Hepatitis C Drug [telaprevir] Raises Cure Rate in a Late Trial - NYTimes.com

Hepatitis C Drug Raises Cure Rate in a Late Trial - NYTimes.com: "An experimental drug for hepatitis C from Vertex Pharmaceuticals sharply increased the cure rate in a clinical trial, while reducing the time needed for treatment.

Experts say the results could herald a new era in treating a sometimes fatal disease that is often overlooked, despite afflicting as many as 3.9 million Americans and 170 million people worldwide.

About 75 percent of patients in the trial who got the standard dose of Vertex’s drug in combination with the existing treatment were essentially cured, compared with 44 percent of those who got only the existing therapy."

FDA Panel to Decide Fate of Egrifta [tesamorelin], a Promising Gut Fat Fighter - by David Evans

POZ.com - Web Exclusives : FDA Panel to Decide Fate of Egrifta, a Promising Gut Fat Fighter - by David Evans: "“People’s lives and their quality of life are at stake here. It’s hard to quantify, but quality of life is so very, very important to living and thriving with HIV,” says Jeff Berry, who will be testifying at the FDA hearing on behalf of the AIDS Treatment Activists Coalition (ATAC)."

Treatment News : Daily Zinc Supplements May Slow CD4 Cell Loss and Reduce Diarrhea

POZ: Daily Zinc Supplements May Slow CD4 Cell Loss and Reduce Diarrhea: "Daily zinc supplementation may help slow disease progression, notably in people living with HIV who are unable to maintain viral loads below undetectable while on an antiretroviral (ARV) drug regimen, and reduce diarrhea, according to a new study�published in the June 15 issue of Clinical Infectious Diseases (CID)."

Finding About Anti-Inflammatory Cells Could Lead to New HIV Treatments

POZ : Finding About Anti-Inflammatory Cells Could Lead to New HIV Treatments: "A new study suggests that HIV throws off the balance of two types of inflammation-reducing cells, thus allowing the virus to persist in the body and cause ongoing damage to the immune system. This finding—published May 19 in the journal Science Translational Medicine and announced by researchers at the University of California in San Francisco (UCSF)—could lead to a new generation of effective HIV medications that operate in a completely different manner from current antiretroviral (ARV) drugs."

Alcohol Use Accelerates HIV Disease Progression

Mary Ann Liebert, Inc. - AIDS Research and Human Retroviruses - 26(5):511: "Frequent alcohol users (two or more drinks daily) were 2.91 times (95% CI: 1.23–6.85, p=0.015) more likely to present a decline of CD4 to ≤200 cells/μl, independent of baseline CD4 cell count and HIV viral load, antiretroviral use over time, time since HIV diagnosis, age, and gender."

Stop an ADAP Wait List in Illinois

Stop an ADAP Wait List in Illinois | AIDS Connect: "“Because the program is deeply underfunded, Illinois must take immediate steps to preserve services for those who rely on ADAP for their life-saving care,” said David Ernesto Munar, vice president of the AIDS Foundation of Chicago (AFC), and a member of the ADAP Medical Issues Advisory Board, which made the recommendation. “The program faces total fiscal collapse unless immediate actions are taken.”

TAKE ACTION NOW!"

Immune Exhaustion Occurs Concomitantly With Immune Activation ...

Immune Exhaustion Occurs Concomitantly With Immune Activatio... : JAIDS Journal of Acquired Immune Deficiency Syndromes: "Conclusions: Immune exhaustion is a component of aberrant immune activation in chronic HIV-1 infection and is associated with loss of Tregs and ongoing virus replication. These defects are corrected partially with effective virologic control by potent antiretroviral therapy"

Time to Review Workplace Reviews?

Time to Review Workplace Reviews? - Well Blog - NYTimes.com: "A number of studies have documented the health toll of workplace stress, showing that unhappy workers are at higher risk for heart problems and depression, among other things. This month, Danish researchers reported on a 15-year study of 12,000 nurses finding that nurses struggling with excessive work pressures had double the risk for a heart attack. And a British study tracking 6,000 workers for 11 years found that those who regularly worked more than 10 hours a day had a 60 percent higher risk for heart disease than those who put in 7 hours. ...

“Who is the biggest source of stress on the job? It’s your immediate supervisor,” he said. “The pile of evidence coming out shows that if you want to be an effective organization or an effective boss, you’ve got to strike a balance between humanity and performance.”

BBC News - Smallpox demise linked to spread of HIV infection

BBC News - Smallpox demise linked to spread of HIV infection: "Experts say the vaccine used to wipe out smallpox offered some protection against the Aids virus and, now it is no longer used, HIV has flourished.
The US investigators said trials indicated the smallpox jab interferes with how well HIV multiplies.
But they say in the journal BMC Immunology it is too early to recommend smallpox vaccine for fighting HIV."

amfAR Consortium To Speed Search for HIV/AIDS Cure

amfAR Consortium To Speed Search for HIV/AIDS Cure: "The initial round of funding for the newly constituted amfAR Research Consortium on HIV Eradication (ARCHE) includes projects in each of three areas that are widely considered central to HIV eradication:
The search for a sterilizing cure that would eliminate all HIV from the body;
The search for a functional cure that would achieve permanent viral suppression without therapy; and
The characterization of viral reservoirs, the barrier that must be overcome to achieve a cure."

HIV Treatment and Lifestyle Factors Influence Death Rates

POZ.com: "'It is particularly encouraging that there was no evidence that rates of death from any specific cause were increasing over the study period, and no emerging trends in unexpected causes of deaths were identified,' the authors said.

A number of factors were associated with higher death rates, including low CD4s and high viral loads. Likewise, smoking was related to higher deaths from all causes, as were diabetes and hypertension—all correctable risk factors. People who were excessively thin or overweight were also at an increased risk of death. Not surprisingly, hepatitis C virus (HCV) and hepatitis B virus infection increased the likelihood of dying from liver disease.

Conversely, the percentage of deaths overall was extremely low in people with CD4 counts over 350, indicating that the preservation or return of higher CD4 counts has a protective effect against a number of causes of death. Death rates in people with low viral loads were also reduced."

Avexa halts apricitabine development due to cash shortage

Aidsmap: "Avexa announced on Monday that it is halting the development of its nucleoside analogue reverse transcriptase inhibitor apricitabine because it cannot find a partner to develop the drug and obtain licensing in key markets. The company cannot afford to develop the drug alone.

The Australian company’s shares fell by 79% on the Sydney stock exchange after the announcement, which come despite positive clinical trials results for the product.

Avexa said that negotiations with other companies had proved difficult due to the high dosing requirement of the drug (800mg twice daily), which would make it difficult to coformulate with other antiretrovirals.

Potential partners were also concerned by the difficulty in determining the potency of the drug. The use of new high active agents in the optimised background regimen, which make it easier for treatment-experienced patients to achieve an undetectable viral load, may mask the effectiveness of apricitabine, some argued."

Drug Regimen with Short Pauses Controls HIV and Could Lower Costs, Toxicity

Blog.AIDS.gov: "A clinical trial in Uganda has found that pausing antiretroviral therapy (ART) for just two days every week is at least as effective as taking ART continuously over a 72-week period. In addition, the intermittent regimen was associated with less drug toxicity relative to continuous ART. These findings, reported on April 22 in PLoS ONE, may have implications for increasing the number of HIV-infected individuals on ART in resource-limited settings."

The Future of Sex Education Starts with a Great Website | AIDS Connect

AIDS Connect: "Overall, Future of Sex Ed is a great example of how to execute an issue-specific site that gives interested advocates a menu of options to get involved."

Comment: We think this site could be better at getting new people interested in sex education. But for those already interested, the information is well organized.

Impact of CD8 T Cell Activation on ... Mortality in HIV-infected Ugandans Initiating Antiretroviral Therapy

Impact of CD8 T Cell Activation on CD4 T Cell Recovery and Mortality in HIV-infected Ugandans Initiating Antiretroviral Therapy

Note, JSJ: The last graph on the NATAP report on this presentation shows a large difference in death rate based on T-cell activation (which is believed to increase HIV replication, contributing to disease progression).

When-to-start-treatment controversy

POZ: START Wars - by Tim Horn: "Few experts and activists argue that the research supporting early treatment is anything less than encouraging. Where there is less agreement, however, is whether enough sound, scientific research has been conducted to spell out the benefits and risks—the increased (or decreased) likelihood of short- and long-term side effects, adherence challenges and the development of drug resistance, for example—of early treatment and to warrant major changes to public policy. In fact, some of the most experienced and trusted sources of HIV prevention and treatment policy are struggling to make the right call."

Note: For more information on the START trial (Strategic Timing of AntiRetroviral Therapy) see http://insight.ccbr.umn.edu/start/

Majority of HIV patients in North America need to start treatment at time of diagnosis

Aidsmap | Majority of HIV patients in North America need to start treatment at time of diagnosis: "The majority of patients newly diagnosed with HIV in North America have a CD4 cell count that is low enough to warrant the immediate initiation of antiretroviral therapy, investigators report in the June 1st edition of Clinical Infectious Diseases.

Until November 2009 US HIV treatment guidelines recommended that a patient should start taking antiretroviral drugs when their CD4 cell count is around 350 cells/mm3. However, 54% of patients in the study had a CD4 cell count below this level.

In November 2009 new US guidelines were issued which recommend treatment for everyone with a CD4 count below 500, and also propose that people with CD4 counts over 500 should consider starting treatment too."

In Uganda, AIDS War Is Falling Apart - NYTimes.com

In Uganda, AIDS War Is Falling Apart - NYTimes.com: "On the grounds of Uganda’s biggest AIDS clinic, Dinavance Kamukama sits under a tree and weeps.

Her disease is probably quite advanced: her kidneys are failing and she is so weak she can barely walk. Leaving her young daughter with family, she rode a bus four hours to the hospital where her cousin Allen Bamurekye, born infected, both works and gets the drugs that keep her alive.

But there are no drugs for Ms. Kamukama. As is happening in other clinics in Kampala, all new patients go on a waiting list. A slot opens when a patient dies"

New recommendations for cancer prevention

Note: These recommendations are for everybody, but people with HIV are at higher risk of many kinds of cancer. Be careful of the recommendation on cooking meat; undercooking may be the greater danger for people with immune deficiency. JSJ

Op-Ed Columnist - New Alarm Bells About Chemicals and Cancer - NYTimes.com: "To help people manage the uncertainty prudently, the report has a section of recommendations for individuals:

* Particularly when pregnant and when children are small, choose foods, toys and garden products with fewer endocrine disruptors or other toxins. (Information about products is at www.cosmeticsdatabase.com or www.healthystuff.org.)

* For those whose jobs may expose them to chemicals, remove shoes when entering the house and wash work clothes separately from the rest of the laundry.

* Filter drinking water.

* Store water in glass or stainless steel containers, or in plastics that don’t contain BPA or phthalates (chemicals used to soften plastics). Microwave food in ceramic or glass containers.

* Give preference to food grown without pesticides, chemical fertilizers and growth hormones. Avoid meats that are cooked well-done.

* Check radon levels in your home. Radon is a natural source of radiation linked to cancer."

Note: To download the original report, click http://deainfo.nci.nih.gov/advisory/pcp/pcp08-09rpt/PCP_Report_08-09_508.pdf

Study in elite who control HIV without drugs points way for vaccine

"Research in people who have controlled HIV at very low levels for years without drugs has revealed that a human genetic trait linked to autoimmunity may point the way to an effective vaccine against HIV, researchers from Boston report today in the online edition of the journal Nature.

"A very small proportion of people (around 0.5%) who become infected with HIV experience little or no disease progression, and maintain a viral load that is near to undetectable for many years.

"Scientists led by Professor Bruce Walker of Massachusetts General Hospital have been recruiting these `elite controllers` of HIV for the past four years with the aim of studying how their immune systems control HIV.

"The newly-published study looked at one common feature of many 'elite controllers', a genetic mutation called HLA B57 which is also associated with autoimmune conditions in which immune cells can attack the host’s own proteins because they are not recognised as 'self'."

Read more: http://www.aidsmap.com/en/news/618E4604-C55D-41F1-91B8-B4AF04B62222.asp, May 5, 2010.

Huge variations in price paid for same antiretroviral drug between low-income countries

"An analysis of prices paid for antiretroviral drugs by 113 countries between 2002 and 2008 shows that prices for some generic antiretroviral drugs varied as much as tenfold between low-income countries, and some middle-income countries paid up to 16 times more than other countries with similar levels of development.

"The analysis by Brenda Waning and colleagues at Boston University School of Public Health is published this month in the Journal of Generic Medicines. "

Read more: http://www.aidsmap.com/en/news/BE7048E7-8B8F-4306-8E76-F178C8DD8FF0.asp, May 4, 2010.

BOSTON AREA: BOIL YOUR WATER (May 1, 2010 until further notice; Cambridge is OK))

"The MWRA has issued a boil water order for all households in the City of Boston and surrounding communities. Cambridge is not affected.

"Click here for updated information from the Massachusetts Water Resource Authority.

Water must be boiling for at least one minute before it is safe to drink. Do not use any tap water for cooking, baby formula, tooth-brushing, or food preparation that has not been boiled first, or is not bottled."

Read more: http://www.aac.org/, May 2, 2010.

Comment, JSJ: This warning applies to everyone, but is especially important for persons with immune deficiency.

Note: The break in a-10-foot diameter water main was discovered May 1, and became "catastrophic" during the day -- almost doubling the flow of the adjacent Charles River. To maintain water for uses like firefighting, flushing, and showers, the state had to use emergency water sources that are not safe for drinking. The emergency may end within a few days; then people in the affected areas will need to follow instructions to flush the pipes of houses and other buildings to remove the unsafe water.

U.S. Trade Watch List Threatens Access to Lifesaving Drugs

"The U.S. government’s decision to place India, Thailand, Brazil, and other countries on its annual trade "Watch Lists" is a tactic that threatens access to affordable generic drugs for patients in the developing world, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today. ...

"Thailand, Brazil and India—the world’s principal producer of quality generic medicines—were singled out for insufficient enforcement of intellectual property. However, the countries challenged are acting within their legal rights when they limit the issuance of patents—such as in India and Brazil—or when they override existing medicine patents through the use of compulsory licenses, as Thailand has done in the past.

"It is unacceptable that the U.S. is continuing to threaten developing countries aiming to provide medicines to their populations, and disregarding international commitments to ensure access to medicines," said Emi MacLean, U.S. director of MSF's Access to Essential Medicines Campaign. "The U.S. is using its trade laws to bully developing countries into applying arbitrary pharmaceutical industry requests at the expense of millions of people who depend on generic medicines in developing countries." ...

"In India this isn't a trade story, it's quite literally a life and death issue," said Leena Menghaney, MSF Access Campaign manager in New Delhi. "Any attempt or threat to India’s ability to continue to produce quality generics—and the U.S. actions today represent just that—will have a devastating effect on people living with HIV all over the developing world. ... "

Read more: http://www.doctorswithoutborders.org/press/release.cfm?id=4397&cat=press-release, April 30, 2010.