British Medical Journal: "Neurologists and paediatricians call for action on “massive” rises in the prices of orphan drugs.
"We are writing to you as a group of clinicians treating patients with so called “orphan” diseases (and one representative of a patients’ group) to express our concern at an unintended effect of the European Union’s regulations on orphan drugs. The original purpose of this legislation, passed in 1999, was to encourage drug companies to conduct research into rare diseases and develop novel treatments. However, as the rules are currently enacted, many drug companies merely address their efforts to licensing drugs that are already available rather than developing new treatments. Once a company has obtained a licence, the legislation then gives the company sole rights to supply the drug. This in turn allows the company to set an exorbitant price for this supply and effectively to bar previous suppliers of the unlicensed preparation from further production and distribution.
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December 30, 2010
December 27, 2010
[Forced HIV medication] Sotomayor protests court's refusal of appeals
USATODAY.com: "She forcefully dissented when the justices refused to hear the appeal of a Louisiana prisoner who claimed he was punished for not taking his HIV medication. He said prison officials subjected him to hard labor in 100-degree heat. Writing alone, she said the inmate had a persuasive claim of cruel and unusual punishment."
Also see New York Times, http://www.nytimes.com/2010/12/28/us/politics/28bar.html: "The prisoner, Anthony C. Pitre, had stopped taking his H.I.V. medicine to protest his transfer from one facility to another. Prison officials responded by forcing him to perform hard labor in 100-degree heat. That punishment twice sent Mr. Pitre to the emergency room."
Also see New York Times, http://www.nytimes.com/2010/12/28/us/politics/28bar.html: "The prisoner, Anthony C. Pitre, had stopped taking his H.I.V. medicine to protest his transfer from one facility to another. Prison officials responded by forcing him to perform hard labor in 100-degree heat. That punishment twice sent Mr. Pitre to the emergency room."
December 24, 2010
Prompt treatment and better screening could prevent many cancer deaths in patients taking HIV therapy
Aidsmap: "Many cancer-related deaths in patients taking antiretroviral therapy are potentially preventable, a US study published in the online edition of AIDS suggests.
"A low CD4 cell count, detectable viral load, late diagnosis of cancer, and not receiving cancer treatment were all associated with an increased risk of mortality.
"'Our findings could be explained by poor cancer awareness, inadequate screening practices, or lack of prompt therapy,' write the investigators."
"A low CD4 cell count, detectable viral load, late diagnosis of cancer, and not receiving cancer treatment were all associated with an increased risk of mortality.
"'Our findings could be explained by poor cancer awareness, inadequate screening practices, or lack of prompt therapy,' write the investigators."
Bristol-Myers Squibb buys festinavir, new NRTI active against MDR HIV
Aidsmap: "Bristol Myers-Squibb will pay up to $286 million for development rights to festinavir, a new once-daily nucleoside reverse transcriptase inhibitor that is active against viruses resistant to both tenofovir and abacavir, the company announced on December 20th.
"Festinavir is a derivative of d4T (stavudine), but its developers say it is far less toxic than that drug."
"Festinavir is a derivative of d4T (stavudine), but its developers say it is far less toxic than that drug."
Nevirapine rather than efavirenz-based HIV treatment more likely to suppress viral load to zero
Aidsmap: "The inclusion of nevirapine rather than efavirenz in an HIV treatment combination was more likely to suppress viral load in the blood to completely undetectable levels, French investigators report in the online edition of AIDS.
"A total of 81% of patients taking nevirapine (Viramune) had a viral load below 1 copy/ml compared to 55% of individuals treated with efavirenz (Sustiva). The study involved 165 patients and was retrospective. All the patients had had an undetectable viral load for at least six months and were taking either nevirapine or efavirenz in combination with FTC (emtricitabine, Emtriva) and tenofovir (Viread, the two drugs are usually combined in a single pill, Truvada, and are also available co-formulated with efavirenz in Atripla)."
"A total of 81% of patients taking nevirapine (Viramune) had a viral load below 1 copy/ml compared to 55% of individuals treated with efavirenz (Sustiva). The study involved 165 patients and was retrospective. All the patients had had an undetectable viral load for at least six months and were taking either nevirapine or efavirenz in combination with FTC (emtricitabine, Emtriva) and tenofovir (Viread, the two drugs are usually combined in a single pill, Truvada, and are also available co-formulated with efavirenz in Atripla)."
Beneficial Effects of a Switch to a Lopinavir/ritonavir-Containing Regimen for Patients with Partial or No Immune Reconstitution with Highly Active...
AIDS Research and Human Retroviruses: "Switching patients to an LPV/r-containing regimen improved CD4+ counts in patients with prior immunologic failure, and this may be due to an effect of LPV/r on apoptosis."
Identification of Three Immunologic Correlates for HIV Type 1 Pathogenesis in Youth
AIDS Research and Human Retroviruses:: "Overall, circulating IL-10, IL-18, and soluble CD30 could partially track unfavorable responses to HIV-1 infection in youth. These markers of persistent immune activation are individually and collectively indicative of HIV-1 pathogenesis."
New Drug Shows Promise in Fighting HIV
Doctors Lounge: "A new drug based on a compound produced by the human body appears to block fusion peptides and halt an early stage of HIV infection by thwarting interaction between the virus and host cells, according to research published in the Dec. 22 issue of Science Translational Medicine."
University of Minnesota discovery suggests a new way to prevent HIV from infecting human cells
University of Minnesota media release: "Researchers at the University of Minnesota have discovered how HIV binds to and destroys a specific human antiviral protein called APOBEC3F. The results suggest that a simple chemical change can convert APOBEC3F to a more effective antiviral agent and that shielding of a common feature shared by related proteins may yield a similar outcome.
"This discovery highlights the potential for a novel approach to combating HIV/AIDS that would seek to stabilize and harness the innate antiviral activity of certain human proteins, according to lead author John Albin, a researcher in the laboratory of Reuben Harris, associate professor of biochemistry, molecular biology and biophysics in the College of Biological Sciences.
"The finding was published in the Journal of Biological Chemistry."
"This discovery highlights the potential for a novel approach to combating HIV/AIDS that would seek to stabilize and harness the innate antiviral activity of certain human proteins, according to lead author John Albin, a researcher in the laboratory of Reuben Harris, associate professor of biochemistry, molecular biology and biophysics in the College of Biological Sciences.
"The finding was published in the Journal of Biological Chemistry."
December 16, 2010
“Legalise and regulate drugs” says UK’s former drugs and defence Minister
Transform Drug Policy Foundation Blog: "Leaving the drugs market in the hands of criminals causes huge and unnecessary harms to individuals, communities and entire countries, with the poor the hardest hit. We spend billions of pounds without preventing the wide availability of drugs. It is time to replace our failed war on drugs with a strict system of legal regulation, to make the world a safer, healthier place, especially for our children. We must take the trade away from organised criminals and hand it to the control of doctors and pharmacists."
December 15, 2010
Cutting Through the Hype Surrounding One Man’s HIV “Cure”
Discover Magazine: "But doctors commenting on the research are careful to point out that a treatment that was seemingly effective in one man does not equal a cure for the 33 million people living with HIV worldwide."
FDA Approves Prezista/Ritonavir Once-Daily Dosing for HIV-1 Treatment-Experienced Adults With No Darunavir Resistance-Associated Mutations
Tibotec Therapeutics: "...the U.S. Food and Drug Administration (FDA) has approved a revision to the dosing recommendation to include once-daily dosing of PREZISTA® (darunavir) tablets in combination with ritonavir for the treatment of human immunodeficiency virus (HIV-1) in treatment-experienced adult patients with no darunavir resistance-associated mutations (DRV RAMs)."
December 14, 2010
Big Pharma caught spying on the WHO - Wikileaks
Wikileaks, Dec. 10, 2009: "Confidential documents related to the World Health Organization Expert Working Group on innovative financing for research and development surfaced today, revealing the group’s thinking as well as pharmaceutical industry thinking about the WHO process. The documents immediately raised concern about possible undue access to the process by industry; the WHO told Intellectual Property Watch the industry group was not supposed to have the documents.
"The documents appear to have come from the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), and include draft reports on innovative financing mechanisms from the working group as well as an analysis by the IFPMA on the reports’ contents. They were released on Wikileaks, a website that anonymously publishes sensitive documents."
"The documents appear to have come from the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), and include draft reports on innovative financing mechanisms from the working group as well as an analysis by the IFPMA on the reports’ contents. They were released on Wikileaks, a website that anonymously publishes sensitive documents."
Stem cell transplant has cured HIV infection in 'Berlin patient', say doctors
Aidsmap: "Doctors who carried out a stem cell transplant on an HIV-infected man with leukaemia in 2007 say they now believe the man to have been cured of HIV infection as a result of the treatment, which introduced stem cells which happened to be resistant to HIV infection.
"The man received bone marrow from a donor who had natural resistance to HIV infection; this was due to a genetic profile which led to the CCR5 co-receptor being absent from his cells. The most common variety of HIV uses CCR5 as its ‘docking station’, attaching to it in order to enter and infect CD4 cells, and people with this mutation are almost completely protected against infection.
"The case was first reported at the 2008 Conference on Retroviruses and Opportunistic Infections in Boston, and Berlin doctors subsequently published a detailed case history in the New England Journal of Medicine in February 2009.
"They have now published a follow-up report in the journal Blood, arguing that based on the results of extensive tests, “It is reasonable to conclude that cure of HIV infection has been achieved in this patient.”"
Note: See lots of comments on Twitter (you do NOT need a Twitter account):
http://twitter.com/#!/search/HIV-positive. As noted above, this cure has been discussed for some time. The new article in the journal Blood reported the latest failure to find any evidence of HIV in the patient. And the bone-marrow stem-cell transplant has permanently changed the Berlin Patient's blood to that of the donor, who has a fairly rare mutation that gives almost complete immunity to HIV infection.
"The man received bone marrow from a donor who had natural resistance to HIV infection; this was due to a genetic profile which led to the CCR5 co-receptor being absent from his cells. The most common variety of HIV uses CCR5 as its ‘docking station’, attaching to it in order to enter and infect CD4 cells, and people with this mutation are almost completely protected against infection.
"The case was first reported at the 2008 Conference on Retroviruses and Opportunistic Infections in Boston, and Berlin doctors subsequently published a detailed case history in the New England Journal of Medicine in February 2009.
"They have now published a follow-up report in the journal Blood, arguing that based on the results of extensive tests, “It is reasonable to conclude that cure of HIV infection has been achieved in this patient.”"
Note: See lots of comments on Twitter (you do NOT need a Twitter account):
http://twitter.com/#!/search/HIV-positive. As noted above, this cure has been discussed for some time. The new article in the journal Blood reported the latest failure to find any evidence of HIV in the patient. And the bone-marrow stem-cell transplant has permanently changed the Berlin Patient's blood to that of the donor, who has a fairly rare mutation that gives almost complete immunity to HIV infection.
High triglycerides increase risk of neuropathy for patients with HIV
Aidsmap: "HIV-positive patients with high triglycerides have an increased risk of neuropathy, according to US research published in the online edition of AIDS. The association between triglyceride levels and neuropathy was independent of any other risk factor."
Abstract: http://journals.lww.com/aidsonline/Abstract/publishahead/Hypertriglyceridemia_in_combination.99313.aspx
Abstract: http://journals.lww.com/aidsonline/Abstract/publishahead/Hypertriglyceridemia_in_combination.99313.aspx
Using Twitter at the HIV Prevention Leadership Summit
Blog.AIDS.gov: "Part of NPIN’s mission is to “provide timely information and resources to prevention partners through innovative approaches to knowledge/information transfer”. To help further that mission, NPIN will be using Twitter at the HIV Prevention Leadership Summit next week in Washington, DC. We’ll be using Twitter to support and encourage attendees’ conversations and provide virtual attendees with up-to-the-minute updates on the conference, plenaries, and workshops."
Comments: This conference ends tomorrows, December 15. But anyone can follow it DURING OR AFTER the conference at http://twitter.com/search?q=2010HPLS (you do NOT need a Twitter account).
However, most of the "tweets" from this conference that we've seen so far are not very useful to the general public outside the meeting. In our experience, Twitter works well for certain specific purposes -- for example, informing people about some resource -- often on a Web page, or at a certain event or location in the conference (for people who are there). Announcements often work; for example, the most famous tweet of all time consisted of a single word, "arrested" (sent by a U.S. journalist in Egypt). But except for certain kinds of uses, where Twitter can work extremely well, it's hard to say much in 140 characters.
Comments: This conference ends tomorrows, December 15. But anyone can follow it DURING OR AFTER the conference at http://twitter.com/search?q=2010HPLS (you do NOT need a Twitter account).
However, most of the "tweets" from this conference that we've seen so far are not very useful to the general public outside the meeting. In our experience, Twitter works well for certain specific purposes -- for example, informing people about some resource -- often on a Web page, or at a certain event or location in the conference (for people who are there). Announcements often work; for example, the most famous tweet of all time consisted of a single word, "arrested" (sent by a U.S. journalist in Egypt). But except for certain kinds of uses, where Twitter can work extremely well, it's hard to say much in 140 characters.
Going Viral Against HIV [social media and HIV/STIs]
Pew Research Center's Internet & American Life Project: "speaker after speaker talked about the power of small groups to make a difference: ..."
Governments Remove Sexual Orientation from UN Resolution Condemning Extrajudicial, Summary or Arbitrary Executions
IGLHRC, Nov. 17: "The International Gay and Lesbian Human Rights Commission (IGLHRC) and ARC International are deeply disappointed with yesterday’s vote in the Third Committee of the United Nations General Assembly to remove a reference to sexual orientation from a resolution on extrajudicial, summary or arbitrary executions. The resolution urges States to protect the right to life of all people, including by calling on states to investigate killings based on discriminatory grounds. For the past 10 years, the resolution has included sexual orientation in the list of discriminatory grounds on which killings are often based.
"The removed reference was originally contained in a non-exhaustive list in the resolution highlighting the many groups of people that are particularly targeted by killings - including persons belonging to national or ethnic, religious and linguistic minorities, persons acting as human rights defenders (such as lawyers, journalists or demonstrators) as well as street children and members of indigenous communities. Mentioning sexual orientation as a basis on which people are targeted for killing highlights a situation in which particular vigilance is required in order for all people to be afforded equal protection.
"The amendment removing the reference to sexual orientation was sponsored by Benin on behalf of the African Group in the UN General Assembly and was adopted with 79 votes in favor, 70 against, 17 abstentions and 26 absent.
"'This vote is a dangerous and disturbing development,' said Cary Alan Johnson, Executive Director of IGLHRC. 'It essentially removes the important recognition of the particular vulnerability faced by lesbian, gay, bisexual and transgender people - a recognition that is crucial at a time when 76 countries around the world criminalize homosexuality, five consider it a capital crime, and countries like Uganda are considering adding the death penalty to their laws criminalizing homosexuality.'
"This decision in the General Assembly flies in the face of the overwhelming evidence that people are routinely killed around the world because of their actual or perceived sexual orientation, and renders these killings invisible or unimportant. The Special Rapporteur on Extrajudicial, Summary or Arbitrary Executions has highlighted documented cases of extrajudicial killings on the grounds of sexual orientation including individuals facing the death penalty for consensual same-sex conduct; individuals tortured to death by State actors because of their actual or perceived sexual orientation; paramilitary groups killing individuals because of their actual or perceived sexual orientation as part of “social cleansing” campaigns; individuals murdered by police officers with impunity because of their actual or perceived sexual orientation; and States failing to investigate hate crimes and killings of persons because of their actual or perceived sexual orientation."
Comment: Big money goes a long way in poor countries.
"The removed reference was originally contained in a non-exhaustive list in the resolution highlighting the many groups of people that are particularly targeted by killings - including persons belonging to national or ethnic, religious and linguistic minorities, persons acting as human rights defenders (such as lawyers, journalists or demonstrators) as well as street children and members of indigenous communities. Mentioning sexual orientation as a basis on which people are targeted for killing highlights a situation in which particular vigilance is required in order for all people to be afforded equal protection.
"The amendment removing the reference to sexual orientation was sponsored by Benin on behalf of the African Group in the UN General Assembly and was adopted with 79 votes in favor, 70 against, 17 abstentions and 26 absent.
"'This vote is a dangerous and disturbing development,' said Cary Alan Johnson, Executive Director of IGLHRC. 'It essentially removes the important recognition of the particular vulnerability faced by lesbian, gay, bisexual and transgender people - a recognition that is crucial at a time when 76 countries around the world criminalize homosexuality, five consider it a capital crime, and countries like Uganda are considering adding the death penalty to their laws criminalizing homosexuality.'
"This decision in the General Assembly flies in the face of the overwhelming evidence that people are routinely killed around the world because of their actual or perceived sexual orientation, and renders these killings invisible or unimportant. The Special Rapporteur on Extrajudicial, Summary or Arbitrary Executions has highlighted documented cases of extrajudicial killings on the grounds of sexual orientation including individuals facing the death penalty for consensual same-sex conduct; individuals tortured to death by State actors because of their actual or perceived sexual orientation; paramilitary groups killing individuals because of their actual or perceived sexual orientation as part of “social cleansing” campaigns; individuals murdered by police officers with impunity because of their actual or perceived sexual orientation; and States failing to investigate hate crimes and killings of persons because of their actual or perceived sexual orientation."
Comment: Big money goes a long way in poor countries.
Pending Trade Deal Worries AIDS Activists
Voice of America: "Katy Athersach is a policy advisor for Doctors Without Borders in Geneva.
"'The reason why this is so important to us is that 80 percent of the medicines we use to treat people living with HIV and AIDS across our projects in the developing world come from generic companies in India,' says Athersach. 'And these drugs are vastly cheaper than alternatives because of the competition that has allowed these Indian companies to compete together and lower prices.'
"Among other concerns, Athersach says Doctors Without Borders is worried a trade agreement will strengthen European patent protections, denying Indian companies immediate access to new drug developments. Similar concerns sparked a demonstration by AIDS activists last week in Nairobi.
"Activists have also rallied in India, Thailand and London, says Athersach.
"'We are very hopeful that our arguments will be heard, that our voices will be taken into account and that these provisions will be removed from the agreement. But of course this is by no means certain,' she says."
"'The reason why this is so important to us is that 80 percent of the medicines we use to treat people living with HIV and AIDS across our projects in the developing world come from generic companies in India,' says Athersach. 'And these drugs are vastly cheaper than alternatives because of the competition that has allowed these Indian companies to compete together and lower prices.'
"Among other concerns, Athersach says Doctors Without Borders is worried a trade agreement will strengthen European patent protections, denying Indian companies immediate access to new drug developments. Similar concerns sparked a demonstration by AIDS activists last week in Nairobi.
"Activists have also rallied in India, Thailand and London, says Athersach.
"'We are very hopeful that our arguments will be heard, that our voices will be taken into account and that these provisions will be removed from the agreement. But of course this is by no means certain,' she says."
December 13, 2010
Berlin Patient Follow-Up 'Strongly Suggests' HIV Cure - by Tim Horn
AIDSmeds: "The “Berlin Patient”—a man living with HIV who underwent a transplant involving HIV-resistant stem cells in 2007 for the treatment of leukemia—has been classified as cured of his HIV, according to an update of the patient’s experience published online, ahead of print, on December 8 by the journal Blood. The man has remained off HIV treatment for three-and-a-half years with normal CD4 counts and no evidence of HIV replication.
"Though it was initially suspected that HIV archived in the man’s cells would begin proliferating once his immune system began to recover from pre- and post-transplantation treatment, this was not observed and the team monitoring the patient now conclude, 'our results strongly suggest that cure of HIV has been achieved in this patient.'"
"Though it was initially suspected that HIV archived in the man’s cells would begin proliferating once his immune system began to recover from pre- and post-transplantation treatment, this was not observed and the team monitoring the patient now conclude, 'our results strongly suggest that cure of HIV has been achieved in this patient.'"
Development of a Low Bias Method for Characterizing Viral Populations Using Next Generation Sequencing Technology
PLoS ONE: : "The goal of this work is to develop a novel method for amplifying viral RNA into large quantities of DNA suitable for processing into Illumina (or other) libraries without relying on PCR and primers that assume specific sequences are present within the sample. By avoiding the use of virus-specific primers, one can reduce the bias associated with this step and potentially amplify the entire 9709 base pair HIV genome with unprecedented levels of coverage."
Note: This study is using new genetic techniques to better understand how HIV becomes resistant to drugs.
Note: This study is using new genetic techniques to better understand how HIV becomes resistant to drugs.
December 12, 2010
HIV/AIDS at WikiLeaks: 10 cables have AIDS news (so far)
As of today WikiLeaks has released only about 0.5% (1344 cables out of 251,287 total) of the leaked State Department cables, creating headlines around the world. Only 10 of the 1344 already released include the word HIV (a good search term for finding AIDS-related information). If you click on a cable, you can use the local search in your browser (often control-F) to find the HIV references quickly.
Here are the 10 cables that mention HIV, starting with the most recent:
10LUANDA84
09PRETORIA2245
09KAMPALA1197
09LONDON2005
09STATE80163
09STATE37561
09STATE37566
08STATE116392
07BEIJING1840
01PRETORIA1173
Best estimate of the total number of cables with HIV/AIDS information but not yet released: about 1800.
Also see our news blog of WikiLeaks tweets, at www.RepliCounts.org (in a green box on the right of that page).
Note: Please let us know of sites that include a search of all the released cables at once. To find the 10 above, we had to download a copy of the cables into a folder, then search locally for 'HIV'.
Here are the 10 cables that mention HIV, starting with the most recent:
10LUANDA84
09PRETORIA2245
09KAMPALA1197
09LONDON2005
09STATE80163
09STATE37561
09STATE37566
08STATE116392
07BEIJING1840
01PRETORIA1173
Best estimate of the total number of cables with HIV/AIDS information but not yet released: about 1800.
Also see our news blog of WikiLeaks tweets, at www.RepliCounts.org (in a green box on the right of that page).
Note: Please let us know of sites that include a search of all the released cables at once. To find the 10 above, we had to download a copy of the cables into a folder, then search locally for 'HIV'.
Too long a wait for housing
Philadelphia Inquirer: "We represent a group of 80 medical and public-health professionals who have authored a consensus statement on this crisis. The group includes experienced physicians such as Ellen Tedaldi, the director of Temple's comprehensive HIV program and the doctor who treated Carlos when he was first diagnosed.
"We present the scientific documentation for the effectiveness of subsidized housing in HIV prevention and treatment and urge city government to recognize that providing housing for people living with HIV and AIDS is an essential public-health intervention (see www.housingistreatment.org). Our city must house everyone on the waiting list and expand the reach of the federal housing program to include people before they become so sick that they are on the verge of very painful deaths. These small steps, which will cost the city approximately 0.1 percent of its current budget, are necessary components of any plan to effectively combat our alarming HIV epidemic.
"Unlike too many others, Carlos Gonzalez was fortunate enough to see his condition improve. After two years on the waiting list, Carlos began receiving rental subsidies in early 2010. He now lives in a one-bedroom apartment in South Philadelphia. Because he is able to take all scheduled treatment doses, the HIV virus cannot be detected in his blood. As a result, his immune system is much stronger, and he no longer spends two weeks each year in a hospital bed.
"Today, Carlos is a certified HIV counselor. He gives back to the community and provides hope to others going through the same struggles he successfully overcame. Because he knows that so many of the people he reaches out to on the streets will not survive the wait for housing, Carlos has become a tireless advocate. We stand with him in asking Mayor Nutter and City Council to end the waiting list for housing assistance for people living with HIV and AIDS."
"We present the scientific documentation for the effectiveness of subsidized housing in HIV prevention and treatment and urge city government to recognize that providing housing for people living with HIV and AIDS is an essential public-health intervention (see www.housingistreatment.org). Our city must house everyone on the waiting list and expand the reach of the federal housing program to include people before they become so sick that they are on the verge of very painful deaths. These small steps, which will cost the city approximately 0.1 percent of its current budget, are necessary components of any plan to effectively combat our alarming HIV epidemic.
"Unlike too many others, Carlos Gonzalez was fortunate enough to see his condition improve. After two years on the waiting list, Carlos began receiving rental subsidies in early 2010. He now lives in a one-bedroom apartment in South Philadelphia. Because he is able to take all scheduled treatment doses, the HIV virus cannot be detected in his blood. As a result, his immune system is much stronger, and he no longer spends two weeks each year in a hospital bed.
"Today, Carlos is a certified HIV counselor. He gives back to the community and provides hope to others going through the same struggles he successfully overcame. Because he knows that so many of the people he reaches out to on the streets will not survive the wait for housing, Carlos has become a tireless advocate. We stand with him in asking Mayor Nutter and City Council to end the waiting list for housing assistance for people living with HIV and AIDS."
December 10, 2010
India-EU generic drug row 'resolved' at Brussels summit
BBC News: "A row between the EU and India over the transit of generic drugs through Europe has been resolved, negotiators told Reuters news agency.
"As a result of the deal at an India-EU summit in Brussels, an Indian complaint to the World Trade Organization will be suspended, India's trade minister said."
Note: We seem to have been wrong in the comment below. See the Daily Nation [Kenya]: Deal Spells Doom for Our Chronically Sick.
Comment: This has been an AIDS issue for some time. If Indian companies make generic drugs legally and ships them to African countries (for example) where they are also legal, can EU stop the shipments in transit -- in Amsterdam, for example, because the drugs do not meet European intellectual-property requirements? The European Union has done so, presumably at the request of multinational pharmaceutical companies.
We don't know the details of this new deal. It's probably a victory, since India would never be happy with letting that interference continue.
"As a result of the deal at an India-EU summit in Brussels, an Indian complaint to the World Trade Organization will be suspended, India's trade minister said."
Note: We seem to have been wrong in the comment below. See the Daily Nation [Kenya]: Deal Spells Doom for Our Chronically Sick.
We don't know the details of this new deal. It's probably a victory, since India would never be happy with letting that interference continue.
December 8, 2010
Aspirin Helps Reduce Cancer Deaths, Study Finds
NYTimes.com: "Many Americans take aspirin to lower their risk of heart disease, but a new study suggests a remarkable added benefit, reporting that patients who took aspirin regularly for a period of several years were 21 percent less likely decades later to die of solid tumor cancers, including cancers of the stomach, esophagus and lung.
"As part of the new study, published online Monday in the journal Lancet, researchers examined the cancer death rates of 25,570 patients who had participated in eight different randomized controlled trials of aspirin that ended up to 20 years earlier."
Note and comment:
Abstract available at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62110-1/fulltext
Sorry, The Lancet charges $31.50 to non-subscribers just to download a full-text copy of this article -- though The Lancet contributed nothing to the cost of doing the research. Many other medical journals do the same (and many others don't). Our (conservative) estimate of The Lancet's profit margin for this transaction is 100,000% -- yes, one hundred thousand percent -- assuming a cost of 3 cents for its server to download the article (it's probably much less).
Researchers don't like this system because it reduces the usefulness and impact of their work. Often they put up with it only because they do not have a couple thousand dollars to pay expenses for peer-reviewed online open-access publication, for example in PLoS (Public Library of Science) journals. (If researchers just uploaded their work to a blog, the medical/scientific/academic/media world would seldom take it seriously -- because it's so hard to judge credibility, when even full peer review frequently gets is wrong). How different from the worlds of mathematics or astronomy, for example, where there is much less money attached, making transparency and effective collaboration far easier, since there's so much less motive to keep secrets or to scam.)
Our point is not that The Lancet is mercenary, but that we have a harmful, long-time public-policy failure. While the funding of this research is listed as "none" (welcome, in our view, since funding introduces very serious corruption in medical research -- but unwelcome in that the lack of explicit Federal funding will let The Lancet restrict the article for decades) taxpayers largely pay for the research infrastructure which made this research possible. And Congress creates the intellectual-property laws for the benefit of the very rich and the largest corporations, in return for campaign contributions and other favors -- without regard to the public interest.
Meanwhile, off to the drugstore for low-dose aspirin. Ask your doctor first, if you have serious medical problems.
"As part of the new study, published online Monday in the journal Lancet, researchers examined the cancer death rates of 25,570 patients who had participated in eight different randomized controlled trials of aspirin that ended up to 20 years earlier."
Note and comment:
Abstract available at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62110-1/fulltext
Sorry, The Lancet charges $31.50 to non-subscribers just to download a full-text copy of this article -- though The Lancet contributed nothing to the cost of doing the research. Many other medical journals do the same (and many others don't). Our (conservative) estimate of The Lancet's profit margin for this transaction is 100,000% -- yes, one hundred thousand percent -- assuming a cost of 3 cents for its server to download the article (it's probably much less).
Researchers don't like this system because it reduces the usefulness and impact of their work. Often they put up with it only because they do not have a couple thousand dollars to pay expenses for peer-reviewed online open-access publication, for example in PLoS (Public Library of Science) journals. (If researchers just uploaded their work to a blog, the medical/scientific/academic/media world would seldom take it seriously -- because it's so hard to judge credibility, when even full peer review frequently gets is wrong). How different from the worlds of mathematics or astronomy, for example, where there is much less money attached, making transparency and effective collaboration far easier, since there's so much less motive to keep secrets or to scam.)
Our point is not that The Lancet is mercenary, but that we have a harmful, long-time public-policy failure. While the funding of this research is listed as "none" (welcome, in our view, since funding introduces very serious corruption in medical research -- but unwelcome in that the lack of explicit Federal funding will let The Lancet restrict the article for decades) taxpayers largely pay for the research infrastructure which made this research possible. And Congress creates the intellectual-property laws for the benefit of the very rich and the largest corporations, in return for campaign contributions and other favors -- without regard to the public interest.
Meanwhile, off to the drugstore for low-dose aspirin. Ask your doctor first, if you have serious medical problems.
December 5, 2010
Alicia Keys, Other Celebs “Kill” Social Media Identities for HIV/AIDS Charity
The Afro-American Newspapers: "To support Keys’ Keep a Child Alive charity, the stars signed off of social media sites such as Twitter and Facebook. Their Twitter and Facebook sites will remain active with information on how to donate, but the stars themselves will refrain from posting personal updates or new information to their social media profiles while the campaign is underway.
"Supporters can donate $5 or $10 through text messages or through the Keep a Child Alive Web site. Once the charity’s $1 million goal is reached, the stars will resume posting on the sites.
"Just two days after the campaign’s Dec. 1 launch, fans had contributed more than $200,500 to bring their favorites back to 'life.'"
"Supporters can donate $5 or $10 through text messages or through the Keep a Child Alive Web site. Once the charity’s $1 million goal is reached, the stars will resume posting on the sites.
"Just two days after the campaign’s Dec. 1 launch, fans had contributed more than $200,500 to bring their favorites back to 'life.'"
December 1, 2010
Presidential Proclamation--World AIDS Day
The White House: "On this World AIDS Day, as we approach the thirtieth year of the HIV/AIDS pandemic, we reflect on the many Americans and others around the globe lost to this devastating disease, and pledge our support to the 33 million people worldwide who live with HIV/AIDS. We also recommit to building on the great strides made in fighting HIV, to preventing the spread of the disease, to continuing our efforts to combat stigma and discrimination, and to finding a cure."
AIDS Activism Growing on Campuses
NYTimes.com: "Mr. Messac, the University of Pennsylvania medical student, explored the origins of Mr. Bush’s AIDS program in a 120-page paper, 'Lazarus at America’s Doorstep,' for his Harvard undergraduate thesis. Mr. Carel, who spent last summer working at a hospital in the rural South African village of Tugela Ferry, now studies Zulu and persuaded a visiting professor from South Africa to let him take her upper-level course on 'the political economy of AIDS.' (He had to skip Zulu class for the Emanuel protest; he said his professor understood.)
"The students have also befriended a longtime veteran of the AIDS wars, Gregg Gonsalves, who at 47 is completing his undergraduate degree in evolutionary biology on a full scholarship at Yale. Mr. Gonsalves often lectures public-health classes on what he calls “ancient history” — the work of groups like Act Up in the 1990s.
"'Theirs is not a first-person commitment, in the sense that none of them is living with H.I.V.,' Mr. Gonsalves said of the new AIDS protesters. 'It’s all based out of a sense of solidarity and social justice. I used to wonder where the next generation would come from. They’re here.'
"Inside the White House, Dr. Emanuel, for one, is not impressed. He says the students are serving up tired arguments about dollar amounts that ignore the Obama administration’s emphasis on spending money more efficiently and offering services, like circumcision, that can reduce the spread of H.I.V. While Mr. Bush emphasized AIDS and malaria, Mr. Obama is promoting a six-year, $63 billion 'global health initiative' that seeks to address a range of diseases, with emphasis on women and children."
"The students have also befriended a longtime veteran of the AIDS wars, Gregg Gonsalves, who at 47 is completing his undergraduate degree in evolutionary biology on a full scholarship at Yale. Mr. Gonsalves often lectures public-health classes on what he calls “ancient history” — the work of groups like Act Up in the 1990s.
"'Theirs is not a first-person commitment, in the sense that none of them is living with H.I.V.,' Mr. Gonsalves said of the new AIDS protesters. 'It’s all based out of a sense of solidarity and social justice. I used to wonder where the next generation would come from. They’re here.'
"Inside the White House, Dr. Emanuel, for one, is not impressed. He says the students are serving up tired arguments about dollar amounts that ignore the Obama administration’s emphasis on spending money more efficiently and offering services, like circumcision, that can reduce the spread of H.I.V. While Mr. Bush emphasized AIDS and malaria, Mr. Obama is promoting a six-year, $63 billion 'global health initiative' that seeks to address a range of diseases, with emphasis on women and children."
World AIDS Day funeral at the White House
ACT UP Philadelphia: For 1.8 million who died this year without treatment. Excellent photos by ACT UP photographer Katie Riek -- click the title above.
On World AIDS Day, activists renew push for a cure
WHYY, Philadelphia: "Last year, the AIDS Policy Project launched a campaign to get more money to fund research for a cure. Kate Krauss, executive director of the project, said she was surprised to learn that very little money was available -- she estimates only 3 percent of the AIDS budget at the National Institutes of Health goes toward finding a cure. But, she said, the research that is happening is promising.
"'So, it's actually a really exciting time, a pivotal time. And it's a question of whether this epidemic ... what we do now, is going to determine whether this epidemic lasts for five or 10 years, or whether it lasts 30 or 40 years,' she said. 'Can we break down these research obstacles? Can we get researchers new money?'
"Krauss, who launched a letter-writing campaign out of her home in West Philadelphia, wants to quadruple the funding that the NIH directs toward finding a cure. Her work has garnered national attention from advocates and researchers.
"'This has not escalated into a demand for a cure, or research for a cure,' said Larry Kramer, the founder of ACT-UP, an activist group that has pushed for AIDS prevention and treatment since 1988. 'And what this group from Philadelphia has done on their own is to reignite this issue and try and run with it.'"
"'So, it's actually a really exciting time, a pivotal time. And it's a question of whether this epidemic ... what we do now, is going to determine whether this epidemic lasts for five or 10 years, or whether it lasts 30 or 40 years,' she said. 'Can we break down these research obstacles? Can we get researchers new money?'
"Krauss, who launched a letter-writing campaign out of her home in West Philadelphia, wants to quadruple the funding that the NIH directs toward finding a cure. Her work has garnered national attention from advocates and researchers.
"'This has not escalated into a demand for a cure, or research for a cure,' said Larry Kramer, the founder of ACT-UP, an activist group that has pushed for AIDS prevention and treatment since 1988. 'And what this group from Philadelphia has done on their own is to reignite this issue and try and run with it.'"
November 29, 2010
When the Rubber Hits the Road: Paying for Expanded HIV Testing and Care
HIV/AIDS Clinical Care: "Doubling the rate of HIV testing among U.S. adults over the next 5 years would lead to an additional 46,000 new diagnoses but would cost an additional $2.7 billion.
"In 2006, the CDC recommended expanding HIV testing in the U.S., but the recommendation was not accompanied by any increases in federal funding for testing or subsequent care. Now, researchers have used a computer simulation model to explore how expanded testing and treatment would affect U.S. government budgets over the next 5 years."
"In 2006, the CDC recommended expanding HIV testing in the U.S., but the recommendation was not accompanied by any increases in federal funding for testing or subsequent care. Now, researchers have used a computer simulation model to explore how expanded testing and treatment would affect U.S. government budgets over the next 5 years."
[Philadelphia] Free buses to DC for World AIDS Day
"ON WORLD AIDS DAY, WILL YOU SIMPLY MOURN THE DEAD?
…OR WILL YOU FIGHT LIKE HELL FOR THE LIVING, TOO?
Join ACT UP and our allies in DC on World AIDS Day (December 1st) as we call on President obama to keep the promise he made to ensure everyone with HIV has access to treatment.
Wednesday, December 1st
Free buses leave from Broad & Walnut at 7:30am.
Lunch will be provided, and tokens will be available for those who need them.
RSVP not required, but encouraged, to actupphilly@gmail.com or 215-386-1981
More info: actupphilly.org
PLEASE WEAR BLACK!
Why? There are over 4,000 people with HIV in the US who are forced onto waiting lists for AIDS drugs. Countless others can’t even get on the waiting list, because the are too “rich” or because their insurance companies are denying them care. Around the world, 10 million people were promised medication, but they do not have access. All of these people will die unless President Obama keeps his promise to fund AIDS treatment at home and abroad."
…OR WILL YOU FIGHT LIKE HELL FOR THE LIVING, TOO?
Join ACT UP and our allies in DC on World AIDS Day (December 1st) as we call on President obama to keep the promise he made to ensure everyone with HIV has access to treatment.
Wednesday, December 1st
Free buses leave from Broad & Walnut at 7:30am.
Lunch will be provided, and tokens will be available for those who need them.
RSVP not required, but encouraged, to actupphilly@gmail.com or 215-386-1981
More info: actupphilly.org
PLEASE WEAR BLACK!
Why? There are over 4,000 people with HIV in the US who are forced onto waiting lists for AIDS drugs. Countless others can’t even get on the waiting list, because the are too “rich” or because their insurance companies are denying them care. Around the world, 10 million people were promised medication, but they do not have access. All of these people will die unless President Obama keeps his promise to fund AIDS treatment at home and abroad."
Gilead asks FDA to approve new HIV drug combo - BusinessWeek
BusinessWeek: [Nov. 23] "Drugmaker Gilead Sciences Inc. said Tuesday it asked the Food and Drug Administration to approve a single pill combination of its HIV treatment Truvada and Tibotec Pharmaceuticals' rilpivirine.
"The companies have been working together to develop the combination since July of 2009."
"The companies have been working together to develop the combination since July of 2009."
Isentress Once-Daily Is Less Effective Than Twice-Daily
AIDSmeds: "Fewer people who took the integrase inhibitor Isentress (raltegravir) once-daily were able to control their HIV levels compared with people who took the drug twice-daily, as is currently recommended, according to a release from the drug’s maker Merck.
"Isentress was approved in 2007 to treat people with HIV resistant to most other antiretroviral drugs and in 2009 to treat people who were new to therapy. Given how quickly the body processes and eliminates Isentress, it was initially studied and approved as a twice-daily dose."
"Isentress was approved in 2007 to treat people with HIV resistant to most other antiretroviral drugs and in 2009 to treat people who were new to therapy. Given how quickly the body processes and eliminates Isentress, it was initially studied and approved as a twice-daily dose."
AIDS cure article in Philadelphia Gay News
AIDS cure article in Philadelphia Gay News
"The AIDS Policy Project, headquartered in Philadelphia and San Francisco, is taking a rarely employed approach to the HIV/AIDS epidemic, pressing not for enhanced prevention and treatment methods but for a more final solution: a cure.
Kate Krauss, founder and executive director of the project, said she and other staffers have worked both in the prevention and treatment arenas and, while both are crucial in the fight against HIV/AIDS, researchers need to start looking further into the future.
"'We know that prevention is not going to save the lives of the 33 million people who have AIDS now,' she said. 'And treatment is very different when it comes to different countries: There are about 15 million people who need treatment immediately, but only about 36 percent are actually receiving it. The number of people with AIDS is increasing and most don’t have access to treatment, so they’re just dying.'"
"The AIDS Policy Project, headquartered in Philadelphia and San Francisco, is taking a rarely employed approach to the HIV/AIDS epidemic, pressing not for enhanced prevention and treatment methods but for a more final solution: a cure.
Kate Krauss, founder and executive director of the project, said she and other staffers have worked both in the prevention and treatment arenas and, while both are crucial in the fight against HIV/AIDS, researchers need to start looking further into the future.
"'We know that prevention is not going to save the lives of the 33 million people who have AIDS now,' she said. 'And treatment is very different when it comes to different countries: There are about 15 million people who need treatment immediately, but only about 36 percent are actually receiving it. The number of people with AIDS is increasing and most don’t have access to treatment, so they’re just dying.'"
Dr. Collins, Please increase the AIDS cure budget to $240 million.
AIDS Policy Project petition: "I am writing to ask you to make a cure for AIDS a greater funding priority at the NIH. We truly applaud the NIH's innovative AIDS cure programs, but they are underpowered because they are underfunded."
Comment: For most impact, sign on NOW for petition delivery on World AIDS Day.
Comment: For most impact, sign on NOW for petition delivery on World AIDS Day.
What's All the Noise About PrEP For?
Civil Society Partnerships Advisor, UNAIDS, blogging in POZ: "I think we would be better off using all this air time and hype to promote the AIDS Cure Project - to call for investing in the development of collaborative research for a cure or for effective vaccines or microbicides.
"Even if PrEP works, no one is going to afford it; not unless the price is pennies a day; and what healthy person would want to take it for life with the horrible side effects that now exist from ARVs. Dosing the water supply with ARVs is not the answer - a cure is!!"
"Even if PrEP works, no one is going to afford it; not unless the price is pennies a day; and what healthy person would want to take it for life with the horrible side effects that now exist from ARVs. Dosing the water supply with ARVs is not the answer - a cure is!!"
Presidential Memorandum--Review of Human Subjects Protection
The White House: "Recently, we discovered that the U.S. Public Health Service conducted research on sexually transmitted diseases in Guatemala from 1946 to 1948 involving the intentional infection of vulnerable human populations. The research was clearly unethical. In light of this revelation, I want to be assured that current rules for research participants protect people from harm or unethical treatment, domestically as well as internationally.
"I ask you, as the Chair of the Presidential Commission for the Study of Bioethical Issues, to convene a panel to conduct, beginning in January 2011, a thorough review of human subjects protection to determine if Federal regulations and international standards adequately guard the health and well-being of participants in scientific studies supported by the Federal Government. I also request that the Commission oversee a thorough fact-finding investigation into the specifics of the U.S. Public Health Service Sexually Transmitted Diseases Inoculation Study."
"I ask you, as the Chair of the Presidential Commission for the Study of Bioethical Issues, to convene a panel to conduct, beginning in January 2011, a thorough review of human subjects protection to determine if Federal regulations and international standards adequately guard the health and well-being of participants in scientific studies supported by the Federal Government. I also request that the Commission oversee a thorough fact-finding investigation into the specifics of the U.S. Public Health Service Sexually Transmitted Diseases Inoculation Study."
November 28, 2010
Rare disease reveals new path for creating stem cells
Harvard Medical School Press Release: "FINDINGS: Researchers have found that by mimicking a rare genetic disorder in a dish, they can rewind the internal clock of a mature cell and drive it back into an adult stem-cell stage.
"RELEVANCE: Direct application for these findings is the field of tissue engineering and personalized medicine. It is conceivable that transplant patients may one day have some of their own endothelial cells extracted, reprogrammed, and then grown into the desired tissue type for implantation. Host rejection would not be an issue."
"RELEVANCE: Direct application for these findings is the field of tissue engineering and personalized medicine. It is conceivable that transplant patients may one day have some of their own endothelial cells extracted, reprogrammed, and then grown into the desired tissue type for implantation. Host rejection would not be an issue."
November 24, 2010
To WBAI, Pacifica: Open letter on denialist radio show
John S. James, AIDS Treatment News:"Gary Null's take-home message (often delivered as quotes from others) is that AIDS is not sexually transmitted, and not caused by HIV -- and that the mainstream view of tens of thousands of doctors, scientists, and other workers in the U.S. and around the world is a lie, a grand fraud and cruel deception, existing to scare people and keep government money flowing. Persons who believe this can easily conclude that they do not need to worry about condoms or self-control -- and that if they are diagnosed with HIV they can reject their doctors' advice and cure themselves with nutrition and lifestyle changes instead. Yes, real people do follow such advice. ...
"In 1996 good HIV/AIDS treatments started becoming available in the U.S. And some other rich countries. U.S. Government death statistics were a year or two behind due to long ne- glect of public-health infrastructure. But in San Francisco we could see what was happening much faster through the decreasing obituaries in the Bay Area Reporter(www.ebar.com), the city's biggest circulation gay newspaper. Before the new protease inhibitors and triple-drug "cocktails," 25 or more deaths could be reported in the weekly listing, almost all gay men dying of AIDS. In one week there were 33 obituaries. As the new drugs came into use the number of obituaries went down to about four or five a week, with around half of those deaths having nothing to do with AIDS. Meanwhile, we started hearing that leading AIDS doctors were no longer having deaths in their practices.
"Note: All the obituaries published in the Bay Area Reporter have been archived by the GLBT Historical Society; see www.glbthistory.org/obituaries. We checked the first half of 2010, and there are fewer than three obituaries per week. That's a long way from more than 20. To our knowledge there is no reason for the great drop in deaths, except that the new HIV/AIDS drugs were keeping people alive.
"But many leading denialists in California died of AIDS, even after good treatments were available, because they refused to take them. They were sincere. Some were great people. They should not have died."
Read the full letter at hrrp://www.aidsnews.org/WBAI-Pacifica-Null.pdf
"In 1996 good HIV/AIDS treatments started becoming available in the U.S. And some other rich countries. U.S. Government death statistics were a year or two behind due to long ne- glect of public-health infrastructure. But in San Francisco we could see what was happening much faster through the decreasing obituaries in the Bay Area Reporter(www.ebar.com), the city's biggest circulation gay newspaper. Before the new protease inhibitors and triple-drug "cocktails," 25 or more deaths could be reported in the weekly listing, almost all gay men dying of AIDS. In one week there were 33 obituaries. As the new drugs came into use the number of obituaries went down to about four or five a week, with around half of those deaths having nothing to do with AIDS. Meanwhile, we started hearing that leading AIDS doctors were no longer having deaths in their practices.
"Note: All the obituaries published in the Bay Area Reporter have been archived by the GLBT Historical Society; see www.glbthistory.org/obituaries. We checked the first half of 2010, and there are fewer than three obituaries per week. That's a long way from more than 20. To our knowledge there is no reason for the great drop in deaths, except that the new HIV/AIDS drugs were keeping people alive.
"But many leading denialists in California died of AIDS, even after good treatments were available, because they refused to take them. They were sincere. Some were great people. They should not have died."
Read the full letter at hrrp://www.aidsnews.org/WBAI-Pacifica-Null.pdf
November 23, 2010
AIDS Risk Greatly Lowered by Daily Pill, Study Finds
NYTimes.com: "In a development that could change the battle against AIDS, researchers have found that taking a daily antiretroviral pill greatly lowers the chances of getting infected with the fatal virus.
"In the study, published Tuesday by the New England Journal of Medicine [full text], researchers found that the hundreds of gay men randomly assigned to take the drugs were 44 percent less likely to get infected than the equal number assigned to take a placebo.
"But when only the men whose blood tests showed they had taken their pill faithfully every day were considered, the pill was more than 90 percent effective, said Dr. Anthony S. Fauci, head of the division of the National Institutes of Health, which paid for the study along with the Bill and Melinda Gates Foundation.
"'That’s huge,' Dr. Fauci said. 'That says it all for me.'
"The large study, nicknamed iPrEx, included nearly 2,500 men in six countries and was coordinated by the Gladstone Institutes of the University of California, San Francisco.
"The results are the best news in the AIDS field in years, even better than this summer’s revelation that a vaginal microbicide protected 39 percent of all the women testing it and 54 percent of those who used it faithfully.
"Also, the antiretroviral pill — Truvada, a combination of two drugs, tenofovir and emtricitabine — is available by prescription in many countries right now, while the microbicide gel is made only in small amounts for clinical trials. ...
"Because Truvada is available now, some clinicians already prescribe it for prophylaxis, Dr. Fauci said, but whether doing so becomes official policy will depend on discussions by the Centers for Disease Control and Prevention, the Food and Drug Administration, medical societies and others, which could take months."
Comment, JSJ: Of course this should be prescribed -- at least for men who need it and want it to reduce their risk of getting infected with HIV.
"In the study, published Tuesday by the New England Journal of Medicine [full text], researchers found that the hundreds of gay men randomly assigned to take the drugs were 44 percent less likely to get infected than the equal number assigned to take a placebo.
"But when only the men whose blood tests showed they had taken their pill faithfully every day were considered, the pill was more than 90 percent effective, said Dr. Anthony S. Fauci, head of the division of the National Institutes of Health, which paid for the study along with the Bill and Melinda Gates Foundation.
"'That’s huge,' Dr. Fauci said. 'That says it all for me.'
"The large study, nicknamed iPrEx, included nearly 2,500 men in six countries and was coordinated by the Gladstone Institutes of the University of California, San Francisco.
"The results are the best news in the AIDS field in years, even better than this summer’s revelation that a vaginal microbicide protected 39 percent of all the women testing it and 54 percent of those who used it faithfully.
"Also, the antiretroviral pill — Truvada, a combination of two drugs, tenofovir and emtricitabine — is available by prescription in many countries right now, while the microbicide gel is made only in small amounts for clinical trials. ...
"Because Truvada is available now, some clinicians already prescribe it for prophylaxis, Dr. Fauci said, but whether doing so becomes official policy will depend on discussions by the Centers for Disease Control and Prevention, the Food and Drug Administration, medical societies and others, which could take months."
Comment, JSJ: Of course this should be prescribed -- at least for men who need it and want it to reduce their risk of getting infected with HIV.
November 22, 2010
HIV drugs interfere with blood sugar, lead to insulin resistance
Newsroom | Washington University in St. Louis: "Hruz’s lab made the discovery in mice that lacked the GLUT4 protein. When researchers gave these mice ritonavir, the drug had no effect on their glucose tolerance. However, when they gave the drug to normal mice, their blood glucose shot up very quickly, showing that the drugs impair glucose tolerance and promote insulin resistance.
“What we saw were very acute effects on insulin sensitivity that we could reverse in the mice,” Hruz says. “But when insulin resistance goes on for a long time, secondary changes develop, such as high triglycerides, and those are harder to reverse,” he says."
“What we saw were very acute effects on insulin sensitivity that we could reverse in the mice,” Hruz says. “But when insulin resistance goes on for a long time, secondary changes develop, such as high triglycerides, and those are harder to reverse,” he says."
November 20, 2010
Discovery in how HIV thwarts the body's natural defense opens up new target for drug therapies
EurekAlert!: "Natural killer cells are major weapons in the body's immune system. They keep the body healthy by knocking off tumors and cells infected with viruses, bombarding them with tiny lethal pellets. But natural killer cells are powerless against HIV, a fact that has bedeviled science for over 20 years.
"Now, researchers at Rush University Medical Center have discovered the reason why.
"The study, posted online this week in the prestigious peer-reviewed journal Cell Host & Microbe, marks the 'beginning of a fascinating story that will shed new light on an important but still poorly understood aspect of the interaction of HIV with natural killer cells,' according to an editorial in the journal.
"'With this information, we now have a major new target for drug therapies that could potentially stop HIV and allow the body's natural killer cells to do what they are designed to do – protect the body from this lethal virus,' said Edward Barker, PhD, associate professor of immunology and microbiology at Rush University and lead author of the study."
Note: Also see http://www.aidsmeds.com/articles/hiv_vpu_nkcells_1667_19447.shtml
Note: Full text of original technical article, http://download.cell.com/cell-host-microbe/pdf/PIIS1931312810003495.pdf
Comment: On natural killer cells, also see http://www.npr.org/templates/story/story.php?storyId=131064823
"Now, researchers at Rush University Medical Center have discovered the reason why.
"The study, posted online this week in the prestigious peer-reviewed journal Cell Host & Microbe, marks the 'beginning of a fascinating story that will shed new light on an important but still poorly understood aspect of the interaction of HIV with natural killer cells,' according to an editorial in the journal.
"'With this information, we now have a major new target for drug therapies that could potentially stop HIV and allow the body's natural killer cells to do what they are designed to do – protect the body from this lethal virus,' said Edward Barker, PhD, associate professor of immunology and microbiology at Rush University and lead author of the study."
Note: Also see http://www.aidsmeds.com/articles/hiv_vpu_nkcells_1667_19447.shtml
Note: Full text of original technical article, http://download.cell.com/cell-host-microbe/pdf/PIIS1931312810003495.pdf
Comment: On natural killer cells, also see http://www.npr.org/templates/story/story.php?storyId=131064823
HIV-positive inmate in city denied medication, suit alleges
http://www.stltoday.com/ [St. Louis, MO]: "Medical care in city jails, already the subject of wrongful-death lawsuits, was challenged again on Thursday with an ACLU claim that an HIV-positive inmate was deprived of his medications for 17 days and got only sporadic care thereafter.
"A lawsuit filed in federal court by the American Civil Liberties Union of Eastern Missouri alleges that the John Doe plaintiff was deprived of his rights at both the Justice Center downtown and the Medium Security Institution on Hall Street.
"'It's inexcusable, and it's serious,' said Tony Rothert, legal director for the ACLU here.
The ACLU says this case and others reflect a pattern of failures at the lockups. It made specific allegations in a 2009 report that accused the jails of inadequate medical attention, inmate abuse, falsification of reports and unsanitary conditions.
"The latest suit names the city and a contractor, Correctional Medical Services, as defendants, along with the jail superintendent, Eugene Stubblefield, and two CMS physicians, Drs. Brenda Mallard and Susan Singer."
"A lawsuit filed in federal court by the American Civil Liberties Union of Eastern Missouri alleges that the John Doe plaintiff was deprived of his rights at both the Justice Center downtown and the Medium Security Institution on Hall Street.
"'It's inexcusable, and it's serious,' said Tony Rothert, legal director for the ACLU here.
The ACLU says this case and others reflect a pattern of failures at the lockups. It made specific allegations in a 2009 report that accused the jails of inadequate medical attention, inmate abuse, falsification of reports and unsanitary conditions.
"The latest suit names the city and a contractor, Correctional Medical Services, as defendants, along with the jail superintendent, Eugene Stubblefield, and two CMS physicians, Drs. Brenda Mallard and Susan Singer."
[Condom Art Contest -- this one for Philadelphia]
Outreach @ STDPhilly.org > Home: "Condoms Work! The Philadelphia Department of Public Health, STD Control Program is sponsoring a condom art contest for its first ever, custom labeled condoms. With syphilis and gonorrhea rates in the city at outbreak proportions, it’s vitally important that you help the STD Control program enhance its current outbreak control measures to include custom labeled condoms that promote healthy condom use behavior and that are current, socially relevant, and visually interesting – making them much more likely to be requested, promoted, and used.
"The contest will officially launch on Friday, November 19, 2010 and all artwork must be submitted no later than November 28th."
Comment: There could also be national or worldwide condom-package-art contests -- with much larger monetary prizes.
"The contest will officially launch on Friday, November 19, 2010 and all artwork must be submitted no later than November 28th."
Comment: There could also be national or worldwide condom-package-art contests -- with much larger monetary prizes.
Burma HIV patients face eviction
The Press Association: "Burma's government ordered more than 80 people at a shelter for patients with HIV and Aids to leave after a visit by newly-freed democracy leader Aung San Suu Kyi, the centre's organisers said.
"Suu Kyi, released a week ago from seven years under house arrest, visited the shelter on the outskirts of Rangoon on Wednesday, promising to provide it with badly needed medicines. She also addressed a crowd of more than 600 who came to see her.
"A day after her visit, government officials told patients they would have to leave by next week or face legal action because the centre's permit was not being renewed, said Phyu Phyu Thin, a pro-democracy activist who founded the operation.
"By law, home owners must seek government permission every two weeks to allow visitors to stay overnight."
"Suu Kyi, released a week ago from seven years under house arrest, visited the shelter on the outskirts of Rangoon on Wednesday, promising to provide it with badly needed medicines. She also addressed a crowd of more than 600 who came to see her.
"A day after her visit, government officials told patients they would have to leave by next week or face legal action because the centre's permit was not being renewed, said Phyu Phyu Thin, a pro-democracy activist who founded the operation.
"By law, home owners must seek government permission every two weeks to allow visitors to stay overnight."
We must all build on HIV/Aids success
Times LIVE: "And there is much success to build on. Globally, more than five million people in low- and middle-income countries are on HIV treatment, and the American people support more than half of these individuals through the President's Emergency Plan for Aids Relief (Pepfar). In addition, Pepfar programmes have helped more than 340000 babies to be born free of HIV. Millions more have benefited from HIV prevention and care programmes."
Pope Benedict says that condoms can be used to stop the spread of HIV
The Observer: "In a break with his traditional teaching, Pope Benedict XVI has said the use of condoms is acceptable 'in certain cases', in an extended interview to be published this week.
"After holding firm during his papacy to the Vatican's blanket ban on the use of contraceptives, Benedict's surprise comments will shock conservatives in the Catholic church while finding favour with senior Vatican figures who are pushing for a new line on the issue as HIV ravages Africa.
"The comments were made in a book-length interview with a German journalist, Peter Seewald. In the case of a male prostitute, says Benedict, using a condom to reduce the risk of HIV infection 'can be a first step in the direction of moralisation, a first assumption of responsibility, on the way toward recovering an awareness that not everything is allowed and that one cannot do whatever one wants'."
Note: Also see UNAIDS welcomes Pope Benedict’s support to HIV prevention.
"After holding firm during his papacy to the Vatican's blanket ban on the use of contraceptives, Benedict's surprise comments will shock conservatives in the Catholic church while finding favour with senior Vatican figures who are pushing for a new line on the issue as HIV ravages Africa.
"The comments were made in a book-length interview with a German journalist, Peter Seewald. In the case of a male prostitute, says Benedict, using a condom to reduce the risk of HIV infection 'can be a first step in the direction of moralisation, a first assumption of responsibility, on the way toward recovering an awareness that not everything is allowed and that one cannot do whatever one wants'."
Note: Also see UNAIDS welcomes Pope Benedict’s support to HIV prevention.
November 19, 2010
Bionor Gains $45 Million in Value After Resuming HIV Drug Study
Bloomberg: "Bionor Pharma ASA almost quadrupled in value in Oslo trading, gaining more than $45 million, after the drugmaker said its experimental HIV vaccine unexpectedly reduced virus levels. ...
"The drugmaker last month canceled the Vacc-4x program after an early study showed patients taking the vaccine were just as likely as those receiving a placebo to have to resume antiretroviral therapy. The study was designed to see if the vaccine helped patients to stay off the therapy, which typically consists of a combination of three or more drugs.
"Further analysis of the study data showed the vaccine triggered an 'unexpected' and statistically significant drop in levels of the virus, which causes AIDS, Bionor said today. Virus levels in vaccinated patients didn’t return to pre-therapy levels, which normally happens, the company said.
"'A therapeutic HIV vaccine like Vacc-4x reducing the viral load set-point, could have significant implications for future HIV management' ..."
"The drugmaker last month canceled the Vacc-4x program after an early study showed patients taking the vaccine were just as likely as those receiving a placebo to have to resume antiretroviral therapy. The study was designed to see if the vaccine helped patients to stay off the therapy, which typically consists of a combination of three or more drugs.
"Further analysis of the study data showed the vaccine triggered an 'unexpected' and statistically significant drop in levels of the virus, which causes AIDS, Bionor said today. Virus levels in vaccinated patients didn’t return to pre-therapy levels, which normally happens, the company said.
"'A therapeutic HIV vaccine like Vacc-4x reducing the viral load set-point, could have significant implications for future HIV management' ..."
November 18, 2010
TODAY, in Philadelphia: Community Forum on AIDS Cure
Date: November 18, 2010
Time: 7 pm
Place: Friends Center, 15th and Cherry Streets, Center City, Philadelphia
RSVP: info@AIDSPolicyProject.org or tel: 510-388-7089
TOWN MEETING ON THE CURE
NOVEMBER 18, 2010, 7 PM
Friends Center at 15 th and Cherry Streets
Philadelphia
Featured Speaker:
Jay Kostman, MD
Dr. Kostman is Head of the Division of Infectious Diseases at the Presbyterian Medical Center. He is also the principal investigator at a community consortium of clinical research sites for HIV-infected individuals.
Did you know that a man was cured of AIDS in 2008? There’s exciting science taking place, but much needs to happen before a cure is developed for millions of people. We will talk about the state of cutting-edge science and community action that could help support the push for a cure.
RSVP encouraged but not mandatory: info@AIDSPolicyProject.org or tel: 215-939-7852
Researchers, health professionals, people with AIDS and their friends and allies are
encouraged to attend. Sponsored by the AIDS Policy Project and ACT UP Philadelphia.
Time: 7 pm
Place: Friends Center, 15th and Cherry Streets, Center City, Philadelphia
RSVP: info@AIDSPolicyProject.org or tel: 510-388-7089
TOWN MEETING ON THE CURE
NOVEMBER 18, 2010, 7 PM
Friends Center at 15 th and Cherry Streets
Philadelphia
Featured Speaker:
Jay Kostman, MD
Dr. Kostman is Head of the Division of Infectious Diseases at the Presbyterian Medical Center. He is also the principal investigator at a community consortium of clinical research sites for HIV-infected individuals.
Did you know that a man was cured of AIDS in 2008? There’s exciting science taking place, but much needs to happen before a cure is developed for millions of people. We will talk about the state of cutting-edge science and community action that could help support the push for a cure.
RSVP encouraged but not mandatory: info@AIDSPolicyProject.org or tel: 215-939-7852
Researchers, health professionals, people with AIDS and their friends and allies are
encouraged to attend. Sponsored by the AIDS Policy Project and ACT UP Philadelphia.
November 16, 2010
Checklists cut surgery deaths in half, study finds
Reuters: "Using an exhaustive hospital checklist prevents errors and cuts the risk of death nearly in half for patients who come in for surgery, researchers reported on Wednesday.
The system also reduced the number of complications by one-third, they reported in the New England Journal of Medicine. The study adds to growing evidence that checklists can save trouble, lives and money in hospitals."
The system also reduced the number of complications by one-third, they reported in the New England Journal of Medicine. The study adds to growing evidence that checklists can save trouble, lives and money in hospitals."
November 15, 2010
Congratulations, Katie - The POZ 100
POZ - December #168 : The POZ 100: 51 to 60: "Kate Krauss As executive director of the AIDS Policy Project, Krauss has nearly single-handedly resuscitated the notion of advocating for the cure for AIDS"
Unsafe in Switzerland
HIV/AIDS Clinical Care: "Comment: This study could not answer the question of whether the 'Swiss statement' has led to increased HIV transmission, but it does indicate that the statement has led to decreased condom use, at least in Switzerland. ... Although ART is a promising avenue for preventing the spread of HIV, we need data, not opinions, before we encourage serodiscordant couples to skip the condoms."
Comment by JSJ: We don't know enough to have our own opinion about the 'Swiss statement' controversy. But we note that life is never risk-free. And there can be risks on both sides -- as too many warnings may lead to people ignoring them all, including the ones that do matter.
Comment by JSJ: We don't know enough to have our own opinion about the 'Swiss statement' controversy. But we note that life is never risk-free. And there can be risks on both sides -- as too many warnings may lead to people ignoring them all, including the ones that do matter.
Good Early Results for New ViiV HIV Integrase Inhibitor
POZ: "An experimental integrase inhibitor from ViiV Healthcare, currently known as S/GSK1349572 (S/GSK-572), was as effective as efavirenz (found in Sustiva and Atripla) in controlling HIV levels with fewer side effects over 24 weeks in a Phase II study. These data were presented at the 10th International Congress on Drug Therapy in HIV Infection, which was held November 7 to 11 in Glasgow and reported by the National AIDS Treatment Advocates Project (NATAP).
"Although the current crop of recommended antiretroviral (ARV) drugs is quite potent, each med has its disadvantages. Some have troublesome side effects, while others must be taken several times a day. Needless to say, there’s a demand for new treatments that can be easily joined with other drugs into a single pill that can be taken once daily and that has minimal side effects.
"One candidate with the potential to meet all of those challenges in S/GSK-572. It is a second-generation integrase inhibitor that can be taken once daily, without the need for blood-level boosting by Norvir (ritonavir), and that so far appears to have minimal side effects. What’s more, the daily dose is small enough that it should be easily combinable with other drugs into a single pill."
"Although the current crop of recommended antiretroviral (ARV) drugs is quite potent, each med has its disadvantages. Some have troublesome side effects, while others must be taken several times a day. Needless to say, there’s a demand for new treatments that can be easily joined with other drugs into a single pill that can be taken once daily and that has minimal side effects.
"One candidate with the potential to meet all of those challenges in S/GSK-572. It is a second-generation integrase inhibitor that can be taken once daily, without the need for blood-level boosting by Norvir (ritonavir), and that so far appears to have minimal side effects. What’s more, the daily dose is small enough that it should be easily combinable with other drugs into a single pill."
TB still killing 4,000 people with HIV each day, WHO reports
Aidsmap: "Tuberculosis is still killing more than 4,000 people with HIV every day worldwide, the World Health Organization reported this week. Despite progress over the past few years, more needs to be done to identify and treat HIV in TB patients, and to prevent TB in people with HIV.
"The new tuberculosis control data from the World Health Organization show that despite modest progress in 2009, the majority of people with HIV and TB worldwide are still not receiving antiretroviral therapy or isoniazid preventive therapy.
"Nevertheless the findings, released this week ahead of the 41st Union World Lung Health conference in Berlin, do show substantial improvement in rates of HIV testing among TB patients."
"The new tuberculosis control data from the World Health Organization show that despite modest progress in 2009, the majority of people with HIV and TB worldwide are still not receiving antiretroviral therapy or isoniazid preventive therapy.
"Nevertheless the findings, released this week ahead of the 41st Union World Lung Health conference in Berlin, do show substantial improvement in rates of HIV testing among TB patients."
November 14, 2010
ADAPs with Waiting Lists
NASTAD
[Click on the NASTAD page to open PDF file.]
"3,811 individuals in 9 states*, as of November 11, 2010:
Florida: 2,043 individuals
Georgia: 672 individuals
Iowa: 39 individuals
Louisiana: 404 individuals**
Montana: 10 individuals
North Carolina: 66 individuals
Ohio: 328 individuals
Rhode Island: 10 individuals
South Carolina: 239 individuals"
[Click on the NASTAD page to open PDF file.]
"3,811 individuals in 9 states*, as of November 11, 2010:
Florida: 2,043 individuals
Georgia: 672 individuals
Iowa: 39 individuals
Louisiana: 404 individuals**
Montana: 10 individuals
North Carolina: 66 individuals
Ohio: 328 individuals
Rhode Island: 10 individuals
South Carolina: 239 individuals"
November 11, 2010
POZ - POZ Exclusives : AIDSmeds Video: Quest for a Cure - by David Evans
POZ: "On November 3, people living with HIV and their allies gathered in West Hollywood to hear about an exciting new experiment that’s about to get under way. At the meeting, sponsored by the AIDS Policy Project, John Zaia, MD, from the City of Hope in Duarte, California, and Paula Cannon, PhD, from the University of Southern California in Los Angeles, explained the potential behind their new approach to curing AIDS: genetically modifying stem cells taken from people living with both HIV and lymphoma to render their immune systems resistant to HIV.If the treatment works, not only would it cure the study participants’ lymphoma, it could also cure their HIV.
"If this sounds far-fetched, it’s not. About three years ago, an enterprising German hematologist named Gero Hütter, MD, decided to do something that had never been done before. He had an HIV-positive patient who had leukemia and needed a bone marrow (stem cell) transplant. Hütter decided to look for a bone marrow donor with a unique characteristic: a genetic defect that makes people highly resistant to HIV infection. He found such a donor and then conducted the transplant. Three years later, the patient has no detectable virus and remains off of all antiretroviral therapy."
"If this sounds far-fetched, it’s not. About three years ago, an enterprising German hematologist named Gero Hütter, MD, decided to do something that had never been done before. He had an HIV-positive patient who had leukemia and needed a bone marrow (stem cell) transplant. Hütter decided to look for a bone marrow donor with a unique characteristic: a genetic defect that makes people highly resistant to HIV infection. He found such a donor and then conducted the transplant. Three years later, the patient has no detectable virus and remains off of all antiretroviral therapy."
Egrifta Gets FDA Approval for HIV-Associated Lipodystrophy
POZ: "Egrifta (tesamorelin) has been approved for the treatment of HIV-associated lipodystrophy, according to a November 10 announcement from the U.S. Food and Drug Administration (FDA). The drug, requiring once-daily injections, was approved to reduce visceral adipose tissue (VAT)— deep belly fat surrounding the liver, stomach and other abdominal organs—in people living with HIV experiencing lipodystrophy, a side effect of antiretroviral (ARV) therapy."
NIH scientists unveil mechanisms of immune reconstitution inflammatory syndrome
EurekAlert!: "Newly published research by scientists at the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, sheds light on a poorly understood, acute illness called Immune Reconstitution Inflammatory Syndrome (IRIS) that develops in some HIV-infected individuals soon after they begin antiretroviral therapy."
Most patients in darunavir monotherapy trial stay fully suppressed
Aidsmap: "The latest data from a European trial using boosted darunavir (DRV/r) as the sole HIV drug has found no evidence of increased treatment failure or of viral loads increasing over time, even when viral loads below the usual limit of detectability were investigated with an ultrasensitive assay.
"The latest results from the MONET trial, presented at the recent Tenth Congress on Drug Therapy in HIV Infection, contrast with an African trial using boosted lopinavir monotherapy (LPV/r) also presented which, in the absence of viral load testing, found increased rates of viral failure over time."
"The latest results from the MONET trial, presented at the recent Tenth Congress on Drug Therapy in HIV Infection, contrast with an African trial using boosted lopinavir monotherapy (LPV/r) also presented which, in the absence of viral load testing, found increased rates of viral failure over time."
Mobile phone messages improve adherence and HIV control in Kenyan trial
Aidsmap: "A text message from a clinic each week resulted in better adherence and a higher level of viral load suppression among people with HIV after starting antiretroviral treatment in Kenya, a randomised controlled trial has shown.
"The results were published in the Online First section of The Lancet this week. The trial was sponsored by the US President’s Emergency Plan for AIDS Relief (PEPFAR).
"The intervention cost around 20 cents per patient each month, and would potentially allow one nurse to monitor adherence and other issues in 1000 patients each month, the researchers calculated. ...
"Typically, the slogan "Mambo?" was sent, which is Kiswahili [Swahili] for "How are you?" The health workers used multiple recipient (bulk) messaging functions to improve efficiency. Patients in the intervention group were instructed to respond within 48 hours that either they were doing well ("Sawa") or that they had a problem ("Shida"). The clinician then called patients who said they had a problem or who failed to respond within two days."
"The results were published in the Online First section of The Lancet this week. The trial was sponsored by the US President’s Emergency Plan for AIDS Relief (PEPFAR).
"The intervention cost around 20 cents per patient each month, and would potentially allow one nurse to monitor adherence and other issues in 1000 patients each month, the researchers calculated. ...
"Typically, the slogan "Mambo?" was sent, which is Kiswahili [Swahili] for "How are you?" The health workers used multiple recipient (bulk) messaging functions to improve efficiency. Patients in the intervention group were instructed to respond within 48 hours that either they were doing well ("Sawa") or that they had a problem ("Shida"). The clinician then called patients who said they had a problem or who failed to respond within two days."
November 9, 2010
Trials Prove Experimental Diarrhea Medication Is Effective
POZ: "A twice-daily dose of a new type of anti-diarrhea medication called crofelemer is significantly more effective than a placebo at treating chronic diarrhea in people with HIV. These data, announced November 4 by the drug’s maker, Napo Pharmaceuticals, mean that the drug could be approved by 2012."
Anti-nausea drug has anti-HIV effect too
Aidsmap: "A drug used to quell nausea caused by chemotherapy has a strong anti-HIV effect in the test-tube, and this effect is intensified if the HIV protease inhibitors saquinavir or ritonavir are also present."
Study confirms that the sooner treatment is started the better
Aidsmap: "A study presented at the Tenth International Congress on Drug Therapy in HIV Infection in Glasgow has found that patients who started antiretroviral combination therapy (cART) within the first year after diagnosis were 36% less likely to experience treatment failure, and 65% less likely to develop HIV drug resistance on treatment, than patients in general."
Effect of Antioxidants on Mitochondrial Function in HIV-1-Related Lipoatrophy: A Pilot Study
AIDS Research and Human Retroviruses (October 26): "Our study showed that antioxidant supplementation may have a protective role on mitochondrial function, with limited effects on the reversal of clinical lipodystrophic abnormalities in HIV-1-infected patients."
EU deal threatens HIV drug supplies - In Depth - Al Jazeera English
Al Jazeera English: "Aidsmap: "A study presented at the Tenth International Congress on Drug Therapy in HIV Infection in Glasgow has found that patients who started antiretroviral combination therapy (cART) within the first year after diagnosis were 36% less likely to experience treatment failure, and 65% less likely to develop HIV drug resistance on treatment, than patients in general."
November 8, 2010
Gonsalves: AIDS activism saved my life
Yale Daily News: "AIDS activists from Yale and Harvard took on the president last week. They know — because they did their homework — that the Obama administration has decided to scale back the U.S.’ efforts to scale up AIDS drugs in Africa. They know that the president is being told by some advisers that AIDS treatment isn’t cost-effective, a rehash of the old arguments from the 1990s. They know that rather than seeing AIDS as a public health success worthy of building upon for larger goals, the White House is pitting AIDS against other worthy health priorities. They know that close to 40 deans of schools of public health and medicine and world experts in global health have sent letters to the White House objecting to this shift in policy. Even Nobel Prize-winning organizations such as Doctors Without Borders and Nobel Prize winner Archbishop Desmond Tutu have appealed to the president, to no avail.
"AIDS activists from Yale and Harvard did the right thing last week. As always, when activists “act up,” they’re told that they should have picked a better time and place for their protests. We were told this again and again in the 1980s and 1990s. If activists had listened to the sage advice of their contemporaries back then, I’d be dead and millions of others would be too."
"AIDS activists from Yale and Harvard did the right thing last week. As always, when activists “act up,” they’re told that they should have picked a better time and place for their protests. We were told this again and again in the 1980s and 1990s. If activists had listened to the sage advice of their contemporaries back then, I’d be dead and millions of others would be too."
November 7, 2010
EU deal threatens HIV drug supplies
Al Jazeera English: "The charity Medicins sans Frontieres (MSF) says that hidden clauses in the free trade agreeement (FTA) currently being negotiated between Europe and India will prevent the manufacture and distribution of crucial generic medicines produced in the country.
"There are dirty legal tricks being used," says Dr. Tido von Schoenangerer, who runs the MSF campaign for essential medicines. "Any person living with HIV in the developing world is facing a future scenario in which the medicines they need will be under threat."
"Meanwhile the World Health Organisation, the UN's public health body, has echoed MSF's concerns, saying that if the trade deal does indeed include clauses governing the production of cheap generic medicines, the ramifications for the public health could be serious.
"The issue hinges on a so-called 'data exclusivity' provision in the free trade agreement, which campaigners say would effectively copyright information gathered in the clinical trials that prove the effectiveness and safety of medicines.
"At present, generic manufacturers rely on the results of the original clinical trials carried out by the drug developer to get their cheap version registered. If this information were to become exclusive, Indian companies would be left without the data they need to register their drugs.
"It means companies will have to repeat the trials, which not only would be very costly, but raises ethical issues because it is basically doing research to find out something that is already known," says von Schoenangerer. ...
"The department of essential medicines of WHO has never been given a copy of the draft of the free trade agreement..."
"There are dirty legal tricks being used," says Dr. Tido von Schoenangerer, who runs the MSF campaign for essential medicines. "Any person living with HIV in the developing world is facing a future scenario in which the medicines they need will be under threat."
"Meanwhile the World Health Organisation, the UN's public health body, has echoed MSF's concerns, saying that if the trade deal does indeed include clauses governing the production of cheap generic medicines, the ramifications for the public health could be serious.
"The issue hinges on a so-called 'data exclusivity' provision in the free trade agreement, which campaigners say would effectively copyright information gathered in the clinical trials that prove the effectiveness and safety of medicines.
"At present, generic manufacturers rely on the results of the original clinical trials carried out by the drug developer to get their cheap version registered. If this information were to become exclusive, Indian companies would be left without the data they need to register their drugs.
"It means companies will have to repeat the trials, which not only would be very costly, but raises ethical issues because it is basically doing research to find out something that is already known," says von Schoenangerer. ...
"The department of essential medicines of WHO has never been given a copy of the draft of the free trade agreement..."
November 6, 2010
Study offers new clues to effective HIV vaccine
Reuters: "Slight differences in five amino acids in a protein called HLA-B may explain why certain people resist the human immunodeficiency virus, U.S. researchers said on Thursday in a study that lends new clues about how to make a vaccine to prevent AIDS.
"'For a long time, we've known that some people progress extremely rapidly when they get infected, and others can stay well for three decades and never need treatment and still look entirely well,' said Dr. Bruce Walker of Massachusetts General Hospital and Harvard University, whose study appears in the journal Science.
"'We thought we could apply new techniques from the human genome project to understand what the genetic basis was for that,' he said.
"About one in 300 people infected with HIV can suppress the virus with the immune system, keeping the virus at extremely low levels."
"'For a long time, we've known that some people progress extremely rapidly when they get infected, and others can stay well for three decades and never need treatment and still look entirely well,' said Dr. Bruce Walker of Massachusetts General Hospital and Harvard University, whose study appears in the journal Science.
"'We thought we could apply new techniques from the human genome project to understand what the genetic basis was for that,' he said.
"About one in 300 people infected with HIV can suppress the virus with the immune system, keeping the virus at extremely low levels."
November 4, 2010
Discovery Raises Hope for Treating Ebola, Lassa, Marburg and Other Fast Acting Viruses
Infection Control Today: "A new research report appearing in the Journal of Leukocyte Biology suggests that a purified and modified form of a simple sugar chain may stop fast-acting and deadly viruses, such as Ebola, Lassa, or Marburg viruses, in their tracks. This compound, called chlorite-oxidized oxyamylose or COAM, could be a very attractive therapeutic option because not only did this compound enhance the early-stage immune defenses in mice, but because of sugar's abundance, it is derived from easily obtainable sources."
Comment: Maybe worth looking at as an immune modulator in HIV as well?
Comment: Maybe worth looking at as an immune modulator in HIV as well?
Towards a Cure: HIV Reservoirs and Strategies to Control Them
Journal of the International AIDS Society: "The aim of the workshop, “Towards a Cure: HIV Reservoirs and Strategies to Control Them”, was to invigorate efforts to move beyond ART [antiretroviral therapies], either by eradicating the virus (sterilizing cure) or by achieving long-term remission in the absence of ongoing therapy (functional cure). The organizers placed a particular focus on encouraging young investigators to work on this critically important topic, with the secondary aim of improving the breadth and quality of scientific presentations in the biomedical and pre-clinical field at the XVIII International AIDS Conference (abstracts for the workshop were selected from submissions to the conference)."
November 2, 2010
Inflammation and mortality in HIV-infected adults: analysis of the FRAM study cohort.
JAIDS: "CONCLUSIONS: Fibrinogen and CRP [C-reactive protein] are strong and independent predictors of mortality in HIV-infected adults. Our findings suggest that even in those with relatively preserved CD4 counts >500 cells per microliter, inflammation remains an important risk factor for mortality. Further investigation should determine whether interventions to reduce inflammation might decrease mortality risk in HIV-infected individuals."
November 1, 2010
Drug experts say alcohol worse than crack or heroin
Reuters: "Alcohol is a more dangerous drug than both crack and heroin when the combined harms to the user and to others are assessed, British scientists said Monday."
October 31, 2010
FDA and CONRAD Chart U.S. Regulatory Path for 1% Tenofovir Gel for HIV Prevention
CONRAD: "The U.S. Food and Drug Administration (FDA) held an end-of-Phase II meeting to determine the next steps required for U.S. licensure of 1% tenofovir gel, a microbicide product recently found to be effective at reducing the rate of HIV and herpes infection in women when used before and after sex.
"The meeting, held on October 20, 2010, was requested by CONRAD, a division of the Eastern Virginia Medical School in Norfolk, VA. CONRAD was one of the partners in the Phase II study, “CAPRISA 004,” which evaluated 1% tenofovir gel in prevention of male-to-female HIV transmission in 889 women in South Africa. USAID provided funding for the trial, conducted by the Centre for Programme Research for AIDS in South Africa and U.S. based FHI, which was the first study to show that a vaginal gel can reduce the risk of HIV and herpes infection in women. CONRAD manufactured and provided the tenofovir gel for the study.
"Tenofovir gel was found to be 39% effective in reducing a woman’s risk of becoming infected with HIV during sex and 51% effective in preventing genital herpes infections in the women participating in the trial. Results of the CAPRISA 004 clinical trial were reported in July 2010 and represent the first “proof of concept” for a vaginal microbicide."
Comment (by JSJ): This is great news. But it could be better. 39% reduction means that 61% of the infections were not stopped.
Is there a good case for a higher dose, e.g. 2%? If yes, the 1% approvaL should still proceed, and a (vastly smaller and vastly less expensive) safety trial with higher dose(s) should be done as well. Moving toward approving the 1% is how regulators act, which is how scientists and companies then act, so it may be the best we can expect from the conventional wisdom.
But if the obstacle is that there isn't money any more for big efficacy trials to get "ideal" dose information, people still need to be empowered to make intelligent decisions using all the information to protect themselves and others, and reduce or end the epidemic.
Perhaps test safety of the standard gel with more tenofovir mixed in, so that countries or pharmacists could more easily prepare a higher dose formulation before it becomes standard.
Or maybe test safety of adding a standard tenofovir pill to the post-sex use of the gel? No reformulation needed.
"The meeting, held on October 20, 2010, was requested by CONRAD, a division of the Eastern Virginia Medical School in Norfolk, VA. CONRAD was one of the partners in the Phase II study, “CAPRISA 004,” which evaluated 1% tenofovir gel in prevention of male-to-female HIV transmission in 889 women in South Africa. USAID provided funding for the trial, conducted by the Centre for Programme Research for AIDS in South Africa and U.S. based FHI, which was the first study to show that a vaginal gel can reduce the risk of HIV and herpes infection in women. CONRAD manufactured and provided the tenofovir gel for the study.
"Tenofovir gel was found to be 39% effective in reducing a woman’s risk of becoming infected with HIV during sex and 51% effective in preventing genital herpes infections in the women participating in the trial. Results of the CAPRISA 004 clinical trial were reported in July 2010 and represent the first “proof of concept” for a vaginal microbicide."
Comment (by JSJ): This is great news. But it could be better. 39% reduction means that 61% of the infections were not stopped.
Is there a good case for a higher dose, e.g. 2%? If yes, the 1% approvaL should still proceed, and a (vastly smaller and vastly less expensive) safety trial with higher dose(s) should be done as well. Moving toward approving the 1% is how regulators act, which is how scientists and companies then act, so it may be the best we can expect from the conventional wisdom.
But if the obstacle is that there isn't money any more for big efficacy trials to get "ideal" dose information, people still need to be empowered to make intelligent decisions using all the information to protect themselves and others, and reduce or end the epidemic.
Perhaps test safety of the standard gel with more tenofovir mixed in, so that countries or pharmacists could more easily prepare a higher dose formulation before it becomes standard.
Or maybe test safety of adding a standard tenofovir pill to the post-sex use of the gel? No reformulation needed.
Obama: Republicans Aren’t Funding AIDS Issues
Daily Intel: "According to President Obama, some pesky 'young people' protesting for more global AIDS funding have been showing up 'at every rally' and interrupting him. Today, in Connecticut to discuss the economy, Obama addressed these crazy young people, and ended up addressing AIDS funding in the process."
October 26, 2010
HIV Antibodies Do Control Infection: New Hope for Vaccines and Treatment
POZ: "B-cells and neutralizing antibodies (NAbs) might control HIV levels better than scientists previously suspected, according to a single-patient study reported in the October issue of Nature Communications. The intriguing finding, the authors note, could open a new avenue for both preventive and treatment vaccines for HIV."
HIV-1-Infected Peripheral Blood Mononuclear Cells Enhance Neutrophil Survival and HLA-DR Expression Via Increased Production of GM-CSF: ...
JAIDS Journal of Acquired Immune Deficiency Syndromes: "We conclude that GM-CSF production within the mucosa or draining lymph nodes may promote HIV-1 infection by facilitating sustained contact between viable neutrophils and CD4 lymphocytes. The minimal effect of GM-CSF on HLA-DR expression by neutrophils of elite controllers provides indirect support for this conclusion."
Darunavir working well for highly treatment-experienced patients in Switzerland
aidsmap.com: "Outcomes for treatment-experienced patients receiving “salvage therapy” that includes the protease inhibitor darunavir are equal to, or even better, than those seen in clinical trials, Swiss investigators report in the online edition of HIV Medicine."
Low Cost HIV/AIDS Drugs to be Available by Oct-End
news.outlookindia.com: "'Two Indian pharma companies will partner to manufacture medicines on HIV/AIDS produced by foreign companies following which the the cost would reduce by 75 to 99 per cent compared to the international market. They will be launched during the 3rd National Conference of AIDS Society of India (ASICON 2010) to be held in Hyderabad from October 29,' the society's secretary I S Gilada said."
October 25, 2010
Diabetes Care Misses Mark in HIV Patients
IDSA from MedPage Today: "In scrutinizing how well different types of doctors did in providing routine care, researchers found that only doctors at a Canadian endocrinology clinic came anywhere near meeting treatment benchmarks.
"For example, when it came to foot examinations -- a key part of diabetes surveillance -- the check was done less than 20% of the time at a Toronto immunodeficiency clinic and an American HIV clinic; about 35% of the time at an American primary care clinic; about 65% of the time at an American endocrinology clinic, and about 90% of the time at the Canadian endocrinology clinic."
"For example, when it came to foot examinations -- a key part of diabetes surveillance -- the check was done less than 20% of the time at a Toronto immunodeficiency clinic and an American HIV clinic; about 35% of the time at an American primary care clinic; about 65% of the time at an American endocrinology clinic, and about 90% of the time at the Canadian endocrinology clinic."
Swiss drug policy should serve as model: experts | Reuters
Reuters: "'The number of drug injectors with HIV has been reduced by over 50 percent in 10 years. Overdose mortality among injectors has been reduced by over 50 percent in the decade,' he said. 'Delinquency related to drugs has been reduced enormously.'
"Family doctors now prescribe about 60 percent of opiate substitution treatment in Switzerland and the Internet was vital in informing users about access to treatment, Uchtenhagen added."
"Family doctors now prescribe about 60 percent of opiate substitution treatment in Switzerland and the Internet was vital in informing users about access to treatment, Uchtenhagen added."
October 23, 2010
Antiretroviral Drug Raltegravir May Inhibit Herpes Virus Replication
HIVandHepatitis.com: "SUMMARY: Researchers in Spain have uncovered the structure of a protein complex that enables herpes viruses such as cytomegalovirus (CMV) to package their DNA into new viral particles as it replicates. As reported in the September 14, 2010 Proceedings of the National Academy of Sciences, they also found that the HIV integrase inhibitor raltegravir (Isentress) can bind to the herpes protein complex and interfere with its activity. If confirmed in future studies, raltegravir or related drugs might be active against all members of the herpes family, including the viruses that cause genital herpes simplex, shingles, and Kaposi's sarcoma."
October 22, 2010
[HIV cure 2nd among 18 policy priorities: NMAC]
National Minority AIDS Coalition: "I recently asked you to tell me your policy priorities; an overwhelming number selected Fixing AIDS Drug Assistance Program (ADAP) as the first priority. Please see the results of this survey:
1. Fixing ADAP: 484
2. HIV Cure: 373
3. Test & Treat: 360
4. HIV Prevention Targeting Women: 312
5. HIV Prevention Targeting Gay: 311
6. Medical Infrastructure: 307
7. HIV Prevention Media Campaign: 298
8. Housing: 282
9. NHAS: 229
10.Research: 202
11.Global HIV Treatment: 196
12.HIV Prevention Targeting Trans Community: 179
13.HIV Prevention Targeting Drug Users: 177
14.Vaccines: 173
15.Global Fund: 159
16.Global HIV Prevention: 151
17.Microbicides: 139
18.Prep:102"
1. Fixing ADAP: 484
2. HIV Cure: 373
3. Test & Treat: 360
4. HIV Prevention Targeting Women: 312
5. HIV Prevention Targeting Gay: 311
6. Medical Infrastructure: 307
7. HIV Prevention Media Campaign: 298
8. Housing: 282
9. NHAS: 229
10.Research: 202
11.Global HIV Treatment: 196
12.HIV Prevention Targeting Trans Community: 179
13.HIV Prevention Targeting Drug Users: 177
14.Vaccines: 173
15.Global Fund: 159
16.Global HIV Prevention: 151
17.Microbicides: 139
18.Prep:102"
Merck Announces Expanded Co-Pay Assistance Program for ISENTRESS® (raltegravir)
Merck: "Merck today announced an enhanced co-pay assistance program for people living with HIV-1 who are taking the Company's first-in-class HIV-1 integrase inhibitor, ISENTRESS® (raltegravir) Tablets. The program provides important savings for privately-insured patients with out-of-pocket costs for ISENTRESS, and is part of Merck’s ongoing commitment to providing access to treatment."
City Restores HIV/AIDS Cut
WSJ.com: "Advocates for the programs' recipients—formerly homeless New Yorkers with HIV/AIDS who suffer from mental-health and substance-abuse problems—said they were pleased with the partial restoration. But they faulted the mayor for proposing the cut in the first place."
Elite Controllers Display Higher Activation on Central Memory CD8 T Cells Than HIV Patients Successfully on HAART
AIDS Research and Human Retroviruses: "Factors other than the size of the viral reservoir should explain the high level of activation of central memory CD8 T cells characteristically seen in HIV individuals with spontaneous control of viral replication."
Comment: It seems likely that this immune activation is helping these patients control HIV.
Comment: It seems likely that this immune activation is helping these patients control HIV.
Norvir-Boosted Invirase May Cause Dangerous Heart Rhythms
POZ: "The combination of Norvir (ritonavir)–boosted Invirase (saquinavir) may be associated with a life-threatening side effect on the heart, according to new changes to Invirase’s prescribing information announced by the FDA on Thursday, October 21, and reported by PR Newswire. The prescribing information changes follow a preliminary announcement in February describing a potential link between Norvir/Invirase and heart rhythm disturbances."
Guidelines for treatment of syphilis in patients with HIV have very poor evidence base
Aidsmap: "Current guidelines for the treatment of syphilis in patients with HIV are based on limited clinical data, investigators show in the online edition of Sexually Transmitted Infections.
"Even though their systematic review had broad inclusion criteria, they were only able to identify 23 studies examining the outcomes of HIV-positive patients treated for syphilis. Only two of these studies were rated as “high quality” by the investigators.
"Rates of treatment failure varied considerably, and were as high as 31% for latent syphilis. However, the investigators believe that confounding factors rather than the poor efficacy of treatment are the likely explanation for this."
"Even though their systematic review had broad inclusion criteria, they were only able to identify 23 studies examining the outcomes of HIV-positive patients treated for syphilis. Only two of these studies were rated as “high quality” by the investigators.
"Rates of treatment failure varied considerably, and were as high as 31% for latent syphilis. However, the investigators believe that confounding factors rather than the poor efficacy of treatment are the likely explanation for this."
Darunavir Outcomes Study: Comparative Effectiveness of Virologic Suppression, Regimen Durability, and Discontinuation Reasons for Three-Class Exper...
AIDS Research and Human Retroviruses:: "Introduction: Several new antiretroviral (ARV) agents for treatment experienced HIV-infected patients have been approved since June 2006, including darunavir (DRV) and raltegravir (RAL). While efficacious in clinical trials, the effectiveness, durability, and tolerability of these new ARVs remains understudied in the context of routine clinical care. ...
"Discussion: Among those highly ARV-experienced, regimens containing DRV/r and/or RAL were more likely to achieve 48-week VL <400c/ml and exhibited a trend towards prolonged durability. New agents have transformed the treatment landscape for ARV-experienced patients, with effectiveness in routine clinical care mirroring efficacy in clinical trials."
"Discussion: Among those highly ARV-experienced, regimens containing DRV/r and/or RAL were more likely to achieve 48-week VL <400c/ml and exhibited a trend towards prolonged durability. New agents have transformed the treatment landscape for ARV-experienced patients, with effectiveness in routine clinical care mirroring efficacy in clinical trials."
Low-dose aspirin lowers colon cancer risk: UK study
Reuters: "They found that aspirin reduced the number of cases of colorectal cancer by a quarter and cut colon cancer deaths by a third."
October 20, 2010
New HIV Eradication Study in Progress
AIDSmeds: "Cytheris has announced the launch and recruitment of a new Phase II study of the company’s interleukin-7 (IL-7) drug—combined with the entry inhibitor Selzentry (maraviroc) and the integrase inhibitor Isentress (raltegravir)—with the goal of eradicating HIV."
Switch from efavirenz or AZT associated with improvement in vitamin D levels
Aidsmap: "Switching antiretroviral treatment from efavirenz or AZT was associated with an improvment in vitamin D levels, investigators report in the online edition of AIDS Research and Human Retroviruses. Calendar month and black race were also associated with vitamin deficiency.
"Vitamin D levels increased significantly after patients stopped therapy with efavirenz or AZT and switched to treatment based on the protease inhibitor darunavir (Prezista) boosted by ritonavir.
"'The association between use of efavirenz and vitamin D deficiency is consistent with previous cross-sectional and prospective studies', comment the investigators. They add, 'to our knowledge, this is the first report to show rises in vitamin D levels after switching efavirenz-based antiretroviral treatment to PI [protease inhibitor]-based treatment.'"
"Vitamin D levels increased significantly after patients stopped therapy with efavirenz or AZT and switched to treatment based on the protease inhibitor darunavir (Prezista) boosted by ritonavir.
"'The association between use of efavirenz and vitamin D deficiency is consistent with previous cross-sectional and prospective studies', comment the investigators. They add, 'to our knowledge, this is the first report to show rises in vitamin D levels after switching efavirenz-based antiretroviral treatment to PI [protease inhibitor]-based treatment.'"
$7.5M grant to fund research on interaction of drinking and HIV infection
Science News: "... for people carrying the virus, alcohol consumption can become particularly perilous in intricate ways that are only beginning to be understood. At the Brown Alcohol Research Center on HIV (ARCH) funded by a new $7.5-million, five-year grant from the National Institutes of Health, Brown University scientists will study the health effects of drinking with HIV and provide doctors and patients with the latest guidance their results suggest."
UIC Receives $7 Million Grant to Test and Treat Inmates for HIV
Newswise: "The University of Illinois at Chicago has received a $7 million grant from the National Institutes of Health to study effective ways to seek, test, and treat inmates with HIV.
"The project is led by researchers from the UIC School of Public Health, the UIC College of Medicine and the Cook County Jail."
"The project is led by researchers from the UIC School of Public Health, the UIC College of Medicine and the Cook County Jail."
October 19, 2010
CDC: 1 in 22 blacks will get HIV
USATODAY.com: "Health officials estimate that 1 in 22 black Americans will be diagnosed with the AIDS virus in their lifetime — more than twice the risk for Hispanics and eight times that of whites.
"The Centers for Disease Control and Prevention reported the numbers Thursday. The report says the lifetime risk is 1 in 52 for Hispanics, and 1 in 170 for whites.
"Asian-Americans had the lowest lifetime risk, at about 1 in 222."
"The Centers for Disease Control and Prevention reported the numbers Thursday. The report says the lifetime risk is 1 in 52 for Hispanics, and 1 in 170 for whites.
"Asian-Americans had the lowest lifetime risk, at about 1 in 222."
ASIA: Laws driving HIV prevention underground
IRIN Asia: "In a region where carrying a condom has been construed as evidence of illicit activity, 10 million women sell sex to 75 million men, who then have sex with another 50 million people, according to the multinational Independent Commission on AIDS in Asia.
"'The technology is there to prevent infections, but punitive laws get in the way,' said Steve Kraus, regional director of UNAIDS Asia Pacific."
"'The technology is there to prevent infections, but punitive laws get in the way,' said Steve Kraus, regional director of UNAIDS Asia Pacific."
Early HIV Treatment May Help Prevent Irreversible Immune System Damage
The AIDS Beacon: "Results of a new study suggest that people with HIV who begin antiretroviral therapy soon after infection may better retain the ability to fight off other infectious diseases than people who begin treatment later.
“Our work…suggest[s] that more clinical trials should be aimed at comparing early-treated and chronic-treated patients by a variety of different immunologic parameters,” said Dr. Susan Moir, lead author of the study, in correspondence with The AIDS Beacon.
"The findings shed light on a group of immune cells called B cells and how early initiation of antiretroviral therapy (ART) may help prevent irreversible damage to the immune system."
“Our work…suggest[s] that more clinical trials should be aimed at comparing early-treated and chronic-treated patients by a variety of different immunologic parameters,” said Dr. Susan Moir, lead author of the study, in correspondence with The AIDS Beacon.
"The findings shed light on a group of immune cells called B cells and how early initiation of antiretroviral therapy (ART) may help prevent irreversible damage to the immune system."
Computer Modelling System Predicts Response to Antiretroviral Treatment
HIVandHepatitis.com: "SUMMARY: A U.K. not-for-profit research group last week announced the availability of a new, free web-based system to help healthcare providers predict which antiretroviral therapy (ART) regimen is most likely to work for a particular patient, based on an analysis of drug-resistance data. The HIV Treatment Response Prediction System (HIV-TRePS), which has an estimated accuracy of 80%, is available online at http://www.hivrdi.org."
October 17, 2010
Low Vitamin D Not Linked to Bone Density or Liver Fibrosis in HIV/HCV Group
NATAP: "Although more than 40% of 116 people coinfected with HIV and hepatitis C virus (HCV) had low vitamin D levels in a prospective cohort study, low D did not correlate with either bone mineral density or liver fibrosis [1]. Researchers from Johns Hopkins University believe their findings 'suggest that efforts to increase vitamin D levels in this population may not improve bone or liver outcomes.'"
Comment: Regardless of how this turns out, there are other reasons for supplementing vitamin D, including prevention of some cancers.
Comment: Regardless of how this turns out, there are other reasons for supplementing vitamin D, including prevention of some cancers.
October 16, 2010
Adding drugs to already successful HIV treatment doesn't reduce viral load further
aidsmap: "Intensifying effective HIV therapy with the addition of an extra drug that crosses the blood-brain barrier does not reduce residual levels of viral replication in cerebrospinal fluids or the blood, an international team of investigators report in the online edition of the Journal of Acquired Immune Deficiency Symdromes.
"The researcher also found that patients continued to have evidence of immune activation and inflammation in the brain."
"The researcher also found that patients continued to have evidence of immune activation and inflammation in the brain."
October 15, 2010
Mediterranean diet may trim diabetes risk
Reuters: "In a study of 418 older Spanish adults, researchers found that those instructed to follow a Mediterranean diet were less likely to develop diabetes over four years than those instructed to follow a low-fat diet -- about 10 percent developed the disease, versus 18 percent in the low-fat group. And weight loss did not appear necessary to gain the benefit."
Comment: This was not an HIV study.
Comment: This was not an HIV study.
Bone Loss and Low Vitamin D Levels Are Common among People with HIV
HIVandHepatitis.com: "'Despite the low latitude and high number of sunny days of Spain, moderate vitamin D deficiency in HIV-infected patients is more prevalent in our cohort than in the cohorts of Switzerland, Netherlands and Boston, in which there should be a lower level of exposure to sunlight,' the researchers noted in an ICAAC press release.
"'Since low vitamin D has been related to increased risk of infections, of several malignancies, and with higher cardiovascular risk, studies should be carried out to analyze the impact of vitamin D on the increase of CD4 counts, and on the reduction of cardiovascular episodes, infectious complications, and malignant neoplasias in HIV-infected population[s],' they added."
"'Since low vitamin D has been related to increased risk of infections, of several malignancies, and with higher cardiovascular risk, studies should be carried out to analyze the impact of vitamin D on the increase of CD4 counts, and on the reduction of cardiovascular episodes, infectious complications, and malignant neoplasias in HIV-infected population[s],' they added."
Negative Influence of HIV Infection on Day-Night Blood Pressure Variability
JAIDS Journal of Acquired Immune Deficiency Syndromes: "Conclusions: HIV infection per se negatively affects circadian BP [blood pressure] rhythm. These findings, obtained in subjects without major CV [cardiovascular] risk factors and antiretroviral naive, suggest that day-night BP changes may play a role in the HIV-related increase in CV risk."
Negative Influence of HIV Infection on Day-Night Blood Pressure Variability
JAIDS Journal of Acquired Immune Deficiency Syndromes: "Conclusions: HIV infection per se negatively affects circadian BP [blood pressure] rhythm. These findings, obtained in subjects without major CV [cardiovascular] risk factors and antiretroviral naive, suggest that day-night BP changes may play a role in the HIV-related increase in CV risk."
Inflammation and Mortality in HIV-Infected Adults: Analysis of the FRAM Study Cohort
JAIDS Journal of Acquired Immune Deficiency Syndromes: "Over a 5-year period, HIV-infected participants with fibrinogen levels in the highest tertile [highest third of the patients] (>406 mg/dL) had 2.6-fold higher adjusted odds of death than those with fibrinogen in the lowest tertile (<319 mg/dL). Those with high CRP (>3 mg/L) had 2.7-fold higher adjusted odds of death than those with CRP <1 mg/L. ...
"Conclusions: Fibrinogen and CRP are strong and independent predictors of mortality in HIV-infected adults. Our findings suggest that even in those with relatively preserved CD4 counts >500 cells per microliter, inflammation remains an important risk factor for mortality. Further investigation should determine whether interventions to reduce inflammation might decrease mortality risk in HIV-infected individuals."
"Conclusions: Fibrinogen and CRP are strong and independent predictors of mortality in HIV-infected adults. Our findings suggest that even in those with relatively preserved CD4 counts >500 cells per microliter, inflammation remains an important risk factor for mortality. Further investigation should determine whether interventions to reduce inflammation might decrease mortality risk in HIV-infected individuals."
Attorney General Holder is Wrong to Oppose California’s Marijuana Initiative
Marijuana Policy Project: "The truth is that the use of marijuana — a substance far less harmful than alcohol or tobacco — is widespread in this country and nothing the government can do will ever stop that. The only question is how we structure the market for marijuana so that it is best for society. Will we have marijuana sold in licensed, tax-paying and regulated stores or will we continue to have it sold in a completely unregulated market that makes it more available to teens? Will we impose standards so that purchasers know the quality and purity of the marijuana they are buying or will we keep it in a far less safe unregulated market? Will we have the profits from the sale of marijuana go to legitimate taxpaying American business owners or will they go to underground dealers and cartels who will pay no taxes and defend their interests through violence? ...
"States are the laboratories of our democracy. California voters have an opportunity this November to choose an alternative to the failed policies of marijuana prohibition. Sadly, Attorney General Holder is trying to deny them that chance before the election even takes place."
"States are the laboratories of our democracy. California voters have an opportunity this November to choose an alternative to the failed policies of marijuana prohibition. Sadly, Attorney General Holder is trying to deny them that chance before the election even takes place."
ViiV Healthcare Expands HIV Drug Access Programs
POZ: "First, the company has promised to extend its co-pay assistance program for two more years. The co-payment program covers the first $100 of a person’s co-payment for each ViiV medication.
"The program will now also be available to people residing in Puerto Rico.
"Second, the company’s PAP will now be available to people with higher incomes than before. Previously, the program was only available to a rather small segment of uninsured people who made just a bit too much to qualify for Medicaid. ViiV is raising the income limit to join the program from 250 percent of the federal poverty level (FPL)—about $13,000 per year for a single person—to 500 percent of FPL.
"Third, ViiV has joined, on a pilot basis, a joint program between the nonprofit Welvista organization and the pharmaceutical industry to easily and quickly provide free HIV medications to people on ADAP waiting lists. The Welvista program was built to ensure that these people don’t fall through the cracks and forgo needed ARV treatment."
"The program will now also be available to people residing in Puerto Rico.
"Second, the company’s PAP will now be available to people with higher incomes than before. Previously, the program was only available to a rather small segment of uninsured people who made just a bit too much to qualify for Medicaid. ViiV is raising the income limit to join the program from 250 percent of the federal poverty level (FPL)—about $13,000 per year for a single person—to 500 percent of FPL.
"Third, ViiV has joined, on a pilot basis, a joint program between the nonprofit Welvista organization and the pharmaceutical industry to easily and quickly provide free HIV medications to people on ADAP waiting lists. The Welvista program was built to ensure that these people don’t fall through the cracks and forgo needed ARV treatment."
People with HIV not developing cancers at younger age than rest of population
aidsmap: "People with AIDS are not developing most non-HIV-related cancers at a younger age than individuals in the general population, US investigators report in the October 5th edition of the Annals of Internal Medicine.
"The investigators noted significant structural differences in the ages of those with AIDS and patients in the general population. Once adjustment was made for these differences, the investigators found that the age at which individuals with AIDS developed many non-HIV-related cancers was broadly comparable to that observed in the general population."
"The investigators noted significant structural differences in the ages of those with AIDS and patients in the general population. Once adjustment was made for these differences, the investigators found that the age at which individuals with AIDS developed many non-HIV-related cancers was broadly comparable to that observed in the general population."
Persistence of Racial Differences in Attitudes Toward Homosexuality in the United States
JAIDS Journal of Acquired Immune Deficiency Syndromes: "Among MSM, twice as many black MSM reported that homosexuality is 'always wrong' compared with white MSM (57.1% versus 26.8%, P = 0.003). MSM with unfavorable attitudes toward homosexuality were less likely to report ever testing for HIV compared with MSM with more favorable attitudes (relative risk, 0.50; 95% confidence interval, 0.31 to 0.78).
Conclusions: US attitudes toward homosexuality are characterized by persistent racial differences, which may help explain disparities in HIV infection rates between black and white MSM."
Conclusions: US attitudes toward homosexuality are characterized by persistent racial differences, which may help explain disparities in HIV infection rates between black and white MSM."
Low prevalence of end-stage kidney disease in European HIV patients
[September 15]aidsmap: "Only 0.5% of patients had irreversible kidney damage requiring dialysis or transplant. Most of the patients were young, black men. Only a third of patients on dialysis were considered candidates for a kidney transplant. The most common reason for exclusion was poor control of HIV."
Federal Employees Can Purchase Health Insurance For Their Pets, But Not Their Same-Sex Partners
WonkRoom: "The insurance is a handsome perk for those who can afford it, but what’s illuminating about the ad is that while federal employees can buy pet insurance 'in these challenging economic times,' LGBT workers are still prohibited from purchasing policies for their partners or spouses by the Defense of Marriage Act (DOMA) — a federal law which denies federal benefits to legally married same sex couples."
How HIV Prevention Has to Change
amfAR: "Domestic HIV prevention receives only about 3% of total federal HIV spending."
New look at multitalented protein sheds light on mysteries of HIV
EurakAlert!: "'A better understanding of Gag's behavior might allow researchers to develop antiviral drugs that target the HIV assembly process, which remains unassailed by medical science,' says Hirsh Nanda, a postdoctoral researcher at the NIST Center for Neutron Research (NCNR) and a member of the multi-institutional research team. 'Our method might reveal how to inhibit new viruses as they grow.'"
WHO Updates HIV Treatment Guidelines for Women and Infants
AIDSmeds: "The new WHO guidelines recommend that HIV-positive women who received single-dose regimen be subsequently treated with a regimen that doesn’t contain Viramune. However, because the danger for Viramune treatment failure diminishes over time, the guidelines also state that a Viramune-based regimen may be used in such women—if they start that regimen at least one year after receiving single-dose Viramune during the birthing process.
The new guidelines also give recommendations for treating infants who contract HIV despite receiving single-dose Viramune immediately after birth. In these infants, a subsequent treatment regimen should include Kaletra (lopinavir plus ritonavir) rather than Viramune."
The new guidelines also give recommendations for treating infants who contract HIV despite receiving single-dose Viramune immediately after birth. In these infants, a subsequent treatment regimen should include Kaletra (lopinavir plus ritonavir) rather than Viramune."
Low CD4 cell count associated with heart attack in patients with HIV
aidsmap: "“We demonstrate that decreased CD4 cell count is significantly associated with an increased risk of myocardial infarction and is second only to hypertension in terms of its effect size as a risk factor”, comment the investigators. They add that a CD4 cell count below 200 cells/mm3 was a much more important risk factor for heart attack than treatment with any antiretroviral drug. Indeed, the investigators failed to find a significant relationship between any antiretroviral and an increased risk of heart attack."
October 14, 2010
The MMP1 (-16071G/2G) single nucleotide polymorphism associates with the HAART-related lipodystrophic syndrome
AIDS:"MMP1 SNP, which induced increased serum levels of this protein, was associated with lipodystrophic syndrome."
Comment: This genetic test might be able to tell in advance who is more susceptible to lipodystrophy from HAART.
Comment: This genetic test might be able to tell in advance who is more susceptible to lipodystrophy from HAART.
Virologic and immunologic response to HAART, by age and regimen class
AIDS: "We found no evidence of an interaction between age and initial antiretroviral regimen on virologic or immunologic response to HAART; however, decreased immunologic response with increasing age may have implications for age-specific when-to-start guidelines."
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