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October 30, 2009

White House announces end to HIV travel ban

"President Obama called the 22-year ban on travel and immigration by HIV-positive individuals a decision "rooted in fear rather than fact" and announced the end of the rule-making process lifting the ban.

"The president signed the Ryan White HIV/AIDS Treatment Extension Act of 2009 at the White House Friday and also spoke of the new rules, which have been under development more more than a year. "We are finishing the job," the president said.

"The regulations are the final procedural step in ending the ban, and will be published Monday in the Federal Register, to be followed by the standard 60-day waiting period prior to implementation."

Read more in Washington Post blog, October 30, 2009.

HIV tamed by designer 'leash'

"Researchers have shown how an antiviral protein produced by the immune system, dubbed tetherin, tames HIV and other viruses by literally putting them on a leash, to prevent their escape from infected cells. The insights reported in the October 30th issue of the journal Cell, a Cell Press publication, allowed the research team to design a completely artificial protein -- one that did not resemble native tetherin in its sequence at all -- that could nonetheless put a similar stop to the virus.

"Tetherin is essentially a rod with anchors at either end that are critical for its function," says Paul Bieniasz of Howard Hughes Medical Institute and the Aaron Diamond AIDS Research Center at The Rockefeller University. Either one of those anchors gets incorporated into the envelope surrounding HIV or other viruses as they bud through the plasma membrane of an infected cell. "One anchor gets into the virus and the other in the cell membrane to inevitably form a tether.

"We showed we could design a completely different protein with the same configuration – a rod with lipid anchors at either end – and it worked very well," he continued. The finding helped to confirm that tetherin is capable of acting all on its own, he added.

"They also explain tetherin's broad specificity to protect against many viruses. "It is just targeting lipids," Bieniasz said. "It's not about viral proteins." That's conceptually important, he continued, because there is no specific interaction between tetherin and any viral protein, which makes it a more difficult problem for viruses to evolve resistance. Rather than tweaking an existing protein-coding gene, "the virus has to make the more difficult adjustment of acquiring a new gene antagonist [of tetherin]."

"Unfortunately, many viruses have managed to do just that. In the case of HIV, a protein called Vpu counteracts tetherin. They now show it does so by sequestering the host protein, which prevents its incorporation into the virus. The new insight into tetherin's and Vpu's modes of action, however, may lead to the development of Vpu blockers that could free up the innate host defense and inhibit HIV's spread, Bieniasz suggests."

Read more in EurekAlert!, October 29, 2009.

Beyond Thailand: Making Sense of a Qualified AIDS Vaccine "Success"

By Jon Cohen: "When researchers announced on 24 September that an AIDS vaccine trial had positive results for the first time in history, many wondered whether they were real. Some prominent skeptics remain, but that debate has largely given way to intense discussions about how to build on this surprising finding. Already, researchers have begun discussing the staggering challenge of probing blood samples from the more than 16,000 people in Thailand who participated in the trial to figure out which immune responses led to the modest protection reported. The key question is whether the study will help reveal the long-sought immune responses that correlate with protection."

Subscribers only read more in Science, October 30, 2009.

S.F. AIDS meeting has real-world focus

"More than 3,000 public policy experts, health educators, patients and their advocates are expected to attend this week's U.S. Conference on AIDS in San Francisco. ...

"A lot of AIDS and HIV conferences are about the data and the numbers and the research, or they're for the doctors. This is really geared toward the grassroots people," said Jason Riggs, a spokesman for the Stop AIDS Project in San Francisco. "It's about providing training and networking, so people can advocate in their own communities for the things that people affected by HIV really need."

Read more in San Francisco Chronicle, October 29, 2009.

High prevalence of anal chlamydia in Swiss HIV-positive gay men

"A large proportion of HIV-positive gay men in Switzerland have anorectal infection with chlamydia, investigators report in the November 15th edition of Clinical Infectious Diseases. The researchers suggest that undiagnosed anal chlamydia infections could be contributing to the continued spread of HIV amongst gay men in Switzerland."

Read more in Aidsmap, October 29, 2009.

Darunavir/ritonavir, etravirine and raltegravir has 'remarkable' success in children with resistant virus

"A combination of darunavir/ritonavir, etravirine, and raltegravir is “remarkably” effective in HIV-positive adolescents with extensive prior experience of antiretroviral therapy, French investigators report in the November 13th edition of AIDS. The study involved twelve adolescents, and all but one had a viral load below 400 copies/ml after a year of treatment with this combination. Impressive improvements in CD4 cell counts were observed and there were no serious side-effects.

"'This [study] demonstrates that, as in adults, the majority of extensively treated adolescents can be virologically controlled with by a salvage regimen consisting of a combination of new drugs, despite a long record of suboptimal treatment and viral multiresistance', write the investigators."

Read more in Aidsmap, October 30, 2009.

October 29, 2009

Scientists Discover Gene that 'Cancer-Proofs' Rodent's Cells

"Despite a 30-year lifespan that gives ample time for cells to grow cancerous, a small rodent species called a naked mole rat has never been found with tumors of any kind—and now biologists at the University of Rochester think they know why.

"The findings, presented in today's issue of The Proceedings of the National Academy of Sciences [October 27], show that the mole rat's cells express a gene called p16 that makes the cells "claustrophobic," stopping the cells' proliferation when too many of them crowd together, cutting off runaway growth before it can start. The effect of p16 is so pronounced that when researchers mutated the cells to induce a tumor, the cells' growth barely changed, whereas regular mouse cells became fully cancerous."

Read more in University of Rochester press release, October 27, 2009.

Hepatitis C coinfection doesn't increase risk of progression to AIDS

"A meta-analysis of over 30 studies involving in excess of 100,000 patients with HIV has shown that hepatitis C co-infection does not increase the risk of progression to AIDS. The study is published in the November 15th edition of Clinical Infectious Diseases, and is now available online.

"However, the researchers did find that in the period since effective anti-HIV treatment became available, co-infected patients still have a 35% higher risk of death compared to patients who only have HIV. The investigators believe that that 'the major contributor to mortality among coinfected subjects during the HAART [highly active antiretroviral therapy] era is likely to be liver disease.'

"Antiretroviral therapy means that many people with HIV can look forward to a long and healthy life. However, the predicted prognosis of individuals co-infected with HIV and hepatitis C is significantly shorter than that of patients who are infected with HIV alone."

Read more in Aidsmap, October 27, 2009.

October 27, 2009

Fighting H.I.V., a Community at a Time

"Federal health officials are preparing a plan to study a bold new strategy to stop the spread of the AIDS virus: routinely testing virtually every adult in a community, and promptly treating those found to be infected."

Read more in New York Times, October 26, 2009.

October 23, 2009

TRIPS+ negotiations - death sentence for thousands Ukrainians - please support our protest!!!!

"Dear friends,

"I would like to turn for your support in our advocacy effort to prevent harmful effect of TRIPS+ that Ukraine is currently pushed to accept in EFTA negotiations. We received this information from the reliable source right on the day of the negotiations as the process itself is extremely closed and healthcare sector is not involved into this process. The TRIPS+ provisions are extremely strict and carry real risk of interruption of treatment for more than 10 000 patients with HIV that are on HAART in Ukraine now, but present overall danger for the whole healthcare sector of Ukraine and particularly to the area of access to essential medicines.

"Ukraine is pushed to accept:

"Patent term extensions for medicines for 5 years: the condition which is not taken even in western countries (like US)

"Data exclusivity for 8 years for medicines

"Patent for the new use of old medicines

"These are some of the most outrageous demands that Ukraine has faced with. Accepting such conditions will mean blockage of use of generic medications that currently are the key part of the 1st and 2nd line treatment schemes of HAART in Ukraine which will lead to potential treatment interruption for thousands of people. In nearest future, Ukraine is signing upon death penalty for thousands of people who will require innovative treatment regimen, who are suffering from co-infection of HIV/Hepatitis C and finally for people with MDR-TB which is becoming a first cause of mortality in Ukrainians living with HIV.

"We call upon you to send your letters of protest against accepting these draconian regulations by Ukraine to the current officials and addresses:

Ministry of economy of Ukraine
Ukraine, Kyiv, Grushevskogo Str. 12/2
Mr Danilishin Bogdan Michailovich
Fax: ph. (+38044) 272-5507, fax (+38044) 272-5546

Ministry of Health of Ukraine
Ukraine, Kyiv, Grushevskogo 37
Mr Knyazevich Vasil Michailovich
Tel/Fax +38044 253 24 72

"If you have any questions – please write to me directly

Konstantin Lezhentsev
All-Ukrainian Network of PLWH
87 "В", Mezhyhirska St.,
Kyiv, Ukraine 04071
Tel.: +38 (044) 467 7567; 467 7569; 467 7584; ext. tel. 746
Fax: +38 (044) 467 7566"

Comment, by JSJ: The bullying of smaller countries continues -- to make them sacrifice lives of their people for the benefit of foreign profiteers.

Apparently Obama cannot help because he needs the pharmaceutical industry to help get U.S. healthcare passed.

Co-Payment Assistance for Wasting Drug Serostim

"People with private health insurance using Serostim (recombinant human growth hormone) can now save up to $200 per month on their monthly co-payments, according to information released by the drug’s maker, EMD Serono. The co-payment card, available through health care providers prescribing Serostim, can be used up to six times during a one-year period."

Read more in POZ, October 21, 2009.

Wingnuts Target Jennings & Harvard's ACT UP Exhibit

"They're running out of ammo. The right-wing nuts that have been trying, and miserably failing, to bring down Kevin Jennings, Obama's "safe schools czar," are now trying to use ACT UP as a smear (see WorldNetDaily). It seems Kevin was one of many supporters for a currently running exhibit at Harvard titled ACT UP New York: Activism, Art, and the AIDS Crisis, 1987-1993, which the wingnuts are calling "radical porn" (click on the exhibit poster for a closer look). Even worse, he may have even been a member of ACT UP way back when. The horror!"

Read more in Peter's POZ Blog, October 22, 2009.

October 21, 2009

Syringe programs return $4 for every $1 invested

"Distributing syringes to drug injectors had prevented at least 32,000 HIV infections and 100,000 hepatitis C infections across Australia in the past 10 years, new research has found.

"Harm reduction campaigner, Mr John Ryan, said the national Return on Investment 2 study showed that needle and syringe programs (NSP) had saved Australia $1.28 billion in health costs in the past decade years.

"The study was funded by the Federal Government’s Department of Health and Ageing. It was conducted by the National Centre in HIV Epidemiology and Clinical Research. The study will be launched on Thursday October 22 in Sydney.

"'Nationally, more than 32,000 HIV and almost 100,000 hepatitis C infections have been prevented by providing sterile syringes and counselling to injectors in the past nine years,' said Mr Ryan who is Chief Executive Officer of the Association for Prevention and Harm Reduction Programs Australia (Anex).

"Australia has one of the most extensive NSP networks in the world. It has one of the lowest HIV rates among injectors globally.

"'Only 0.1% of drug injectors are HIV positive, but 14% would be if there were not needle and syringe programs throughout thousands of places in Australia,' Mr Ryan said.

"Heroin remains the most commonly injected illicit drug in Australia, followed by amphetamines. The lower the HIV rate among injectors, the safer the general community was, Mr Ryan said.

"'This proves yet again that syringe programs protect the community and are excellent value for money. Total government funding for NSP nationally was only $27 million a year on average. But, that has saved taxpayers more than $1.3 billion since 2000,” said Mr Ryan. Distributing syringes to drug injectors had prevented at least 32,000 HIV infections and 100,000 hepatitis C infections across Australia in the past 10 years, new research has found.

"Harm reduction campaigner, Mr John Ryan, said the national Return on Investment 2 study showed that needle and syringe programs (NSP) had saved Australia $1.28 billion in health costs in the past decade years.

"The study was funded by Federal Government’s Department of Health and Ageing. It was conducted by the National Centre in HIV Epidemiology and Clinical Research. The study will be launched on Thursday October 22 in Sydney. ...

"The full report is called Return on Investment 2: evaluating the cost effectiveness of needle and syringe programs in Australia. It can be downloaded at"

Read more in Return on Investment 2 [large download], October 21, 2009.

Etravirine, darunavir/ritonavir and raltegravir very effective in highly treatment-experienced patients

"A combination of raltegravir, etravirine and darunavir/ritonavir is highly effective at suppressing viral load to undetectable levels in treatment-experienced patients, French investigators report in the November 1st edition of Clinical Infectious Diseases.

"All 100 patients in the 48-week, prospective, non-comparator study had multiple resistance mutations to protease inhibitors and nucleoside reverse transcriptase inhibitors (NRTIs). Nevertheless, after a year of treatment with the three new drugs, 86% had a viral load below 50 copies/ml."

Read more in Aidsmap, October 19, 2009.

October 19, 2009

Towards a genetic AIDS vaccine

"The study by Philip Johnson and his colleagues of the Children’s Hospital in Pennsylvania published in a recent issue of Nature Medicine presents an unorthodox, yet surprisingly simple approach. These authors used gene transfer technology to produce antibody-like molecules in the blood that effectively block viral infection [2]. First, they created artificial antibody-like proteins called immunoadhesins that were specifically designed to bind to the simian immunodeficiency virus (SIV) that infects macaques to cause an AIDS-like disease. Second, a gene therapy approach was used to deliver the antiviral immunoadhesin gene into the macaques. This immunoadhesin gene therapy approach bypasses the immune system altogether, and promising results were reported in the pre-clinical macaque model. The insights gained from how to achieve protection against SIV infection by a gene therapy approach could possibly be translated to the control of HIV-1 infection in humans."

Read more in Retrovirology, October 16, 2009 (anyone can download a provisional PDF of the article).

Relapse common in HIV/HCV co-infected patients after treatment for HCV

"Relapse after apparently successful treatment for hepatitis C virus occurs in over a third of individuals who are co-infected with HIV and hepatitis C, Spanish investigators report in the November 1st edition of Clinical Infectious Diseases.

"Relapses were more common in co-infected patients who carried the harder-to-treat hepatitis C 1 and 4 genotypes. Most relapses occurred within three months of the completion of hepatitis therapy, and re-infection with hepatitis C accounted for most of the apparent relapses seen after this time."

Read more in Aidsmap, October 19, 2009.

Note: Also see If HCV Treatment Relapse Occurs, It Occurs Quickly, in POZ.

October 16, 2009

Vitamin D for Cancer Prevention: Global Perspective

"RESULTS/CONCLUSIONS: It is projected that raising the minimum year- round serum 25(OH)D level to 40 to 60 ng/mL (100–150 nmol/L) would prevent approximately 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer each year, and three fourths of deaths from these diseases in the United States and Canada, based on observational studies combined with a randomized trial. Such intakes also are expected to reduce case-fatality rates of patients who have breast, colorectal, or prostate cancer by half. There are no unreasonable risks from intake of 2000 IU per day of vitamin D3, or from a population serum 25(OH)D level of 40 to 60 ng/mL. The time has arrived for nationally coordinated action to substantially increase intake of vitamin D and calcium."

Read more in OncologySTAT, October 16, 2009.

Comment: Personally I've been taking 1,000 IU, and may stay with that for now.

IL-2’s Downfall Might Have Been Inflammation

"The failure of Proleukin (Interleukin-2, IL-2) to demonstrate a clinical benefit in the SILCAAT and ESPRIT studies earlier this year might have resulted because the drug increased immune system inflammation, according to an article published October 15 in The New England Journal of Medicine (NEJM)."

Read more in POZ, October 15, 2009.

October 14, 2009

Columbia University Publishes Free HIV Handbook Online

"Columbia University in New York City has published a revised edition of its comprehensive HIV/AIDS handbook, intended for those at risk of HIV infection and people currently living with the virus. You can download the 116-page document for free using the link here.

"The Columbia Handbook on HIV and AIDS combines and updates two previous works originally published by Simon & Schuster (Pocket Books): The Essential AIDS Fact Book and The Essential HIV Treatment Fact Book. The new handbook, which some have called an AIDS bible, offers key information on HIV transmission and prevention methods plus the basics of HIV treatment."

Read more in POZ, October 13, 2009.

HIV Eradication: One Step Closer

"Hopes for HIV eradication have been stymied by the current crop of antiretroviral drugs’ inability to get at the reservoir of inactive HIV-infected CD4 cells that hide in the body. Now, Robert Siliciano, MD, PhD, from Johns Hopkins University says not only that it’s possible to get at these cells, but that his lab is already on track to identifying drugs that can wake up these cells. The discovery represents a significant step on the path to ultimately curing HIV. ...

"The only way to get at this virus is to activate the resting memory CD4 cells, but turning them all on at the same time could be deadly. So how can you turn on only the cells that are infected?

"This seemingly impossible task is exactly what Siliciano and his colleagues set out to tackle. Using a line of cells that they’ve developed, researchers can determine whether various chemical compounds can activate resting CD4s infected with HIV. They’ve already found a handful of compounds that can selectively activate infected cells. While none of these are likely to be safe enough for human use, Siliciano’s group is going to keep looking, and their accomplishment represents a significant step forward in the search for a cure.

"'I’d always been pretty pessimistic about this whole approach,' Siliciano says, “but in looking at about 4,000 drugs, we got nine 'hits.' It wasn’t actually that hard to find these drugs.'"

Read more in POZ, October 13, 2009.

October 12, 2009

Robert Scott, M.D. - Renowned American HIV specialist dies

"Dr Robert Scott, a renowned American doctor who has worked treating HIV and AIDS patients in Zimbabwe for nearly 10 years, has died.

"The Late Dr. Robert Scott, M.D. Dr Scott passed away on October 8 in Oakland, California from complications arising from blood clots. Dr Scott was known both as an HIV/AIDS specialist and an advocate for people living with HIV/AIDS in America as well as in Zimbabwe. ...

"All the patients in Zimbabwe were treated free of charge through the efforts of the AIDS Ministry, which he co-founded at his home church, the Allen Temple Baptist Church in Oakland California."

Read more in The Zimbabwe Times, October 12, 2009.

H1N1 Vaccine Studies in HIV-Positive Youth and Pregnant Women

"'These studies are important because HIV infection and pregnancy both increase the risk for a poor immune response,' explained Anthony Fauci, MD, the director of NIAID. 'Moreover, children, young people and pregnant women are at higher risk for more severe illness from the 2009 H1N1 influenza virus ("swine flu") than other groups, and HIV-infected individuals in these populations may be particularly vulnerable.'"

Read more in POZ, October 12, 2009.

Change in Quality of Life after Being Diagnosed with HIV: A Multicenter Longitudinal Study

"Comparing life at time 1 versus before diagnosis, 109 (31%) patients said their life was better at time 1, 98 (28%) said it was worse, and the rest said it was about the same or did not know. By time 2, approximately one fifth of the patients changed their answers to indicate life improvement and one sixth changed them to indicate life deterioration. In multivariable analysis, change in perception for the better between time 1 and time 2 (versus prediagnosis) was positively associated with time 1 positive religious coping scores, whereas change in perception for the worse was associated with study site, heterosexual orientation, a detectable viral load, shorter duration of HIV, lower spirituality scores, and lower positive religious coping scores. We conclude that many patients with HIV feel that their life is better than it was before their diagnosis, although results of such comparisons often change over time."

Read a little more in AIDS Patient Care and STDs, October 12, 2009.

Reports of evidence planting by police among a community-based sample of injection drug users in Bangkok, Thailand

"252 IDU were recruited between July and August, 2008, among whom 66 (26.2%) were female and the median age was 36.5 years. In total, 122 (48.4%) participants reported having drugs planted on them by police. In multivariate analyses, this form of evidence planting was positively associated with midazolam use (Adjusted Odds Ratio [AOR] = 2.84; 95% Confidence Interval [CI]: 1.58 - 5.11), recent non-fatal overdose (AOR = 2.56; 95%CI: 1.40 - 4.66), syringe lending (AOR = 2.08; 95%CI: 1.19 - 3.66), and forced drug treatment (AOR = 1.88; 95%CI: 1.05 - 3.36). Among those who reported having drugs planted on them, 59 (48.3%) paid police a bribe in order to avoid arrest."

Read more in BMC International Health and Human Rights, October 12, 2009.

October 11, 2009

HIV vaccine: it may take two to tango, but no party time yet

"This is the first positive signal of any degree of vaccine efficacy in humans, more than a quarter-century after scientists discovered the virus that causes AIDS. ... On the other hand, many questions remain about the RV144 trial, and these issues will be addressed in this editorial."

Read more in Retrovirology, October 9, 2009 - open access, full editorial available for download.

FDA committee recommends approval of maraviroc for first-line treatment in US

"People with HIV in the United States are likely to get a further option for use in first-line drug combinations within the next few weeks, following yesterday’s decision by the US Food and Drug Administration’s Antiviral Drugs Advisory Committee to recommend marketing approval for maraviroc (Selzentry in the USA, Celsentri elsewehere), the CCR5 inhibitor manufactured by Pfizer.

"Maraviroc has already been approved for use in combination with other antiretroviral drugs in treatment-experienced patients with HIV that is CCR5-tropic (virus which uses the CCR5 receptor to gain entry to CD4 cells). Maraviroc is the first of a new class of antiretroviral drugs which block the CCR5 receptor.

"All patients being considered for maraviroc treatment must undergo tropism testing to ensure that they have CCR5-tropic virus. Anyone with a virus population that is not CCR5-tropic will not experience a viral load reduction when treated with maraviroc."

Read more in Aidsmap, October 9, 2009.

October 8, 2009

Viramune Launches Co-Pay Program

"People with private health insurance can now save up to $50 on their co-payment on every monthly refill of a Viramune prescription for up to one year, according to an announcement by the drug?s maker, Boehringer Ingelheim (BI). The Co-Pay Savings Program does not include BI?s protease inhibitor Aptivus (tipranavir).

"The program is the first to use a MasterCard debit card as the method for handling the co-pay. According to a BI spokesperson, using a point-of-purchase debit card will greatly expand the number of pharmacies that will participate in the program and allow many mail-order pharmacies to participate, something that most of the other co-pay programs are unable to do.

"As with similar programs from other companies, people on Medicaid, Medicare or ADAP are not eligible for BI?s co-payment savings, nor are residents of Massachusetts. BI is making the cards available only through health care providers. Once customers receive their cards, they must activate them by calling 888.998.4726 or visiting"

Read more in POZ, October 7, 2009.

CD4 cell count below 500 increases cancer risk for patients with HIV

"Maintaining a CD4 cell count above 500 cells/mm3 will protect HIV-positive patients from a range of AIDS-defining and non-AIDS-defining cancers, French investigators conclude in a paper published online on October 8th inth Lancet Oncology.

"The investigators analysed the rates of the seven most common cancers in people with HIV and found that CD4 cell count was the strongest risk factor for several of them. Most of the patients in the study, which included data collected between 1998 and 2006, were taking antiretroviral therapy.

"'Our results suggest that combination antiretroviral therapy would be most beneficial if it restores or maintains the CD4 cell count above 500 cells/mm3, thereby indicating earlier diagnosis of HIV infection and earlier treatment initiation", comment the authors."

Read more in Aidsmap, October 8, 2009.

October 7, 2009

World’s First Engineered T Cell Receptor Trial Opens with New Cellular Therapy for HIV

"Researchers at Adaptimmune Limited and the University of Pennsylvania School of Medicine, today announced the approval of an Investigational New Drug (IND) application from the US Food and Drug Administration (FDA) and opening for enrollment of the first ever study using patients’ cells carrying an engineered T cell receptor to treat HIV (SL9  HA-GAG-TCR). The trial may have important implications in the development of new treatments for HIV potentially slowing – or even preventing – the onset of AIDS.
The trial makes use of the body’s natural ability to recognize infected cells by enhancing the power of the T cell receptor (TCR) on killer T cells. ...

Last year, with colleagues at the University of Pennsylvania, theyengineered and tested a killer T-cell receptor that can recognize all the different disguises HIV is known to have used to evade detection. The researchers transferred this receptor to the killer T-cells to create genetically engineered "bionic assassins" able to destroy HIV-infected cells in culture. Now, less than a year later, they are taking their unique technology into the clinic. ..."

Read more in Penn Medicine News, October 7, 2009.

October 6, 2009

Second Analysis of Vaccine Trial Casts Doubts on Result

"Now Cohen reports that a second analysis showed a trend toward benefit in those who were vaccinated, but failed to demonstrate a statistically significant difference. This means the difference was small enough that it could have occurred by chance."

Read more in POZ, October 6, 2009.

Comment: This finding weakens the positive vaccine result. But remember that the line between statistically significant, or not significant but only a trend, is an arbitrary one, depending on history and custom in medical research. Crossing this line does not cross any line in nature.

Food insecurity increases risk of death for patients taking HIV treatment in Canada

"When the researchers took into account possible confounding factors, they still found that food insecure patients had a 50% increase in their risk of death (adjusted hazard ratio [AHR] = 1.51, 95% CI, 1.03-2.23)."

Read more in Aidsmap, October 6, 2009.

October 5, 2009

Retroviruses Conference (CROI): Deadlines tomorrow (researchers), and October 16 (young investigator awards)

"As a reminder, the deadline for abstract submission for CROI is tomorrow, Tuesday, October 6 at 5:30 pm EDT. Please visit the conference web site,, for the submission instructions and subject categories.

"The Scientific Program Committee will provide a large number of young investigator awards for fellows, graduate students and undergraduate students who are presenting their work at the conference. The deadline for young investigator award recommendations is Friday, October 16 at 5:30 pm EDT. Information on this program is available on line (see Awards and Scholarships)."

Read more in CROI dates and deadlines, October 5, 2009.

Avexa Closes Phase III Trial of HIV Drug Apricitabine

"Avexa announced that it is closing a planned 48-week Phase III study of its antiretroviral drug apricitabine (ATC) early in order to analyze the data and make decisions about the drug’s fate, according to a press release the company issued October 2.

"Apricitabine is a second-generation nucleoside reverse transcriptase inhibitor (NRTI) in the same family as Epivir (lamivudine) and Emtriva (emtricitabine) and was designed to work against HIV resistant to those two drugs. A Phase IIb study indicated that ATC does, in fact, work against Epivir- and Emtriva-resistant virus. ...

"'The rationale for closing the trial…was based on two key factors. First, the results may offer key insight into ATC’s role in the overall HIV treatment landscape, and discussions with regulatory authorities may clarify the ATC approval path. Secondly, this will allow for a mature enough data point to enable potential partners the ability to make a definitive decision on licensing of ATC,' stated Julian Chick, PhD, Avexa’s chief executive officer."

Read more in POZ, October 5, 2009.

Topical treatment for pre-cancerous anal cell changes safe and moderately effective

"A course of treatment with topical trichloroacetic acid appears to provide a safe and effective treatment for pre-cancerous cell changes in the anus, US investigators report in a study published in the online edition of the Journal of Acquired Immune Deficiency Syndromes. The treatment was equally effective in HIV-positive and HIV-negative men.

"'Given its ease of use, low cost, and good safety profile, trichloroacetic acid represents a reasonable first-line therapy with carefully selected patients', comment the investigators.

"Higher rates of anal cancer are seen in gay men, especially those with HIV, than in the general population. Anal intraepithelial neoplasia (AIN) is the name given to pre-cancerous changes in the anus. AIN is graded AIN I, AIN II, and AIN III according to its severity."

Read more in Aidsmap, October 5, 2009.

Long-Term Combination Antiretroviral Therapy Is Associated with the Risk of Coronary Plaques in African Americans with HIV Infection

"This study suggests that long-term exposure to ART may be associated with coronary plaques. Because long-term use of ART and HIV replication may be associated with the presence of noncalcified plaques, some of which may be more vulnerable to rupture, an intensive lifestyle intervention to reduce traditional risk factors for coronary artery disease (CAD) is ultimately vital to those who are on ART."

Read more in AIDS Patient Care and STDs, October 5, 2009.

Comment: This trial studied only African Americans. Therefore the same finding may apply to other patients as well -- which seems likely.

October 4, 2009

Three-quarters of HIV-positive US prisoners stop anti-HIV drugs after release from jail

"Few HIV-positive prisoners in the US continue to take HIV treatment once they are released from jail, Canadian and US investigators report in the online journal PLoS One.

"'We are concerned about the deleterious effects of intermittent therapy in light of the SMART data and the possibility of the development of resistance', comment the investigators.

"They continue, 'our study…highlights the need to support continuous antiretroviral therapy and the importance of continuity of care services for HIV infected persons who enter the cycle of incarceration.'

"HIV is a significant health problem in US prisons especially as it has been estimated that up to a quarter of HIV-positive individuals in the US will be imprisoned at some point."

Read more in Aidsmap, October 2, 2009.

HIV-Infected Adults from Minority Ethnic Groups are Willing to Participate in Research if Asked

"The strongest predictor of participation was being asked (RR 3.0; p<0.001). The majority of patients would agree (65%) or consider (30%) participating in a study if recommended by their PCP [primary care provider]. Being treated like a “guinea pig” was the most common (40%) concern of patients." Read more in AIDS Patient Care and STDs, October 2, 2009.

October 2, 2009

Immune surveillance below the radar: study offers explanation for acyclovir’s failure to reduce HIV risk

"The background to the work is that HSV-2 infection has been consistently associated with a 2 to 3-fold increased risk of acquiring HIV; a meta-analysis published in 2006 reported a relative risk of 3.1, 2.7 and 1.7 for women, heterosexual men and men who have sex with men, respectively. [3]

"Recently analysed data from the Merck vaccine trial are consistent with these findings in that HSV-2-infected participants were found to have approximately double the risk of acquiring HIV infection during the study.

"The mechanism by which HSV-2 infection increases HIV acquisition risk is not so clear, however, and has been the subject of debate.


"The researchers acknowledge in the conclusion to the paper that the number of participants was small, but nevertheless state: “we feel that our central finding – that HSV reactivation leaves a residual inflammatory response not appreciated clinically – is typical of HSV-2 genital lesions.” They also note that “the wide anatomical distribution of HSV-2 in the male and female genital tract underscores the importance that these localized reservoirs of inflammatory cells are likely to have in HIV acquisition.”"

Read more in i-base, September/October 2009.

Many Prisoners Revert to Intermittent Treatment After Incarceration

"Less than 17 percent of HIV-positive inmates on antiretroviral (ARV) therapy continue taking their treatment consistently once they are released from prison, according to a study published September 22 in the online journal PLoS One.

Though there are often still many barriers to effective HIV therapy in prison, researchers have known that some incarcerated people are better able to access and adhere to ARV treatment while in prison than after they are released. Potential reasons for this include lack of housing, employment, access to care and social support. "

Read more in POZ, October 1, 2009.

CD4 responses after viral suppression for more than 7 years on HAART

"Most patients responded well to treatment: the median CD4 cell count after four years of HAART was 560 cells/mm3 (IQR, 390-776).

"However, 151 patients (41%) had a CD4 cell count that was less than 500 cells/mm3 at year 4, of whom 61 eventually had a confirmed increase to >500 cells/mm3. Many of the remaining patients remained below this threshold through 10 years of observation.

"Results strongly correlated with baseline CD4 count: 95%, 75% and 56% of patients who started treatment at >300, 100–200 and <100 cells/mm3 respectively, were able to achieve a CD4 cell count >500 cells/mm3. Baseline CD4 count also correlated with time to reaching CD4 >500 and inversely with magnitude of the changes in CD4 count.

"In multivariate analysis, age was the only factor consistently associated with CD4 cell count increases, with younger patients having greater increases than older patients. HCV coinfection, sex, and pre-HAART nucleoside use were not statistically significant predictors of CD4 cell count increases."

Read more in i-base, September/October 2009.