"KAMPALA, Uganda—Ninsiima Agatha, a 20-year-old mother of two, showed up at a medical clinic here last month, weak, coughing, and desperate to save herself and her two children. She had just discovered that her husband was infected with HIV—and now she had the virus too. If she didn't get access to life-saving drugs quickly, she could easily pass the disease to the baby she was breast-feeding.
"But the staff at the Joint Clinical Research Centre had to tell her the bad news. Even though her husband, a clothes merchant with a girlfriend on the side, was already receiving the so-called AIDS cocktail of drugs elsewhere, there would be none for her. The clinic had enrolled its full quota of patients under its contract with the U.S. government. Ms. Agatha, sprawled on a hospital bed with a toddler and an infant, could barely move. "I feel desperate," she said."
Read more in Wall Street Journal, January 30, 2010.
|
January 30, 2010
Vaccine stops TB in African HIV trial
"An experimental vaccine helps prevent tuberculosis in people infected with HIV, researchers have found.
"The Mycobacterium vaccae, or MV vaccine, reduced the rate of tuberculosis by 39 per cent among 2,000 people infected with HIV in Tanzania, researchers said in Friday's online issue of the journal AIDS.
"Tuberculosis accounts for up to a third of AIDS deaths worldwide, and TB worsens HIV, according to the World Health Organization."
Read more in CBC News, January 29, 2010.
"The Mycobacterium vaccae, or MV vaccine, reduced the rate of tuberculosis by 39 per cent among 2,000 people infected with HIV in Tanzania, researchers said in Friday's online issue of the journal AIDS.
"Tuberculosis accounts for up to a third of AIDS deaths worldwide, and TB worsens HIV, according to the World Health Organization."
Read more in CBC News, January 29, 2010.
January 29, 2010
Neuron breakthrough offers hope on Alzheimer’s and Parkinson’s
"Neurons have been created directly from skin cells for the first time, in a remarkable study that suggests that our biological makeup is far more versatile than previously thought.
"If confirmed, the discovery that one tissue type can be genetically reprogrammed to become another, could revolutionise treatments for conditions such as Parkinson’s disease and Alzheimer’s, opening up the possibility of turning a patient’s own skin cells into the neurons that they need.
"The study by scientists from Stanford University, California, also suggests that skin cells could be reprogrammed to provide a limitless supply of blood or bone marrow for personalised transfusions."
Read more in Times Online (UK), January 28, 2010.
"If confirmed, the discovery that one tissue type can be genetically reprogrammed to become another, could revolutionise treatments for conditions such as Parkinson’s disease and Alzheimer’s, opening up the possibility of turning a patient’s own skin cells into the neurons that they need.
"The study by scientists from Stanford University, California, also suggests that skin cells could be reprogrammed to provide a limitless supply of blood or bone marrow for personalised transfusions."
Read more in Times Online (UK), January 28, 2010.
January 28, 2010
Long-Lasting HIV Nucleoside Analogue in Development
"A research team from the University of Missouri at Columbia is developing a novel nucleoside reverse transcriptase inhibitor (NRTI) that remains active against HIV for days after a single dose, according to a report published online by ScienceDaily. Stefan Sarafianos, PhD, who heads to the MU team, said the compound is more potent and longer-lasting than current NRTIs and may find use not only as a component of antiretroviral (ARV) therapy but also as a preventive microbicide.
"'This new compound, EFdA, is 60,000 times more potent than any other drug that is currently being used to treat HIV,' said Sarafianos, assistant professor of microbiology and immunology in the MU School of Medicine and an investigator in the Christopher Bond Life Sciences Center. 'This compound has a different chemical makeup than other approved therapies and creates an exceptional amount of antiviral activity. EFdA is activated very quickly and stays long in the body to fight the virus and protect from infection.'"
Read more in POZ, January 28, 2010.
"'This new compound, EFdA, is 60,000 times more potent than any other drug that is currently being used to treat HIV,' said Sarafianos, assistant professor of microbiology and immunology in the MU School of Medicine and an investigator in the Christopher Bond Life Sciences Center. 'This compound has a different chemical makeup than other approved therapies and creates an exceptional amount of antiviral activity. EFdA is activated very quickly and stays long in the body to fight the virus and protect from infection.'"
Read more in POZ, January 28, 2010.
Premature Aging of the Brain Seen in HIV Patients
"It's not clear if the virus or the drugs that treat it -- or both -- are contributing to the aging. But one thing is clear: The blood flow in HIV patients is about the same as in those of uninfected people who are 15 to 20 years older. ...
"In the study, researchers used MRI scans to study the blood flow in the brains of 26 HIV-infected people and 25 other people who weren't infected. The average age and education level of the participants were similar.
"The researchers found reduced blood flow in the brains of younger HIV-infected patients who were infected recently, not just the older ones."
Read more in Healthfinder.gov, January, 2010.
"In the study, researchers used MRI scans to study the blood flow in the brains of 26 HIV-infected people and 25 other people who weren't infected. The average age and education level of the participants were similar.
"The researchers found reduced blood flow in the brains of younger HIV-infected patients who were infected recently, not just the older ones."
Read more in Healthfinder.gov, January, 2010.
January 27, 2010
Genetic marker predicts fat loss due to d4T in Thai patients
"A genetic marker can predict with a high level of accuracy whether Thai patients receiving antiretroviral therapy that contains d4T (stavudine) will develop lipoatrophy (subcutaneous fat loss) as a result of treatment, researchers from Thailand and Japan report in Clinical Infectious Diseases this week.
"Lipoatrophy – fat loss from the limbs, face and buttocks - is a frequent side-effect of antiretroviral therapy that contains d4T, and to a lesser extent AZT (zidovudine).
"Around 40% of patients develop this side-effect after two to three years of treatment, and for this reason d4T has been dropped as a component of first-line treatment in Europe, North America and other well-resourced settings."
Read more in Aidsmap, January 26, 2010.
"Lipoatrophy – fat loss from the limbs, face and buttocks - is a frequent side-effect of antiretroviral therapy that contains d4T, and to a lesser extent AZT (zidovudine).
"Around 40% of patients develop this side-effect after two to three years of treatment, and for this reason d4T has been dropped as a component of first-line treatment in Europe, North America and other well-resourced settings."
Read more in Aidsmap, January 26, 2010.
January 26, 2010
Obama Seeks Freeze on Many Domestic Programs
"President Obama will call for a three-year freeze in spending on many domestic programs, and for increases no greater than inflation after that, an initiative intended to signal his seriousness about cutting the budget deficit, administration officials said Monday."
Read more in New York Times, January 25, 2010.
Comment: We just emailed the following comment to the New York Times:
"This is crazy -- playing politics with the economy in the middle of a very serious crisis.
"After stuffing hundreds of billions into Wall St. for bonuses, now it's time to abandon homeowners, the unemployed, and much of the middle class."
Note: Most email comments to the New York Times are published.
Also, you can have influence without writing -- by recommending the comments you like.
People all over the world read these comments, and note the recommendations.
Read more in New York Times, January 25, 2010.
Comment: We just emailed the following comment to the New York Times:
"This is crazy -- playing politics with the economy in the middle of a very serious crisis.
"After stuffing hundreds of billions into Wall St. for bonuses, now it's time to abandon homeowners, the unemployed, and much of the middle class."
Note: Most email comments to the New York Times are published.
Also, you can have influence without writing -- by recommending the comments you like.
People all over the world read these comments, and note the recommendations.
Prevalence and Impact of Body Physical Changes in HIV Patients Treated with Highly Active Antiretroviral Therapy: Results from a Study on Patient and Physician Perceptions
"This study reflects the high prevalence of patient and physician-perceived BPC [physical body changes] in the HIV population, and the adverse impact on daily life. Physicians should be aware of the psychosocial consequences of BPC in HIV patients in order to improve patient well-being."
Read more in AIDS Patient Care and STDs, January 24, 2010.
Read more in AIDS Patient Care and STDs, January 24, 2010.
January 23, 2010
Preliminary data from Phase 1 study of Sangamo BioSciences' SB-728-T announced
"Sangamo BioSciences, Inc. (Nasdaq: SGMO) announced today that preliminary data from the University of Pennsylvania investigator sponsored Phase 1 safety study of Sangamo's zinc finger nuclease (ZFN) based product, SB-728-T, for HIV/AIDS were presented on Friday, January 15, 2010 at the Keystone Symposium Session "HIV Biology and Pathogenesis." Sangamo's collaborator, Carl June, M.D., Director of Translational Research at the Abramson Family Cancer Research Institute at the University of Pennsylvania School of Medicine, presented the data as an invited speaker in an NIAID Workshop entitled "The Next Challenge: Elimination of HIV Reservoirs."
"While only representative of a single individual in the trial, these data are very exciting," said Dr. June. "They demonstrate that the ZFN-modified T-cells were well tolerated by the body and persisted in the circulation at stable levels for the duration of our monitoring. In fact, we calculate that more ZFN-modified cells were present at 20 weeks than were initially infused. Total CD4+ T-cell counts were also stable during this time. Interestingly, we also observed ZFN-modified cells in the gut associated lymphoid tissue (GALT) which is a major reservoir of immune cells and a critical reservoir of HIV infection and suggests that the modified cells are functioning and trafficking normally in the body."
Read more in The Medical News, January 20, 2010.
"While only representative of a single individual in the trial, these data are very exciting," said Dr. June. "They demonstrate that the ZFN-modified T-cells were well tolerated by the body and persisted in the circulation at stable levels for the duration of our monitoring. In fact, we calculate that more ZFN-modified cells were present at 20 weeks than were initially infused. Total CD4+ T-cell counts were also stable during this time. Interestingly, we also observed ZFN-modified cells in the gut associated lymphoid tissue (GALT) which is a major reservoir of immune cells and a critical reservoir of HIV infection and suggests that the modified cells are functioning and trafficking normally in the body."
Read more in The Medical News, January 20, 2010.
January 22, 2010
Subtle changes in immune system soon after HIV infection show who may benefit from earlier treatment
"'Immunologic disturbances…are established early in HIV infection and are observed even among subjects with relatively preserved CD4 cell counts', write the investigators, who also note that 'the magnitude of these disturbances correlate with progression.'"
Read more in Aidsmap, January 21, 2010.
Read more in Aidsmap, January 21, 2010.
Why Your DNA Isn't Your Destiny
"DNA, we thought, was an ironclad code that we and our children and their children had to live by. Now we can imagine a world in which we can tinker with DNA, bend it to our will. It will take geneticists and ethicists many years to work out all the implications, but be assured: the age of epigenetics has arrived."
Read more in Time, January 6, 2010.
Comment: Not directly about HIV, but worth knowing.
Read more in Time, January 6, 2010.
Comment: Not directly about HIV, but worth knowing.
January 21, 2010
Prospective, Randomized, Open Label Trial of Efavirenz vs Lopinavir/Ritonavir in HIV+ Treatment-Naive Subjects With CD4+ (less than) 200 cell/mm3 in Mexico
"Conclusions: In these very advanced HIV-infected ARV-naive subjects, EFV-based highly active antiretroviral therapy had superior virologic efficacy than LPV/r-based highly active antiretroviral therapy, with a more favorable lipid profile."
Read more in JAIDS, January 20, 2010.
Read more in JAIDS, January 20, 2010.
Organisations with HIV-specific experience in Haiti seek donations, volunteers for relief efforts
"Several organisations which have been at the forefront of providing HIV treatment and care in Haiti are seeking donations to support earthquake relief efforts. These organisations already have extensive experience of providing health care in Haiti, and are seeking to step up their activities in order to mitigate the extensive damage caused by last week’s devastating earthquake.
"Partners in Health has been working in Haiti for nearly 20 years, and has over 100 doctors, 600 nurses and 4000 employees on the ground in Haiti working from 10 existing Partners in Health hospitals to provide relief services to those affected by last week’s earthquake and is urgently seeking donations and medical volunteers; visit www.standwithhaiti.org/haiti for further information."
Read more in Aidsmap, January 19, 2010.
"Partners in Health has been working in Haiti for nearly 20 years, and has over 100 doctors, 600 nurses and 4000 employees on the ground in Haiti working from 10 existing Partners in Health hospitals to provide relief services to those affected by last week’s earthquake and is urgently seeking donations and medical volunteers; visit www.standwithhaiti.org/haiti for further information."
Read more in Aidsmap, January 19, 2010.
Risk of kidney problems argues for 'strategic' use of tenofovir in higher risk patients
"Treatment with tenofovir causes long-term declines in kidney function, US investigators report in the January 1st edition of the Journal of Acquired Immune Deficiency Syndromes.
"Their retrospective cohort study, which monitored patients for over two years, found that those taking tenofovir had more evidence of kidney dysfunction than individuals taking other antiretroviral drugs."
Read more in Aidsmap, January 19, 2010.
"Their retrospective cohort study, which monitored patients for over two years, found that those taking tenofovir had more evidence of kidney dysfunction than individuals taking other antiretroviral drugs."
Read more in Aidsmap, January 19, 2010.
January 19, 2010
Fish oil slows burn of genetic fuse in ageing, say scientists
"Fish oil may be the true elixir of youth, according to new evidence of its effect on biological ageing. Omega-3 fatty acids from fish oil preserve the genetic "fuse" that determines the lifespan of cells, say scientists.
"The discovery, made in heart disease patients, may explain many of the claimed health benefits of omega-3.Fish oil may be the true elixir of youth, according to new evidence of its effect on biological ageing."
Read more in Guardian (UK), January 19, 2010.
"The discovery, made in heart disease patients, may explain many of the claimed health benefits of omega-3.Fish oil may be the true elixir of youth, according to new evidence of its effect on biological ageing."
Read more in Guardian (UK), January 19, 2010.
January 18, 2010
Anal cytology tests useful for detecting pre-cancerous cell changes in patients with HIV
"The investigators believe that their finding that the screening tool is especially accurate in patients with lower CD4 cell counts is important, “given the late diagnosis of HIV in a proportion of people with HIV and further increased risk of anal cancer in this group”. They also note that the accuracy of anal cytology is comparable to cervical cytology.
"Rates of cervical cancer in England fell dramatically after screening programmes were introduced. By contrast, the number of cases of anal cancer diagnosed in recent years has increased. Especially high rates of the disease are seen in HIV-positive individuals.
"Before anal cancer develops, the pre-cancerous lesions form in the anus. These are called anal intraepithelial neoplasia. Prompt diagnosis means that these pre-cancerous changes can be effectively treated."
Read more in Aidsmap, January 18, 2010.
"Rates of cervical cancer in England fell dramatically after screening programmes were introduced. By contrast, the number of cases of anal cancer diagnosed in recent years has increased. Especially high rates of the disease are seen in HIV-positive individuals.
"Before anal cancer develops, the pre-cancerous lesions form in the anus. These are called anal intraepithelial neoplasia. Prompt diagnosis means that these pre-cancerous changes can be effectively treated."
Read more in Aidsmap, January 18, 2010.
Bone loss following onset of menopause may put HIV-positive women at risk for fractures
"Postmenopausal HIV-positive women may be at high risk for fractures because of low bone mineral density (BMD), according to a study appearing in The Journal of Clinical Endocrinology and Metabolism.
"The article reports on significant differences observed by US researchers comparing HIV-positive post-menopausal Hispanic and African-American women to otherwise similar HIV-negative women.
"The HIV-positive cohort had lower BMD than the HIV-negative cohort, and also appeared to be experiencing a faster rate of metabolic change in bone tissue."
Read more in Aidsmap, January 18, 2010.
"The article reports on significant differences observed by US researchers comparing HIV-positive post-menopausal Hispanic and African-American women to otherwise similar HIV-negative women.
"The HIV-positive cohort had lower BMD than the HIV-negative cohort, and also appeared to be experiencing a faster rate of metabolic change in bone tissue."
Read more in Aidsmap, January 18, 2010.
January 17, 2010
Are Patents Impeding Medical Care and Innovation?
"Pharmaceutical and medical device manufacturers argue that the current patent system is crucial for stimulating research and development (R&D), leading to new products that improve medical care. The financial return on their investments that is afforded by patent protection, they claim, is an incentive toward innovation and reinvestment into further R&D. But this view has been challenged in recent years. Many commentators argue that patents are stifling biomedical research, for example by preventing researchers from accessing patented materials or methods they need for their studies. Patents have also been blamed for impeding medical care by raising prices of essential medicines, such as antiretroviral drugs, in poor countries. This debate examines whether and how patents are impeding health care and innovation."
Read more in PLOS Medicine, January 5, 2010.
Read more in PLOS Medicine, January 5, 2010.
January 16, 2010
New Partnership Aims to Tackle DC's HIV/AIDS Epidemic
"This week, NIAID Director Anthony S. Fauci, M.D. and District of Columbia Mayor Adrian Fenty announced the launch of the D.C. Partnership for HIV/AIDS Progress, an ambitious, research-focused initiative designed to address the District’s HIV/AIDS epidemic.
"It’s a much-needed partnership. Our nation’s capital has one of the highest rates of HIV/AIDS in the country with at least 3 percent of the city’s adults and adolescents infected with HIV. The number is likely higher as many may not know they are infected. The African-American community bears the greatest burden of the disease, representing 76 percent of D.C.’s HIV/AIDS cases."
Read more in AIDS.gov, January 15, 2010.
"It’s a much-needed partnership. Our nation’s capital has one of the highest rates of HIV/AIDS in the country with at least 3 percent of the city’s adults and adolescents infected with HIV. The number is likely higher as many may not know they are infected. The African-American community bears the greatest burden of the disease, representing 76 percent of D.C.’s HIV/AIDS cases."
Read more in AIDS.gov, January 15, 2010.
Abacavir, ddI and two protease inhibitors remain associated with heart attacks in largest cohort study
"The latest report on the D:A:D (Data Collection on Adverse Events of Anti-HIV Drugs) Study, the largest cohort study monitoring the effects of HIV drugs, published in the Journal of infectious Diseases, reports a continued association between current or recent use of the two nucleoside (NRTI) drugs abacavir and ddI (didanosine) and heart attacks.
"Patients who were currently on the drugs or who had stopped them no more than six months previously had, respectively, a 70% and 30% increased risk of having a heart attack during this time, even after adjusting for other heart attack risks such as blood lipid level, diabetes and high blood pressure."
Read more in Aidsmap, January 15, 2010.
"Patients who were currently on the drugs or who had stopped them no more than six months previously had, respectively, a 70% and 30% increased risk of having a heart attack during this time, even after adjusting for other heart attack risks such as blood lipid level, diabetes and high blood pressure."
Read more in Aidsmap, January 15, 2010.
New Wave of Transmitted Drug Resistance Predicted for San Francisco
"The number of new HIV infections with virus resistant to HIV drugs known as non-nucleoside reverse transcriptase inhibitors (NNRTIs) could rise significantly in San Francisco and become a self-sustaining epidemic, according to a study published online January 14 in the journal Science and reported by Bloomberg News. The authors also fear that an upswing in transmitted drug-resistant virus could imperil efforts to test and treat nearly everyone living with HIV in developing countries.
"Transmitted drug resistance (TDR) is an ever-present concern for scientists, physicians and people with HIV. When people with drug-resistant HIV pass their virus to others, those newly infected people have fewer treatment options.
Thus far, TDR has remained fairly stable at about 14 percent or less of new infections in many Western countries. About 75 percent of TDR HIV cases in San Francisco involve virus resistant to NNRTIs, such as Sustiva (efavirenz) and Viramune (nevirapine)."
Read more in POZ, January 15, 2010.
Also see Evolutionary Dynamics of Complex Networks of HIV Drug-Resistant Strains: The Case of San Francisco.
"Transmitted drug resistance (TDR) is an ever-present concern for scientists, physicians and people with HIV. When people with drug-resistant HIV pass their virus to others, those newly infected people have fewer treatment options.
Thus far, TDR has remained fairly stable at about 14 percent or less of new infections in many Western countries. About 75 percent of TDR HIV cases in San Francisco involve virus resistant to NNRTIs, such as Sustiva (efavirenz) and Viramune (nevirapine)."
Read more in POZ, January 15, 2010.
Also see Evolutionary Dynamics of Complex Networks of HIV Drug-Resistant Strains: The Case of San Francisco.
January 14, 2010
Proposed Medicare Coverage for Facial Wasting Treatment
"Medicare administrators are offering a proposal to use approved injectable fillers to treat people with HIV who have facial wasting—but only if they provide proof that their facial wasting lead to depression. People may send public comments to Medicare officials on this proposal until January 22."
Read more in POZ, January 14, 2010.
Read more in POZ, January 14, 2010.
Anal Pap Smears About as Effective as Cervical Cancer Screening
"Anal Pap smears are similar to cervical Pap smears in their ability to detect precancerous cells, according to a study published online January 6 in AIDS, and they appear to work better in people with HIV whose CD4 counts are below 400, compared with those with higher CD4s. However, anal Paps are not as effective at finding precancerous cells as an expert visual examination of the anus and rectum through a scope.
"Anal cancer is on the rise in people living with HIV. Anal cancer also occurs at higher rates among people with HIV than among HIV-negative people, even when HIV-positive people have high CD4 cells."
Read more in POZ, January 12, 2010.
"Anal cancer is on the rise in people living with HIV. Anal cancer also occurs at higher rates among people with HIV than among HIV-negative people, even when HIV-positive people have high CD4 cells."
Read more in POZ, January 12, 2010.
January 13, 2010
[Haiti earthquake: Partners in Health needs support]
"Currently, our greatest need is financial support. Haiti is facing a crisis worse than it has seen in years, and it is a country that has faced years of crisis, both natural disaster and otherwise. The country is in need of millions of dollars right now to meet the needs of the communities hardest hit by the earthquake. Our facilities are strategically placed just two hours outside of Port-au-Prince and will inevitably absorb the flow of patients out of the city. In addition, we need cash on-hand to quickly procure emergency medical supplies, basic living necessities, as well as transportation and logistics support for the tens of thousands of people that will be seeking care at mobile field hospitals in the capital city. Any and all support that will help us respond to the immediate needs and continue our mission of strengthening the public health system in Haiti is greatly appreciated. Help us stand up for Haiti now."
Read more in PIH.org, January 13, 2010.
Note: Also see POZ, January 13.
Read more in PIH.org, January 13, 2010.
Note: Also see POZ, January 13.
Switching From Kaletra to Isentress: Benefits and Hazards
"Switching from Kaletra (lopinavir plus ritonavir) to Isentress (raltegravir) when viral load is undetectable might help reduce elevated cholesterol and triglyceride (lipid) levels, but it might also raise the risk of losing control of the virus, according to two studies published online January 13 in The Lancet and reported by MedPage Today."
Read more in POZ, January 13, 2010.
Read more in POZ, January 13, 2010.
Successful Viral Suppression With Subsequent Efavirenz-Based Regimen in HIV-1-Infected Patients Who Stop Nevirapine Prior to Discontinuation of the NRTI Backbone
"Conclusion: The strategy of extended short half-life NRTIs in the regimen after discontinuation of NVP is justified."
Read more in Journal of the International Association of Physicians in AIDS Care (JIAPAC), January 13, 2010.
Read more in Journal of the International Association of Physicians in AIDS Care (JIAPAC), January 13, 2010.
Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis
"Conclusions Angiotensin receptor blockers are associated with a significant reduction in the incidence and progression of Alzheimer’s disease and dementia compared with angiotensin converting enzyme inhibitors or other cardiovascular drugs in a predominantly male population."
Read more in British Medical Journal, January 12, 2010.
Comment: Not an HIV study, but may be relevant for some patients.
Read more in British Medical Journal, January 12, 2010.
Comment: Not an HIV study, but may be relevant for some patients.
January 12, 2010
Perceptions of HIV-Related Websites among Persons Recently Diagnosed with HIV
"Qualitative findings suggested that the most appealing websites to PRDH included those that: (1) provided usable information on topics of immediate concern; (2) used accessible formats that were easy to navigate; (3) were perceived as trustworthy, and (4) provided access to diverse perspectives of persons living with HIV/AIDS. Topics that PRDH found most useful included various medical treatment-related issues, tools for coping with depression and fear, and learning how others cope with HIV."
Read more in AIDS Patient Care and STDs, January 10, 2010.
Read more in AIDS Patient Care and STDs, January 10, 2010.
January 9, 2010
The Wrong Story About Depression
"And here the truer story about mental health care in America begins to unfold. The trouble is not that the drugs don’t work; it’s that the care is not very good."
Read more in New York Times, January 8, 2010.
Read more in New York Times, January 8, 2010.
Antiretroviral Prescribing Patterns in Treatment-Naïve Patients in the United States
"The most dramatic shift in drug selection involved an increase in emtricitabine plus tenofovir plus efavirenz, from 0% in 2003 to 85% in 2007. During the study period, 205 of 482 (43%) patients required a change in initial therapy. Of these, 156 of 205 (76%) had a unique sequence of regimens. A shift toward homogeneity of initial ART was observed (85% of patients received the same first-line regimen in 2007). In contrast, regimen sequencing beyond the first regimen remained complex."
Read more in
AIDS Patient Care and STDs, January 8, 2010.
Read more in
AIDS Patient Care and STDs, January 8, 2010.
Sex with Older Partners Is Associated With Primary HIV Infection Among Men Who Have Sex With Men in North Carolina
"The mean age of sex partners differed significantly: men with PHI [primary HIV infection] had partners on average 6 years older than themselves, whereas uninfected men's partners were 4 months their junior (P < 0.001). After adjusting for race, sex while intoxicated, and having a serodiscordant/serostatus unknown partner, a participant had twice the odds of PHI if his sex partner was 5 years his senior (odds ratio 2.0, 95% confidence interval: 1.2 to 3.3). "
Read more in JAIDS Journal of Acquired Immune Deficiency Syndromes, January 7, 2010.
Circumcision may protect against HIV due to changes in bacteria
"The reduction in HIV infection risk after circumcision may be the result of a decline in bacteria on the surface of the penis that assist the process of infection, according to findings from the research team that helped establish the evidence base for using male circumcision as an HIV prevention strategy.
"If this is the case, and if the bacteria can be eliminated without removing the foreskin, such a procedure might provide an important non-surgical alternative to circumcision in settings where the procedure is culturally unacceptable or difficult to implement.
"The recent study, which appears in the January 2010 edition of PLoS ONE, analysed penile swabs taken from twelve participants in the Rakai, Uganda circumcision study, which enrolled almost 5,000 uncircumcised HIV-negative men and randomised half of them to be circumcised."
Read more in Aidsmap, January 8, 2010.
"If this is the case, and if the bacteria can be eliminated without removing the foreskin, such a procedure might provide an important non-surgical alternative to circumcision in settings where the procedure is culturally unacceptable or difficult to implement.
"The recent study, which appears in the January 2010 edition of PLoS ONE, analysed penile swabs taken from twelve participants in the Rakai, Uganda circumcision study, which enrolled almost 5,000 uncircumcised HIV-negative men and randomised half of them to be circumcised."
Read more in Aidsmap, January 8, 2010.
Can We Treat Our Way Out of HIV?
"The timing of the interest in a test and treat strategy and this first foray into exploring its potential implementation come at a critical juncture in the history of HIV/AIDS in the United States, where recent data from the CDC indicate that the prevalence and incidence of HIV are considerably higher than had previously been thought, and the Obama administration is currently developing a National HIV/AIDS Strategy (NHAS) whose three primary goals are reducing HIV incidence, increasing access to care, and reducing HIV-related health disparities. Indeed, the test and treat strategy is possibly unique in its direct relevance to all three main goals of the NHAS."
Read more in
AIDS Research and Human Retroviruses, January 7, 2010.
Read more in
AIDS Research and Human Retroviruses, January 7, 2010.
January 6, 2010
Global Funding for AIDS Is Justified
"HIV costs much more to prevent and treat, the opponents of PEPFAR argue, compared with other deadly diseases. Therefore, they say, a larger share of the world’s health care funds ought to be spent on preventing and treating these other diseases, and less on HIV specifically. The underlying assumption is there will always be too few resources to meet global health care needs.
"In response, two Harvard University professors—Rochelle Walensky, MD, MPH, and Daniel Kuritzkes, MD—are making the case in the January 15 issue of Clinical Infectious Diseases (available now online) that programs such as PEPFAR have not only succeeded in their mission, but have also had benefits that go far beyond their original intent.
"PEPFAR, Walensky and Kurtizkes contend, has been an unqualified success in regards to its originally stated mission. By October 2008, they write, 10.1 million people worldwide were receiving HIV care, and 2.1 million were receiving HIV treatment. 'AIDS-related mortality in PEPFAR countries decreased by 10.5 percent relative to non-PEPFAR countries,' they state, 'a difference that translates into 1.2 million lives saved.'
"The pair also laud the impact of HIV-specific care and treatment on many other aspects of health in PEPFAR-funded countries, writing, 'Antiretroviral treatment and [PCP pneumonia medication] provided to HIV-infected adults in a Ugandan cohort was not only associated with a 95 percent decrease in mortality of infected adults, but also an 81 [percent] reduction in mortality of uninfected children and a 93 percent decrease in orphanhood.'"
Read more in POZ Special Report, January 5, 2010.
"In response, two Harvard University professors—Rochelle Walensky, MD, MPH, and Daniel Kuritzkes, MD—are making the case in the January 15 issue of Clinical Infectious Diseases (available now online) that programs such as PEPFAR have not only succeeded in their mission, but have also had benefits that go far beyond their original intent.
"PEPFAR, Walensky and Kurtizkes contend, has been an unqualified success in regards to its originally stated mission. By October 2008, they write, 10.1 million people worldwide were receiving HIV care, and 2.1 million were receiving HIV treatment. 'AIDS-related mortality in PEPFAR countries decreased by 10.5 percent relative to non-PEPFAR countries,' they state, 'a difference that translates into 1.2 million lives saved.'
"The pair also laud the impact of HIV-specific care and treatment on many other aspects of health in PEPFAR-funded countries, writing, 'Antiretroviral treatment and [PCP pneumonia medication] provided to HIV-infected adults in a Ugandan cohort was not only associated with a 95 percent decrease in mortality of infected adults, but also an 81 [percent] reduction in mortality of uninfected children and a 93 percent decrease in orphanhood.'"
Read more in POZ Special Report, January 5, 2010.
Aging, HIV infection and the immune system
"In the November 9th issue of New York Magazine, David France reports on the emerging issue of accelerated aging in people with HIV infection. The article offers a series of disturbing vignettes about the complications some individuals are facing as they age, such as bone problems and impaired cognitive function, and raises important questions about how much attention is being paid to the issue by current research, particularly in terms of pursuing new therapeutic options. [1]
"However, beyond mentioning inflammation, the piece does not really delve into the underlying immunological parallels between HIV infection and aging and consider how they might fit into the picture. This is a potentially important omission, as there is accumulating evidence that the accelerated aging of the immune system that has been documented in people with HIV is likely to be related to many of the clinical phenomena described in France’s article."
Read more in HIV Treatment Bulletin, November/December 2009.
"However, beyond mentioning inflammation, the piece does not really delve into the underlying immunological parallels between HIV infection and aging and consider how they might fit into the picture. This is a potentially important omission, as there is accumulating evidence that the accelerated aging of the immune system that has been documented in people with HIV is likely to be related to many of the clinical phenomena described in France’s article."
Read more in HIV Treatment Bulletin, November/December 2009.
New resistance becoming rarer as more patients achieve undetectable HIV viral load
"There has been a drastic fall in the incidence of new cases of drug-resistant HIV amongst patients taking antiretroviral therapy in the Canadian province of British Columbia.
"In the January 1st edition of Clinical Infectious Diseases investigators report that the incidence of newly detected resistance fell twelve-fold between 1996 and 2008.
"'There has been a drastic decrease in the incidence of new cases of HIV-1 drug resistance, despite increases in annual (and, especially, cumulative) exposure to antiretrovirals”, write the investigators. They also note “this has occurred alongside a steady increase in the proportion of patients achieving virological suppression.'"
Read more in Aidsmap,January 5, 2010.
"In the January 1st edition of Clinical Infectious Diseases investigators report that the incidence of newly detected resistance fell twelve-fold between 1996 and 2008.
"'There has been a drastic decrease in the incidence of new cases of HIV-1 drug resistance, despite increases in annual (and, especially, cumulative) exposure to antiretrovirals”, write the investigators. They also note “this has occurred alongside a steady increase in the proportion of patients achieving virological suppression.'"
Read more in Aidsmap,January 5, 2010.
January 4, 2010
Year in Review 2009: HIV/AIDS Clinical Care
"Each year, the physician-editors of Journal Watch AIDS Clinical Care offer their perspective on the year's most important stories in HIV medicine. In reviewing these stories for 2009, one is struck by a remarkable sense of progress in the field, especially in prevention. ... Although there is a relative lack of novel new agents in development, the reason behind this shortage is only positive — our currently available therapies are more effective than ever, so much so that treatment guidelines are moving in the direction of recommending therapy for virtually everyone with HIV infection."
Read more in Journal Watch, January 4, 2010.
Comment: The publishers of the New England Journal of Medicine also publish Journal Watch, and offer 10 articles reviewing HIV in 2009, free for anyone (most Journal Watch articles require a subscription). The links to these 10 articles are included in the one above.
Also, Journal Watch published a similar review of 2009 advances in psychiatry, including depression, and how to stay healthy. The first article, with links to the others, is at http://psychiatry.jwatch.org/cgi/content/full/2010/104/1
Read more in Journal Watch, January 4, 2010.
Comment: The publishers of the New England Journal of Medicine also publish Journal Watch, and offer 10 articles reviewing HIV in 2009, free for anyone (most Journal Watch articles require a subscription). The links to these 10 articles are included in the one above.
Also, Journal Watch published a similar review of 2009 advances in psychiatry, including depression, and how to stay healthy. The first article, with links to the others, is at http://psychiatry.jwatch.org/cgi/content/full/2010/104/1
US HIV travel ban has now ended
"HIV-positive individuals can legally visit and migrate to the US from today.
President Obama announced the end of the ban at the end of October 2009, but there was a 60-day waiting period before this finally came into effect.
"Introduced early in the HIV pandemic, the US travel ban prevented visits to the US by people with HIV except in exceptional circumstances. Although it was widely flouted, individuals with HIV who were detected by US immigration staff were refused entry to the country and deported. ...
"Following the removal of the ban, the International AIDS Society confirmed that the 2012 International AIDS Conference will be held in Washington D.C. The US capital has an HIV prevalence of 3% - the threshold for a severe, generalised epidemic is 1%. ...
"A list of countries and their entry policies for people with HIV can be read here"
Read more in Aidsmap, January 4, 2010.
President Obama announced the end of the ban at the end of October 2009, but there was a 60-day waiting period before this finally came into effect.
"Introduced early in the HIV pandemic, the US travel ban prevented visits to the US by people with HIV except in exceptional circumstances. Although it was widely flouted, individuals with HIV who were detected by US immigration staff were refused entry to the country and deported. ...
"Following the removal of the ban, the International AIDS Society confirmed that the 2012 International AIDS Conference will be held in Washington D.C. The US capital has an HIV prevalence of 3% - the threshold for a severe, generalised epidemic is 1%. ...
"A list of countries and their entry policies for people with HIV can be read here"
Read more in Aidsmap, January 4, 2010.
Longer duration of infection with HIV linked with hardening of coronary arteries
"Using CT scans, US investigators have found that young men with HIV are significantly more likely than their HIV-negative peers to have hardening of the arteries. In a study published in the on-line edition of AIDS the researchers also found that arterial disease was so severe in 7% of men with HIV that it was blocking blood flow. Longer duration of HIV infection was the most important risk factor for hardening of the coronary arteries.
"'The current study shows an increased prevalence and greater degree of subclinical coronary artery disease in asymptomatic young HIV-infected men without prior history of cardiovascular disease', write the investigators."
Read more in Aidsmap, January 4, 2010.
"'The current study shows an increased prevalence and greater degree of subclinical coronary artery disease in asymptomatic young HIV-infected men without prior history of cardiovascular disease', write the investigators."
Read more in Aidsmap, January 4, 2010.
January 2, 2010
Vitamin D Deficiency: A Major Public Health Problem?
"During the past decade, we've learned two remarkable things about vitamin D. First, many adults and children in the U.S. and other developed nations have vitamin D deficiency (JW Gen Med Mar 20 1998). Second, the adverse health effects of vitamin D deficiency could extend well beyond bone disease to encompass excess risk for cancer (particularly colon, prostate, and breast), hypertension, autoimmune diseases (e.g., multiple sclerosis, type 1 diabetes), and other diseases. Vitamin D deficiency also might be associated with all-cause and cardiovascular mortality."
Read more in Journal Watch, December 31, 2009.
Read more in Journal Watch, December 31, 2009.
Subscribe to:
Posts (Atom)