Fixing the Body: An Immune-Based Approach to HIV

"8. Why would we think this drug [Cytolin] might work?

"Because before 1996 when viral cocktails were invented, doctors used this drug on many patients (188 of them) and we know from the records of those patients that the drug seemed to help them.

"In general, using the antibody showed some return in the ability to fight illnesses, an increased number of T cells, and a drop in the amount of virus. The way scientists measured this was to use a test of the body’s ability to recognize enemy germs, a skin test and it was clear that people who were not able to fight some illnesses got this ability back after using the antibody. Some of the well known scientists who worked with this antibody years ago were contacted by the non-profit organization Search For A Cure and interviewed. All of them indicated that they would like to see Cytolin studied because they felt it had potential."

Read more in Search for a Cure, December 2009.

In New Way to Edit DNA, Hope for Treating Disease

"At the University of Pennsylvania, Dr. Carl June and colleagues have used the technique to disrupt a gene in patients’ T cells, the type attacked by the AIDS virus. They have then infused those cells back into the body. A clinical trial is now under way to see if the treated cells will reconstitute a patient’s immune system and defeat the virus.

"The technique, which depends on natural agents called zinc fingers, may revive the lagging fortunes of gene therapy because it overcomes the inability to insert new genes at a chosen site. Other researchers plan to use the zinc finger technique to provide genetic treatments for diseases like bubble-boy disease, hemophilia and sickle-cell anemia.

"In principle, the zinc finger approach should work on almost any site on any chromosome of any plant or animal. If so, it would provide a general method for generating new crop plants, treating many human diseases, and even making inheritable changes in human sperm or eggs, should such interventions ever be regarded as ethically justifiable."

Read more in New York Times, December 29, 2009.

Vaccine Prevents SIV Disease Progression in Monkeys

"The results of a recent animal study suggests researchers may be one step closer to developing a vaccine to prevent or slow HIV disease progression in people who become infected with the virus, according to an article published December 11 in the journal Vaccine and reported by Science Daily.

"Some vaccines against diseases, like Polio, have relied on delivering a whole virus—either live or killed—to trigger a protective immune response against the disease. HIV is so dangerous, however, that researchers usually take fragments of the virus and combine it with other less harmful viruses. They in turn deliver the HIV fragments to the immune system to trigger a protective response. The harmless virus used to deliver the fragments is called a vector. With HIV, the vector can determine the success of the vaccine as much as the choice of which HIV fragments are used.

"One promising vector that has been suggested and studied is a weakened form of the rabies virus. To determine whether a vaccine made up of a weakend rabies virus and fragments of HIV’s primate counterpart—simian immunodeficiency virus (SIV)— could monkeys against SIV infection or disease progression, Elizabeth Faul, PhD, from Thomas Jefferson University in Philadelphia, and her colleagues tested two versions of such a vaccine in 12 monkeys. Encouraging results, the authors state, would potentially pave the wave for a similar approach using HIV fragments to vaccinate humans. ...

"The authors acknowledge that the vaccine did not protect against infection, but expressed excitement that they were able to cause such a large immune response that could protect against disease progression with only two vaccine injections."

Read more in POZ, December 28, 2009.

EACS releases three updated management guidelines

"The European AIDS Clinical Society publishes three management guidelines that make extensive use of summaries, bullet point list and supportive tables to produce resources that are easy to follow. The three main updates (version 5) were launched at this year’s conference.

"PDF versions are now available to download from the societies website..."

Read more in HIV Treatment Bulletin, November/December 2009.

Association between inflammation and sleep apnea in the MACS cohort

"Prompted by the concern that systemic inflammation may contribute to sleep apnea, Susheel Patil and colleagues from Johns Hopkins University presented an interesting analysis from the gently named SIESTA study (Study of Immune Effects on Sleep, (HIV) Treatment and Apnea).

"The study looked at obstructive sleep apnea (OSA) and the relationship with inflammation markers (TNF-alpha soluble TNF-a receptors I and II and IL-6), in three groups of men from the MACS cohort: HIV-positive and not on HAART (n=41), HIVpositive and on HAART (n=58) and HIV negative (n=60). ...

"When looking at participants with normal BMI (<25 kg/m2) however, the relationship indicated a trend for higher prevalence in the no-HAART group: 25% HIV-negative (n=20), 24% on HAART (n=29) and 50% in the no HAART group (n=22); (p=0.1)"

Read more in HIV Treatment Bulletin, November/December, 2009.

Visceral adipose tissue returns to baseline after stopping therapeutic intervention with rHGH

"Central fat accumulation remains one of the most distressing but least understood metabolic complications, with very limited management options. Several studies have reported that recombinant Human Growth Hormone (rHGH) can reduce central visceral adipose tissue (VAT), although earliest studies at higher doses (4-6 mg/day) were associated with significant toxicity. Additionally, any benefit seemed dependent on maintaining treatment, and the optimal dose remained to be established.

"It was important to see the 3-years results from a study from the Massachusetts General Hospital, presented by Steven Grinspoon, carried out in people with reduced growth hormone (GH) secretion (peak GH <7.5 ng/mL). ..."

Read more in HIV Treatment Bulletin, November/December, 2009.

Intermuscular tissue is decreased in HIV infection

"The first study in the main conference looked at a intermuscular adipose tissue (IMAT) - the distribution of fat that is beneath the muscle facia and muscle tissue – as a new parameter of metabolic disturbances. Led by Carl Grunfeld with the FRAM study, this group has provided important insight into the association of HIV to metabolic changes by using full body MRI to identify changes and including an HIV-negative control group. Results from the study concluded that fat loss and fat gain are separate unrelated dysfunctions and that fat loss rather than fat accumulation is the driving mechanism behind HIV-related changes."

Read more in HIV Treatment Bulletin, November/December, 2009.

HIV-Positive Children Surviving and Thriving

"The death rates of children living with HIV have decreased ninefold since combination antiretroviral (ARV) therapy became widely available in the mid-1990s, according to results from a large pediatric HIV study published in the December 15 issue of the Journal of Acquired Immune Deficiency Syndromes. But there’s still tremendous room for improvement: Young people with HIV continue to die at 30 times the rate of youth of similar age who do not have HIV."

Read more in POZ, December 22, 2009.

Heavy Drinking Raises Heart Disease Risk in HIV-Positive Men

"Looking only at the HIV-positive veterans and after controlling the data to exclude common traditional causes of CVD [cardiovascular disease] — such as age, cholesterol levels, high blood pressure and cigarette smoking — hazardous drinking was associated with a 74 percent increase in the risk of congestive heart failure (CHF), whereas alcohol abuse and dependence was associated with a 67 percent increase in the risk of coronary heart disease (CHD) and a 99 percent increased risk of CHF. Past drinkers—those who hadn’t used alcohol in the preceding 12 months—faced a 78 percent increased risk of a stroke.

"Interestingly, when the researchers looked at the HIV-negative veterans and controlled for traditional risk factors, there was no statistically significant association between alcohol consumption and CVD risk. This lack of association, the authors write, 'suggest[s] that the effect of alcohol may be more pronounced among those infected with HIV.'"

Read more in POZ, December 21, 2009.

Symptoms of Psychological Distress: A Comparison of Rural and Urban Individuals Enrolled in HIV-Related Mental Health Care

"Rural participants had significantly higher mean scores on the hostility dimension of the BSI [Brief Symptom Inventory], F(1, 93)=8.77, p=0.004, than their urban counterparts. Furthermore, the rural participants had a greater proportion of individuals who had a T-score ≥63, a level indicative of a need for further psychological evaluation, for generalized anxiety, hostility, and psychoticism. The results indicated that rural individuals presented with higher levels of symptoms of psychological distress than their urban counterparts. These differences may be reflective of situational circumstances in rural areas where access to care, social isolation, and perceived stigma may delay screening for, and treatment of, psychological distress."

Read more in AIDS Patient Care and STDs, December 21, 2009.

Crazy for the Holidays

"Depending on how you slice and dice the numbers, up to 15 million people in the United States will experience major depression each year. Forty million people suffer from some degree of serious anxiety ...

"Stats show that for people living with HIV, incidences of depression are even worse. Up to half of HIV-positive people in most studies have struggled with depression. Nobody can say for sure whether the increased rates are due to the fact that people who get depressed are more likely to become infected, or whether people who get infected are more likely to become depressed. I suspect it’s both. ...

"One of the most tragic things about living with mental illness, just like with HIV, is that you often feel like you are the only one. The illness also keeps you silent. You just feel like you can’t tell anyone how bad it really is."

Read more in POZ, December 19, 2009.

A Few Things That Are Certain

"So let me start out by stating the bottom line: If the national strategy is a plan to end AIDS, then it must include real strategies that end homelessness and housing instability for people living with HIV and those most at risk. Anything short of that is a plan to maintain the epidemic, not to bring it to an end.

"Now I know that some will argue that this statement overreaches. But the reality is that we have now poured billions of dollars into individual-level interventions when so much research points to the many socioeconomic drivers of the epidemic. Homelessness is one leading driver that is proved to be amenable to intervention and has been shown to have a direct, independent and powerful impact on both prevention and health outcomes.

"Very simply, prevention interventions that focus on changing the behavior of individuals are doomed to fail if we deny these individuals access to a proven, cost-effective prevention and health care intervention—a safe and secure place to live. The research—and there is a lot of it now—clearly shows that persons who lack stable housing are far more likely to become HIV infected, will have limited access to care once they are infected, and will live less healthy and shorter lives than persons just like them who are fortunate enough to have a home.

"Why is housing so critical? Because having a safe, secure place to live is fundamental to the basic activities of daily living. When one is homeless or facing housing instability, immediate survival must, by necessity, take priority over other activities and choices."

Charles King, Housing Works, New York

Read more in POZ, December 18, 2009.

Treatment for Everyone With HIV?

"The panel now recommends people with CD4 cell counts of 500 or below start HIV treatment right away. Previously, the guidelines recommended waiting until CD4s fell to below 350. The panel was split 50/50 about whether people with over 500 CD4s should start; half of the panelists essentially recommended treatment for everyone with HIV. Aside from the personal health benefits of being on ARV treatment, the panelists in favor of very early treatment also cited a public health benefit—suppressing viral loads in a large number of people to slow the ongoing spread of HIV.

"In contrast, the more skeptical activists and providers contend that while very savvy and experienced physicians and patients know enough about the data—or the lack thereof—to assess the risks and benefits of earlier treatment, most providers and patients don’t. Paul Dalton, a longtime activist who is an HIV-positive member of the DHHS panel, stresses that these caveats are discussed in the heavily annotated discussion sections of the guidelines. “My belief is that many users of the guidelines look at our tables and look at our bullet points, but don’t look at the discussion sections,” he says."

Read more in POZ, December 18, 2009.

Reyataz and Sustiva Co-Pay Programs Expanded

"The prescription co-payment programs run by Bristol-Myers Squibb (BMS) will now begin with the first dollar a person pays a pharmacy or mail-order service for his or her Reyataz (atazanavir) or Sustiva (efavirenz) prescriptions. Previously, people with HIV had to cover the first $50 of their co-pay before the BMS programs began to contribute."

Read more in POZ, December 18, 2009.

HAART Associated With A Reduced Risk Of Suicide In HIV-Infected Patients

"A study published Wednesday in the American Journal of Psychiatry shows that HIV-positive individuals experienced reduced rates of suicide after the initiation of highly active antiretroviral therapy (HAART)."

Read more in The AIDS Beacon, December 19, 2009.

New Insight Into Selective Binding Properties of Infectious HIV

"The lead investigators, Dr. Zoltan Beck and Dr. Carl Alving, researchers with MHRP in the Division of Retrovirology, Walter Reed Army Institute of Research (WRAIR), explain that the data show that although infectious HIV-1 virus particles that bind to red blood cells comprise only a small amount, perhaps as little as a mean of 2.3% of a typical HIV-1 preparation, erythrocyte-bound HIV-1 is then approximately 100-fold more infectious than free (non-cell-bound) HIV-1 for infection of target cells.

"The study concludes that infectious virions constitute only a small fraction of a typical HIV-1 preparation and that, in a laboratory setting, all of the infectious virions can bind to red blood cells and other non-permissive cells (i.e., cells that cannot be infected). ...

"Dr. Beck adds, 'This study suggests that erythrocytes [red blood cells] might serve as an important, and perhaps hidden, reservoir for infectious HIV-1 virions.'"

Read more in ScienceDaily, December 15, 2009.

Most NNRTI-experienced patients in southern Africa will benefit from etravirine

"Nearly all patients in southern Africa who have received treatment with the NNRTIs efavirenz or nevirapine would benefit from therapy with etravirine, a study published in the December 15th edition of the Journal of Acquired Immune Deficiency Syndromes suggests.

"Over 90% of patients previously exposed to efavirenz or nevirapine in the southern African treatment programmes will remain susceptible to etravirine despite prolonged exposure to first-line NNRTI-based regimens", comment the investigators."

Read more in Aidsmap, December 18, 2009.

Heavy drinking increases cardiovascular disease risk for men with HIV

"Heavy drinking increases the risk of cardiovascular disease for men with HIV, US investigators report in an article published in the online edition of the Journal of Acquired Immune Deficiency Syndromes.

"'Hazardous drinking and alcohol abuse or dependence were significantly associated with an increased prevalence of cardiovascular disease as compared with infrequent or moderate drinkers', comment the investigators. ...

"'The effect of alcohol [in causing illnesses] may be more pronounced among those infected with HIV', conclude the investigators."

Read more in Aidsmap, December 15, 2009.

UNITAID EXECUTIVE BOARD APPROVES BREAKTHROUGH PLAN TO MAKE AIDS TREATMENT MORE WIDELY AVAILABLE AT LOWER COST

"Today UNITAID's Executive Board made a landmark decision to establish a Patent Pool for AIDS medicines. The pool, scheduled to start operating in mid-2010, aims to make newer medicines available in patient-adapted form, at lower prices, for low- and middle-income countries. UNITAID has committed to provide start-up funds of up to US$ 4 million over the next year. Expected savings exceed one billion dollars a year, which will make more medicines available for more people.

"'This is an historic day,' said Philippe Douste-Blazy, Chair of UNITAID's Executive Board. 'UNITAID has now put in place a mechanism that will make medical advances work for the poor, while compensating companies for sharing their technology.'

"The Patent Pool will allow generic companies to make lower cost versions of widely patented new medicines by creating a common space for patent holders to license their technology in exchange for royalties. This will spur competition and further bring down the price of vital new and effective medicines, giving hope to millions of patients. Companies with which UNITAID has had consultations include Gilead, Tibotec, Merck and Sequoia.

"UNITAID has identified 19 products from nine companies for potential inclusion into the pool. The pool will facilitate the development of fixed-dose combinations (FDCs). For some years now clinical evidence has revealed that these combinations are the best way for patients to access safe, effective treatment. Until now, patents have created barriers to developing FDCs combining newer and more effective drugs from different companies. Today, with the first concrete step in the realisation of the Patent Pool, the door is open for new FDCs to enter the market.

"'FDCs are especially important in the treatment of children, who make up 10% of current treatment needs,' said Jorge Bermudez, UNITAID Executive Secretary. 'The Patent Pool will greatly help us accomplish our mission of scaling up treatment access, particularly for specific target groups otherwise neglected by the market – that is, children and people who fail on older therapies.'

"The idea of a Patent Pool has been in discussion for a number of years. In 2006, Knowledge Ecology International and Médecins Sans Frontières proposed it to UNITAID. Today UNITAID has become the first international body to translate this idea into reality."

Read more in UNITAID, December 14, 2009.

Drinking cups of tea and coffee 'can prevent diabetes'

"Tea and coffee drinkers have a lower risk of developing type 2 diabetes, a large body of evidence shows.

"And the protection may not be down to caffeine since decaf coffee has the greatest effect, say researchers in Archives of Internal Medicine.

"They looked at 18 separate studies involving nearly 500,000 people. This analysis revealed that people who drink three or four cups of coffee or tea a day cut their risk by a fifth or more, say researchers.

"The same amount of decaffeinated coffee had an even bigger effect, lowering risk by a third. ...

"'If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes mellitus, or who are at future risk of developing it, would be substantial.""

Read more in BBC News, December 15, 2009.

Companies Shed More Light On Health Bill Lobbying

"Several news outlets report on the lobbying efforts of interest groups, including drug makers, big business and insurers.

"USA Today: 'Sweeping ethics rules passed by Congress in 2007 require corporate interests that lobby Washington to reveal more information than ever, such as how much they donate to politicians' favorite charities. Yet companies don't have to detail how much money they give to powerful trade associations, nor does federal law require trade groups to disclose the amount they receive from each member for political activity.' ..."

Read more in Kaiser Health News, December 14, 2009.

Tens of Millions of TB Patients Cured

"The cure rate goal for TB internationally has been reached for the first time since the target was set in 1991. Some 2.3 million people were cured of TB in 2008, and the cure rate of 87 percent exceeded the 85 percent global target. Much of the credit was given to aggressive implementation of Directly Observed Therapy, Short-course, or DOTS, the strategy of having health professionals witness first-hand that TB treatments are taken correctly."

Read more in NPIN, December 14, 2009.

Disappointment as microbicide fails to protect against HIV

"PRO 2000 microbicide gel failed to protect women against HIV infection in the largest microbicide study to date, partners in the Microbicide Development Programme’s 301 study have announced. ...

"The study recruited 9385 women, compared to 3099 women in the HPTN 035 study, and because of the larger number of participants, more infections took place in the study. As a result MDP 301 has much greater power to detect differences in infection rates.

"However, after one year of microbicide use, there was no significant difference in the risk of infection between women who received PRO 2000 or the placebo gel. PRO 2000 failed to show a protective effect (hazard ratio 1.05 [95% confidence interval 0.82 – 1.34], p=0.172).

"There were 130 HIV infections out of 3,156 women who were given 0.5% PRO 2000 gel (4.5 per 100 person years), and 123 HIV infections out of 3,112 given the placebo gel (4.3 per 100 person years). ...

"The future

"The full results of MDP 301 are likely to be presented and published early in 2010, and the field is now awaiting the results of a South African study of a microbicide containing the antiretroviral drug tenofovir.

"That study, the CAPRISA 004 trial, is testing the use of tenofovir gel in women in KwaZulu-Natal, and the results are expected to be presented in the summer of 2010.

"CAPRISA 004 is a pilot study, and will be followed by results from the VOICE study, which is directly comparing a tenofovir gel with oral tenofovir pre-exposure prophylaxis (PrEP) in 4200 women at 10 sites in South Africa, Malawi, Uganda, Zambia and Zimbabwe."

Read more in Aidsmap, December 14, 2009.

[Washington DC] HIV funds bypassing areas in need

"'We're in one of the most powerful cities in the world. It's not fair to these kids that we didn't get it right.'"

Read more in Washington Post, December 13, 2009.

Lost to AIDS, but Still Friended

"'There is a real hunger for information about this period, this history and these lost lives,' said that friend, Chris Bartlett, a former classics scholar who has set out to rescue the memories of those lives, specifically 4,600 gay Philadelphia men who perished of AIDS in the 1980s and ’90s. While the memorializing impulse is ancient, the method Mr. Bartlett came up with is as new as the latest app; he has created a social networking site for the dead.

"Modest by the standards of memorial Web sites like Tributes.com — a for-profit company that amasses 80 million obituaries — Mr. Bartlett’s site, gayhistory.wikispaces.com, is far from the first AIDS commemoration. But its appearance now links it to a resurgence of attempts to reclaim the memories of thousands who died during a calamitous era, when H.I.V. was still a death sentence."

Read more in New York Times, December 11, 2009.

Transmission of Drug-Resistant HIV Drops 12-Fold in Vancouver

"The transmission of drug-resistant strains of HIV has dropped dramatically in Vancouver, according to a study published January 1 in Clinical Infectious Diseases. The study authors claim the 12-fold reduction in transmitted resistance is at least partly due to the fact that nearly 90 percent of people taking antiretroviral (ARV) therapy are now able to keep their HIV fully suppressed."

Read more in POZ, December 11, 2009.

Immunologic and Virologic Predictors of AIDS-Related Non-Hodgkin Lymphoma in the Highly Active Antiretroviral Therapy Era

"Among HIV-infected individuals in the HAART era, NHLs are linked to immunosuppression and extended periods of uncontrolled HIV viremia."

Read more in JAIDS, December 9, 2009.

Use of HIV Resistance Testing After Prolonged Treatment Interruption

"Conclusions: HIV genotypic resistance assays may identify mutations even when performed after a prolonged treatment interruption and may offer clinically significant information. Current guidelines that discourage resistance testing after treatment interruptions of longer than 4 weeks should be re-evaluated."

Read more in JAIDS, December 9, 2009.

CD4+ T-Cell Restoration After 48 Weeks in the Maraviroc Treatment-Experienced Trials MOTIVATE 1 and 2

"Objectives: To determine factors associated with CD4 responses to maraviroc (MVC)-containing regimens in treatment-experienced patients. Methods: Forty-eight-week data from MOTIVATE 1 and 2 was used to assess MVC once or twice daily versus placebo (PBO), each with optimized background therapy (N = 1047). ... Conclusions: MOTIVATE patients receiving MVC had larger CD4+ T-cell increases than those receiving PBO, even after adjusting for the greater virologic potency of MVC-containing regimens. This additional CD4 response was associated with a longer time to the development of AIDS-defining events on MVC. (C) 2009 Lippincott Williams & Wilkins, Inc."

Read more in JAIDS, December 9, 2009.

Oxidative Stress in HIV-Infected Individuals: A Cross-Sectional Study

"HIV infection increases the oxidative stress process, and antiretroviral combination therapy increases protein oxidation and preexistent oxidative stress. The latter induces production of reactive oxygen species. Lipid peroxidation (LPO) is a means of determining oxidative stress. There is also a deficiency of glutathione in HIV infection. Persistent oxidative load leads to an accelerated rate of consumption of glutathione (GSH). This study measured LPO and GSH levels in plasma of HIV-infected individuals with or without therapy and compared these with healthy controls. ... The mean glutathione level in HIV-infected individuals was significantly lower in compared to healthy controls (p value<0.0001). There was a significant positive correlation between absolute CD4 cells and GSH levels (ρ=0.182, p=0.045). There is increased oxidative stress in HIV-infected patients. Whether supplementation with antioxidants will reduce this oxidative stress is still unknown." Read more in AIDS Research and Human Retroviruses, December 10, 2009.

The Association Between Alcohol Consumption and Prevalent Cardiovascular Diseases Among HIV-Infected and HIV-Uninfected Men

"Conclusions: Among HIV-infected men, hazardous drinking and alcohol abuse and dependence were associated with a higher prevalence of CVD compared with infrequent and moderate drinking even after adjusting for traditional CVD risk factors, antiretroviral therapy, and CD4 count."

Read more in JAIDS, December 9, 2009.

[13C]Methionine Breath Test as a Marker for Hepatic Mitochondrial Function in HIV-Infected Patients

"Metabolic disturbances such as dyslipidemia, lipodystrophy syndrome, visceral obesity, hyperlactatemia, diabetes mellitus, and hepatic steatosis have been recognized as serious complications in long-term antiretroviral-treated HIV-infected patients. The oxidative capacity of liver mitochondria plays a central role in their pathogenesis and can be analyzed using the [13C]methionine breath test. ... Patients with hepatic steatosis, hypertriglyceridemia, lipohypertrophy, and older age showed reduced methionine metabolism. Hepatic mitochondrial function is impaired in antiretroviral-treated HIV-infected patients with disturbances of lipid metabolism."

Read more in AIDS Research and Human Retroviruses, December 9, 2009.

Palmitic Acid Is a Novel CD4 Fusion Inhibitor That Blocks HIV Entry and Infection

"We investigated a large number of natural products, and from Sargassum fusiforme we isolated and identified palmitic acid (PA) as a natural small bioactive molecule with activity against HIV-1 infection. ... Understanding the structure–affinity relationship (SAR) between PA and CD4 should lead to the development of PA analogs with greater potency against HIV-1 entry."

Read more in AIDS Research and Human Retroviruses, December 9, 2009.

Full results of DART lab monitoring study published

"The results of the DART study, which showed that patients who did not undergo routine CD4 cell or drug toxicity laboratory monitoring were only marginally more likely to experience disease progression or die while receiving antiretroviral therapy during a five-year study in Zimbabwe and Uganda, were first presented at the International AIDS Society conference in Cape Town in July.

"The study was designed to determine whether antiretroviral therapy could be implemented safely and effectively in a resource-limited setting without routine use of expensive laboratory tests."

Read more in Aidsmap, December 9, 2009.

New U.S. Plan on AIDS Slows Growth in Treatment

"As the Obama administration slowly unveils its global AIDS plan, the drive to put more people on drugs is being scaled back as emphasis is shifted to prevention and to diseases that cost less to fight, including pneumonia, diarrhea, malaria and fatal birth complications. ...

"'I’m holding my nose as I say this, but I miss George W. Bush,' said Gregg Gonsalves a long-time AIDS campaigner. 'On AIDS, he really stepped up. He did a tremendous thing. Now, to have this happen under Obama is really depressing.' ...

"Chris Collins, director of public policy at amfAR, the AIDS research foundation, said: 'We can’t keep kids alive to age 13 till they die of something more expensive. Also, a high percentage of health care workers are infected; we’ve got to keep them alive.'

"AIDS advocates said they had heard that, since taking office in June, Dr. Goosby had pressed hard for treatment for five million people [instead of four million] but had lost."

Read more in The New York Times, December 8, 2009.

Also see talk by Gregg Gonsalves on World AIDS Day, December 1.

UCLA researchers demonstrate that stem cells can be engineered to kill HIV

"'We have demonstrated in this proof-of-principle study that this type of approach can be used to engineer the human immune system, particularly the T-cell response, to specifically target HIV-infected cells,' said lead investigator Scott G. Kitchen, assistant professor of medicine in the division of hematology and oncology at the David Geffen School of Medicine at UCLA and a member of the UCLA AIDS Institute. 'These studies lay the foundation for further therapeutic development that involves restoring damaged or defective immune responses toward a variety of viruses that cause chronic disease, or even different types of tumors.'

"Taking CD8 cytotoxic T lymphocytes — the 'killer' T cells that help fight infection — from an HIV-infected individual, the researchers identified the molecule known as the T-cell receptor, which guides the T cell in recognizing and killing HIV-infected cells. These cells, while able to destroy HIV-infected cells, do not exist in enough quantities to clear the virus from the body. So the researchers cloned the receptor and genetically engineered human blood stem cells, then placed the stem cells into human thymus tissue that had been implanted in mice, allowing them to study the reaction in a living organism.

"The engineered stem cells developed into a large population of mature, multifunctional HIV-specific CD8 cells that could specifically target cells containing HIV proteins. The researchers also found that HIV-specific T-cell receptors have to be matched to an individual in much the same way that an organ is matched to a transplant patient."

Read more in UCLA press release, December 7, 2009.

Tuberculosis and HIV within prisons skyrocketing, a public health threat

"Overcrowding, low access to health care, lack of political will and the prominence of high-risk populations among prisoners all contribute to a “perfect storm” for HIV and TB infection among prison populations worldwide, researchers announced at the 40th Union World Conference on Lung Health this Saturday in Cancun, Mexico.

"Dr. Fabienne Hariga of the UN Office on Drugs and Crime and UNAIDS’ Dr. Alasdair Reid both highlighted dismal health statistics for those behind bars. According to Hariga, up to 65% of some prison populations are infected with HIV.

"Adding to this, says Reid, TB rates in prisons are up to fifty times higher than in the general population. Increased rates are found in prisoners who have served longer sentences, tying TB acquisition with prison time. Prisoners are also more likely to die from TB and/or default from treatment than non-incarcerated populations."

Read more in Aidsmap, December 7, 2009.

Sweden to cut aid to Uganda over anti-gay law

"Offenders would face death for having sex with a minor or a disabled person, or for infecting their partners with HIV. It would also punish attempted homosexuality as well as the failure of a third party to report homosexual relationships. ...

"In Canada, Prime Minister Stephen Harper’s conservative government called the proposed law 'vile and hateful', while Britain’s Gordon Brown raised the issue with President Museveni during the recent Commonwealth summit in Trinidad and Tobago. Ms Carlsson said the law would make it 'much more difficult' for Sweden to continue helping Uganda."

Read more in Sunday Monitor [Kampala], December 6, 2009.

Comment: More information is needed on allegations that the proposed law was due to enormous amounts of money from a secretive, politically connected group in the United States.

Also, the rights of people with a disability should be considered. It is hard enough for them to find sexual partners already. Most disabled people are as mentally competent as anyone else, so they can certainly give or withhold consent.

GSK warn US doctors of possible association between fosamprenavir and heart attack

"The move comes after a French study (FHDH ANRS CO4) presented to the Conference on Retroviruses and Opportunistic Infections earlier this year showed that each year of therapy with the drug increased the risk of heart attack by 54%.

"GSK are also reminding healthcare professionals of the importance of monitoring cholesterol and triglycerides before and during treatment with fosamprenavir. The company also recommends that other risk factors for cardiovascular disease, such as high blood pressure, diabetes and smoking should also be evaluated."

Read more in Aidsmap, December 3, 2009.

Gene-Based Drug Fights Hep C in Chimps—Maybe HIV One Day

"A new type of drug targeting a portion of hepatitis C virus (HCV) known as microRNA substantially reduced HCV levels in chimps and continued to work for several months after dosing stopped, according to an announcement by the Southwest Foundation for Biomedical Research (SFBR) in San Antonio. What’s more, say the researchers, the novel treatment approach might also work against other viruses such as HIV."

Read more in POZ, December 4, 2009.

Two standards of care for HIV: Why are Africans being short-changed?

"The impact of the XIIIth International Conference on AIDS in Durban, South Africa, in 2000 was much more than scientific. It also highlighted the non-acceptability of continuing to deny access to life-saving antiretroviral drugs to HIV-infected people in developing countries. This was in spite of efforts by then President Thabo Mbeki of South Africa to undermine the conference through his ridiculous and irresponsible insinuations that HIV might not be the cause of AIDS. Since 2000, it is estimated that the numbers of people in Africa receiving antiretroviral therapy has increased to approximately four million from about 7000 at the time of the Durban Conference. However, the fact is that almost all HIV-infected persons in developing country settings are today receiving therapies that are considered to be sub-standard by Western criteria."

Read more in Retrovirology, December 1, 2009.

Lack of Fluoroquinolone Resistance in Non-Typhoidal Salmonella Bacteremia in HIV-Infected Patients in an Urban US Setting

"Unlike reports from Asia, no fluoroquinolone resistance was identified in any of the Salmonella strains isolated in this setting. Optimal treatment of NTS in the HIV-infected patient in the United States should include therapy with fluoroquinolones as well as attaining complete viral suppression and immune reconstitution with ART."

Read more in Journal of the International Association of Physicians in AIDS Care (JIAPAC), December 1, 2009.

New Initiative: “Positive Charge” to Help Address Barriers and Provide Support to People Living with HIV/AIDS

"The National AIDS Fund (NAF) and Bristol-Myers Squibb Company (NYSE: BMY) announced today their intention to launch “Positive Charge,” a new multiyear initiative aimed at helping to break down the barriers that prevent people living with HIV from receiving HIV care, treatment and necessary support. The initiative is slated to launch in January 2010. ...

"Bristol-Myers Squibb commissioned a national survey over the past year to better understand the barriers to HIV testing, care and treatment. The survey concluded that there are significant personal, societal and structural barriers that prevent people from taking action. 'It’s sad, but true that in 2009, stigma still plays a huge role in preventing people from getting tested and into care,” said Ms. Ferree. “We are proud to work in collaboration with Bristol-Myers Squibb to help break down these barriers by creating a targeted initiative that supports collaborative and highly coordinated, community-based efforts to reduce barriers and provide the supportive services people living with HIV/AIDS need to effectively access health care.'"

Read more in National AIDS Fund, November 30, 2009.

Comment: We are skeptical of pharmaceutical industry initiatives. Most are self-centered fragments that don't deal well with the big picture, the overall needs, though the community may use the programs due to desperation. We take this effort more seriously because it seems to have a solid basis in mutual self-interest, and have a plausible partnership as well. Addressing and overcoming the real barriers to medical care for HIV is essential, to support individuals and also to reduce transmission, decreasing the epidemic. And a successful program will profit corporations, by bringing many thousands of new people into medical care, including antiretroviral prescriptions in many cases.

Expert Panel Revises U.S. HIV/AIDS Treatment Guidelines; Recommends Starting HIV Meds Earlier

"On Dec. 1, the U.S. health department released an updated set of HIV treatment guidelines. Although these guidelines aren't official U.S. policy, they're regarded as the most reputable set of expert recommendations in the country, and many HIV health care workers are likely to follow them. The guidelines themselves were revised by a panel of 30 HIV/AIDS experts from across the U.S.

"We'll summarize a few of the major changes in the revised guidelines below. A more detailed, official listing of changes is available online, as is a 168-page PDF of the full guidelines. ..."

Read more in The Body Pro, December 1, 2009.

Comment: This is the long-expected recommendation to start antiretrovirals at any CD4 count below 500 (instead of 350). Half the panel also thought that treatment should begin above 500; the other half considered this optional, except in three special situations. There is also guidance for treating HIV2, a virus found mostly in West Africa that causes a less severe form of AIDS. See the short summary of changes, in the first link above.

[Interview: AIDS Treatment News, yesterday and today]

"John S. James, who started an AIDS Treatment newsletter, talks about his work during an interview at a coffee shop in West Philadelphia on November 30, 2009. James will be honored at the Pennsylvania Academy of Fine Arts this week. ...

"Philadelphia FIGHT's event will take place tomorrow [December 2] at the Pennsylvania Academy of Fine Arts at 128 N. Broad Street from 6 to 8:30 p.m. The event is open to the public and will benefit the Jonathan Lax Treatment Center, FIGHT's HIV primary care clinic."

Read more in Philadelphia Daily News, December 1, 2009.

AIDS cure isn't out of reach

"Outside medical research circles, though, the idea of a cure for AIDS is rarely discussed seriously. There is no special organization or department at the National Institutes of Health dedicated to a cure. There are no editorials in the press calling for more research into "HIV eradication," the technical term for a cure. There is no annual research update on the subject for the general public or annual prize for the most promising work in the field - even though 33 million people have HIV and 25 million have died of AIDS.

"Yet, in private conversations, small meetings, and medical journals, leading researchers are calling for a renewed focus on eradicating the AIDS virus. They also have identified promising avenues for attacking the problem. Although few people realize it, eradication studies require fewer patients than the huge trials needed to test a vaccine, and they can often be done more quickly.

"At the same time, the National Institutes of Health - perhaps our best hope for funding a cure for AIDS - has been underfunded since 2003. One consequence has been less money for HIV eradication research, and less hope for younger scientists and innovative ideas."

Read more in The Philadelphia Inquirer, December 1, 2009.