Medical Marijuana In HIV/AIDS – Part 1: Legal Support For Medical Marijuana Use Gains Steam

The AIDS Beacon: "Legal support for the use of medical marijuana, including by people with HIV/AIDS, has been a growing trend nationwide. Laws are not uniform and have often been the source of contentious debate; however, an increasing number of states have passed or are considering laws to legalize the drug for medical purposes.

"The most recent advance on the medical marijuana front is in Washington, D.C., whose city council voted last month in favor of legislation to legalize medical marijuana in the district. The bill will allow access to the drug for those with serious illnesses, including HIV infection.

"Mayor Adrian Fenty signed the bill on May 21, sending it to Congress for a mandatory review period (expected to end July 23) before becoming law."

Slow Viral Load Suppression after Starting Antiretroviral Therapy Does Not Lead to Worse Long-term Outcomes

HIVandHepatitis.com: "SUMMARY: People who experience rapid viral load suppression within the first 12 weeks after starting antiretroviral therapy (ART) and those with slower suppression after 3 months had a similar likelihood of maintaining undetectable viral load over the long term, according to an analysis of several large clinical trials presented in the June 19, 2010 issue of AIDS."

AIDS-Defining Opportunistic Illnesses in the U.S.

HIV/AIDS Clinical Care [free full text]: "Comment: The incidence of opportunistic illness has declined dramatically, thanks to the availability of prophylaxis and ART. Nevertheless, even among ART recipients in the most recent period assessed, a low CD4 count (<50 cells/mm3) was the strongest predictor of an incident OI, whereas a high viral load (>100,000 copies/mL) was the most important predictor of an opportunistic malignancy. One must not forget that opportunistic illnesses, while rare, continue to occur, particularly among patients presenting late and those on public insurance (a proxy for lower socioeconomic status). Although not new, the finding that a higher viral load is associated with opportunistic malignancies underscores the importance of maintaining virologic suppression while receiving ART."

Major vaccine report at Vienna conference, July 18, by Global HIV Vaccine Enterprise

Welcome! | Global HIV Vaccine Enterprise: "The Global HIV Vaccine Enterprise (the Enterprise) is a unique alliance of independent organizations around the world dedicated to accelerating the development of a preventive HIV vaccine. The Enterprise will put forward a Scientific Strategic Plan for HIV vaccine research and development in 2010."

From news release, June 29:
Special Report: “The Road to Prevention” (embargoed until Sunday, 18 July 11:15 am Central European time) The Global HIV Vaccine Enterprise releases “The Road to Prevention: A Special Preview of the 2010 Global HIV Vaccine Enterprise Scientific Strategic Plan."

Rosiglitazone Revisited: An Updated Meta-analysis of Risk for Myocardial Infarction and Cardiovascular Mortality

Arch Intern Med: "Conclusions -- Eleven years after the introduction of rosiglitazone, the totality of randomized clinical trials continue to demonstrate increased risk for MI although not for CV or all-cause mortality. The current findings suggest an unfavorable benefit to risk ratio for rosiglitazone."

Comments: This study was not HIV-related. The FDA is considering whether this diabetes drug will stay on the U.S. market.

The Vienna Declaration: A global call to action for science-based drug policy

The Vienna Declaration: A global call to action for science-based drug policy: "28 June 2010 [Vienna, Austria] – Three leading scientific and health policy organizations today launched a global drive for signatories to the Vienna Declaration (www.viennadeclaration.com), a statement seeking to improve community health and safety by calling for the incorporation of scientific evidence into illicit drug policies. Among those supporting the declaration and urging others to sign is 2008 Nobel Laureate and International AIDS Society (IAS) Governing Council member Prof. Françoise Barré-Sinoussi, co-discoverer of HIV.

The Vienna Declaration is the official declaration of the XVIII International AIDS Conference (AIDS 2010), the biennial meeting of more than 20,000 HIV professionals, taking place in Vienna, Austria from 18 to 23 July 2010 (www.aids2010.org)."

NIAID Web Bulletin: NIH Solicits Public-Private Proposals for Research to Purge HIV Reservoirs -- Program Named in Honor of AIDS Activist Martin Delaney

NIAID Web Bulletin: "The National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Mental Health (NIMH), both part of the National Institutes of Health, today announced a new research funding opportunity to design, develop and evaluate new strategies for curing HIV infection through partnerships among government, industry and academia. NIAID and NIMH will fund one or two grants with a total of $8.5 million per year for five years.

This request for applications (RFA), called “Martin Delaney Collaboratory: Towards an HIV-1 Cure,” is named in honor of influential AIDS activist Martin Delaney, who died of liver cancer in 2009. Mr. Delaney championed the concept of accelerating progress toward a cure for HIV infection through a public-private partnership in which the government contributes funding, regulatory oversight and coordination; industry contributes drug discovery, technology and expertise; and academia contributes innovative ideas and investigative capacity."

Oral Sex Cause of Throat Cancer Rise (WebMD)

WebMD: "Changing sexual practices have led to a dramatic rise in throat cancer in the United States over the past two decades, and experts say they fear an epidemic of the disease.

"The comments were made Wednesday at a news conference held by the American Association for Cancer Research to discuss research into the role of the sexually transmitted human papilloma virus ( HPV) in head and neck cancer.

"Increasing rates of HPV infection, spread through oral sex, is largely driving the rapid rise in oropharyngeal cancers, which include tumors of the throat, tonsils, and base of the tongue..."

People Over 60 Respond Well to HIV Treatment

POZ.com: "The vast majority of HIV-positive people older than 60 respond well to antiretroviral (ARV) therapy—achieving undetectable virus levels and substantial CD4 cell increases—according to a study published in the July 1 issue of the Journal of Acquired Immune Deficiency Syndromes."

Pipeline Problems

POZ.com - by David Evans: "“It’s getting harder and harder to hit a homerun with a new HIV drug,” says Bob Huff, a longtime HIV treatment activist from San Diego. “The current drugs are very good, and most doctors and patients are fairly satisfied…. The incentive for companies to invest in developing new HIV drugs is not strong right now.”

“It’s disconcerting,” Sharp agrees. “In terms of practical issues around drug development, we do need to put our heads together and strategize about fixing the things that are broken.”"

The Impact of Kidney Function at Highly Active Antiretroviral Therapy Initiation on Mortality in HIV-Infected Women

JAIDS Journal of Acquired Immune Deficiency Syndromes: "Conclusions: Kidney function at HAART initiation remains an independent predictor of death in HIV-infected individuals, especially in those with a history of AIDS. Our study emphasizes the necessity of monitoring kidney function in this population."

Inflammation and Mortality in HIV-Infected Adults: Analysis of the FRAM Study Cohort

JAIDS Journal of Acquired Immune Deficiency Syndromes: "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."

HIV and hepatocellular and esophageal carcinomas related to consumption of mycotoxin-prone foods in sub-Saharan Africa

American Journal of Clinical Nutrition: "Conclusions: HIV transmission frequency is positively associated with maize consumption in Africa. The relation between cancer and food suggests that fumonisin contamination rather than aflatoxin is the most likely factor in maize promoting HIV. Changes to the quality of maize may avoid up to 1,000,000 transmissions of HIV annually."

Kidneys transplanted between HIV-infected patients

The Associated Press: "South African surgeons have transplanted kidneys between donors and patients who were both infected with the AIDS virus — a medical first that has some U.S. doctors buzzing about whether it could be tried here.

The first four of the transplants, which occurred in 2008, are described in Thursday's New England Journal of Medicine.

Five more have been done since then at the same Cape Town hospital, Groote Schuur. It's the only medical center in the world to have done them, said one of the transplant surgeons, Dr. Elmi Muller."

HIV Infection, Inflammation, and Premature Aging [video presentations]

CFAR Symposium 2010: HIV Infection, Inflammation, and Premature Aging:
Tuesday, May 18, 2010 (date of symposium)


The Intersection of HIV and Aging

Development and Reversion of Immunosenescence in HIV-1 Infection
Victor Appay, PhD

The Role of HIV-Associated Inflammation in Aging
Russell P. Tracy, PhD

Polarized Immune Responses Regulate Cancer Development
Lisa Coussens, PhD

How Might HIV Infection and Therapy Drive Aging and Age-Related Disease?
Judith Campisi, PhD

The HIV Tat Protein Regulates Immune Activation via SIRT1
Melanie Ott, MD, PhD


Translational Implications of HIV and Aging

Non-AIDS Morbidity: Accelerated Aging or Disease-Related Risk Factor?
Carl Grunfeld, MD, PhD

The Intersection of HIV and Geriatric Medicine
Kenneth Covinsky, MD, MPH

Bridging the Basic and Clinical: Novel Therapeutic Strategies to Prevent HIV-Associated Aging
Peter Hunt, MD

HIV and Osteoporosis
Steven T. Harris, MD, FACP

HIV-Associated Inflammation and Accelerated Decline in Renal Function
Andy Choi, MD

HIV, Inflammation, and Atherosclerosis
Priscilla Hsue, MD

HIV-1, Inflammation, and Neuropathogenesis: Implications for Neurological and Cognitive Function
Serena Spudich, MD

Myriad Genetics Suspends Its HIV Maturation Inhibitor Program

AIDSmeds.com: "Myriad Genetics announced it is suspending its HIV drug development program and will focus instead on oncology drugs. The company says it is taking this step “for strategic, business reasons; and a reduction in workforce.”

Myriad had been developing a maturation inhibitor called bevirimat (MPC-4326, PA-457) since 2009, after purchasing the rights to the drug from Panacos Pharmaceuticals."

Video coverage of San Francisco awards to Dr. Hütter

CBS5.com: "Three years ago, a doctor from Berlin performed a stem cell transplant that likely cured a man's HIV. Now California researchers hope to advance the doctor's research.

On the steps of City Hall in San Francisco, top dignitaries honored a young doctor from Germany, and for very good reason. Dr. Gero Hütter may have found a way to cure patients of HIV infections and AIDS."

Notes:

CBS video interview at http://cbs5.com/video/?id=65956@kpix.dayport.com

Also see ABC's coverage at http://abclocal.go.com/kgo/story?section=news/health&id=7477511

The awards and ceremony to honor the work of Dr. Gero Hütter were organized by the AIDS Policy Project. The patient, a U.S. citizen treated in Berlin, has been free of detectable HIV for about three years so far.

GERMAN DOCTOR HONORED FOR FIRST FUNCTIONAL CURE FOR HIV/AIDS

AIDS Policy Project: June 3, San Francisco City Hall, Front Steps, 11:30 AM

"Gero Hütter, MD, the Berlin physician who performed the historic stem cell transplant in 2007 that has to date functionally cured an American patient with HIV/AIDS, will be honored by San Francisco Supervisor Ross Mirkarimi and the AIDS Policy Project on the steps of San Francisco City Hall.

"Dr. Hütter’s achievement, known colloquially as the “Berlin patient,” has sparked great interest in the scientific community. However, few people outside the scientific world have taken note of this case, which is likely the first successful cure of a person with AIDS. The patient has been completely HIV-free for three years; there is no fixed threshold for when a patient is considered officially cured, since it has never happened before. Grassroots AIDS treatment activists, including many people with AIDS, asked Supervisor Mirkarimi to make this proclamation thanking Dr. Hütter for his work."

Universal Care Linked to High HIV Treatment Success Rates in U.S. Military

POZ: "HIV-positive U.S. military personnel—all of whom receive free health care—had much higher rates of success with antiretroviral (ARV) therapy than is typically seen in the average medical practice, according to a study published May 27 in AIDS Research and Therapy."

Two Independent Epidemics of HIV in Maryland

JAIDS Journal of Acquired Immune Deficiency Syndromes: "Conclusions: Multiple HIV-1 subtypes exist in the Baltimore-Washington metropolitan area with a significant non-B-infected population in the Maryland suburbs of Washington, DC, suggesting 2 independent epidemics of HIV in Maryland. Population-based surveillance inclusive of groups at higher risk of non-B strains is essential to monitor the prevalence and variations of HIV subtypes in Maryland and the United States."

Loss caused by some anti-HIV drugs persists in the long term

Aidsmap: "Discontinuing treatment with d4T, the drug most associated with fat loss, had little long-term impact on limb-fat gain. Patients who adopted this strategy experienced an average annual increase of fat in the leg of only 1%. “Likewise”, write the investigators, “little gain was associated with discontinuation of AZT or other antiretroviral drugs."

Lost funding means lost lives, says MSF

Aidsmap: "'About 75 percent of HIV funding in developing countries is international – you can't replace that in the short term,' said Mit Philips, a health policy analyst at MSF and one of the report's authors."

Treatment and PrEP could be on a ‘collision course’, warns resistance expert

Aidsmap: “I’ve explained the importance of resistance at major think-tanks and people just don’t get it,” he said. People did not make the connection between the misuse of drugs as prophylaxis and subsequent drug resistance: “Look at all the cows being bombed with antibiotics and the number of resistant enteropathogens like MRSA developing.”

Abacavir/Lamivudine/Zidovudine Maintenance After Standard Induction in Antiretroviral Therapy-Naïve Patients: FREE Randomized Trial Interim Results

AIDS Patient Care and STDs: "Maintenance with a triple nucleoside reverse transcriptase Inhibitor (NRTI) regimen after successful induction with a dual NRTI/protease inhibitor (PI) combination may be advantageous, because of low pill burden, favorable lipids, and less drug interactions. ... Patients were randomized after reaching VL less than 50 copies per milliliter on two consecutive occasions between 12 and 24 weeks after start of zidovudine/lamuvidine and lopinavir/ritonavir combination. ... Patients on successful standard ART can be safely switched to a NRTI-only regimen, at least for the tested time period."

Rituximab Treatment for Thrombotic Thrombocytopenic Purpura Associated with Human Immunodeficiency Virus Failing Extensive Treatment with Plasma Ex...

AIDS Patient Care and STDs:"Initial treatment with plasma exchange resulted in resolution of these abnormalities. However, the discontinuation of plasma exchange resulted in the prompt recurrence of laboratory abnormalities diagnostic for TTP. Treatment failure was established after observing 6 and 4 such responses requiring 41 and 40 episodes of plasma exchange for each patient, respectively. Patients were subsequently treated with 2–4 doses of weekly rituximab resulting in durable remission. These patients are now 21 and 9 months beyond rituximab treatment. Rituximab appears to be safe and effective in this setting."

Prevalence and Factors Associated with Renal Dysfunction Among HIV-Infected Patients

AIDS Patient Care and STDs - 0(0):"In summary, renal dysfunction was relatively uncommon among our HIV-infected patients, perhaps due to their young age, lack of comorbidities, or as a result of our definition that did not include proteinuria. Renal dysfunction was associated with duration of tenofovir use. Factors associated with renal loss among tenofovir users included female gender, African American ethnicity, and CD4 nadir <200cells/mm3. Consideration for more frequent monitoring of kidney function among these select HIV patients may be warranted."