APHA: Protect the public’s health by letting the U.S. Environmental Protection Agency (EPA) move ahead with urgently needed new rules to curb global warming pollution. That’s the message of a new joint letter from 120 of America’s top public health organizations and experts, including the American Public Health Association (APHA), the American Nurses Association (ANA), the American Academy of Pediatrics (APA), the American Medical Association (AMA) and the American Lung Association (ALA).
"The letter notes that preserving the authority of the EPA to regulate global warming emissions is of paramount concern to the health of “children, older adults, those with serious health conditions and the most economically disadvantaged.”
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September 29, 2010
AIDS treatment up in 2009; 2010 targets in doubt: WHO
Reuters: "A record 1.2 million people in low and middle income countries started antiretroviral therapy for HIV/AIDs in 2009, the World Health Organization said on Tuesday, but targets set for 2010 are unlikely to be met. ...
"The report said eight low and middle income countries -- Botswana, Cambodia, Croatia, Cuba, Guyana, Oman, Romania and Rwanda -- met the goal of giving treatment to at least 80 per cent of patients in need in 2009, well ahead of the end-2010 deadline agreed by world leaders in 2006."
"The report said eight low and middle income countries -- Botswana, Cambodia, Croatia, Cuba, Guyana, Oman, Romania and Rwanda -- met the goal of giving treatment to at least 80 per cent of patients in need in 2009, well ahead of the end-2010 deadline agreed by world leaders in 2006."
September 28, 2010
Tesamorelin Growth Hormone-releasing Factor Reduces Visceral Fat in Diverse Patient Groups
HIVandHepatitis.com: "SUMMARY: Tesamorelin (TH9507, brand name Egrifta), a recombinant form of human growth hormone-releasing factor, decreased the amount of visceral abdominal fat over 1 year in a variety of sub-populations of HIV patients with lipodystrophy, according to research presented at the recent 50th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2010). A related study found that fat loss measured by CT scans was reflected in reduced waist size and improved patient-reported body image."
Program Offers Free HIV Drugs for ADAP Waitlisted
AIDSmeds:
"A nonprofit group has formed a partnership with three pharmaceutical companies and a mail order pharmacy to offer free antiretroviral (ARVs) drugs to people in states that have instituted waiting lists for their AIDS Drug Assistance Programs (ADAPs).
"The great recession has hit people with HIV particularly hard. Lower tax revenues have decimated state budgets and have kept the federal government from offering enough dollars to meet the shortfall. As a result, programs like ADAP—which offer free HIV medications (and sometimes other drugs) through a combination of federal and state dollars—are suffering financial crises.
"As of September 2010, nine states have frozen new ADAP enrollments and 3,214 people are on waiting list. Thirteen other states are considering new cost-containment measures. Though Congress approved a recent one-time infusion of additional cash, activists say it falls far short of what is needed.
"The pharmaceutical industry does offer an alternative: The companies provide free medication through their patient assistance programs (PAPs) to people with low to moderate incomes who don’t have health insurance. Activists have expressed concern, however, that some people who’ve been wait-listed for ADAP will fall through the cracks.
"'The effort to obtain free drugs from programs run by the pharmaceutical manufacturers can be overwhelming, due to complicated paperwork processes, different income-eligibility determinations by each manufacturer, lack of a single entry point and other hurdles,' wrote Jeffrey R. Lewis—the president of the Heinz Family Philanthropies—in an opinion piece in the Boston Herald.
"Lewis’s foundation is working jointly with a mail-order pharmacy called Welvista and three ARV-producing pharmaceutical companies—Abbott, Merck and Tibotec—to offer free medications to people who’ve been put on ADAP waiting lists. What’s unique about this partnership is that people don’t even have to fill out any paperwork. It makes enrollment in the program automatic as soon as a person is placed on an ADAP waiting list. Free drugs are then shipped within a day to someone’s home or to his or her provider’s office.
"'Unfortunately, Abbott, Merck and Tibotec are the only three pharmaceutical manufacturers that produce HIV/AIDS medications that currently participate in this program,' Lewis said. 'The entry of all the other pharmaceutical manufacturers [notably Gilead, ViiV Healthcare, Bristol-Myers Squibb, Roche and Boehringer Ingelheim] would be greatly encouraged and welcomed.' These companies’ participation will be necessary to help streamline access to ARVs not produced by Abbott, Merck and Tibotec.
"HIV activist groups, such as the Fair Pricing Coalition, have urged these other companies to consider joining this partnership, and several are actively considering it."
"A nonprofit group has formed a partnership with three pharmaceutical companies and a mail order pharmacy to offer free antiretroviral (ARVs) drugs to people in states that have instituted waiting lists for their AIDS Drug Assistance Programs (ADAPs).
"The great recession has hit people with HIV particularly hard. Lower tax revenues have decimated state budgets and have kept the federal government from offering enough dollars to meet the shortfall. As a result, programs like ADAP—which offer free HIV medications (and sometimes other drugs) through a combination of federal and state dollars—are suffering financial crises.
"As of September 2010, nine states have frozen new ADAP enrollments and 3,214 people are on waiting list. Thirteen other states are considering new cost-containment measures. Though Congress approved a recent one-time infusion of additional cash, activists say it falls far short of what is needed.
"The pharmaceutical industry does offer an alternative: The companies provide free medication through their patient assistance programs (PAPs) to people with low to moderate incomes who don’t have health insurance. Activists have expressed concern, however, that some people who’ve been wait-listed for ADAP will fall through the cracks.
"'The effort to obtain free drugs from programs run by the pharmaceutical manufacturers can be overwhelming, due to complicated paperwork processes, different income-eligibility determinations by each manufacturer, lack of a single entry point and other hurdles,' wrote Jeffrey R. Lewis—the president of the Heinz Family Philanthropies—in an opinion piece in the Boston Herald.
"Lewis’s foundation is working jointly with a mail-order pharmacy called Welvista and three ARV-producing pharmaceutical companies—Abbott, Merck and Tibotec—to offer free medications to people who’ve been put on ADAP waiting lists. What’s unique about this partnership is that people don’t even have to fill out any paperwork. It makes enrollment in the program automatic as soon as a person is placed on an ADAP waiting list. Free drugs are then shipped within a day to someone’s home or to his or her provider’s office.
"'Unfortunately, Abbott, Merck and Tibotec are the only three pharmaceutical manufacturers that produce HIV/AIDS medications that currently participate in this program,' Lewis said. 'The entry of all the other pharmaceutical manufacturers [notably Gilead, ViiV Healthcare, Bristol-Myers Squibb, Roche and Boehringer Ingelheim] would be greatly encouraged and welcomed.' These companies’ participation will be necessary to help streamline access to ARVs not produced by Abbott, Merck and Tibotec.
"HIV activist groups, such as the Fair Pricing Coalition, have urged these other companies to consider joining this partnership, and several are actively considering it."
An HIV vaccine is within sight but the field is threatened by funding cuts
guardian.co.uk: "There have been unprecedented developments in HIV vaccine research recently, but the field is threatened by the global downturn in funding for HIV/Aids. Ahead of the Aids Vaccine 2010 conference starting in Atlanta on 28 September, IRIN/PlusNews spoke to Mitchell Warren, executive director of the Aids Vaccine Advocacy Coalition, about the future of HIV vaccine research and development."
Save the Date: CROI 2011
HIV/AIDS Clinical Care: "The 18th Conference on Retroviruses and Opportunistic Infections will take place in Boston from February 27 through March 2, 2011."
September 27, 2010
Establishment of HIV-1 latency in resting CD4 T cells depends on chemokine-induced changes in the actin cytoskeleton
Establishment of HIV-1 latency in resting CD4 T cells depends on chemokine-induced changes in the actin cytoskeleton — PNAS: "Eradication of HIV-1 with highly active antiretroviral therapy (HAART) is not possible due to the persistence of long-lived, latently infected resting memory CD4 T cells. We now show that HIV-1 latency can be established in resting CD4 T cells infected with HIV-1 after exposure to ligands for CCR7 (CCL19), CXCR3 (CXCL9 and CXCL10), and CCR6 (CCL20) but not in unactivated CD4 T cells. ... We propose a unique pathway for establishment of latency by direct HIV-1 infection of resting CD4+ T cells during normal chemokine-directed recirculation of CD4+ T cells between blood and tissue." [technical - relevant to cure research]
Polyunsaturated liposomes are antiviral against hepatitis B and C viruses and HIV by decreasing cholesterol levels in infected cells
PNAS: "The greatest antiviral activity in all three systems was the inhibition of viral infectivity through the reduction of virus-associated cholesterol. Our study demonstrates that PERLs are a broadly effective antiviral therapy and should be developed further in combination with encapsulated drug mixtures for enhanced in vivo efficacy." [technical article -- full text free]
September 24, 2010
Revise Social Security HIV Disability Requirements Says Institute of Medicine
POZ: "Confusing matters further, the IOM report only addresses changes to SSDI and SSI qualification requirements—the committee sidesteps the important issue of access to care that, for thousands of people living with HIV, is tied to SSA disability status. At present, people living with HIV who are uninsured can access Medicare or Medicaid, once they have been deemed disabled by SSA. While the new recommendations may make it easier for some people living with HIV to qualify for these public health insurance programs, it is possible that the absence of list of serious opportunistic infections—some of which can occur at CD4 counts above 50—will hinder the ability of others to access health care when they need it.
"Although the issues of … access to care [is] critical in the discussion of Social Security disability benefits," the IOM report authors write, "in-depth discussion of the means by which people receive treatment and medications was deemed outside the Committee’s scope." SSA, in turn, will be left to grapple with the issue of how to retain people in care and on ARV treatment if the criteria for disability benefits are changed, a task that will likely be made much more difficult in light of existing AIDS Drug Assistance Program (ADAP) waiting lists for uninsured or under-insured people living with HIV and other changes stemming from the recent passage of health care reform legislation."
Comment: Healthcare reform, if it works, could solve one key issue, by ending the requirement for a disability declaration in order to get access to medical care, under the current system where these people are uninsurable.
"Although the issues of … access to care [is] critical in the discussion of Social Security disability benefits," the IOM report authors write, "in-depth discussion of the means by which people receive treatment and medications was deemed outside the Committee’s scope." SSA, in turn, will be left to grapple with the issue of how to retain people in care and on ARV treatment if the criteria for disability benefits are changed, a task that will likely be made much more difficult in light of existing AIDS Drug Assistance Program (ADAP) waiting lists for uninsured or under-insured people living with HIV and other changes stemming from the recent passage of health care reform legislation."
Comment: Healthcare reform, if it works, could solve one key issue, by ending the requirement for a disability declaration in order to get access to medical care, under the current system where these people are uninsurable.
Antiretroviral Therapy Is the Biggest Expense in HIV Care
POZ - Treatment News : Antiretroviral Therapy Is the Biggest Expense in HIV Care: "Antiretroviral (ARV) therapy accounts for the lion’s share of health care costs for people living with HIV in the United States, according to an article published online September 20 in the journal AIDS.
"HIV care is expensive, and it has been since the beginning of the HIV epidemic. In 1996, average costs exceeded $20,000 per year in the United States. By 1998, this had dropped slightly to $18,300 per year."
"HIV care is expensive, and it has been since the beginning of the HIV epidemic. In 1996, average costs exceeded $20,000 per year in the United States. By 1998, this had dropped slightly to $18,300 per year."
FTC therapy reduces risk of important resistance mutation
aidsmap: "The important M184V resistance mutation is less likely to emerge if a patient is receiving an HIV treatment combination that includes FTC and tenofovir rather than a combination that contains 3TC, an international team of investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes.
"The study also showed that treatment with a boosted protease inhibitor was protective against the emergence of the M184V mutation and that the combination of FTC and tenofovir had a high genetic barrier to resistance.
"The investigators believe that the study’s “overall findings highlight the importance to identify those drug combinations that can minimize drug resistance to HAART [highly active antiretroviral therapy]. Understanding the point is crucial to maximize the opportunity for successful and subsequent therapies after viral rebound not only in western countries but also in resource-limited settings."
"The study also showed that treatment with a boosted protease inhibitor was protective against the emergence of the M184V mutation and that the combination of FTC and tenofovir had a high genetic barrier to resistance.
"The investigators believe that the study’s “overall findings highlight the importance to identify those drug combinations that can minimize drug resistance to HAART [highly active antiretroviral therapy]. Understanding the point is crucial to maximize the opportunity for successful and subsequent therapies after viral rebound not only in western countries but also in resource-limited settings."
Elevated HIV Prevalence Despite Lower Rates of Sexual Risk Behaviors Among Black Men in the District of Columbia Who Have Sex with Men
AIDS Patient Care and STDs:: "The District of Columbia (DC) has among the highest HIV/AIDS rates in the United States, with 3.2% of the population and 7.1% of black men living with HIV/AIDS. ... Of 500 MSM, 35.6% were black. Of all men, 14.1% were confirmed HIV positive; 41.8% of these were newly identified HIV positive. Black men (26.0%) were more likely to be HIV positive than white (7.9%) or Latino/Asian/other (6.5%) men (p<0.001). Black men had fewer male sex partners than non-black, fewer had ever engaged in intentional unprotected anal sex, and more used condoms at last anal sex. Black men were less likely to have health insurance, have been tested for HIV, and disclose MSM status to health care providers. Despite significantly higher HIV/AIDS rates, black MSM in DC reported fewer sexual risks than non-black. These findings suggest that among black MSM, the primary risk of HIV infection results from nontraditional sexual risk factors, and may include barriers to disclosing MSM status and HIV testing. There remains a critical need for more information regarding reasons for elevated HIV among black MSM in order to inform prevention programming."
Comment: Another possibility is that Africans and African Americans may be more susceptible to HIV infection than whites, due to genetic differences. For example, the double CCR5 deletion mutation, which gives almost complete immunity to HIV, occurs in about 1% of whites but 0% of Africans. (The single CCR5 deletion, associated with slower HIV progression, occurs in more whites; it might further reduce the infection rate.) Such genetic differences could lead to higher HIV prevalence in one population than another, despite less behavioral risk.
But for another theory, see Higher HIV rates among black MSM in the US may be linked to attitudes about homosexuality.
Comment: Another possibility is that Africans and African Americans may be more susceptible to HIV infection than whites, due to genetic differences. For example, the double CCR5 deletion mutation, which gives almost complete immunity to HIV, occurs in about 1% of whites but 0% of Africans. (The single CCR5 deletion, associated with slower HIV progression, occurs in more whites; it might further reduce the infection rate.) Such genetic differences could lead to higher HIV prevalence in one population than another, despite less behavioral risk.
But for another theory, see Higher HIV rates among black MSM in the US may be linked to attitudes about homosexuality.
Nonstick coating of a protein found in semen reduces HIV infection
EurekAlert: "A non-stick coating for a substance found in semen dramatically lowers the rate of infection of immune cells by HIV a new study has found.
"The new material is a potential ingredient for microbicides designed to reduce transmission of HIV, a team from the University of Rochester Medical Center and the University of California, San Diego reports in a forthcoming issue of the Journal of Biological Chemistry."
"The new material is a potential ingredient for microbicides designed to reduce transmission of HIV, a team from the University of Rochester Medical Center and the University of California, San Diego reports in a forthcoming issue of the Journal of Biological Chemistry."
AIDS, HIV patients getting help from pharmaceutical companies
MiamiHerald.com: "Despite a statewide waiting list of more than 1,400 newly diagnosed HIV and AIDS patients who need antiretroviral drugs but can't pay for them, a robust response from big pharmaceutical companies so far is filling most of the crucial need, state health officials say.
"`I'm not shy about criticizing pharmaceutical companies. But I have to say they have helped us respond to this crisis so we don't have lapses in drug treatment,'' said Thomas Liberti, chief of the Bureau of HIV/AIDS in the Florida Department of Health.
"It could have been tragic, Liberti said. A $1 million state funding cut last year to Florida's AIDS Drug Assistance Program (ADAP) coincided with a ``perfect storm'' of new patients needing drugs to stay alive, he said."
"`I'm not shy about criticizing pharmaceutical companies. But I have to say they have helped us respond to this crisis so we don't have lapses in drug treatment,'' said Thomas Liberti, chief of the Bureau of HIV/AIDS in the Florida Department of Health.
"It could have been tragic, Liberti said. A $1 million state funding cut last year to Florida's AIDS Drug Assistance Program (ADAP) coincided with a ``perfect storm'' of new patients needing drugs to stay alive, he said."
Did doctors jumpstart the HIV pandemic?
msnbc.com: "Because the villagers who first caught HIV would be long dead today, Pepin decided to use the less-deadly hepatitis C virus as well as another blood-borne virus (human T cell lymphotropic virus 1, or HTLV-1) as models for how HIV could have been inadvertently transmitted by the French colonial doctors treating sleeping sickness.
"What they found was striking: if a person had been treated for the sleeping disease before 1951, the chances that he or she had been infected with hepatitis C tripled. And HTLV-1 showed a similar pattern.
"'What happened is that for a long time, the needles and syringes used to administer the intravenous drugs were not single-use,' Pepin told Reuters Health. 'There were a lot of patients and not a lot of needles, so the sterilization of needles was not very efficient.'
"'If HIV was present in one of these patients 50 years ago, we can assume that they probably transmitted HIV,' he said. 'It is exactly like intravenous drug users who share needles.'
"According to Pepin, that would also explain why the number of people 65 years and older who'd been treated for sleeping sickness was six times lower than would be expected from historical data: the missing seniors could have died of AIDS, the immune system breakdown caused by HIV."
"What they found was striking: if a person had been treated for the sleeping disease before 1951, the chances that he or she had been infected with hepatitis C tripled. And HTLV-1 showed a similar pattern.
"'What happened is that for a long time, the needles and syringes used to administer the intravenous drugs were not single-use,' Pepin told Reuters Health. 'There were a lot of patients and not a lot of needles, so the sterilization of needles was not very efficient.'
"'If HIV was present in one of these patients 50 years ago, we can assume that they probably transmitted HIV,' he said. 'It is exactly like intravenous drug users who share needles.'
"According to Pepin, that would also explain why the number of people 65 years and older who'd been treated for sleeping sickness was six times lower than would be expected from historical data: the missing seniors could have died of AIDS, the immune system breakdown caused by HIV."
September 23, 2010
1 in 5 Gay/Bi Men Have HIV, Nearly Half Don't Know
WebMD: "One in five gay/bisexual men in the 21 U.S. cities hardest hit by AIDS have HIV infections -- and nearly half don't know it, a CDC survey finds."
September 22, 2010
Annie Lennox: Why I am an HIV/AIDS activist
Video on TED.com: "For the last eight years, pop singer Annie Lennox has devoted the majority of her time to her SING campaign, raising awareness and money to combat HIV/AIDS. She shares the experiences that have inspired her, from working with Nelson Mandela to meeting a little African girl in a desperate situation.
About Annie Lennox
"The most successful female British pop musician in history, Annie Lennox has now committed herself to raising awareness of, and supporting actions against, the HIV/AIDS crisis in Africa."
About Annie Lennox
"The most successful female British pop musician in history, Annie Lennox has now committed herself to raising awareness of, and supporting actions against, the HIV/AIDS crisis in Africa."
Inovio begins testing new HIV vaccine
Vaccine News Daily: "Pennavax-B is a DNA vaccine that uses a proprietary electroporation technique developed by Inovio. Electroporation uses millisecond long electrical pulses to help the DNA vaccine to permeate cell membranes, according to the Philadelphia Business Journal. This technique allows for a significantly greater uptake of the biological material that was injected into local tissue."
Zimbabwe Drops Charges Against HIV/AIDS Health Workers
Voice of America: "The six were initially accused of running HIV/AIDS clinics in Harare and Mutoko without authorization. The Americans work under the auspices of the Allen Temple Baptist Church AIDS Ministry in Oakland, California.
"Reports said the California-based medical workers have been traveling to Zimbabwe three or four times a year at their own expense to provide antiretroviral drugs, vitamins, clothing and food to poor people with AIDS."
"Reports said the California-based medical workers have been traveling to Zimbabwe three or four times a year at their own expense to provide antiretroviral drugs, vitamins, clothing and food to poor people with AIDS."
[San Francisco] Town meeting: What health care reform means for people with HIV/AIDS Wednesday, September 29th
Project Inform Calendar of Events [scroll down]: [San Francisco] "This law has the potential to dramatically improve access to care for people with HIV and there are also many challenges that we will need to address."
Lopinavir Monotherapy: High Risk for Viral Relapse in the Central Nervous System
HIV/AIDS Clinical Care: "The trial was stopped prematurely when 6 of the 29 patients on [Kaletra] monotherapy — versus none of the 31 on triple-drug therapy — experienced treatment failure in the blood (defined as 2 consecutive plasma viral loads >400 copies/mL). These failures all occurred within the first 6 months of monotherapy and in patients who had nadir CD4 counts <200 cells/mm3; four of the patients developed neurological symptoms."
September 20, 2010
Antiretroviral Therapy Down-Regulates Innate Antiviral Response Genes in Patients With AIDS in Sub-Saharan Africa
JAIDS Journal of Acquired Immune Deficiency Syndromes: "Conclusions: By using ART to block the viral stimulus, we identified transcripts involved in innate antiviral immunity, including antiviral restriction factors and pattern recognition receptors, that were not previously known to be induced by HIV infection."
Effect of vitamin supplements on HIV shedding in breast milk
American Journal of Clinical Nutrition: "Conclusions: VA/BC [vitamin A and β-carotene] supplementation in lactating women increases the HIV load in breast milk. This finding contributes to explaining the adverse effect of VA/BC on mother-to-child transmission. β-Carotene appears to have an effect on breast-milk viral load, independent of preformed vitamin A."
Switch to nevirapine can happen at any CD4 count, says European drug regulator
aidsmap: "People with HIV who have an undetectable viral load can safely switch to nevirapine (Viramune) at any CD4 cell count, the European Medicines Agency has concluded.
"The agency has issued a revised Summary of Product Characteristics to allow switching in people with suppressed viral load who want to switch to nevirapine for reasons of tolerability or cost.
"The agency’s Committee for Medical Products for Human Use reviewed evidence from clinical studies to determine whether people who switched to nevirapine from an existing antiretroviral regimen had an increased risk of liver toxicity or hypersensitivity reaction at higher CD4 cell counts.
"People who have never taken antiretroviral treatment are at increased risk of these reactions at higher CD4 cell counts. Women with CD4 counts above 250 and men with CD4 counts above 400 should not start treatment with the drug, regulatory agencies have ruled.
"However, evidence from cohort studies conducted prior to the ruling has demonstrated that switching to nevirapine after achieving an undetectable viral load is not associated with an increased risk of toxicity, even if a person’s CD4 count has risen above the CD4 count thresholds that rule out use of the drug in untreated people."
"The agency has issued a revised Summary of Product Characteristics to allow switching in people with suppressed viral load who want to switch to nevirapine for reasons of tolerability or cost.
"The agency’s Committee for Medical Products for Human Use reviewed evidence from clinical studies to determine whether people who switched to nevirapine from an existing antiretroviral regimen had an increased risk of liver toxicity or hypersensitivity reaction at higher CD4 cell counts.
"People who have never taken antiretroviral treatment are at increased risk of these reactions at higher CD4 cell counts. Women with CD4 counts above 250 and men with CD4 counts above 400 should not start treatment with the drug, regulatory agencies have ruled.
"However, evidence from cohort studies conducted prior to the ruling has demonstrated that switching to nevirapine after achieving an undetectable viral load is not associated with an increased risk of toxicity, even if a person’s CD4 count has risen above the CD4 count thresholds that rule out use of the drug in untreated people."
Switch to nevirapine can happen at any CD4 count, says European drug regulator
aidsmap: "People with HIV who have an undetectable viral load can safely switch to nevirapine (Viramune) at any CD4 cell count, the European Medicines Agency has concluded.
"The agency has issued a revised Summary of Product Characteristics to allow switching in people with suppressed viral load who want to switch to nevirapine for reasons of tolerability or cost.
"The agency’s Committee for Medical Products for Human Use reviewed evidence from clinical studies to determine whether people who switched to nevirapine from an existing antiretroviral regimen had an increased risk of liver toxicity or hypersensitivity reaction at higher CD4 cell counts.
"People who have never taken antiretroviral treatment are at increased risk of these reactions at higher CD4 cell counts. Women with CD4 counts above 250 and men with CD4 counts above 400 should not start treatment with the drug, regulatory agencies have ruled.
"However, evidence from cohort studies conducted prior to the ruling has demonstrated that switching to nevirapine after achieving an undetectable viral load is not associated with an increased risk of toxicity, even if a person’s CD4 count has risen above the CD4 count thresholds that rule out use of the drug in untreated people."
"The agency has issued a revised Summary of Product Characteristics to allow switching in people with suppressed viral load who want to switch to nevirapine for reasons of tolerability or cost.
"The agency’s Committee for Medical Products for Human Use reviewed evidence from clinical studies to determine whether people who switched to nevirapine from an existing antiretroviral regimen had an increased risk of liver toxicity or hypersensitivity reaction at higher CD4 cell counts.
"People who have never taken antiretroviral treatment are at increased risk of these reactions at higher CD4 cell counts. Women with CD4 counts above 250 and men with CD4 counts above 400 should not start treatment with the drug, regulatory agencies have ruled.
"However, evidence from cohort studies conducted prior to the ruling has demonstrated that switching to nevirapine after achieving an undetectable viral load is not associated with an increased risk of toxicity, even if a person’s CD4 count has risen above the CD4 count thresholds that rule out use of the drug in untreated people."
Longer viral load is undetectable, lower the risk of rebound
aidsmap: "'We found that once viral suppression was initially achieved, high levels of adherence were still needed for at least the first year. Over time, however, the risk of viral rebound decreased with maintained viral suppression irrespective of the level of adherence', comment the investigators.
"Nevertheless, the investigators emphasise that patients should aim to take all their doses correctly.
"Treatment with combination antiretroviral therapy can extend the life expectancy of HIV-positive patients to near normal levels.
"To get the maximum benefit from their treatment, it is necessary for patients to take their treatment correctly. The best outcomes are seen in individuals who take at least 95% of their doses. Adherence below that level has been associated with an increase in viral load and the development of drug-resistant virus."
"Nevertheless, the investigators emphasise that patients should aim to take all their doses correctly.
"Treatment with combination antiretroviral therapy can extend the life expectancy of HIV-positive patients to near normal levels.
"To get the maximum benefit from their treatment, it is necessary for patients to take their treatment correctly. The best outcomes are seen in individuals who take at least 95% of their doses. Adherence below that level has been associated with an increase in viral load and the development of drug-resistant virus."
Volunteer to Save Our State at the 2010 AIDS Run and Walk
AIDS Connect: "This year, AFC’s policy department will be gearing up sailor-style to Save Our State. The-Titanic-is-sinking-themed tent will urge event participants to learn more about Illinois’ budget crisis and how they can fight to change it - plus folks can play our Save to State game and win a free t-shirt! In addition, AFC will be running a separate tent to register Illinois residents to vote. All this madness means only one thing – WE NEED YOU!"
Comment: Could this offer fundraising models for other AIDS uses?
Comment: Could this offer fundraising models for other AIDS uses?
Flu shot linked to reduced heart attack risk
Reuters: "Middle-aged and older adults who get the flu vaccine may be less likely to suffer a first-time heart attack in the following year than those who skip the shot, according to a study published Monday."
September 14, 2010
Latent HIV infection focus of NIDA’s 2010 Avant-Garde Award
Science Blog: "The long-term persistence of HIV in a latent state in patients treated with HAART prevents the eradication of the disease, and forces patient to remain on HAART for their entire life. At this time, our understanding of how latent HIV infection occurs is basic. Dr. Verdin’s project aims to develop a new single cell technology to examine how HIV latency is established, maintained, and how the virus becomes reactivated, in primary human lymphoid cells. By observing the fate of the virus in single cells, Dr. Verdin hopes to be able to devise novel strategies to eliminate latent HIV infection, or to restrict the latent pool to a size that can be controlled by the immune system."
Black Mans HIV Status Leads to Breakthrough in Research
BV Black Spin: "The U.S. government recently stated that its scientists have found three new antibodies to fight the disease, one of which can neutralize 91 percent of HIV strains. That's more than any antibody has produced thus far. The antibodies don't cure HIV, but they can be used in powerful new vaccines.
"The HIV antibodies, which led to the developments, were found in the cells of a 60-year-old black man. Scientists have not released his name and only refer to him as 'Donor 45.' His body made the antibodies naturally, and scientists are using his results to create a vaccine that will produce the antibodies in anyone who takes it."
"The HIV antibodies, which led to the developments, were found in the cells of a 60-year-old black man. Scientists have not released his name and only refer to him as 'Donor 45.' His body made the antibodies naturally, and scientists are using his results to create a vaccine that will produce the antibodies in anyone who takes it."
Mymetics' Novel HIV Vaccine to Begin New NIH-Funded Study at University of California, Davis
MarketWatch: "Mymetics Corporation, a pioneer in the development of vaccines preventing mucosal transmission of human infectious diseases, announced today that its innovative HIV vaccine will enter a new preclinical trial at the University of California, Davis. The study will be led by Professor Christopher J. Miller of the California National Primate Research Center, a leader in immunodeficiency virus transmission in nonhuman primate models, and partially funded by the NIH (National Institutes of Health). It follows a recently completed smaller study at the Institute of Laboratory Animal Science (ILAS) in Beijing, China in which the vaccine provided an unprecedented 100% protection in macaque monkeys. The vaccine is also currently in a Phase I trial in human volunteers."
More than 3000 People Now on State ADAP Waiting Lists
HIVandHepatitis.com: "A total of 3423 people with HIV in 11 states were on AIDS Drug Assistance Program (ADAP) waiting lists as of early September, according to the latest figures compiled by the National Alliance of State and Territorial AIDS Directors (NASTAD). In the wake of the ongoing economic crisis, about a dozen other states have instituted cost-containment strategies or expect to do so by the spring of 2011."
Meta-analysis Finds Tenofovir Linked to Modest Kidney Impairment, No Increase in Bone Fractures
HIVandHepatitis.com: "SUMMARY: Use of tenofovir (Viread, also in the Truvada and Atripla combination pills) was found to be associated with statistically significant loss of kidney function in a systematic review and meta-analysis, but this was considered to have only a modest clinical impact, researchers reported in the September 15, 2010 issue of Clinical Infectious Diseases. This review also found no link between tenofovir and bone fractures. Researchers concluded that tenofovir use does not need to be limited in areas where kidney function cannot be adequately monitored."
Elvitegravir "Quad" Single-tablet Regimen Shows Continued HIV Suppression at 48 Weeks
HIVandHepatitis.com: "SUMMARY: Gilead Science's experimental 'Quad' pill -- a once-daily single-tablet coformulation containing the new integrase inhibitor elvitegravir, the novel boosting agent cobicistat (GS 9350), and tenofovir plus emtricitabine (the drugs in the Truvada pill) -- continued to demonstrate potent antiviral activity and good tolerability at 48 weeks, according to data presented this week at the 50th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2010). In a second comparison, cobicistat worked as well as ritonavir as a booster for atazanavir, with similar changes in kidney function."
September 11, 2010
American Doctors Held in Zimbabwe
NYTimes.com [dated Sept. 12]: "Five Americans — two doctors, two nurses and an organizer — who carried donated AIDS drugs to Zimbabwe for distribution to the poor were arrested Thursday and remained jailed in Harare on Saturday on a charge of dispensing the medicine without the supervision of a pharmacist or proper licenses, their lawyer said. ...
"The Americans belong to the Allen Temple Baptist Church AIDS Ministry in Oakland, Calif. The church serves a predominantly African-American congregation. Three or four times a year since 2000, members have paid their own way to Zimbabwe to give antiretroviral medicine, vitamins, clothing and food baskets to impoverished people with AIDS.
"The epidemic is severe throughout Zimbabwe and the country’s broken health system fails to treat most people in need.
"On this trip, the team had brought a four-month supply of antiretroviral drugs for about 800 people with AIDS, some of them orphaned children, in Harare and Mutoko, a rural district.
"Arnold Perkins, the retired public health director in Alameda County, Calif., said in a telephone interview from California that he had made the trip six times and seen skeletal AIDS patients restored to health by the medicine. The arrest of the team there “breaks my heart,” he said.
"'If this work stops, it’s a human tragedy,' he said. 'People will die. That’s a fact.'"
"The Americans belong to the Allen Temple Baptist Church AIDS Ministry in Oakland, Calif. The church serves a predominantly African-American congregation. Three or four times a year since 2000, members have paid their own way to Zimbabwe to give antiretroviral medicine, vitamins, clothing and food baskets to impoverished people with AIDS.
"The epidemic is severe throughout Zimbabwe and the country’s broken health system fails to treat most people in need.
"On this trip, the team had brought a four-month supply of antiretroviral drugs for about 800 people with AIDS, some of them orphaned children, in Harare and Mutoko, a rural district.
"Arnold Perkins, the retired public health director in Alameda County, Calif., said in a telephone interview from California that he had made the trip six times and seen skeletal AIDS patients restored to health by the medicine. The arrest of the team there “breaks my heart,” he said.
"'If this work stops, it’s a human tragedy,' he said. 'People will die. That’s a fact.'"
September 10, 2010
A ’Blue Button’ for Health Data
Healthleadersmedia.com: "In his talk, the President said that for the first time ever, veterans will be able to go to the Department of Veterans Affairs website, 'click a simple blue button, and download or print your personal health records so you have them when you need them, and can share them with your doctors outside of the VA.'
"And, similar plans are in the works for www.MyMedicare.gov to offer it to Medicare beneficiaries, Markle noted. So why can't medical practices, hospitals, insurers, pharmacies, and laboratory services consider blue buttons as well for their websites as well?"
Comment: The beauty of the blue-button idea is that all difficulty of teaching patients how to download their records goes away. But developing a useful introduction and summary for patients from that data will not be simple at all. Guarding medical privacy is not easy, either. Yet the complexities are behind the scenes, for experts to deal with, and do not affect patients' ability to click the blue button and get their records.
The last sentence quoted above suggests what's still beyond the abilities of America's for-profit medical system: the ability to press one blue button and get all one's medical date from the various "medical practices, hospitals, insurers, pharmacies, and laboratory services" that have it.
"And, similar plans are in the works for www.MyMedicare.gov to offer it to Medicare beneficiaries, Markle noted. So why can't medical practices, hospitals, insurers, pharmacies, and laboratory services consider blue buttons as well for their websites as well?"
Comment: The beauty of the blue-button idea is that all difficulty of teaching patients how to download their records goes away. But developing a useful introduction and summary for patients from that data will not be simple at all. Guarding medical privacy is not easy, either. Yet the complexities are behind the scenes, for experts to deal with, and do not affect patients' ability to click the blue button and get their records.
The last sentence quoted above suggests what's still beyond the abilities of America's for-profit medical system: the ability to press one blue button and get all one's medical date from the various "medical practices, hospitals, insurers, pharmacies, and laboratory services" that have it.
Role of Pyrimidine Depletion in the Mitochondrial Cardiotoxicity of Nucleoside Analogue Reverse Transcriptase Inhibitors
JAIDS Journal of Acquired Immune Deficiency Syndromes: "Conclusions: Zidovudine (AZT) and zalcitabine (ddC) induce a mitochondrial cardiomyopathy, which is antagonized with uridine supplementation, implicating pyrimidine pool depletion in its pathogenesis. Pyrimidine pool replenishment may be exploited clinically because uridine is well tolerated."
UT Southwestern researchers testing new HIV vaccine
Salud: "Researchers at the University of Texas Southwestern Medical Center at Dallas announced today that they testing a combination of two potential vaccines to see if they will prevent HIV/AIDS. ...
"Researchers are recruiting, non-HIV-infected men, ages 18 to 45, who have sex with men and transgender women who have sex with men."
"Researchers are recruiting, non-HIV-infected men, ages 18 to 45, who have sex with men and transgender women who have sex with men."
September 8, 2010
Ghana certifies Nevada-made product for HIV treatment
Carson City Nevada News - Carson Now: "The Ministry of Health in Ghana has certified one of the products produced by Carson City, Nevada-based Aloha Medicinals, as a soul therapeutic treatment for HIV infection."
Comment: We don't have more information, or know what to think of this.
Comment: We don't have more information, or know what to think of this.
HIV spread out of control among French gay men
Reuters: "Transmission of the AIDS virus seems to be 'out of control' among gay men in France despite an overall fall in the number of new HIV cases in the country, according to a study published on Thursday.
"Scientists from the French National Institute for Public Health Surveillance found that nearly half of the 7,000 people newly infected with HIV in the country in 2008 were gay men, and the incidence among homosexual men is 200 times higher than in the heterosexual population."
"Scientists from the French National Institute for Public Health Surveillance found that nearly half of the 7,000 people newly infected with HIV in the country in 2008 were gay men, and the incidence among homosexual men is 200 times higher than in the heterosexual population."
September 7, 2010
HIV diagnoses fall as treatment expands in British Columbia
Aidsmap: "Canadian researchers have published a large cohort study indicating that higher uptake of antiretroviral therapy might reduce HIV transmission considerably in some populations."
Comment: We noted the original paper on July 18, but this is a good summary.
Comment: We noted the original paper on July 18, but this is a good summary.
September 6, 2010
Syphilis and HIV: The Intersection of Two Epidemics
HIV/AIDS Clinical Care: "A comprehensive review of the epidemiology, clinical presentation, diagnosis, treatment, and monitoring of syphilis in HIV-infected patients"
September 4, 2010
Imiquimod a good treatment for pre-cancerous anal lesions in men with HIV
aidsmap.com: "HIV treatment centres should screen and treat pre-cancerous anal lesions, UK investigators argue in the online edition of AIDS. They were prompted to make this suggestion by research showing that treatment with imiquimod cream resolved or downgraded high-grade pre-cancerous anal lesions in 61% of HIV-positive gay men. ...
"Imiquimod cream is a possible treatment for such lesions and has two distinct advantages: the patient applies it, and it is suitable for the treatment of extensive lesions. Earlier research has shown that it is an effective therapy for pre-cancerous lesions in the cervix."
"Imiquimod cream is a possible treatment for such lesions and has two distinct advantages: the patient applies it, and it is suitable for the treatment of extensive lesions. Earlier research has shown that it is an effective therapy for pre-cancerous lesions in the cervix."
Diabetes drug may keep lung cancer at bay
Reuters: "Other studies have shown that metformin can cut diabetics' risk of pancreatic and breast cancers, and the latest finding now suggests it may defend the body against smoking-induced lung tumors.
"'This important laboratory study, together with prior laboratory and epidemiology research, suggests that metformin may be useful in cancer prevention and treatment,' said Dr. Michael Pollak of McGill University in Montreal, who wrote a review on metformin research in the same journal."
"'This important laboratory study, together with prior laboratory and epidemiology research, suggests that metformin may be useful in cancer prevention and treatment,' said Dr. Michael Pollak of McGill University in Montreal, who wrote a review on metformin research in the same journal."
Groups of friends key to changing health behaviors
Reuters: "People in the small friend groups registered four times as fast as those with less connected networks.
"'It spread through the population so quickly. It saturates very, very fast,' Centola said.
"Social scientists had thought that it would be redundant to give a health message to a person more than once. But Centola said when it comes to health habits, people are quicker to change when they hear the message from more than one source."
"'It spread through the population so quickly. It saturates very, very fast,' Centola said.
"Social scientists had thought that it would be redundant to give a health message to a person more than once. But Centola said when it comes to health habits, people are quicker to change when they hear the message from more than one source."
AIDS Quest to Kill `Sleeping' Virus Enlists Merck Cancer Drug
Bloomberg: "Researchers at the University of North Carolina in Chapel Hill plan to test Merck’s drug, Zolinza, next year in about 20 people infected with HIV, the AIDS virus. The goal is to determine if Zolinza, or a medicine like it, can force HIV out of cells where it can reside, concealed from attack by potent antiviral treatments, said David Margolis, a professor of medicine who’s leading the research.
"... Zolinza, approved in 2006 for use against a rare type of blood cancer, may work by blocking an enzyme that helps the virus avoid detection.
“It’s really all about trying to move the field ahead,” Margolis said in a telephone interview. “We don’t expect to cure anybody, but we expect to really show whether it can work the way we think it does in people -- or not."
"... Zolinza, approved in 2006 for use against a rare type of blood cancer, may work by blocking an enzyme that helps the virus avoid detection.
“It’s really all about trying to move the field ahead,” Margolis said in a telephone interview. “We don’t expect to cure anybody, but we expect to really show whether it can work the way we think it does in people -- or not."
First Medical Marijuana Ad Airs in California: Is it Wrong?
Health Blog - CBS News: "No one seemed out of joint earlier this week when a California TV station broadcast what is believed to be the first-ever paid spot for medical weed. Or were they just keeping a lid on their feelings?"
Comment:This may be the first TV ad, but small weekly papers in California at least have carried medical marijuana ads for years.
Currently the reader poll with the article shows 89% in favor of medical marijuana, 7% opposed, and 4% apparently undecided.
Comment:This may be the first TV ad, but small weekly papers in California at least have carried medical marijuana ads for years.
Currently the reader poll with the article shows 89% in favor of medical marijuana, 7% opposed, and 4% apparently undecided.
Money Missing to Confirm Trial of Microbicide Against H.I.V.
NYTimes.com: "When scientists celebrated the announcement in July that a vaginal microbicide had finally been found that significantly reduced H.I.V. infections in women, there was still a prosaic — though essential — piece of the puzzle missing: money.
"Donors have not committed enough money for even one of the two studies needed to confirm a promising South African trial of the microbicide and get it into women’s hands. Only about $58 million of the $100 million needed for follow-up research has been pledged, according to Unaids, the United Nations AIDS agency. Experts say shifting global health priorities and tight finances in the West are making it hard to raise the rest."
"Donors have not committed enough money for even one of the two studies needed to confirm a promising South African trial of the microbicide and get it into women’s hands. Only about $58 million of the $100 million needed for follow-up research has been pledged, according to Unaids, the United Nations AIDS agency. Experts say shifting global health priorities and tight finances in the West are making it hard to raise the rest."
September 1, 2010
Drug costs would push millions more into poverty: study
Reuters: "Tens of millions of people in low and middle income countries would be pushed below the poverty line by buying common but vital medicines which are already unaffordable to hundreds of millions more, a study has found."
People with HIV with higher CD4 counts should not miss seasonal flu jabs
aidsmap.com: "They recommend that all HIV-positive patients should have an annual influenza vaccine to help them to establish flu-specific memory immune cells, the formation of which can be difficult after the immune system suffers serious damage."
HIV Prevention: Pay Now, Save Later
POZ: "For the first time in the history of the epidemic, our country has a comprehensive National HIV/AIDS Strategy. What’s more, researchers now claim that a short-lived, but large infusion of cash could cut the infection rate almost in half within 10 years and save hundreds of billions of dollars. Yes we’re in the middle of a terrible recession, and Congress has never been more averse to spending, but activists argue that the cost of not coming together as a community to fight for more prevention dollars is too high."
Specific eradication of HIV-1 from infected cultured cells
AIDS Research and Therapy: "Here we show that combination of peptides that stimulate integration together with the protease inhibitor Ro 31-8959 caused apoptotic cell death of HIV infected cells with total extermination of the virus. This combination did not have any effect on non-infected cells. Thus it appears that cell death is promoted only in the infected cells. It is our view that the results described in this work suggest a novel approach to specifically promote death of HIV-1 infected cells and thus may eventually be developed into a new and general anti-viral therapy." [full text free]
Many HIV-positive gay men have post-traumatic stress disorder
aidsmap.com: "A third of HIV-positive gay men have post-traumatic stress disorder, UK investigators report in AIDS Patient Care and STDs. Events including starting treatment, HIV-related illness, and witnessing an HIV-related death were all linked to the development of symptoms associated with post-traumatic stress disorder. Emotional responses to such events - rather than actual physical threat - were associated with the development of symptoms of posttraumatic stress."
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