possible. Additionally, these stories generate media attention on the importance of healthcare reform for people living with HIV/AIDS."

Read more in Treatment Education Expansion Project, August 2009.

Note: this survey of healthcare nightmares by the AIDS Foundation of Chicago has only 3 questions.

New Synthetic Proteins Block HIV

"Synthetic proteins dubbed “foldamers” effectively keep HIV from infecting cells in test tube studies and could point the way to future treatments, according to an announcement by researchers at the University of Wisconsin at Madison.

"While there has been interest in using altered naturally occurring peptides to disrupt the interaction between human cells and HIV, getting the altered peptides where they belong isn’t easy. The injected peptides are long and delicate and thus require large quantities of medication to be therapeutically effective; in addition, the peptides must be administered via injection to circumvent digestive enzymes that break down the strands.

"Now, however, a group of researchers from the University of Wisconsin, the University of Pittsburgh and Weill Medical College at Cornell University in New York City, have developed synthetic peptides that are large enough to disrupt communication between HIV and cells, but sturdy enough that the body can’t break them down easily. The results of this initial collaborative work have been published online in theProceedings of the National Academy of Medicine.

Read more in POZ, August 18, 2009.

"Participation Powers Prevention": Highlights from CDC's 3rd National Conference on Health Communication, Marketing, and Media

"Another theme we heard throughout the conference was the importance of developing our messages first — then finding the most appropriate tools to communicate them. The conference's organizers further highlighted the themes of the conference by sorting presentations into the following tracks: Health Marketing: Nuts, Bolts and Beyond; Health Disparities and Social Determinants of Health; New Frontiers — Trends and Technology; and Partnerships/Collaborations — Synergistic Relationships.

"We wanted to bring some of the key messages from the conference to people who couldn't be there in person, so we used our Flip camera to record interviews with several speakers and participants about their advice for the HIV community."

Read more in Blog, August 18, 2009.

Activation of Latent HIV Type 1 Gene Expression by Suberoylanilide Hydroxamic Acid (SAHA), an HDAC Inhibitor Approved for Use to Treat Cutaneous T...

"Activation of latent proviruses from the infected cells in combination with ART is a therapeutic strategy that may lead to the complete elimination of HIV infection. We report here that suberoylanilide hydroxamic acid (SAHA), a histone deacetylase inhibitor that has been approved for the treatment of cutaneous T cell lymphoma (CTCL), can activate an HIV-1 vector provirus in a cell model system. Treatment of cells harboring a latent, HIV-1-derived provirus caused activation of both early and late viral gene expression, acetylation of nucleosome on the 5’ long terminal repeat (LTR), and remodeling of the chromatin at the 5’ LTR. Several compounds, including valproic acid, have been tested for their ability to activate latent HIV-1, but have met with disappointing results. SAHA, a relatively nontoxic, FDA-approved compound, should be considered for developing a strategy to eliminate HIV from patients."

Read more in AIDS Research and Human Retroviruses, August 18, 2009.

August 17, 2009

The 14th International Conference on Human Retrovirology: HTLV and related retroviruses (July 1-4, 2009; Salvador, Brazil)

HTLV: "The "14th International Conference on Human Retrovirology: HTLV and Related Retroviruses" was held in Salvador, Bahia, from July 1st to July 4th 2009. The aim of this biennial meeting is to promote discussion and share new findings between researchers and clinicians for the benefit of patients infected by human T-lymphotropic virus (HTLV). HTLV infects approximately 15-20 million individuals worldwide and causes a broad spectrum of diseases including neurodegeneration and leukemia. The scientific program included a breadth of HTLV research topics: epidemiology, host immune response, basic mechanisms of protein function, virology, pathogenesis, clinical aspects and treatment. Exciting new findings were presented in these different fields, and the new advances have led to novel clinical trials. Here, highlights from this conference are summarized."

Read more in Retrovirology, August 17, 2009.

Note: This publication focuses not on HIV, but on HTLV, a different retrovirus that infects about 15-20 million people worldwide. The full text of a provisional PDF draft is available to anyone at this time.

Genetic test predicts who will respond to hepatitis C treatment

"The investigators found that a specific gene was strongly associated with a sustained virological response to treatment. This association was most pronounced in individuals of European ancestry, with the patients who carried this gene having a significantly increased chance of a response to treatment with anti-hepatitis C drugs than patients who did not (odds ratio [OR], 7.3; 95% CI: 5.1-10.4). The gene also increased the chances of treatment working in African-Americans and Hispanics, but to a lesser degree than in whites.

"Furthermore, the investigators found that the gene was more strongly associated with response to treatment in European-Americans than either baseline hepatitis C viral load or liver fibrosis, the usual predictors of hepatitis C treatment response.

"However, in African-Americans and Hispanics, both of these traditional risk factors were a better guide to treatment response than the presence of the gene."

Read more in Aidsmap, August 17, 2009.

The Association Between Food Insecurity and Mortality Among HIV-Infected Individuals on HAART

"Conclusions: Food insecurity is a risk factor for mortality among antiretroviral therapy-treated individuals in British Columbia, particularly among individuals who are underweight. Innovative approaches to address food insecurity should be incorporated into HIV treatment programs."

Comment: This problem is likely to be more severe in the U.S. than in Canada.

Read more in JAIDS, August 13, 2009.

The Acute Effects of HIV Protease Inhibitors on Insulin Suppression of Glucose Production in Healthy HIV-Negative Men

"Conclusions: Some PIs can acutely blunt the ability of insulin to suppress EGP, but, as with insulin resistance, the effects of PIs on EGP are drug-specific, not class-specific."

Read more in JAIDS, August 14, 2009.

August 16, 2009

Treat Early or Wait and Monitor? A Qualitative Analysis of Provider Hepatitis C Virus Treatment Decision-Making in the Context of HIV Coinfection

"Providers agreed that stable HIV disease, favorable genotype, and significant signs of liver disease progression are all signs of need for treatment. However, two divergent treatment approaches emerged for genotype 1 and 4 patients with minimal disease, and in definitions of patient readiness. Providers with lower treatment rates preferred to delay treatment in hopes of better future treatment options, and were more conservative in requiring complete mental health screens and treatment and abstinence from substance use. Conversely, providers with higher treatment rates viewed all patients as needing treatment as soon as possible, and defined readiness more leniently, with some willing to treat even in the context of untreated depression and drug use, so long as ability to adhere well was demonstrated."

Read more in AIDS Patient Care, August 10, 2009.

August 14, 2009

More evidence of bone loss with HIV therapy, more confusion over the role of specific drugs

"While evidence linking antiretroviral therapy to bone loss grows, so does the confusion around which anti-HIV drugs may be responsible for the condition. Two new studies have found that starting and maintaining antiretroviral therapy was linked to a decrease in bone mineral density, but neither study could identify specific anti-HIV drugs responsible for the decrease. With a growing push to earlier treatment of HIV, bone loss may become a more pressing clinical issue for people with HIV and their doctors."

Read more in Aidsmap, August 13, 2009.

A Systematic Review of Permanent and Semipermanent Dermal Fillers for HIV-Associated Facial Lipoatrophy

"Although short-term safety appeared favorable, of the seven studies that reported lumps, three studies reported these events in more than 40% of patients. Long-term safety data were lacking. Evidence suggests that permanent and semipermanent dermal fillers achieve their objective, which is to decrease the visible effects of HIV-associated facial lipoatrophy, with high patient satisfaction. Safety appears favorable in the short term, but further studies are required to determine long-term outcomes."

Read more in AIDS Patient Care and STDs, August12 , 2009.

Protesters seek cheaper drugs at HIV/AIDS meeting

"Hepatitis C + silence = death," read the banner carried by protesters accusing pharmaceutical giant Roche AG (ROG.VX) of setting the price of a drug to fight Hepatitis C virus (HCV) too high for dying patients to afford."

Read more in Reuters, August12 , 2009.

Aids Activists Rally This Sunday To Support Lifting U.S. Ban On HIV-Positive Immigrants And Visitors

"WHO: Hundreds of people living with HIV and their supporters from Canada and the U.S. Speakers at the Surrey, BC event include Surrey Mayor Barinder Rasode and Vancouver Centre Member of Parliament Dr. Hedy Fry. Speakers at the Fort Erie event include representatives from local AIDS Service Organizations from both Canada and the United States."

Read more in, August 16 (rally), 2009.

Comment: The main rally is in Canada, near Buffalo, NY. The website has contacts for information about other locations.

August 11, 2009

Anal Cancer Survival Similar in HIV-Positive and HIV-Negative People

"HIV-positive people diagnosed with anal cancer have a survival rate similar to their HIV-negative counterparts, according to a study published August 15 in the Alimentary Pharmacology & Therapeutics.

"The rates of some non-AIDS-related malignancies, particularly anal cancer, are higher in people with HIV than in their HIV-negative counterparts. What’s more, the number of people with HIV diagnosed with anal cancer each year has grown, rather than decreased, since the introduction of potent antiretroviral therapy."

Read more in POZ, August 10, 2009.

Maternal death rate five times higher in women with HIV, South African audit shows

"Maternal mortality ratios in Johannesburg, South Africa in HIV-infected women are more than six times higher than in HIV-negative women despite integration of antiretroviral treatment into prenatal services, reported Vivian Black and colleagues in a five-year audit published in the August 2009 issue of Obstetrics and Gynecology. ...

The global maternal mortality ratio of 400 per 100,000 live births as estimated by the World Health Organization does not reveal the considerable regional variations.

In 2005, South Africa—a middle income country—had a ratio close to the global average but considerably higher than countries of similar gross domestic product per person, for example, Portugal and Brazil which had a ratio of 11 and 110 respectively. "

Read more in Aidsmap, August 10, 2009.

August 8, 2009

[revised] Second-line treatment: Clinton Foundation announces new price cut

"A co-packaged combination of four drugs for second-line antiretroviral treatment for developing countries will be made available from early 2010 for $425, the Clinton HIV/AIDS Initiative announced today.

"With immediate effect the drugs —tenofovir, lamivudine (3TC), atazanavir and a boosting dose of ritonavir—will be available at a price of $475. That’s $115 less than the previous cheapest option for second-line treatment, lopinavir/ritonavir plus tenofovir/3TC, currently being offered to qualifying countries in the developing world by the Clinton HIV/AIDS Initiative Procurement Consortium at a ceiling price of $590 a year. "

Read more in Aidsmap, August 6, 2009.

Stroger’s HIV vaccine testing proposal hits a stumbling block

"The testing of a possible two-in-one HIV vaccine—a drug its manufacturer hopes would be used to both prevent and treat infections—has resulted in a dispute between Cook County Board President Todd Stroger and board and foundation members of the Ruth M. Rothstein CORE Center, Cook County’s South Side HIV/AIDS and infectious diseases clinic. Stroger, who initiated the testing proposal, is eager for trials to begin. CORE Center officials, however, have refused to go forward, citing concerns for patients and finances."

Read more in Chicago Free Press, August 6, 2009.

Comment: This appears to be a legitimate dispute with understandable reasons on both sides. Our first impression would be to side with GeoVax and do the trial.

High Viral Load Patients Equally Fine on Epzicom or Truvada

"People who start antiretroviral treatment for the first time with a viral load over 100,000 do equally well on a regimen containing abacavir (found in Ziagen, Epzicom and Trizivir) as on a regimen containing tenofovir (found in Viread, Truvada and Atripla), according to a study published in the September 1 issue of The Journal of Infectious Diseases. These results counter a previously reported study that suggested abacavir—notably its Epzicom co-formulation with lamivudine—is less likely to keep viral load undetectable among people initiating HIV treatment with high viral loads."

Read more in POZ, August 7, 2009.

Note: See abstract of Virological Response to Initial Antiretroviral Regimens Containing Abacavir or Tenofovir.

August 7, 2009

A New Avenue Opens for Treating KS, CMV and Other Herpes Diseases

"After screening several dozen drugs that disrupt the development of new protease enzymes, they found several that were quite potent against Kaposi’s sarcoma–associated herpesvirus (KSHV) and CMV. “All known herpes virus proteases are structurally similar,” Craik said. “The inhibitor we found knocks out not only KS, but also the cytomegalovirus protease, so the site we’ve identified here could be a target for a broad-acting inhibitor against the entire viral family.”

"Though the drugs they found aren’t at all ready for human testing, the work of Shahian, Craik and their colleagues could pave the way for drug development that could substantially move the treatment of all herpes viruses a huge leap forward."

Read more in POZ, August 4, 2009.

August 4, 2009

Debunking the “Beehive” of AIDS Denialism

"One of the “Most Talked About” stories recently on is a brief article on a new book titled Denying AIDS: Conspiracy Theories, Pseudoscience and Human Tragedy, originally from the June 2009 issue of POZ magazine. ...

"In the book you compare AIDS denialism to a beehive. Could you explain that?

"What I was trying to convey is that if you take a look at all the different denialist websites and the blogs and the magazine articles, a lot of it looks fairly chaotic from a distance. You’ve got people saying HIV doesn’t even exist and no one can prove it. Then you’ve got Peter Duesberg who’s saying HIV does exist but it’s harmless. Then you’ve got other people who say HIV isn’t harmless, but it’s not sexually transmitted. And from a distance it looks like it’s a very uncoordinated, sort of swarm. Like a beehive does from a distance. But as you get closer, you see that it’s very well organized. And actually there is a centralized group, and it is the Rethinking AIDS group. And there are three or four people who are very involved in that.

"To write this book I actually went undercover. I never misrepresented myself. I posed as a student of public health, which of course I am. But I had to be able to talk to these guys without barriers. I wanted to get to know what was really going on with them. And as I did that, I saw they’re very well connected with each other. In fact, there’s a vetting process that I went through to be listed as an AIDS dissident on the Rethinking AIDS website. Christine Maggiore herself vetted me, and I was posted. And once I was listed on there, the door was open to me. They would all talk to me. And it was actually very well organized. And, in that way, like a beehive.

"And the other part of the swarm thing is, I do expect to get stung by this. The hate mail has already started. The online assault has started—which I fully expect. For the book to be successful, they’ve got to come after me. If they don’t then I think the book was probably a waste of time.

"What do you hope readers take away from the book?

"I hope there’s a couple things that they take away. One thing I hope they take away is that they can’t believe everything they read online and in books. They really need to think critically about the information that they’re getting; they need to think hard about the doctor they are seeing and be really good consumers of health care. Not to be close-minded, but be critically thinking. If a new idea comes out or if they hear something different that their doctor didn’t tell them, they should listen and attend to it.

"One thing I really hope that folks with HIV will look at carefully is the credibility of who’s saying what they’re listening to. Not the credentials, but the credibility. You have professors saying HIV doesn’t cause AIDS and that you don’t have to worry about it. And those same professors say that the Loch Ness Monster exists. That should mean something.

"That’s something that I’d hope the readers of POZ walk away with. That they really have a role in combating this misinformation. They have a role to become informed and to not be silent when they see misinformation. If they see something on a blog that they know to be garbage, comment on it. People who are buying into it are very vocal and very visible. And everyone else is ignoring them. So it looks like everybody’s buying into this.

"All royalties from Denying AIDS will help the Family Treatment Fund provide antiretroviral medication for people living with HIV/AIDS in Africa."

Read more in POZ, August 3, 2009.

Raltegravir, Etravirine, and Ritonavir-Boosted Darunavir: A Safe and Successful Rescue Regimen for Multidrug-Resistant HIV-1 Infection

"Conclusion: The combination of raltegravir, ETR, and DRV/r was a highly effective and well-tolerated antiretroviral salvage regimen in patients infected with multidrug-resistant HIV-1."

Read more in JAIDS, August 3 , 2009.

August 3, 2009

Are We Meeting the American Diabetes Association Goals for HIV‐Infected Patients with Diabetes Mellitus?

"American Diabetes Association goals (for hemoglobin A1c, blood pressure, and lipid levels) were defined by 2008 American Diabetes Association guidelines. HIV‐infected diabetic patients achieved American Diabetes Association goals at rates similar to those in general medicine clinic patients. A multidisciplinary approach is needed to improve diabetes management in HIV clinics."

Read a little more in Clinical Infectious Diseases, July 27, 2009.

Scientists Learn Why Even Treated Genital Herpes Sores Boost the Risk of HIV Infection

"New research helps explain why infection with herpes simplex virus-2 (HSV-2), which causes genital herpes, increases the risk for HIV infection even after successful treatment heals the genital skin sores and breaks that often result from HSV-2.

Scientists have uncovered details of an immune-cell environment conducive to HIV infection that persists at the location of HSV-2 genital skin lesions long after they have been treated with oral doses of the drug acyclovir and have healed and the skin appears normal. These findings are published in the advance online edition of Nature Medicine on Aug. 2."

Read more in NIAID news release, August 2, 2009.

Acetylcholine-Esterase Inhibitor Pyridostigmine Decreases T Cell Overactivation in Patients Infected by HIV

"Here we showed that pyridostigmine is able to modify T cell overactivation and proliferation in patients chronically infected with HIV. Pyridostigmine led to an increase in the antiinflammatory cytokine IL-10 and a decrease in T cell proliferation and production of the proinflammatory cytokine IFN-γ."

Read more in AIDS Research and Human Retroviruses, online August 1, 2009.

Comment: This early human study could be important. The drug is approved but hazardous; it may have caused Gulf War Syndrome in the 1991 war, when it was used as protection against possible nerve-gas attack.

August 1, 2009

Coverage of 2009 International AIDS Society conference, July 19–22, 2009, Cape Town, South Africa

"Most of the oral sessions at the meeting focused on reviewing the current state-of-the-art treatment, biological prevention strategies, patient management and epidemiological data in order to bring continuing education to clinicians and practioners where the epidemic is raging. Given the timing and location of this conference, translating science into operational practice was also a major focus."

Read more in Project Inform, August 1 , 2009.