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July 30, 2010

[Illinois] ADAP's gonna make it after all! But what about everything else?

AIDS Connect: "WHEW! Illinois AIDS Drug Assistance Program (ADAP) clients and AIDS advocates breathed a sigh of relief on July 16. State public health officials announced that day that Governor Quinn had allocated enough state funding to avoid an ADAP waiting list or major cost containment. THANK GOVERNOR QUINN!

"But will people with HIV have access to housing and care programs that help them connect to ADAP and stay healthy? Will people at risk of HIV be able to turn to HIV prevention programs to help them stay negative? Last year, these programs were cut by over $7 million. Make sure they’re not cut again!"

Illinois Prisons Test HIV Telemedicine

AIDS Connect: "Kudos to the Illinois Department of Corrections for trying a new HIV and hepatitis treatment system! AIDSConnect looks forward to learning more about this project."

New laws will reduce the spread of HIV/AIDS, advocates say

Politics on the Hudson: "Gov. David Paterson announced today that he signed two bills aimed at reducing the spread of HIV/AIDS. The first will allow patients to agree to HIV testing in a general consent form that stays in effect until it expires or consent is revoked, and it will require health-care providers to offer testing to patients who are between 13 and 64. The second law clarifies that intravenous drug users who are part of a needle-exchange program can’t be prosecuted for having trace amounts of drugs in syringes they are turning in.

“By making HIV testing a routine part of health care, this legislation will increase HIV testing rates, letting people learn their status and begin treatment at an earlier stage, which can significantly improve the length and quality of life and help reduce transmission of the disease,” Paterson said in a statement."

Wood: Drug war has hand in HIV epidemic (Austin): "Vienna was selected to host the biannual meeting of HIV experts because it is the gateway to one of the world's most rapidly growing HIV epidemics: that among heroin users in Eastern Europe. Outside sub-Saharan Africa, about one in three new HIV infections stems from injecting illegal drugs, and in some parts of Eastern Europe and Central Asia, 70 percent of those who inject illicit drugs are infected with the virus.

"In response to these statistics, this year's conference endorsed as its official statement the Vienna Declaration, a document I helped draft to draw widespread attention to how the U.S.-led war on drugs has played a central role in driving the HIV epidemic around the world.

"Writing in the medical journal the Lancet, where the Vienna Declaration was also published, Michel Sidibe, the executive director of the Joint United Nations Program on HIV/AIDS (UNAIDS) and other prominent scientific leaders stated the situation succinctly: "The war on drugs has failed."

"Criminalizing drug abuse drives addicts deeper underground and into the kinds of unsafe practices such as needle-sharing that spread infection. We have seen that countries with the most draconian drug laws also have the highest rates of HIV infection among users. In Russia, for example, where one in 100 adults is now estimated to be HIV-infected, a drug war has outlawed basic harm reduction tools, such as methadone maintenance treatment. Methadone is on the World Health Organization's list of essential medicines, but Russian physicians cannot openly discuss the need to prescribe the treatment without fear of reprisals.

"The mass incarceration of drug users is particularly alarming, given the spread of HIV in prisons. A Pew Trusts analysis of U.S. Department of Justice data noted that one in nine [U.S.] black males ages 20 to 34 is in prison, many of them as a result of drug law enforcement. Given the link between prisons and HIV, it is not surprising that in places such as Washington more than 80 percent of HIV cases identified between 2001 and 2006 were among blacks. ...

"Given the international public health emergency presented by HIV among drug users and the estimated $2.5 trillion in tax dollars wasted on the drug war over the last 40 years, the U.S. should move forward with this simple call."

N.J. restores drug funds for low-income HIV/AIDs patients "Alaigh said that the state learned this month that it will receive approximately $5 million in additional rebates recently negotiated from pharmaceutical companies and that — along with newly available federal AIDS grant funding will enable the department to automatically transfer those no longer eligible for the ADDP program into the new program called the Temporary AIDS Supplemental Rebate and Federal Assistance Program.

"The National Alliance of State and Territorial AIDS Directors recently convened a crisis task force which successfully negotiated additional rebates from pharmaceutical companies in response to cost containment efforts that many states were forced to make.

"In addition, New Jersey expects to receive a share of a new federal ADDP grant program announced earlier this month by the U.S. Department of Health and Human Services."

July 27, 2010

New findings may impact HIV drug use

Sydney Morning Herald: "The findings showed that Ritonavir, an older, commonly used drug, which was formerly linked to heart risk, had more adverse effects on people's metabolisms than the newer drug, Raltegravir.

"Ritonavir looks like it's increasing blood fat levels, not only when people are fasting but also after (eating) meals," one of the researchers, Associate Professor Katherine Samaras, told AAP. ...

"The key message, she says, is that each individual's heart risk profile should be assessed before prescriptions are decided.

"'When we weigh up the risks and the benefits of HIV treatment, we have to consider the best drug to stop the virus,' she said.

"'If there are other drugs available that do the job equally well then it looks like (some) people should be considered for (a drug) that does not increase heart risk.'"

Ohio to cut HIV drug program to trim spending

Dayton Daily News: "The state plans to drop another 500 Ohioans from a program that pays for their HIV medications, in order to save Ohio nearly $3 million per year.

"Officials are working on a plan to help only the sickest Ohioans with HIV pay for their medicine, said Jay Carey, a management analyst for the HIV drug program.

"The plan, which Carey said will likely start next month, comes after 250 people were dropped from the program earlier this month."

Comment: It doesn't make sense to require people to get sick first, before getting essential treatment.

Nor to have patients die instead of having corporations supply more drugs to the state program for the same total price -- at very little marginal cost to produce them.

Nor that Congress today appropriated more that 10,000 times the $3 million, for yet another installment on the wars.

Clearly the social compact isn't working. But so far there isn't much attention on how to change it so that it does.

The Cure Blog: A lab, a plant, a compound ten times more powerful than prostratin?

The Cure Blog: "It's exciting--the compound works using two different mechanisms. When cells are latent, it reactivates the virus. Also, it protects uninfected cells around any infected cells.

"So it activates HIV but decreases HIV infection in culture [in the Petri dish or test tube]. The idea would be to use pulsing treatments—on again, off again.

"Next step: To test the compound in mice.

"Obstacles: There is not much money for basic science research in Europe."

Tibotec Submits Approval Application for HIV Non-Nuke Rilpivirine "Tibotec Therapeutics, a subsidiary of Johnson & Johnson, announced on Monday, July 26, that it has filed a New Drug Application (NDA) with the U.S. Food and Drug Administration for rilpivirine (TMC278), its experimental non-nucleoside reverse transcriptase inhibitor (NNRTI). Tibotec is seeking approval of rilpivirine as a once-a-day option for patients starting HIV treatment for the first time.

"The company’s NDA is based on the 48-week results of two Phase III clinical trials, known as ECHO and THRIVE. Preliminary results from these two studies were reported Thursday, July 22, at the XVIII International AIDS Conference in Vienna."

The Cure Blog: An AIDS Patient Quits his Drugs

The Cure Blog: "This patient with an incredibly tiny viral load stopped taking his AIDS drugs. And stayed near HIV-free for 50 days. And then the HIV-infected cells, which still existed in small numbers somewhere in his body, started to divide. The amount of HIV in his body started to increase. He had to start his AIDS drugs again. ...

"Yet this will be the acid test that will determine whether any patient is cured. This was the test that the Berlin Patient passed (see a previous post; we will also discuss the case of the Berlin Patient again in the future). Either the patient must be taken off his or her drugs, or researchers must develop a clinical marker that shows whether or not the patient's body is HIV-free or is controlling the virus without actually having to risk stopping the drugs."

July 25, 2010

Talk's cheap; treating HIV isn't "The blueprint earns points for being the first presidential master plan to decrease AIDS and HIV, an important step in a nation where 1.1 million people are infected already and health experts believe that thousands more are unaware that they have the disease and could infect others.

"But national strategies require national funding. On that score, Obama's plan falls short.

"If it succeeds, it will add more patients to an overcrowded, underfunded pool. The $19 billion a year that the United States already spends on HIV and AIDS won't cover them."

July 24, 2010

AIDS 2010 Conference blog

AIDS 2010: "Here are the final numbers for AIDS 2010:

• 19,300 participants, including:
- 16,012 delegates
- 845 participants from Austria*
- 1,218 participants from Eastern Europe and Central Asia
- 848 scholarship recipients
- 1,276 media delegates
• 770 volunteers
• 197 countries represented
• 10,831 abstracts submitted, 6,238 abstracts accepted
• 248 sessions (59 non-abstract driven sessions, 79 workshops, 110 abstract-driven sessions)
• 19 plenary speeches
• 18 special sessions
• 279 Global Village activities, including 55 sessions, 95 NGO booths and 27 Networking Zones
• 151 exhibits
• 127 satellite meetings
• 10 scientific prizes and awards
• 12,324 Facebook fans, 8,420 #AIDS2010 tweets and 48 blog posts
• 71,043 visits to (since Sunday, 18 July)
• 12,725+ Vienna Declaration signatures (as of Friday, 22 July)

* Does not include general public participation in the Global Village, which is difficult to estimate." "The intersection of aging and HIV infection appears to have a destructive impact on bone health. Researchers at Emory University School of Medicine have shown in an animal model that the presence of HIV proteins, even without a replicating virus, leads to alterations in cells that break down bone.

"The team’s results were published this week online in the Early Edition of the Proceedings of the National Academy of Sciences.

"We found that HIV proteins, by themselves, can alter the output of hormones that affect the balance between bone formation and bone breakdown leading to bone loss,” says senior author M. Neale Weitzmann, MD, assistant professor of endocrinology at Emory University School of Medicine. “This information could help doctors decide the best way to stave off osteoporosis and bone fractures, which are becoming increasingly common in individuals living with HIV infection.”

July 23, 2010

Closing Session of the International AIDS Conference in Vienna [Video]

Closing Session - Kaiser Global Health:

This video works well. Length is almost two hours, but you can move the slider to get to the speaker you want.

Waheedah Shabazz of ACT UP Philadelphia, speaking on human rights, is introduced at 1:28:50 (one hour 28 minutes and 50 seconds into the video).


"Closing Remarks
Brigitte Schmied (Austria)

Co-Organizers' Remarks
Rachel Ong (Singapore)
Patricia Perez (Argentina)
Introduction of the New IAS President
Julio Montaner (Canada)

Presentation of the IAS Presidential Award
Awardee: Jack Whitescarver (United States)

Inaugural Speech
Elly Katabira (Uganda)

Video Message
U.S. President Barack Obama and U.S. Secretary of State Hillary Clinton

Human Rights as a Conscious Achievement
Waheedah Shabazz (United States)

Introducing AIDS 2012 Local Partners/ Hand-Over of the AIDS 2010 Globe
Diane Havlir, AIDS 2012 Local Co-Chair (United States)

AIDS 2012 in Washington, D.C.
Sch�nbrunn Palace String Quartet

Thank You to Sponsors and Supporters/Closing Ceremony"

CDC Study Reveals High HIV Infection Rates Linked to Poverty More than Race "SUMMARY: Local HIV/AIDS epidemics in some large U.S. cities have reached the status of 'generalized epidemic,' meaning there is significant HIV transmission outside defined risk groups such as gay/bisexual men and injection drug users, researchers from the Centers for Disease Control and Prevention (CDC) reported at the XVIII International AIDS Epidemic this week in Vienna. They also found that poverty, rather than race/ethnicity per se, is the major demographic factor influencing HIV prevalence among heterosexuals in economically disadvantaged urban areas."

New International AIDS Society-USA Guidelines Recommend Starting Antiretroviral Therapy at 500 "Coinciding with the XVIII International AIDS Conference (AIDS 2010) this week in Vienna, the International AIDS Society-USA (IAS-USA) has released new antiretroviral therapy (ART) guidelines for adults with HIV. The updated guidelines, published in the July 21, 2010 Journal of the American Medical Association (JAMA) concur with the current U.S. Department of Health and Human Services recommendations, which advise that asymptomatic people should initiate ART when their CD4 T-cell count falls to 500 cells/mm3. But there is no CD4 count upper limit for starting treatment, and the expert panel recommended therapy for certain groups regardless of CD4 cell level. However, they emphasized, it is important to assess individual readiness before starting ART."

Comment: The two U.S. guidelines generally agree on important matters.

Experimental integrase inhibitor GSK-572 shows continued promise "The second-generation integrase inhibitor S/GSK1349572, or GSK-572 for short, continues to demonstrate potent antiviral activity – including activity against HIV strains resistant to raltegravir (Isentress) – as it prepares to enter Phase III clinical trials, according to two studies presented this week at the Eighteenth International AIDS Conference in Vienna."

Second-ever pre-exposure prophylaxis study reports no safety concerns and promising result "The last day of the Vienna International AIDS Conference featured the results of the second-ever completed randomised controlled trial of pre-exposure prophylaxis (PrEP) – giving antiretrovirals to HIV-negative people at high risk of HIV to prevent them becoming infected.

"The trial, which randomised 400 gay men to take either a daily tenofovir (Viread) or a daily placebo pill, was too small to serve as an efficacy trial.

"Lisa Grohskopf of the US Centers for Disease Control (CDC) told the conference that none of the seven men who became infected with HIV during the trial was taking tenofovir but, because of the size of the trial, this could possibly be a random effect – nothing could be read into it about the efficacy of once-daily tenofovir as a means of preventing HIV."

Penal reform, decriminalisation of illicit drugs, and increased advocacy all central to improving prisoners' health "Speaking of his own experience, Albert Zaripov of Russia said that he regularly saw syringes used by 20 or 30 people, with substances being easily procured. “There was no aid at all, no social aid, no medical aid, nothing at all,” he said. “This is quite common in places of … detention.”"

UK: one in six gay men testing HIV-positive were infected recently "The first data from new systems of detecting recent HIV infection in the UK have shown that among those diagnosed, one in six gay men were infected in the past few months, whereas only one in 16 heterosexuals were. Sam Lattimore of the Health Protection Agency presented the results to the Eighteenth International AIDS Conference today.

"A Recent Infection Testing Algorithm (RITA, sometimes also known as Serological Testing Algorithm for Recent HIV Seroconversion, or STARHS) works by looking for specific antibody markers, which give different results in the months immediately following infection. If a test gives a result below a pre-determined cut-off point, it is deemed to be a recent infection (approximately the last six months)."

CASCADE analysis finds antiretroviral treatment benefits are evident below CD4 count of 500, uncertain above this level "Starting antiretroviral therapy with a CD4 cell count between 350 and 500 cells/mm3 reduces the likelihood of HIV disease progression and death relative to initiation below 350 cells/mm3, according to findings from the large CASCADE study presented on Thursday at the Eighteenth International AIDS Conference in Vienna. Starting treatment with more than 500 cells/mm3 did not appear to confer additional benefit, but this analysis did not take into account non-AIDS-related conditions.

"Numerous randomised trials have demonstrated the benefits of starting antiretroviral treatment before significant immune system damage occurs; that is, before the CD4 cell count falls much below 350 cells/mm3 and certainly before it hits 200 cells/mm3."

Strong scientific findings presented at AIDS 2010 point to promise ahead and underscore the need to stay the course

AIDS2010: "'International governments say we face a crisis of resources, but that is simply not true: The challenge is not finding money, but changing priorities. When there is a Wall Street emergency or an energy crisis, billions upon billions of dollars are quickly mobilized. People's health deserves a similar financial response and much higher priority,' said Dr. Julio Montaner, AIDS 2010 Chair, President of the International AIDS Society and Director of the B.C. Centre for Excellence in HIV/AIDS in Vancouver, Canada. 'Billions of people stand in solidarity with us in our drive for universal access. We must rally their support behind Michel Sidibé's Prevention Revolution and Treatment 2.0 initiative and UNAIDS to ensure that world leaders do not turn their backs on their pledge to reach the goal of universal access.'"

New drugs; Hep C; Human rights; Activism; More

Aidsmap (NAM)

Today's post from International AIDS Conference


"New drug – rilpivirine does well in trials
New drug – experimental integrase inhibitor shows promise
HIV and hepatitis C – bone problems more common
HIV and children – early treatment cost-effective
HIV and tuberculosis – rapid ART saves lives
Human rights central to HIV prevention for men who have sex with men
Extended-release nevirapine works well
Where now for AIDS activism?
Treatment literacy illustrated – and translated
More coverage of the conference"

Towards a Cure: HIV Reservoirs and Strategies to Control Them

Towards a Cure: HIV Reservoirs and Strategies to Control Them: "From 16 to 17 July, immediately prior to the XVIII International AIDS Conference (AIDS 2010), the International AIDS Society held a workshop addressing the critically important subject of moving beyond antiretroviral therapy and addressing HIV persistence. Towards a Cure: HIV Reservoirs and Strategies to Control Them was co-sponsored by the French National Agency for Research on AIDS and Viral Hepatitis (ANRS), Bundesministirium fur Wissenschaft und Forschung (BMWFa), the National Institutes of Health (NIH), Sidaction and Treatment Action Group (TAG). ...

"In the closing session, Daria Hazuda from Merck & Co. reviewed some of the issues in conducting industrial-scale screening of compounds for anti-latency activity. As Hazuda noted, many research teams have identified compounds known as histone deacetylase (HDAC) inhibitors that can prod HIV out of hiding, and a number of the drugs (such as SAHA) already are approved for human use in cancer. Several additional pharmaceutical companies are known to be initiating programs to search for potentially curative drugs.

"Detailed rapporteur summaries from the workshop will soon be available on the AIDS 2010 website, and a meeting summary will be published in the Journal of the IAS. The Thursday conference session “Persistence of HIV Reservoirs” (THAA01) will include some of the abstracts that were presented, and additional background materials and a press release about the workshop will be made available today. Slide presentations will be posted on the workshop website by the end of July.

"A background review outlining the key scientific issues was published in Science on 9 July 2010."

July 22, 2010

AIDS Research Alliance awarded $250,000 by Pepsi Refresh Project

"(LOS ANGELES, CA, July 22, 2010).  Today, Carolyn Carlburg, President & Chief Operating Officer of AIDS Research Alliance of America, expressed deep gratitude to the hundreds of thousands of donors and friends across the United States who voted for AIDS Research Alliance in the Pepsi Refresh competition (, an online social marketing campaign conducted through the month of June.  Estimates suggest that AIDS Research Alliance garnered about half a million votes over 30 days, ending the month of June as a finalist.  Declared a winner by the Pepsi Refresh Project today, AIDS Research Alliance will receive a grant of $250,00 to purchase state-of-the-art laboratory equipment to advance its cure-focused research."

Comment: Good news, but also note the social significance of this kind of event. Win considerable money through a contest to engage the most people in a Pepsi campaign (here, half a million people -- 50 cents each for Pepsi, actually much less counting those who voted in the losing campaigns). I don't know if it's good or bad, but it won't work for most organizations. They will motivate their volunteers, then disappoint them with zero return.

Great work by AIDS Research Alliance, however. JSJ

Vienna protest photos, AIDS2010 day 1

Click here to choose photos.
By Kaytee Riek,

The future of AIDS activism: looking for sustained energy and new tactics 10 years after Durban "But activists are worried that the next decade may not be as energetic as the one prior, which was spurred on by Durban successes. “I’m questioning how we can sustain the energy that we made at Durban another ten years,” said Mark Heywood, Executive Director of South Africa’s Section 27 (formerly the AIDS Law Project). “We have more tools than we had before, we have more knowledge that we had before. But tools and knowledge are not self-implemented. There has to be an energy… What we need most is our ability to sustain … effective civil society.”

"According to Paula Akugizibwe of the AIDS and Rights Alliance for Southern Africa (ARASA), the movement may in fact be entering its most trying period yet. “The situation today is a lot more complex,” she said. “We’re still facing financially driven political hostility, but [now] it’s being presented under pseudo-scientific arguments.”

“I think there’s a danger in fighting for political decisions to be made […] and then thinking that we’ve wont the battle,” Akugizibwe continued. “But that’s actually when [it] really begins. And that’s often the most difficult battle because [it] is not so clearly defined.”

"According to Heywood, political gains can both harm and help the AIDS movement. Heywood questions the effectiveness of what he calls “the co-option of activists into the national response … Sometimes it is very difficult to tread the line between constructive partnership … and … forced silences that become a condition of ongoing partnerships.” Heywood noted that he speaks from personal experience, acting as chairperson of the South African National AIDS Council, which comprises representatives from government, civil society and the business sector.

"Akugizibwe contends that supporting activists working locally is key to the continued success of the movement. Noting that many ARASA partners face intimidation by both government offices and UN agencies when speaking out about health systems’ failings, Akugizibwe said: “These are the realities in which activism is taking place in many countries in the African region … we have seen a strong pushback from governments.”

National AIDS Fund Receives $3.6 Million Social Innovation Fund Award From Corporation for National and Community Service For Access to Care Initiative

National AIDS Fund: "WASHINGTON, D.C. July 22, 2010 - The National AIDS Fund (NAF) announced today it is one of 11 organizations to receive the first-ever Social Innovation Fund (SIF) grants, an initiative administered by the Corporation for National and Community Service. The $3.6 million SIF grant will enable NAF to expand the scope of its Access to Care initiative in support of innovative public-private partnerships to improve individual health outcomes and strengthen local services systems, connecting economically and socially marginalized individuals living with HIV to high quality supportive services and health care."

TBR-652 blocks both CCR5 and CCR2, inhibiting HIV replication and reducing inflammation "TBR-652, a dual antagonist or blocker of both the CCR5 and CCR2 cell surface receptors, shows potent activity against HIV and also dampens inflammation, participants heard at the Eighteenth International AIDS Conference this week in Vienna.

"HIV can use two different surface co-receptors – CCR5 and CXCR4 – along with the CD4 receptor to enter T-cells. CCR5 blockers interfere with this process by preventing HIV from attaching to cells. Unlike the sole approved CCR5 antagonist maraviroc (Celsentri), however, TBR-652 also disrupts attachment to CCR2.

"As David Martin from Tobira Pharmaceuticals explained at the conference, CCR2 plays a role in inflammation by binding to monocyte chemoattractant protein 1 (MCP-1), a chemical messenger that summons monocytes and macrophages, types of immune system white blood cells. CCR2 has been studied in relation to a variety of inflammatory diseases including atherosclerosis and metabolic syndrome, and blockade of this receptor appears safe to date.

"A growing body of evidence indicates that low-level persistent HIV infection – even in people on suppressive antiretroviral therapy – can trigger ongoing immune activation and chronic inflammation that contribute to a range of non-AIDS health problems including cardiovascular disease, neurocognitive impairment and non-AIDS-defining cancers. Eventually persistent cell activation can result in immunosenescence, or premature aging and depletion of the immune system.

"Researchers designed a Phase 2 study to test multiple doses of TBR-652 monotherapy, given orally once daily for ten days. A total of 54 participants with confirmed CCR5-tropic HIV were randomly assigned to five groups receiving TBR-652 doses of 25, 50, 75, 100 or 150mg per day; the 100mg group used a slightly different formulation. Two participants in each cohort received placebo."

J&J AIDS drug shows promise, raises questions

Reuters: "Two pivotal trials of a Johnson & Johnson (JNJ.N) experimental HIV drug found it worked as well as an existing drug, with fewer side effects but also with nearly twice as many patients failing to respond to treatment.

"The drug, rilpivirine or TMC278, is a non-nucleoside reverse transcriptase inhibitor (NNRTI) being developed for use in combination therapy for treating the human immunodeficiency virus (HIV) that causes AIDS.

"J&J already has a deal with U.S. biotech company Gilead Sciences (GILD.O) to develop a single pill combining rilpivirine with Truvada, a drug containing Gilead's tenofovir and emtricitabine.

"Gilead currently sells a once-daily pill, Atripla, that combines Truvada with Sustiva, an older NNRTI made by Bristol-Myers Squibb (BMY.N). But it earns no profit on the Bristol drug, known generically as efavirenz, and all of the Atripla components lose patent protection in the next few years. ...

"Fewer TMC278 patients, 2 percent, dropped out of the trials due to side effects versus 7.2 percent of the Sustiva group, according to results presented at the International AIDS Conference in Vienna on Thursday.

"Serious side effects, including psychiatric and neurologic problems, were seen in 16 percent of the TMC278 group versus 31 percent of the Sustiva group.

"But the data also showed 9 percent of TMC278 patients experienced virologic failure compared to 4.8 percent of Sustiva-treated patients."

End abuse of injecting drug users, step up treatment: IAS urges in global report "“Seek, test, treat and retain” are the main points of today’s report, which advocates a new approach to treating injecting drug users (IDUs).

"'Offering Opioid Substitution Therapy (OST), such as methadone or buprenorphine, significantly decreases HIV acquisition and transmission and increases the chances of HIV positive people who inject drugs taking up and staying on highly active anti retroviral therapy (HAART),' said Professor Dr Charles O’Brien.

"A researcher from the University of Pennsylvania and co-author, he says: 'This in turn can lead to reductions in the community viral load and decrease new infections.'

The authors call for expanded access to highly-active antiretroviral treatment (HAART) among 'high-risk, hard-to-reach drug using populations'."

Note: Press release.

Barack Obama 'hurt' by global Aids funding criticism

The Guardian (UK): "But Stephen Lewis, a former UN special envoy for HIV/Aids in Africa and founder of Aids Free World, told the conference there were no excuses. 'Somewhere between $1tn and $2tn were freed up for a stimulus package to bail out huge numbers of financial institutions,' he said.

"'It is just not reasonable in the state of human priorities to think that [an extra] $1bn [in addition to the expected $1bn donation to the global fund] cannot be raised to confront one of the health tragedies of our times.'"

Today - GcMAF poster exhibition, #THPE0051, best from 12:30 - 14:30

by John S. James

Why It Matters

Here is an HIV-eradication research direction ignored by the AIDS research mainstream, though many peer-reviewed papers have been published -- one claiming HIV eradication in patients in clinical trials in Japan. Not only Drs. N. Yamamoto and others, whose work will be presented today at the International AIDS Conference, but also other research teams have worked with this substance (usually in cancer not HIV); there is agreement that it does have anti-cancer activities at least in mice, and should be a basis for drug development (for example, to find a small molecule that mimics its effects).

GcMAF also got into the cancer-treatment underground, which may be why few scientists have paid attention to it.

At today's poster, the presenting author is listed as Dr. Marco Ruggiero, a molecular biologist who has not published on GcMAF before. We do not know if Dr. Yamamoto (who is the senior author of the poster) will be there.

If GcMAF eradicates HIV in patients as Dr. Yamamoto describes, this poster could be the most important presentation at the Vienna conference.

Do we think it's a cure? No, because most treatments fail. But it could possibly be a major advance, so it should get attention. Today is the best time for scientists around the world to get a look.

A recent press report quoted Dr. Dieffenbacher, director of the AIDS Division at US NIAID, as saying "there is really a dearth of new approaches" for HIV eradication. Could this be a garden-variety case of group dynamics, where insiders talk to each other and keep narrowing their focus, not seeing anything of interest outside the narrow spotlight beam, and becoming increasingly irrelevant? Big advances often come from outside.

Background Info

Today's (Thursday's) poster is # THPE0051, titled "Gc protein-derived macrophage activating factor (GcMAF) stimulates activation and proliferation of human circulating monocytes," by M. Ruggiero, S. Pacini, and N. Yamamoto. It is in the poster exhibition. The presenter is usually there from 12:30-14:30.

Dr. Yamamoto's most recent paper, which reports HIV eradication in people, is Immunotherapy of HIV-Infected Patients With Gc Protein-Derived Macrophage Activating Factor (GcMAF) (Journal of Medical Virology, January 2009).

Also search PubMed ( for GcMAF. The substance has different names, so also try DPB-MAF. Or search for "vitamin D binding protein" -- which is a precursor of GcMAF.

And for any of those searches you can look at Related Citations -- e.g. the 132 citations related to the search result for GcMAF.


AIDS Treatment News and this writer have no conflict of interest, no relationship with anyone involved with GcMAF.

Avahan: The Business of HIV Prevention at Scale

Bill & Melinda Gates Foundation: "Many of us came from a business background, where scale and growth are what creates value, and when we created Avahan, the India AIDS Initiative of the Bill & Melinda Gates Foundation, we wanted to bring that vision to the epidemic. We were conscious we had a lot to learn, but a lot to share too.

"Four years later, Avahan is proving it is possible to integrate sound business and public health principles to create a large-scale program. Our session in Vienna 'The business of prevention at scale' was well attended by those who recognize our work and those who wanted to learn more"

July 21, 2010

The Vienna Declaration

Over 11,200 people have signed the Vienna Declaration. Have you? You do NOT need to attend the International AIDS Conference in Vienna.

"The Vienna Declaration is a statement seeking to improve community health and safety by calling for the incorporation of scientific evidence into illicit drug policies. We are inviting scientists, health practitioners and the public to endorse this document in order to bring these issues to the attention of governments and international agencies, and to illustrate that drug policy reform is a matter of urgent international significance. We also welcome organizational endorsements. For a brief listing of high profile endorsements to date, please click here."

Note: also refers people to the International Centre for Science in Drug Policy.

ACT UP banners in Vienna

"People keep coming by the networking zone at AIDS2010 where the ACT UP banners are hanging, and taking photos of the banners. Some people even pose in front of the banners!

"People really like the 'AIDS is not in recession' one!"

Kaytee Riek, to ACT UP Philadelphia

The 2010 Pipeline Report

Treatment Action Group: "Treatment Action Group's 2010 Pipeline Report reports on all the latest developments in the treatment pipeline for HIV, tuberculosis, hepatitis C, and this year, hepatitis B. This year TAG collaborated with HIV i-Base UK. Simon Collins contributed an in-depth analysis of the Antiretroviral Pipeline and Polly Clayden wrote new chapters for the report on Pediatric Antiretrovirals and HIV diagnostics."

Costa Rica: Abbott Against Hetero with PLWA caught in the Middle

Agua Buena Human Rights Association: "During the past four to six weeks, an Abbott Laboratories HIV product representative has been contacting People Living with HIV/AIDS in Costa Rica, urging them to participate in a lawsuit to be filed with the Costa Rica Supreme Court, declaring that a generic version of Abbott’s ARV Kaletra(Lopinavir/Ritonavir) produced by Hetero drugs of India is unsafe and should not be used in Costa Rica.

"Hetero drugs won a competitive bidding process in February of this year, and the drugs were legally approved by the Costa Rica Ministry of Health for purchase and are now in the country. Abbott by encouraging PLWA to participate in a lawsuit, is attempting to block their distribution. When the current stock of Abbott’s Kaletra runs out, in early July, the health care system will begin using the generic version, unless the Court rules otherwise."

Shionogi-ViiV Healthcare Announces Commitment to Phase III Development Program for Investigational Once-Daily HIV Integrase Inhibitor

AlphaTrade Finance: "Shionogi-ViiV Healthcare LLC today announced that it will be progressing its once-daily, unboosted investigational integrase inhibitor, S/GSK1349572 ('572) into Phase III clinical trials. '572 will be the only once-daily, unboosted integrase inhibitor in Phase III clinical development.  

"This decision is based on promising results from two Phase IIb trials, SPRING-1 and VIKING, which are being presented this week at the XVIII International AIDS Conference in Vienna, Austria (Abstract Numbers THLBB205 & MOAB0105). These trials explored the efficacy of '572 in treatment-naive HIV subjects as well as in treatment-experienced subjects resistant to raltegravir. Further study in Phase III is necessary to determine conclusively the safety, efficacy and resistance profile of '572."

MACS: Childhood Sex Abuse and Victimization Linked to Increased HIV Risk - by Tim Horn "Gay and bisexual men enrolled in the Multicenter AIDS Cohort Study (MACS) who reported sexual abuse and social shaming in childhood experience psychosocial health problems later in life known to substantially increase the risk of HIV infection, according to data reported Wednesday, July 21, at the XVIII International AIDS Conference in Vienna.

"The elaborate study, presented in Vienna by Sin How Lim, PhD, of the University of Pittsburgh and her colleagues, included 1,086 HIV-positive and -negative gay and bisexual men enrolled in the MACS, which was started in 1983 and remains the longest-running National Institutes of Health–funded investigation of HIV/AIDS."

MPP, Allies Call on Pres. Obama to Withdraw Nominee for DEA Administrator

MPP Blog: "Today, a coalition of organizations supportive of medical marijuana patients and providers — including MPP, Drug Policy Alliance (DPA), NORML, California NORML, Law Enforcement Against Prohibition (LEAP), and Students for Sensible Drug Policy (SSDP) – is calling on President Obama to withdraw his nomination of Michele Leonhart to serve as administrator of the Drug Enforcement Administration (DEA). ...

"Ms. Leonhart, who is currently the DEA’s acting-administrator, has not demonstrated that she is capable of leading the agency in a thoughtful manner at a time when 14 states have enacted medical marijuana laws and science is increasingly confirming the therapeutic benefits of the substance.

"Under Leonhart’s leadership, the DEA has staged medical marijuana raids in apparent disregard of Attorney General Eric Holder’s directive to respect state medical marijuana laws. Most recently, DEA agents flouted a pioneering Mendocino County (CA) ordinance to regulate medical marijuana cultivation by raiding the very first grower to register with the sheriff. Joy Greenfield, 69, had paid more than $1,000 for a permit to cultivate 99 plants in a collective garden that had been inspected and approved by the local sheriff.

"Ms. Leonhart has also demonstrated that she is unable to be objective in carrying out the duties of the administrator as it relates to medical marijuana research. In January 2009, she refused to issue a license to the University of Massachusetts to cultivate marijuana for FDA-approved research, despite a DEA administrative law judge’s ruling that it would be “in the public interest” to issue the license. This single act has blocked privately funded medical marijuana research in this country. The next DEA administrator will likely influence the outcome of a marijuana-rescheduling petition currently before the agency. It is critical that an administrator with an open mind toward science and research is at the helm."

Researchers find 'broad spectrum' antiviral that fights multitude of viruses

UCLA Newsroom, February 2010: "A group of researchers led by a team from UCLA and including others from the University of Texas at Galveston, Harvard University, Cornell University and the United States Army Medical Research Institute of Infectious Diseases may have found just such a compound.

"In a proof-of-principle study published online in Proceedings of the National Academy of Sciences, the researchers have identified an antiviral small molecule that is effective against numerous viruses, including HIV-1, influenza A, filoviruses, poxviruses, arenaviruses, bunyaviruses, paramyxoviruses and flaviviruses. These viruses cause some of the world's deadliest diseases, such as AIDS, Nipah virus encephalitis, Ebola, hemorrhagic fever and Rift Valley fever.

"Even better, the compound — a rhodanine derivative that the researchers have dubbed LJ001 — could be effective against new, yet-to-be discovered enveloped viruses.

"'Since the government has changed its priorities to support development of broad spectrum therapeutics, more and more groups have been screening compound libraries for antivirals that are active against multiple viruses in a specific class,' said Dr. Benhur Lee, associate professor of microbiology, immunology and molecular genetics at the David Geffen School of Medicine at UCLA and the primary investigator of the four-year study."

Notes: Published in February; we just saw it today.

The abstract is free, but the full text is behind a paywall. A PDF of supplemental technical information is also free. Links are available through the press release.

Is there a cure for AIDS? Forum lifts a taboo

Yahoo! News: "Around 200 researchers held a two-day workshop in Vienna last week ahead of the 18th International AIDS Conference at a proposal by France's 2008 Nobel laureate, Francoise Barre-Sinoussi.

"They mapped a broad strategy to identify areas of fundamental research and coordinate work, Barre-Sinoussi told AFP on Wednesday. Further meetings are planned, along with the creation of a pool to swap knowledge and debate theories.

"'What we took away from the meeting was that a lot of the easy things have been done, a lot of the obvious things have been done, but there is really a dearth of new approaches for tackling this thing,' said Carl Dieffenbach, director of the AIDS division at the US National Institute of Allergy and Infectious Diseases (NIAID).

"Fearful of overstoking expectations, the scientists are not using the media-friendly word 'cure.' Instead, they talk about 'attacking the reservoir.'"

Obama’s Overdue AIDS Bill - by Desmond Tutu "Thanks to these efforts [of PEPFAR under the Bush administation] — and similar initiatives, like those spearheaded by the Global Fund to Fight AIDS, Tuberculosis and Malaria — the number of African patients with access to AIDS drugs jumped tenfold from 2003 to 2008. Since 2004, the AIDS-related mortality rate in sub-Saharan Africa has dropped 18 percent.

"Yet President Obama added only $366 million to the program this year — well below the $1 billion per year he promised to add when he was on the campaign trail. (Pepfar’s total budget now stands at $7 billion.) Most of the countries in Pepfar will see no increase in aid.

"Under the Bush administration, about 400,000 more African patients received treatment every year. President Obama’s Pepfar strategy would reduce the number of new patients receiving treatment to 320,000 — resulting in 1.2 million avoidable deaths over the next five years, according to calculations by two Harvard researchers, Rochelle Walensky and Daniel Kuritzkes. Doctors would have to decide which of the 22 million Africans afflicted with H.I.V. should receive treatment and which should not."
Under the Bush administration, about 400,000 more African patients received treatment every year. President Obama’s Pepfar strategy would reduce the number of new patients receiving treatment to 320,000 — resulting in 1.2 million avoidable deaths over the next five years, according to calculations by two Harvard researchers, Rochelle Walensky and Daniel Kuritzkes. Doctors would have to decide which of the 22 million Africans afflicted with H.I.V. should receive treatment and which should not."

Protesters Storm AIDS Conference "The group, organized by the Global Network of Sex Work Projects, loudly criticized Eric Goosby, the U.S. global AIDS coordinator and chief implementer of the President’s Emergency Plan for AIDS Relief, which requires that any organization that receives PEPFAR dollars must have a policy explicitly opposing prostitution and sex trafficking."

Tomorrow in Vienna: New video online re GcMAF poster on Thursday

by John S. James

As we noted here recently, a new approach to treatment and possible cure of HIV has been caught up in unrelated controversy.

Dr. M. Ruggiero, who is presenting a scientific poster on Thursday at the Vienna conference, was interviewed this week (2010-07-19) in English on Russian TV. See it at Some of his opinions about AIDS are controversial.

But the Thursday presentation is on the work of Dr. N. Yamamoto and others, who are not part of the controversy. The poster is # THPE0051, titled "Gc protein-derived macrophage activating factor (GcMAF) stimulates activation and proliferation of human circulating monocytes" (page 306 of the conference program book); it lists both researchers among the three authors. Dr. Yamamoto has been working on this project for about 15 years, and has reported that the treatment has eradicated HIV in a small clinical trial in Japan (see Immunotherapy of HIV-Infected Patients With Gc Protein-Derived Macrophage Activating Factor (GcMAF) (Journal of Medical Virology, January 2009).

Dr. Yamamoto and his team have been publishing on this project for about 15 years. Dr. Ruggiero has not published on GcMAF until this week, to our knowledge. But he is better known, and hopefully will bring this work to wider attention.

The presentation tomorrow in Vienna is an excellent opportunity for interested scientists to learn more about this research.

History shows that most proposed treatments fail. But sometimes, important advances can come from unexpected directions. These can be lost, because conventional wisdom reflexively says "No." It would be tragic if that happens in HIV.

Note: To see all our posts on this topic, search for "gcmaf" (search box at upper left of this page).

Analysis of infectious virus clones from two HIV-1 superinfection cases suggests that the primary strains have lower fitness

Retrovirology: "These preliminary findings suggest the interesting scenario that superinfection occurs preferentially in patients infected with a relatively attenuated HIV-1 isolate."

New ViiV Integrase Inhibitor Effective Against Some Isentress-Resistant HIV Strains - by David Evans

POZ - POZ Magazine - "An experimental integrase inhibitor being developed by Shionogi Pharmaceuticals and ViiV Healthcare—currently dubbed S/GSK-572—effectively reduces HIV levels in at least some people with HIV resistant to Isentress (raltegravir). These findings were reported in a presentation Monday, July 19, at the International AIDS Conference (IAC), taking place July 18 to 23 in Vienna."

HIV infections soar amongst Eastern European 'street youth' "As many as 40% of young people living on the streets in some areas of Eastern Europe are infected with HIV, according to doctors, activists and UNICEF representatives presenting at the Eighteenth International AIDS Conference in Vienna this week. While HIV rates among this population were previously unknown, incidence studies conducted over the last five years have shed new light on this burgeoning epidemic.

A report released by UNICEF on Monday (Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia) is the first of its kind to comprehensively outline the health, social and economic issues fueling the numbers of young people living on the street, as well as the HIV rates within the population"

Child mortality falls after mothers receive HIV drugs "Children born to mothers with HIV in a rural district of KwaZulu-Natal were 75% less likely to die before the age of five if their mothers received antiretroviral therapy, researchers from the Africa Centre reported on Monday July 20th at the Eighteenth International AIDS Conference in Vienna."

July 20, 2010

Good Nutrition Can Improve Treatment for People Living With HIV

WFP | United Nations World Food Programme - Fighting Hunger Worldwide: "VIENNA – The United Nations World Food Programme (WFP) is urging health care providers, governments and other partners to include a simple, yet vital, ingredient in the treatment of people living with HIV - good nutrition."

Advocates decry New Jersey changes in AIDS, HIV assistance

Philadelphia Inquirer | 07/20/2010: "Effective Aug. 1, nearly 1,000 New Jersey residents with AIDS and HIV will be dropped from a state program that helps pay for their lifesaving medications.

"A measure in the New Jersey budget signed by Gov. Christie last month slashed the annual income permitted for enrollees in the AIDS Drug Assistance Program, saving the state an estimated $7.4 million. ...

"New Jersey is 'going backward' in its policy and putting people - and state finances - at risk, Condoluci said. The cost of pharmaceutical assistance is far cheaper than the expense of emergency room visits or long hospital stays after a person goes off drugs, he said.

"An average hospital stay to treat an AIDS patient who has infections from not taking medications - a process that can take five days or more - may cost tens of thousands of dollars, he said.

"President Obama announced a goal last Tuesday of reducing new HIV and AIDS infections by 25 percent within five years. A week prior, U.S. Health and Human Services Secretary Kathleen Sebelius released $25 million to help states with their struggling drug-assistance programs.

"So far, the money has been targeted to states with qualified applicants on waiting lists. With fewer people eligible for the program, New Jersey won't have a waiting list, say state officials."

Gates, Clinton Call for More Efficient Use of AIDS Funding

PND, Foundation Center: "Speaking at the eighteenth International AIDS Conference in Vienna, Austria, this week, Bill & Melinda Gates Foundation co-chair Bill Gates and former U.S. President Bill Clinton urged AIDS activists to get the most out of every dollar given to fight HIV/AIDS, saying donors cannot be expected to give more in these tough economic times unless the money is carefully spent, Reuters reports.

"Addressing twenty thousand AIDS scientists, health workers, and activists at the conference, Gates and Clinton said efficiency savings are vital in delivering HIV/AIDS prevention services and treatment in the countries hardest hit and at highest risk. During his speech, Gates outlined several key opportunities for AIDS investments to be more cost-effective and have greater impact, including rapid scale up of cost-effective prevention tools, better use of data to make prevention decisions, reductions in the cost of delivering treatment, and greater investments in vaccines and other breakthrough tools."

Kaletra/Isentress Shows Promise as HIV Nuceleoside-Sparing Regimen for First-Line Treatment "A nucleoside reverse transcriptase inhibitor (NRTI)-sparing regimen consisting of Kaletra (lopinavir and ritonavir) plus Isentress (raltegravir) is comparable with a standard regimen consisting of Kaletra plus Truvada (tenofovir and emtricitabine) in people living with HIV starting antiretroviral (ARV) therapy for the first time, according to 48-week study results reported Monday, July 19, at the XVIII International AIDS Conference in Vienna."

Poverty Driving HIV's Spread Among Urban Heterosexuals: Report

US News and World Report: "In the poorer neighborhoods of America's cities, about 1 in every 50 heterosexual adults are now infected with HIV -- a much higher rate than is seen in the general population, U.S. health officials report.

"The finding suggests that poverty plays a crucial role in spread of the virus that causes AIDS, according to a team from the U.S. Centers for Disease Control and Prevention (CDC).

"The link between low income and a higher risk of getting infected with HIV held regardless of race or ethnicity, the researchers found. ...

"The rate of HIV infection was especially steep among the least well-off. For example, 2.4 percent of people living below the poverty line were infected with HIV versus 1.2 percent of those living above the poverty line [but still poor], the team found.

"Those rates are substantially higher than the national average of HIV infection, which is estimated at 0.45 percent of the population."

Number of HIV-positive in treatment rose by a quarter last year "Former President Bill Clinton saluted the increase in a speech at the conference. 'Five million people on treatment is a lot compared to where we started, but still [only] a third of those who need treatment today,' he said. 'We cannot get to the end of this epidemic without both more money and real changes in the way we spend it.'"

July 19, 2010

[Fauci on Cure Research]

The Cure Blog:

"Curing Existing Infections

"Despite considerable success in suppressing viremia and preventing disease progression in HIV-infected individuals, it has not been possible to induce permanent remission of disease in the absence of therapy. This is because HIV has the unique ability to shield itself from the immune system and from ART in protected cellular sanctuaries. These persistent reservoirs of infection are major obstacles to curing HIV infection. An increasing research effort is directed at determining the precise mechanisms of HIV persistence and using this information to develop novel interventions to eliminate or permanently suppress these viral reservoirs. The effects of a cure would be significant for individuals and society. Patients would be spared the cumulative effects of drug toxicities; a 'cured' individual would have minimal risk for transmitting the virus; and resources would be made available for other services, not only HIV-related, but also those directed at an overall strengthening of health care systems." Published in JAMA, July 21, 2010.

Studies Offer 2 Paths to Cut H.I.V. Rate for African Women "'This is very encouraging,' said Dr. Michel Sidibe, executive director of Unaids, the United Nations AIDS-fighting agency. 'It can be controlled by women, and put in 12 hours earlier, and that is empowering. They do not have to ask the man for permission to use it. And the cost of the gel is not high.'

In another piece of progress against AIDS, a separate, large study in Malawi sponsored by the World Bank, and made public on Sunday, found that if poor schoolgirls and their families received small monthly cash payments, the girls had sex later, less often and with fewer partners.

"A year and a half after the program started, they were less than half as likely to be infected with the AIDS or herpes viruses as girls whose families got no payments. The likelihood that the girls would turn to older men for sex, gifts and cash declined as the size of the payments from the program rose, suggesting the central role of extreme poverty in sexual choices. ...

"In the $400,000 trial in Malawi, 3,800 teenage girls and young women, ages 13 to 22, were randomly assigned to two groups. Half the girls received no cash payments. The parents of the other half were paid $4 to $10 a month, while those girls themselves got $1 to $5 a month.

"After 18 months, the H.I.V. prevalence among the girls who got the cash was 1.2 percent, compared to 3 percent for the others. “The program empowered these girls to make better choices,” said Berk Ozler, a senior economist with the World Bank’s Development Research Group."

Study of microbicide gel shows reduced risk of HIV and herpes infections in women

EurekAlert! "Researchers have achieved an important scientific breakthrough in the fight against HIV and genital herpes with a vaginal gel that significantly reduces a woman's risk of being infected with these viruses. The results of the ground-breaking safety and effectiveness study of an antiretroviral microbicide gel study were reported today by the Centre for the AIDS Programme of Research in South Africa (CAPRISA) at the XVIII International AIDS Conference in Vienna, Austria.

The microbicide containing 1% tenofovir—an antiretroviral drug widely used in the treatment of HIV—was found to be 39% effective in reducing a woman's risk of becoming infected with HIV during sex and 51% effective in preventing genital herpes infections in the women participating in the trial. Should other studies of tenofovir gel confirm these results, widespread use of the gel, at this level of protection, could prevent over half a million new HIV infections in South Africa alone over the next decade. ...

"The CAPRISA researchers also found that the protective effect against HIV and genital herpes increased as use of the tenofovir gel increased. Women who used the gel in more than 80% of their sex acts had a 54% reduction in HIV infections, whereas those who used the gel in less than half of their sex acts had a 28% reduction in HIV infections. Among those women who became infected, tenofovir gel had no effect on the amount of HIV in their bloodstream at the time of infection. Also, none of the women who became infected with HIV showed resistance to tenofovir."

Cure for HIV infection must now be major scientific priority, Vienna AIDS conference hears "Lewin urged greater resources for an HIV cure and a collaborative effort of basic scientists, clinicians, pharmaceutical companies and funders, as exists for HIV vaccine research. In recent months, amfAR and the US National Institutes of Health have announced funding for cure research, though advocates argue that it is not sufficient.

"'The international conference in Vienna will not be the conference where we announce a cure,' Lewin concluded, 'but it will mark the beginning of a future where we seriously prioritise finding a cure.'"

"Watch the keynote address from Sharon Lewin on the Kaiser Family Foundation website." [Note: Dr. Lewin's talk begins 1 hour 55 minutes and 25 seconds into the presentation.]

Harsh attitudes fuel Eastern Europe HIV epidemic

Harsh attitudes fuel Eastern Europe HIV epidemic | World | Reuters: "An underground HIV epidemic in Eastern Europe and Central Asia is building at an alarming pace, fuelled by drug use, risky sex and severe social stigma that stops people asking for help, the United Nations said on Monday.

"In a report published at an international conference on AIDS, the U.N. children's fund UNICEF said health and social services in the region do little for young people at high risk of HIV, who are instead subject to judgement, recrimination and even prosecution if they seek treatment or information on HIV. ...

"UNICEF said it had had reports of increases in HIV prevalence of up to 700 percent in five regions of Russia. In Ukraine HIV rates of 1.6 percent of the general population are the highest in Europe and experts say Central Asian countries are the new hot-spots of rapidly increasing HIV transmission.

"Anthony Lake, UNICEF's executive director, said efforts to contain this rapid spread were being thwarted by harsh political and social attitudes, particularly to the 3.7 million injecting drug users in the region who are at very high risk of HIV.

"Children and adolescents living on the margins of society need access to health and social welfare services, not a harsh dose of disapproval," he said in commentary with the report. "We need to build an environment of trust and care, not one of judgement and exclusion."

July 18, 2010

Vaginal Gel Study Charts New Course for HIV Prevention Research

BusinessWeek: "Over the past three years, 900 women in South Africa have applied a vaginal gel before and after sex in the hope it would keep them from getting AIDS. If it works, it will show drug treatments can also prevent infections.

"The experimental product, which uses Gilead Sciences Inc.’s Viread AIDS medicine in gel form, is the first gel to employ a proven treatment to stop women from contracting the virus in the first place. Results of a study of the gel will be released tomorrow and may indicate the prospects for drugs being tested in 40 prevention trials involving 30,000 people."

Comment: This very important study will be reported tomorrow in Vienna. We do not know the results yet.

Treating HIV also Prevents its Spread, Study Finds | Health News: "Provocative new research shows that treating people with the AIDS virus can provide a powerful bonus: It cuts the risk that they will infect others.

"New infections plummeted in parts of Canada as more people went on AIDS drugs, which lowered the amount of virus they had and the chances they would spread it, the study found.

"For every 100 people with HIV who started taking AIDS drugs, new infections dropped by 3% in British Columbia, where the study was done. The number of new infections there has been cut in half since 1996, matching a rise in treatment.

"'The more people you put on therapy, the less transmission there is,' said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases. The drop in new cases in Canada 'likely could not be explained by anything else,' he said.

"The U.S. government helped pay for the study. Results were published online Sunday by the British medical journal Lancet and were being presented at the International AIDS Conference in Vienna.


"A study a decade ago in Africa found that people with these very low levels of virus were less likely to infect others. Treating pregnant women with HIV lowers the amount of virus they have and the risk they'll pass it on to their babies.

"The new study is the first clear evidence that the same principle holds true on a population level, in everyday community settings.

"It was led by Dr. Julio Montaner, director of the British Columbia Centre for Excellence in HIV/AIDS in Vancouver."

Lancet title and abstract:

Association of highly active antiretroviral therapy coverage, population viral load, and yearly new HIV diagnoses in British Columbia, Canada: a population-based study

See new discussion below on GcMAF, Dr. Yamamoto

See discussion in the comments on the earlier post. Excerpt:

"The idea behind Dr. Yamamoto's work with GcMAF -- that discovering a new way HIV disables part of the immune system, and reversing that, could lead to a major treatment advance or even a cure -- seems plausible. This treatment possibility must not be rejected out of hand just because some of the methodology is unconventional -- or because of the project's sudden association with a scientist who has been in the news due to controvery on other matters.

"If the treatment doesn't work, a little scientific and community attention spent on it would be a small cost. But the other kind of error, rejecting a treatment that could help, would be catastrophic. ...

"This Thursday, July 22, AIDS scientists from around the world will have an unusual opportunity to attend the poster presentation in Vienna, and discuss this treatment possibility with other experts face to face."

July 17, 2010

Fast news from Vienna conference

by John S. James

The fastest news you can get from the big International AIDS Conference is Vienna is via Twitter. Faster than TV or radio news. Faster than blogs.

You don't need a Twitter account (or any account). Just ONE CLICK to view one of the Twitter news feeds, in the red "Vienna AIDS Conference" box in the right-hand column of this blog.

We also list other news sites with fast, reliable conference coverage.

HIV can be deadly even before CD4 counts fall, researchers say "They reported in the journal Lancet that, when they accounted for other factors affecting deaths, homosexual men with counts between 350 and 500 and who had not received antiviral therapy were 30% more likely than uninfected individuals to die. Heterosexuals were nearly three times as likely to die, injection drug users were more than nine times as likely to die, and those with unknown risk factors were four and one-half times as likely to die.

"The increase in risk was substantial in injecting drug users and the heterosexual group, but was small in men who have sex with men," the authors said in a statement. "This finding suggests that much of the raised risk in the former two risk groups probably results from confounding by socioeconomic and lifestyle factors rather than being an effect of HIV infection itself. The magnitude of the raised risk in the [homosexual] group is more likely to reflect the effect of HIV itself."

HIV infections plummet among young adults: UN report "HIV prevalence among young people has declined by more than 25 percent in 15 of the 21 countries most affected by AIDS. The study also found that in 13 countries, young people are waiting longer before they become sexually active, having fewer partners, and using condoms more often."

Joint statement of UN agencies on criminal charges brought against HIV activists and health and social workers in eastern Europe and central Asia

UNAIDS: "Five United Nations agencies—UNICEF, UNFPA, WHO, UNAIDS, and UNDP—express concern that health and social workers have suffered as a result of their professional activities in the response to HIV in several countries in eastern Europe and central Asia.

"Persecution, criminal investigation, arrests and sentencing of HIV activists as well as health and social workers affect not only the lives of the people involved but also discourage other activists and professionals, and deprive societies of some of the most valuable and vital resources in the response to the epidemic—people’s commitment and energy at the community level."

Controversial Poster Thursday at Vienna Conference: Call for Information on GcMAF

by John S. James

We will not be at the big Vienna conference starting tomorrow (International AIDS Conference, July 18-23), and would like to hear from anyone with a scientific background who can visit the poster below, on Thursday, and the presenter.

A separate paper published last year by N. Yamamoto and others (see the abstract and link to full text at claims to have cured 15 patients in Japan. "In the present study GcMAF therapy was given to nonanemic HIV-infected patients and found to be highly curative."

About 130 peer-reviewed papers related to this work can be found at The proposed mechanism seems plausible -- that HIV produces a substance that shuts down immune responses in monocytes and macrophages, helping HIV infection to continue. The treatment appears to restore the response.

The research is controversial because it claims to have cured HIV infection, and also prostate cancer. The connection is not outlandish, however; for example, U.S.-government funded research at Yale is looking at a possible immune-based potential treatment for the same two illnesses (

Also controversial, the poster presenter at the International AIDS Conference, M. Ruggiero, is an accomplished molecular biologist -- but also a leading HIV denialist (Google: "Marco Ruggiero" HIV -- or see his 14-minute lecture uploaded January, 2010, to -- or see the abstracts of the denialist conference being held in Vienna on the two days before the International AIDS Conference there, However, Dr. Yamamoto is clearly not a denialist -- and apparently has not published with Dr. Ruggiero before the Vienna conference starting Sunday.

There are lots of mysteries here. For example, how has Dr. Yamamoto been publishing this HIV work extensively for at least 15 years in peer-reviewed journals, recently reporting excellent results, with almost no attention from most other HIV researchers?

We are concerned because we have heard that funders of research are not seeing new ideas for curing HIV being proposed. But there are lots of ideas, some credible, and no way to know in advance which ones will work out. Many human groups close themselves off and become increasingly narrow in focus, until they are irrelevant. In that case, new ideas cannot come forward. It would be tragic is this is happening in AIDS.

Here is the reference to the poster on Thursday:

THPE00 51 Gc protein-derived macrophage activating factor (GcMAF) stimulates activation and proliferation of human circulating monocytes
M. Ruggiero (Italy), S. Pacini (Italy), N. Yamamoto (United States)
Program of the XVIII International AIDS Conference, July 18-23, 2010, Vienna, Austria, page 306; Thursday July 22.

July 15, 2010

New Website for AIDS Treatment News

We updated our site before the International AIDS Conference, July 18-23 in Vienna.

The new site looks better, is easier to use, and has better reference information (in the right-hand column). And it combines our website and blog at one address,, so there is no question of what site to visit.

Death Rate From HIV Falls 75% With Early Treatment, Study Finds

Death Rate From HIV Falls 75% With Early Treatment, Study Finds: "Early treatment for HIV cuts patients’ risk of death by about 75 percent, according to a study in the New England Journal of Medicine. ...

"The early-treatment group began taking a combination of zidovudine, lamivudine and efavirenz within two weeks after enrollment, the researchers said. Patients in the standard- treatment group were given the therapy when their CD4+ count fell to 200 or when AIDS developed."

Note: Full text of original article is at

Comment: This study was done in Haiti, but is relevant to care in richer countries also. People who do not get tested will not know when they need to start treatment.

July 14, 2010

A national battle plan against HIV/AIDS

Washington Post Blog: "The domestic goals are reasonably ambitious, meaning they stand a chance of being met."

Ten million deaths and 1 million new HIV infections could be averted if countries meet HIV treatment targets

UNAIDS: "GENEVA, 13 July 2010 — The new UNAIDS Outlook report outlines a radically simplified HIV treatment platform called Treatment 2.0 that could decrease the number of AIDS-related deaths drastically and could also greatly reduce the number of new HIV infections. Evidence shows that new HIV infections among young people, in the 15 countries most affected by HIV, are dropping significantly as young people embrace safer sexual behaviours."

Also see:

July 13, 2010

HIV/AIDS White House policy hailed for targeting spread of disease "The president's plan, which includes targets for controlling the spread of the disease by 2015, calls for reducing new HIV infections annually by 25%, from an estimated 56,300 today.

"It includes more than 100 directives to federal agencies including new standards for assessing prevention programs, new education campaigns for ethnic communities and increased screening of federal prisoners.

"Dr. Georges C. Benjamin, executive director of the American Public Health Assn., called the strategy 'a lifesaving public health intervention,' echoing widespread praise."

See White House press release.

Diabetes Drug Maker Hid Test Data on Risks, Files Indicate "In the fall of 1999, the drug giant SmithKline Beecham secretly began a study to find out if its diabetes medicine, Avandia [rosiglitazone], was safer for the heart than a competing pill, Actos, made by Takeda.

"Avandia’s success was crucial to SmithKline, whose labs were otherwise all but barren of new products. But the study’s results, completed that same year, were disastrous. Not only was Avandia no better than Actos, but the study also provided clear signs that it was riskier to the heart.

"But instead of publishing the results, the company spent the next 11 years trying to cover them up, according to documents recently obtained by The New York Times. The company did not post the results on its Web site or submit them to federal drug regulators, as is required in most cases by law.

“This was done for the U.S. business, way under the radar,” Dr. Martin I. Freed, a SmithKline executive, wrote in an e-mail message dated March 29, 2001, about the study results that was obtained by The Times. “Per Sr. Mgmt request, these data should not see the light of day to anyone outside of GSK,” the corporate successor to SmithKline."

AIDS Cure Research for Everyone: A Beginner’s Guide To How It’s Going And Who’s Paying For It

AIDS Policy Project (PDF download): "Who knows exactly what’s going on with AIDS cure research? Not many people outside the research community. Not members of the general public, nor most health reporters.

"Nor the United States Congress, which decides how much to fund the National Institutes of Health. Not even most AIDS activists, who assume that the cure is decades out of reach. And most importantly, not people with AIDS themselves, millions of whose lives are at stake.

"Who is funding the effort to find a cure, and how much are they spending? Almost no one knows that.

"For these reasons, we have written this simple report to share what we have learned, so far, about the search for a cure for AIDS."

See Larry Kramer's comment on this report.

July 8, 2010

Antibody Kills 91% of HIV Strains "U.S. government scientists have discovered three powerful antibodies, the strongest of which neutralizes 91% of HIV strains, more than any AIDS antibody yet discovered."

Inflammation associated with increased mortality risk for patients with HIV, even when CD4 cell count high

Aidsmap: "High levels of two markers of inflammation – fibrinogen and C-reactive protein – are independently associated with an increased risk of mortality for patients with HIV, even when they have a strong immune system, US investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes.

“We found that elevated levels of fibrinogen and CRP [C-reactive protein] were strong and independent predictors of 5-year mortality risk. Our findings suggest an important role for inflammation in mortality risk”, comment the investigators."

Study says increasing HIV drug treatment will save millions through prevention

Winnipeg Free Press: "The study was published in the U.S.-based journal 'AIDS,' the official journal of the International AIDS Society.
Montaner said the findings are the first to link savings to prevention through increased treatment.
'Until now people failed to incorporate into that cost effectiveness the fact that by treating me I am not infecting you, her, him or whoever and they are not infecting Peter, Paul, Mary and John,' he said.
'The failure of those new generations of infections to be materialized represents a huge saving,' said Montaner, who leads the BC Centre for Excellence in HIV/AIDS."

July 7, 2010

Life in a Day - YouTube, July 24

YouTube - lifeinaday's Channel: "John Cooper, Director of the Sundance Film Festival, talks about Life In A Day, a historic cinematic experiment to create a user-generated documentary film shot in a single day. On July 24, you have 24 hours to capture your life on camera. The most compelling footage will be edited into a documentary film, produced by Ridley Scott, directed by Kevin Macdonald and set to premiere at the 2011 Sundance Film Festival."

Comment: July 24 is the day after the Vienna AIDS conference ends, incidentally. Stories relevant to AIDS should be told. You can be anywhere, of course. And while 6 billion people is a lot of potential competition, your video will probably be on this YouTube channel whether or not it is selected for the film.

July 5, 2010

Atripla Co-pay Program to Cover More People

POZ - POZ Magazine - - Treatment News: "Gilead Sciences and Bristol-Myers Squibb have announced that the co-payment assistance program for Atripla (containing efavirenz, tenofovir and emtricitabine) has been revised and will essentially benefit all people living with HIV with private health insurance who pay any out-of-pocket co-payment fees. The greatly enhanced co-payment program went into effect July 1."

Sex Diseases Higher in Men 40 or Older Taking Viagra, Cialis

BusinessWeek: “Younger people have more sex partners than older folks,” said Jena, a medical resident in internal medicine at Massachusetts General Hospital and Harvard Medical School in Boston. “But per sexual encounter, the actual safeness of the sex is probably lower among older folks in the sense that they don’t use condoms.”

Note: Also see Don't Blame It On Viagra,

July 2, 2010

ARCA seeks volunteers for historic HIV vaccine trial

The Georgia Voice: "[Dr. Melanie] Thompson helped found AIDS Research Consortium of Atlanta 21 years ago to perform HIV clinical trials and has helped to investigate 27 HIV drugs now licensed by the federal Food & Drug Administration. For the GeoVax trial, the non-profit organization needs a very narrow group of people.

“They are people with very special characteristics, and so we know it is not going to be easy to find these people,” Thompson said. “Based on study in monkeys it appears that people who are earlier in their infection are most likely to benefit from the vaccine, so what we are looking for is people who know roughly when they were infected, and have that documented with a negative test and then followed that up with a positive test. ..."

320 Ohioans lose HIV drug aid

Business Courier of Cincinnati: "The Ryan White program cut 320 people that it was serving and made other cuts. The service typically serves 5,000 people a year, according to the report."

And in Florida, the waiting list is now 500. Many people will die in these states and others.

Scientists Make Immune Cells in Mice That Fight Off HIV

Business Week: "'It's a one-shot treatment if it works,' noted study co-author Paula Cannon, associate professor of molecular microbiology at the University of Southern California."

Comment: The Berlin mouse? No radiation or chemotherapy needed.

Technical abstract:

Medical Marijuana in HIV/AIDS – Part 2: Science Is Mostly Positive On Medical Marijuana For People With HIV

The AIDS Beacon: "Kris Hermes, Media Specialist for Americans for Safe Access (ASA), an organization that promotes legalization of medical marijuana, told The AIDS Beacon in an interview that there are a variety of reasons people with HIV use medical marijuana.

“One main reason is relief of side effects from antiretroviral therapy,” said Hermes, “which can make patients better at taking their medications.”

“Many users also say it helps reduce symptoms from other illnesses, such as hepatitis C, that are common in people with HIV,” he added."

Cellular and molecular events that restrict HIV transmission identified -- re article in PLoS Pathogens: "'In the absence of an effective vaccine, there is an increasing demand for the development of effective microbicides that block HIV sexual transmission. Our studies suggest that PPARγ and LXR may be targets for drugs that can simultaneously inhibit a number of aspects of HIV mucosal transmission, including inflammation, DC migration and DC-mediated HIV dissemination. Our findings therefore, provide a rationale for combining drugs that target PPARγ and LXR with conventional anti-viral microbicides that target other aspects of mucosal HIV transmission,' he added."