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March 30, 2010

Drug Resistance Testing Is Effective Even With Low Virus Levels

"It is possible for resistance testing labs to tweak the standard tests so that they are better able to detect resistant virus in people with low virus levels. Data indicate this practice is occurring more frequently now than in the past. It is not a standardized practice, however, given a paucity of research indicating whether modified genotypic testing is sensitive enough to yield conclusive results.

"Hoping to answer this question, a team in London led by Nicola Mackie, MD, from the Imperial College Healthcare National Health Service Trust, examined the results of 7,861 HIV resistance tests—1,001 of which involved samples with viral loads below 1,000 copies—collected from 3,791 people."

Read more in POZ, March 30, 2010.

Health Law Cuts Cost of Being a Woman

"Being a woman is no longer a pre-existing condition. That’s the new mantra, repeated triumphantly by House Speaker Nancy Pelosi, Senator Barbara A. Mikulski and other advocates for women’s health. ...

“The health care industry and health care insurance in general has been riddled with the most discriminatory and unfair practices to women,” said Marcia D. Greenberger, the founder and co-president of the National Women’s Law Center. “This law is a giant leap forward to dismantling the unfairness that has been a part of the system."

Read more in New York Times, March 30, 2010.

Study: Chocolate Could Reduce Heart Risk

"According to a new study, small doses of chocolate every day could decrease your risk of having a heart attack or stroke by nearly 40 percent."

Read more in New York Times (AP), March 30, 2010.

Cardio Risk: Increased Homocysteine Levels Common During HIV Treatment

"HIV treatment is associated with increases in the amino acid homocysteine, which may help explain the higher rates of arterial disease seen in people living with HIV receiving antiretroviral (ARV) therapy compared with those not infected with the virus, according to a small Mexican study published online ahead of print by the Journal of Acquired Immune Deficiency Syndromes (JAIDS). ...

"Going forward, the study authors said, therapies known to lower homocysteine should be explored. “For example, some patients may benefit from betaine (trimethylglycine) or choline (in the form of phosphatidylcholine),” they write. “These therapies have been used in the general population with variable degrees of success."

Read more in POZ, March 29, 2010.

Note: Both betaine and phosphatidylcholine are readily available as supplements.

March 29, 2010

How Health Care Reform is Already Changing Lives

"The final passage of health reform last week is a huge victory for people with HIV and AIDS. Here are some of the short and long-term changes that will impact our community."

Note: Insurance companies already think they have a loophole to delay covering children with pre-existing conditions for four years. The companies agree that the law says they cannot exclude the children's conditions from their policies -- but says that they can refuse to sell those children any insurance at all until 2014, when a new provision kicks in allowing anyone to buy insurance despite pre-existing illnesses.

If this interpretation stands, Congress could respond with a separate law to accelerate the 2014 provision to this year, for children. That would restore the obvious Congressional intent in the health-reform bill, without doing anything else. Let the "family values" advocates vote against it. JSJ

Read more in AIDS Connect, March 29, 2010.

March 28, 2010

[Find HIV Services near your ZIP code -- New York and San Francisco example shown]

Note: Click the link below to check near your ZIP code. Feedback to is requested; this services-location site is not yet complete. JSJ

"In looking at these three elements, we at have released a soft launch of the locator service, a feature that allows users to find HIV/AIDS services for Testing, Housing Assistance, Treatment, and Mental Health related to HIV/AIDS.

"We have already received feedback from some of the service stakeholders and there are features we plan to add and enhance, including a mobile interface, texting capability, more HIV/AIDS services provided by the Federal Government and printable directions. But by doing a soft launch, and through an iterative process, we have the opportunity to engage the HIV/AIDS community to find out what else we can be doing to improve these services."

Read more in, March 25, 2010.

Putting TLC+ to the Test

"If we routinely test everyone for HIV and treat those who are infected, could we bring an end to the HIV/AIDS epidemic? The test and treat concept, modeled on data from South Africa by scientists at the World Health Organization, is a provocative HIV prevention strategy. According to mathematical modeling, a successfully implemented test and treat program could significantly reduce the number of HIV infections in South Africa within 10 years. While a growing number of experts within the HIV/AIDS community are intrigued at the possibility, no one knows whether this strategy would work in the real world.

"The National Institutes of Health (NIH), the premier research institution of the U.S. government, is taking steps to find out. NIH is planning a 3-year study in 6 major U.S. cities. Called TLC+ (for Enhanced Test, Link to Care Plus Treat Strategy), this study will explore the feasibility of expanding HIV testing, better linking those who test HIV positive to medical care and treatment, and improving adherence to HIV treatment. The components of TLC+ will be evaluated against the current standard of HIV testing and treatment."

Read more in, March 25, 2010.

Fair is foul...

"These words came especially to mind as the Illinois Secretary of Human Services Michelle Saddler presented the Department’s budget to a group of advocates last week.

"My reaction was due partly to Secretary Saddler’s description of the proposed cuts, which will be tragic.

“With this budget, we are dismantling the social safety net” she said. “Human services are being kicked to the curb…people will simply disappear if they are not helped…$300 million will be cut from human services, with special gutting of prescription drugs…in mental health, 74,000 will not receive their meds…rehabilitation services cuts will hurt people who, with services, can work, but without services, will not be able to…”

"Services will be available only to those at Medicaid levels – which are set at below federal poverty – and to those who can afford to pay full freight. Others will have no access to virtually any service even if they have children who are autistic, have cerebral palsy, or are intellectually impaired; suffer from mental illness or could live at home rather than a nursing facility at greater cost.

"Also disorienting was what the Secretary said next: “The Department of Human Services in no way supports this budget. Candidly, the governor is not an advocate for this budget either. It is driven by limited resources."

Read more in Protestants for the Common Good, March 25, 2010.

The State of the Crisis: ADAP Advocacy Across the Country

"Dose of Change offers up these examples of advocacy in action as groups across the country respond to the crisis. These are just a few of the endeavors we’ve identified so we are asking you to send us more examples of ADAP advocacy tools in your community. Let’s all learn from each other and stop more cuts before they happen."

Read more in AIDS Connect, March 25, 2010.

March 27, 2010

Public Hearing on Expanded Access of Direct-Acting Antiviral Agents (DAAs) for the Treatment of Chronic Hepatitis C Infection in Patients with Unmet Medical Need

"The US Food & Drug Administration (FDA) is announcing a public hearing to obtain input on the scope and implementation of potential Expanded Access programs with Direct-Acting Antiviral Agents (DAAs) for treating chronic hepatitis C (CHC) infection in patients with unmet medical need."

Read more in FDA, March 26, 2010.

Note: The hearing is April 30.

March 26, 2010


"The Centers for Medicare & Medicaid Services (CMS) today announced its decision to cover facial injections for Medicare beneficiaries who experience symptoms of depression due to the stigmatizing appearance of severely hollowed cheeks resulting from the drug treatment for Human Immunodeficiency Virus (HIV). Today’s decision is effective immediately."

Read more in CMS, March 23, 2010.

March 23, 2010

Minocycline Decreases CD4 T-Cell Activation and Reduces HIV Replication

"SUMMARY: Adding the inexpensive antibiotic minocycline to standard combination antiretroviral therapy (ART) inhibited HIV replication and significant decreased CD4 cell activation in a laboratory study, according to a report published in the April 15, 2010 Journal of Infectious Diseases. Minocycline acts on cells, rather than the virus, and researchers suggested it might be used as an adjunct therapy with ART."

Read more in, March 23, 2010.

Inflammation and Immune Activation Linked to Increased Mortality Risk in People with HIV

"SUMMARY: Inflammation and excessive CD8 T-cell immune activation were independent predictors of increased risk of death both in a U.S. study and among HIV patients starting antiretroviral therapy (ART) in Uganda, according to 2 reports presented at the 17th Conference on Retroviruses and Opportunistic Infections (CROI 2010) last month in San Francisco. While lower CD4 cell count may explain part of the association, inflammation itself was an independent predictor of mortality."

Read more in, March 16, 2010.

March 19, 2010

The Worst Time for a Hospital Visit

"This week in 'Doctor and Patient,' I write about how four factors — hospital occupancy, weekend admissions, nurse staffing and the seasonal flu — can not only increase the risk of dying in a hospital but can also interact in variable ways.

"The result of this interplay, according to a study published this month in the journal Medical Care, is that each hospital has a unique threshold — its own “fingerprint,” according to one of the study authors — beyond which patient safety becomes compromised. One hospital may find that a four-to-one patient-to-nurse ratio and 70 percent occupancy borders on hazardous, whereas another hospital that serves a healthier population will work efficiently at the same staffing ratio until at least 90 percent of the beds are occupied. ...

"Dr. Matthew Davis, an associate professor of pediatrics, internal medicine and public policy at the University of Michigan and senior author of the study, suggested that patients get their seasonal flu vaccinations and speak to their doctors about the timing of their procedure or admission, particularly in relation to the hospital’s overall work flow. 'I think that would be a particularly good conversation for people planning to have elective surgery,' Dr. Davis said. 'Not all of this improvement in safety has to happen within the fours walls of a hospital.'"

Read more in New York Times, March 18, 2010.

March 18, 2010

Insurer targeted HIV patients to drop coverage

"Shortly after his diagnosis, however, his insurance company, Fortis [now known as Assurant Health], revoked his policy. Mitchell was told that without further treatment his HIV would become full-blown AIDS within a year or two and he would most likely die within two years after that. ...

"In 2004, a jury in Florence County, South Carolina, ordered Assurant Health, part of Assurant Inc, to pay Mitchell $15 million for wrongly revoking his heath insurance policy. In September 2009, the South Carolina Supreme Court upheld the lower court's verdict, although the court reduced the amount to be paid him to $10 million.

"By winning the verdict against Fortis, Mitchell not only obtained a measure of justice for himself; he also helped expose wrongdoing on the part of Fortis that could have repercussions for the entire health insurance industry. ...

"Insurance companies have long engaged in the practice of "rescission," whereby they investigate policyholders shortly after they've been diagnosed with life-threatening illnesses. But government regulators and investigators who have overseen the actions of Assurant and other health insurance companies say it is unprecedented for a company to single out people with HIV."

Read more in Aegis, March 17, 2010.

Comment: Re AIDS fundraising, note AEGiS Toolbar - Create Donations by Shopping and Searching.

No Benefit From Cyclosporine During Early Infection

"Adding cyclosporine to an antiretroviral (ARV) regimen during the first few weeks or months of HIV infection does not offer additional benefit in terms of virus suppression, CD4 cell increases or reduced immune activation. That’s the verdict, according to a study published March 17 in The Journal of Infectious Diseases."

Read more in POZ, March 18, 2010.

Response of a simian immunodeficiency virus (SIVmac251) to raltegravir: a basis for a new treatment for simian AIDS and an animal model for studying lentiviral persistence during antiretroviral therapy

"This finding may help to develop effective ART regimens for the simian AIDS model entirely based on drugs adopted for treatment in humans. This ART-treated AIDS nonhuman primate model could be employed to find possible strategies for virus eradication from the body."

Read more in Retrovirology, March 16, 2010 (full text available).

Spontaneous reversal of the developmental aging of normal human cells following transcriptional reprogramming

"Conclusion: Prematurely aged (shortened) telomeres appears to be a common feature of iPS cells created by current pluripotency protocols. However, the spontaneous appearance of lines that express sufficient telomerase activity to extend telomere length may allow the reversal of developmental aging in human cells for use in regenerative medicine."

Read more in Regenerative Medicine, March 16, 2010.

Comment: Not an HIV article, but possibly relevant to cure research.

March 17, 2010

Vacc-C5 to be prepared for phase I/II clinical trial

"Research results to date indicate that Vacc-C5 may induce a protective
antibody response in HIV patients similar to that found in patients with a very
slow or non-progressing disease. This naturally very slow or non-progressing HIV
infection observed in a small minority of patients has been the subject of
academic interest for years and our discovery of these antibodies in such
patients could lead to a significant shift in the approach to treating HIV. The
results have been presented to the company's Clinical Advisory Board with very
encouraging feedback, says Birger Sørensen, CEO of Bionor Immuno.


"The main trigger behind the disease progression from HIV to AIDS is the
hyper-activation of the immune system. This hyper-activation overwhelms and
gradually causes a collapse in the immune system, leading to the AIDS stage of
the disease.

"From research on blood donated by patients with a very slow or non-progressing
HIV disease, the company has succeeded in identifying a specific part of the
virus, C5, which is believed to induce hyper-activation of the immune system.
Antibodies to this specific part are likely to be protective and cause a slow
disease progression. Using its unique technology, the company has developed the
vaccine candidate Vacc-C5, that is designed to induce a similar antibody
response to the one discovered in patients with naturally very slow disease
progression. Vacc-C5 has passed pre-clinical research tests showing that it has
the potential to induce the desired antibodies."

Read more in Bionor Immuno, March 17, 2010.

Comment: Bionor Immuno was acquired by Nutri Pharma in February 2010. Bionor's technology creates peptides (parts of proteins) designed for use in vaccines to cause production of desired antibodies.

March 16, 2010

Chemical in Bananas May Prevent and Treat HIV

"A chemical in bananas has been found to inhibit HIV, according to research findings from a University of Michigan Medical School published in the March 19 issue of the Journal of Biological Chemistry. According to the study authors, this may lead to the development of inexpensive microbicides to prevent HIV transmission and, quite possibly, novel compounds to treat the disease. ...

"The test tube studies conducted by Michael Swanson, a doctoral student at the University of Michigan, and his colleagues, indicate that a lectin isolated from the common banana binds to the sugar-rich HIV envelop protein gp120. Not only may this prove useful in the development of vaginal and rectal microbicides to prevent HIV transmission, Swanson and his fellow authors speculate, but the HIV-inhibiting lectin—dubbed BanLec—may also have therapeutic potential.

"The University of Michigan team discovered that BanLec is similar in potency to Fuzeon (enfuvirtide) and Selzentry (maraviroc), two U.S. Food and Drug Administration–approved fusion/entry inhibitors. Swanson’s group argues, however, that BanLec could be cheaper to create than current antiretrovirals, which use synthetically produced components.

"BanLec may also provide a wide range of preventive and therapeutic protection against drug-resistant virus. “The problem with some HIV drugs is that the virus can mutate and become resistant, but that’s much harder to do in the presence of lectins,” Swanson said. “Lectins can bind to the sugars found on different spots of the HIV envelope, and presumably it will take multiple mutations for the virus to get around them.”

"Swanson pointed out that the clinical use of BanLec is years away. But he is currently developing a process to molecularly alter BanLec to enhance its potential clinical utility."

Read more in POZ, March 15, 2010.

Rates of new HIV diagnoses amongst US gay men 44 times greater than those in other populations

"HIV has a hugely disproportionate impact on gay and other men who have sex with men in the US, according to new figures released by the US Centers for Disease Control and Surveillance (CDC).

"Investigators calculated that the rate of new HIV infections amongst gay and bisexual men is 44 times that seen in other men, and some 40 times greater than women.


“There is no single or simple solution for reducing HIV and syphilis rates among gay and bisexual men”, said Fenton. “We need intensified prevention efforts that are as diverse as the gay community itself. Solutions for young gay and bisexual men are especially critical, so that HIV does not inadvertently become a rite of passage for each new generation of gay men.”"

Read more in Aidsmap, March 11, 2010.

March 12, 2010

HIV Reservoir Found in Blood Progenitor Cells in Bone Marrow

"SUMMARY: HIV can hide in the bone marrow inside hematopoietic progenitor stem cells, even in people with long-term undetectable plasma viral load, according to study results reported in the March 7, 2010 online edition of Nature Medicine. When the cells are forced to differentiate into different types of blood cells, the viral genome becomes active and begins producing new viral particles. The ramifications of this finding are not yet clear, but will certainly have implications for the growing effort to accomplish HIV eradication."

Read more in, March 12, 2010.

March 11, 2010

AIDSmeds in San Francisco: Highlights from CROI 2010

"Though this year’s Conference on Retroviruses and Opportunistic Infections (CROI) won’t likely be remembered for HIV prevention or treatment breakthroughs—there weren’t any—it certainly confirmed that research into the virus and its complications continues at a dizzying clip."

Read more in POZ, March 9, 2010.

March 4, 2010 on Retroviruses conference, related information:

LEDGF Integrase Inhibitors and Capsid Assembly Inhibitors Offer New Approaches for Blocking HIV Replication
ACTG 5202 Shows Abacavir/lamivudine and Tenofovir/emtricitabine Provide Similar HIV Suppression at Low Viral Loads
ACTG 5202 Sub-study Finds Lipoatrophy Uncommon, Antiretroviral Drugs Have Varying Effects on Bone and Body Fat
Early Antiretroviral Therapy Reduces HIV Transmission in Discordant Heterosexual Couples
CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Releases New Strategic Plan
Once-daily Boosted Darunavir (Prezista) Works as Well as Twice-daily for Treatment-experienced Patients
Quitting Smoking Lowers Risk of Cardiovascular Disease in People with HIV
HIV Raises Lung Cancer Risk, but Smoking Is a Much Stronger Predictor
Research Sheds New Light on HIV in the Gut
FDA Announces Preliminary Data Suggesting Heart Risk with Saquinavir (Invirase) plus Ritonavir (Norvir)
Investigational Drug TBR-652 Demonstrates Dual Activity against CCR5 and CCR2 Co-receptors
Poor CD4 Cell Recovery on Antiretroviral Therapy Is Linked to Late Treatment, Leads to Adverse Outcomes
Treatment Intensification with Maraviroc (Selzentry) Did Not Raise CD4 Cell Counts in Small Study
The U.S. HIV Research Agenda and the Future of PEPFAR
Gilead's "Quad" Pill Matches Atripla, New Booster Cobicistat (GS 9350) Looks Good with Atazanavir (Reyataz)
Vicriviroc Fails to Beat Stiff Competition, Merck Will Not File for Treatment-experienced Approval
Conference on Retroviruses and Opportunistic Infections (CROI) Starts Tuesday in San Francisco
Inflammatory Markers and Cardiovascular Risk in Treated and Untreated People with HIV

Read more in, March 4, 2010.

Stopping Tenofovir Doesn’t Always Reverse Kidney Damage

"In conclusion, Wever’s group writes, 'improvements in renal function after tenofovir cessation is variable and incomplete, particularly in patients with more gradual decline in GFR who are not receiving a protease inhibitor.' They also suggest using a GFR below 90, as opposed to a CKD-defining GFR below 60, when determining whether to discontinue tenofovir treatment 'to avoid permanent renal dysfunction.'"

Read more in POZ, March 3, 2010.

March 1, 2010

A highly efficient short hairpin RNA potently down-regulates CCR5 expression in systemic lymphoid organs in the hu-BLT mouse model

"Inhibiting the expression of the HIV-1 coreceptor CCR5 holds great promise for controlling HIV-1 infection in patients. Here we report stable knockdown of human CCR5 by a short hairpin RNA (shRNA) in a humanized bone marrow/liver/thymus (BLT) mouse model."

Read more in, February 25, 2010.

HIV drug that protects a fetus should be avoided for 1 year after childbirth, researchers say

"Women given the human immunodeficiency virus (HIV) prevention drug nevirapine to protect their fetus should not use an HIV-drug regimen that contains nevirapine for at least one year after childbirth, say researchers at the University of Alabama at Birmingham (UAB).

"A new UAB study found that while nevirapine works well to prevent mother-to-child HIV transmission, a single dose of nevirapine in infected pregnant women can trigger resistance to some forms of the AIDS-drug cocktail known as combination antiretroviral treatment (ART). This nevirapine-induced resistance fades after about 12 months and no longer hinders ART, says UAB Professor of Obstetrics and Gynecology Jeffrey S.A. Stringer, M.D., the study's lead author.

"The findings are published in PLoS Medicine, a journal of the nonprofit Public Library of Science. ...

"The UAB study included 878 infected women in Zambia, Cote d'Ivoire and Thailand. Some were given single-dose nevirapine and others were not; all participants were given ART immediately upon confirmed infection and monitored for one year.

"Nevirapine continues to be the backbone of anti-HIV therapy in the developing world, and its usefulness in preventing mother-to-child transmission is confirmed in the new study, Stringer says."

Read more in EurekAlert!, February 25, 2010.

Anti-tetherin activities in Vpu-expressing primate lentiviruses

"Primate lentiviruses show a high degree of flexibility in their use of anti-tetherin factors, indicating a strong selective pressure to counteract tetherin restriction. The identification of an activity against human tetherin in SIVgsn Vpu suggests that the presence of Vpu in the ancestral SIVmus/mon/gsn virus believed to have contributed the 3' half of the HIV-1 genome may have played a role in the evolution of viruses that could counteract human tetherin and infect humans."

Read more in Retrovirology, February 18, 2010.

HIV Poses a Community Risk for Blacks

"HIV prevalence among US blacks is so significant that focusing on high-risk groups within the community leaves the majority unaware of their risk, warned a report presented at the recent 17th Conference on Retroviruses and Opportunistic Infections. African Americans account for 12 percent of the population but half of US HIV cases. 'Part of our challenge is that a lot of the black community has not perceived itself to be at risk based upon the evolution of how we understood risk of HIV in the United States,' said Dr. Kimberly Smith of Chicago’s Rush University Medical Center. 'If we start to focus on this as a community challenge rather than focusing on individual risks, then that may move us in the right direction.'"

Read more in CDCNPIN, February 19, 2010.