FDA and CONRAD Chart U.S. Regulatory Path for 1% Tenofovir Gel for HIV Prevention

CONRAD: "The U.S. Food and Drug Administration (FDA) held an end-of-Phase II meeting to determine the next steps required for U.S. licensure of 1% tenofovir gel, a microbicide product recently found to be effective at reducing the rate of HIV and herpes infection in women when used before and after sex.

"The meeting, held on October 20, 2010, was requested by CONRAD, a division of the Eastern Virginia Medical School in Norfolk, VA. CONRAD was one of the partners in the Phase II study, “CAPRISA 004,” which evaluated 1% tenofovir gel in prevention of male-to-female HIV transmission in 889 women in South Africa. USAID provided funding for the trial, conducted by the Centre for Programme Research for AIDS in South Africa and U.S. based FHI, which was the first study to show that a vaginal gel can reduce the risk of HIV and herpes infection in women. CONRAD manufactured and provided the tenofovir gel for the study.

"Tenofovir gel 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. Results of the CAPRISA 004 clinical trial were reported in July 2010 and represent the first “proof of concept” for a vaginal microbicide."


Comment (by JSJ): This is great news. But it could be better. 39% reduction means that 61% of the infections were not stopped.

Is there a good case for a higher dose, e.g. 2%? If yes, the 1% approvaL should still proceed, and a (vastly smaller and vastly less expensive) safety trial with higher dose(s) should be done as well. Moving toward approving the 1% is how regulators act, which is how scientists and companies then act, so it may be the best we can expect from the conventional wisdom.

But if the obstacle is that there isn't money any more for big efficacy trials to get "ideal" dose information, people still need to be empowered to make intelligent decisions using all the information to protect themselves and others, and reduce or end the epidemic.

Perhaps test safety of the standard gel with more tenofovir mixed in, so that countries or pharmacists could more easily prepare a higher dose formulation before it becomes standard.

Or maybe test safety of adding a standard tenofovir pill to the post-sex use of the gel? No reformulation needed.

Obama: Republicans Aren’t Funding AIDS Issues

Daily Intel: "According to President Obama, some pesky 'young people' protesting for more global AIDS funding have been showing up 'at every rally' and interrupting him. Today, in Connecticut to discuss the economy, Obama addressed these crazy young people, and ended up addressing AIDS funding in the process."

HIV Antibodies Do Control Infection: New Hope for Vaccines and Treatment

POZ: "B-cells and neutralizing antibodies (NAbs) might control HIV levels better than scientists previously suspected, according to a single-patient study reported in the October issue of Nature Communications. The intriguing finding, the authors note, could open a new avenue for both preventive and treatment vaccines for HIV."

HIV-1-Infected Peripheral Blood Mononuclear Cells Enhance Neutrophil Survival and HLA-DR Expression Via Increased Production of GM-CSF: ...

JAIDS Journal of Acquired Immune Deficiency Syndromes: "We conclude that GM-CSF production within the mucosa or draining lymph nodes may promote HIV-1 infection by facilitating sustained contact between viable neutrophils and CD4 lymphocytes. The minimal effect of GM-CSF on HLA-DR expression by neutrophils of elite controllers provides indirect support for this conclusion."

Darunavir working well for highly treatment-experienced patients in Switzerland

aidsmap.com: "Outcomes for treatment-experienced patients receiving “salvage therapy” that includes the protease inhibitor darunavir are equal to, or even better, than those seen in clinical trials, Swiss investigators report in the online edition of HIV Medicine."

Low Cost HIV/AIDS Drugs to be Available by Oct-End

news.outlookindia.com: "'Two Indian pharma companies will partner to manufacture medicines on HIV/AIDS produced by foreign companies following which the the cost would reduce by 75 to 99 per cent compared to the international market. They will be launched during the 3rd National Conference of AIDS Society of India (ASICON 2010) to be held in Hyderabad from October 29,' the society's secretary I S Gilada said."

Diabetes Care Misses Mark in HIV Patients

IDSA from MedPage Today: "In scrutinizing how well different types of doctors did in providing routine care, researchers found that only doctors at a Canadian endocrinology clinic came anywhere near meeting treatment benchmarks.

"For example, when it came to foot examinations -- a key part of diabetes surveillance -- the check was done less than 20% of the time at a Toronto immunodeficiency clinic and an American HIV clinic; about 35% of the time at an American primary care clinic; about 65% of the time at an American endocrinology clinic, and about 90% of the time at the Canadian endocrinology clinic."

Swiss drug policy should serve as model: experts | Reuters

Reuters: "'The number of drug injectors with HIV has been reduced by over 50 percent in 10 years. Overdose mortality among injectors has been reduced by over 50 percent in the decade,' he said. 'Delinquency related to drugs has been reduced enormously.'

"Family doctors now prescribe about 60 percent of opiate substitution treatment in Switzerland and the Internet was vital in informing users about access to treatment, Uchtenhagen added."

Antiretroviral Drug Raltegravir May Inhibit Herpes Virus Replication

HIVandHepatitis.com: "SUMMARY: Researchers in Spain have uncovered the structure of a protein complex that enables herpes viruses such as cytomegalovirus (CMV) to package their DNA into new viral particles as it replicates. As reported in the September 14, 2010 Proceedings of the National Academy of Sciences, they also found that the HIV integrase inhibitor raltegravir (Isentress) can bind to the herpes protein complex and interfere with its activity. If confirmed in future studies, raltegravir or related drugs might be active against all members of the herpes family, including the viruses that cause genital herpes simplex, shingles, and Kaposi's sarcoma."

[HIV cure 2nd among 18 policy priorities: NMAC]

National Minority AIDS Coalition: "I recently asked you to tell me your policy priorities; an overwhelming number selected Fixing AIDS Drug Assistance Program (ADAP) as the first priority. Please see the results of this survey:
1. Fixing ADAP: 484
2. HIV Cure: 373
3. Test & Treat: 360
4. HIV Prevention Targeting Women: 312
5. HIV Prevention Targeting Gay: 311
6. Medical Infrastructure: 307
7. HIV Prevention Media Campaign: 298
8. Housing: 282
9. NHAS: 229
10.Research: 202
11.Global HIV Treatment: 196
12.HIV Prevention Targeting Trans Community: 179
13.HIV Prevention Targeting Drug Users: 177
14.Vaccines: 173
15.Global Fund: 159
16.Global HIV Prevention: 151
17.Microbicides: 139
18.Prep:102"

Merck Announces Expanded Co-Pay Assistance Program for ISENTRESS® (raltegravir)

Merck: "Merck today announced an enhanced co-pay assistance program for people living with HIV-1 who are taking the Company's first-in-class HIV-1 integrase inhibitor, ISENTRESS® (raltegravir) Tablets. The program provides important savings for privately-insured patients with out-of-pocket costs for ISENTRESS, and is part of Merck’s ongoing commitment to providing access to treatment."

City Restores HIV/AIDS Cut

WSJ.com: "Advocates for the programs' recipients—formerly homeless New Yorkers with HIV/AIDS who suffer from mental-health and substance-abuse problems—said they were pleased with the partial restoration. But they faulted the mayor for proposing the cut in the first place."

Elite Controllers Display Higher Activation on Central Memory CD8 T Cells Than HIV Patients Successfully on HAART

AIDS Research and Human Retroviruses: "Factors other than the size of the viral reservoir should explain the high level of activation of central memory CD8 T cells characteristically seen in HIV individuals with spontaneous control of viral replication."

Comment: It seems likely that this immune activation is helping these patients control HIV.

Norvir-Boosted Invirase May Cause Dangerous Heart Rhythms

POZ: "The combination of Norvir (ritonavir)–boosted Invirase (saquinavir) may be associated with a life-threatening side effect on the heart, according to new changes to Invirase’s prescribing information announced by the FDA on Thursday, October 21, and reported by PR Newswire. The prescribing information changes follow a preliminary announcement in February describing a potential link between Norvir/Invirase and heart rhythm disturbances."

Guidelines for treatment of syphilis in patients with HIV have very poor evidence base

Aidsmap: "Current guidelines for the treatment of syphilis in patients with HIV are based on limited clinical data, investigators show in the online edition of Sexually Transmitted Infections.

"Even though their systematic review had broad inclusion criteria, they were only able to identify 23 studies examining the outcomes of HIV-positive patients treated for syphilis. Only two of these studies were rated as “high quality” by the investigators.

"Rates of treatment failure varied considerably, and were as high as 31% for latent syphilis. However, the investigators believe that confounding factors rather than the poor efficacy of treatment are the likely explanation for this."

Darunavir Outcomes Study: Comparative Effectiveness of Virologic Suppression, Regimen Durability, and Discontinuation Reasons for Three-Class Exper...

AIDS Research and Human Retroviruses:: "Introduction: Several new antiretroviral (ARV) agents for treatment experienced HIV-infected patients have been approved since June 2006, including darunavir (DRV) and raltegravir (RAL). While efficacious in clinical trials, the effectiveness, durability, and tolerability of these new ARVs remains understudied in the context of routine clinical care. ...

"Discussion: Among those highly ARV-experienced, regimens containing DRV/r and/or RAL were more likely to achieve 48-week VL <400c/ml and exhibited a trend towards prolonged durability. New agents have transformed the treatment landscape for ARV-experienced patients, with effectiveness in routine clinical care mirroring efficacy in clinical trials."

Low-dose aspirin lowers colon cancer risk: UK study

Reuters: "They found that aspirin reduced the number of cases of colorectal cancer by a quarter and cut colon cancer deaths by a third."

New HIV Eradication Study in Progress

AIDSmeds: "Cytheris has announced the launch and recruitment of a new Phase II study of the company’s interleukin-7 (IL-7) drug—combined with the entry inhibitor Selzentry (maraviroc) and the integrase inhibitor Isentress (raltegravir)—with the goal of eradicating HIV."

Switch from efavirenz or AZT associated with improvement in vitamin D levels

Aidsmap: "Switching antiretroviral treatment from efavirenz or AZT was associated with an improvment in vitamin D levels, investigators report in the online edition of AIDS Research and Human Retroviruses. Calendar month and black race were also associated with vitamin deficiency.

"Vitamin D levels increased significantly after patients stopped therapy with efavirenz or AZT and switched to treatment based on the protease inhibitor darunavir (Prezista) boosted by ritonavir.

"'The association between use of efavirenz and vitamin D deficiency is consistent with previous cross-sectional and prospective studies', comment the investigators. They add, 'to our knowledge, this is the first report to show rises in vitamin D levels after switching efavirenz-based antiretroviral treatment to PI [protease inhibitor]-based treatment.'"

$7.5M grant to fund research on interaction of drinking and HIV infection

Science News: "... for people carrying the virus, alcohol consumption can become particularly perilous in intricate ways that are only beginning to be understood. At the Brown Alcohol Research Center on HIV (ARCH) funded by a new $7.5-million, five-year grant from the National Institutes of Health, Brown University scientists will study the health effects of drinking with HIV and provide doctors and patients with the latest guidance their results suggest."

UIC Receives $7 Million Grant to Test and Treat Inmates for HIV

Newswise: "The University of Illinois at Chicago has received a $7 million grant from the National Institutes of Health to study effective ways to seek, test, and treat inmates with HIV.

"The project is led by researchers from the UIC School of Public Health, the UIC College of Medicine and the Cook County Jail."

CDC: 1 in 22 blacks will get HIV

USATODAY.com: "Health officials estimate that 1 in 22 black Americans will be diagnosed with the AIDS virus in their lifetime — more than twice the risk for Hispanics and eight times that of whites.

"The Centers for Disease Control and Prevention reported the numbers Thursday. The report says the lifetime risk is 1 in 52 for Hispanics, and 1 in 170 for whites.

"Asian-Americans had the lowest lifetime risk, at about 1 in 222."

ASIA: Laws driving HIV prevention underground

IRIN Asia: "In a region where carrying a condom has been construed as evidence of illicit activity, 10 million women sell sex to 75 million men, who then have sex with another 50 million people, according to the multinational Independent Commission on AIDS in Asia.

"'The technology is there to prevent infections, but punitive laws get in the way,' said Steve Kraus, regional director of UNAIDS Asia Pacific."

Early HIV Treatment May Help Prevent Irreversible Immune System Damage

The AIDS Beacon: "Results of a new study suggest that people with HIV who begin antiretroviral therapy soon after infection may better retain the ability to fight off other infectious diseases than people who begin treatment later.

“Our work…suggest[s] that more clinical trials should be aimed at comparing early-treated and chronic-treated patients by a variety of different immunologic parameters,” said Dr. Susan Moir, lead author of the study, in correspondence with The AIDS Beacon.

"The findings shed light on a group of immune cells called B cells and how early initiation of antiretroviral therapy (ART) may help prevent irreversible damage to the immune system."

Computer Modelling System Predicts Response to Antiretroviral Treatment

HIVandHepatitis.com: "SUMMARY: A U.K. not-for-profit research group last week announced the availability of a new, free web-based system to help healthcare providers predict which antiretroviral therapy (ART) regimen is most likely to work for a particular patient, based on an analysis of drug-resistance data. The HIV Treatment Response Prediction System (HIV-TRePS), which has an estimated accuracy of 80%, is available online at http://www.hivrdi.org."

Low Vitamin D Not Linked to Bone Density or Liver Fibrosis in HIV/HCV Group

NATAP: "Although more than 40% of 116 people coinfected with HIV and hepatitis C virus (HCV) had low vitamin D levels in a prospective cohort study, low D did not correlate with either bone mineral density or liver fibrosis [1]. Researchers from Johns Hopkins University believe their findings 'suggest that efforts to increase vitamin D levels in this population may not improve bone or liver outcomes.'"

Comment: Regardless of how this turns out, there are other reasons for supplementing vitamin D, including prevention of some cancers.

Adding drugs to already successful HIV treatment doesn't reduce viral load further

aidsmap: "Intensifying effective HIV therapy with the addition of an extra drug that crosses the blood-brain barrier does not reduce residual levels of viral replication in cerebrospinal fluids or the blood, an international team of investigators report in the online edition of the Journal of Acquired Immune Deficiency Symdromes.

"The researcher also found that patients continued to have evidence of immune activation and inflammation in the brain."

Mediterranean diet may trim diabetes risk

Reuters: "In a study of 418 older Spanish adults, researchers found that those instructed to follow a Mediterranean diet were less likely to develop diabetes over four years than those instructed to follow a low-fat diet -- about 10 percent developed the disease, versus 18 percent in the low-fat group. And weight loss did not appear necessary to gain the benefit."

Comment: This was not an HIV study.

Bone Loss and Low Vitamin D Levels Are Common among People with HIV

HIVandHepatitis.com: "'Despite the low latitude and high number of sunny days of Spain, moderate vitamin D deficiency in HIV-infected patients is more prevalent in our cohort than in the cohorts of Switzerland, Netherlands and Boston, in which there should be a lower level of exposure to sunlight,' the researchers noted in an ICAAC press release.

"'Since low vitamin D has been related to increased risk of infections, of several malignancies, and with higher cardiovascular risk, studies should be carried out to analyze the impact of vitamin D on the increase of CD4 counts, and on the reduction of cardiovascular episodes, infectious complications, and malignant neoplasias in HIV-infected population[s],' they added."

Negative Influence of HIV Infection on Day-Night Blood Pressure Variability

JAIDS Journal of Acquired Immune Deficiency Syndromes: "Conclusions: HIV infection per se negatively affects circadian BP [blood pressure] rhythm. These findings, obtained in subjects without major CV [cardiovascular] risk factors and antiretroviral naive, suggest that day-night BP changes may play a role in the HIV-related increase in CV risk."

Negative Influence of HIV Infection on Day-Night Blood Pressure Variability

JAIDS Journal of Acquired Immune Deficiency Syndromes: "Conclusions: HIV infection per se negatively affects circadian BP [blood pressure] rhythm. These findings, obtained in subjects without major CV [cardiovascular] risk factors and antiretroviral naive, suggest that day-night BP changes may play a role in the HIV-related increase in CV risk."

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

JAIDS Journal of Acquired Immune Deficiency Syndromes: "Over a 5-year period, HIV-infected participants with fibrinogen levels in the highest tertile [highest third of the patients] (>406 mg/dL) had 2.6-fold higher adjusted odds of death than those with fibrinogen in the lowest tertile (<319 mg/dL). Those with high CRP (>3 mg/L) had 2.7-fold higher adjusted odds of death than those with CRP <1 mg/L. ...

"Conclusions: Fibrinogen and CRP are strong and independent predictors of mortality in HIV-infected adults. Our findings suggest that even in those with relatively preserved CD4 counts >500 cells per microliter, inflammation remains an important risk factor for mortality. Further investigation should determine whether interventions to reduce inflammation might decrease mortality risk in HIV-infected individuals."

Attorney General Holder is Wrong to Oppose California’s Marijuana Initiative

Marijuana Policy Project: "The truth is that the use of marijuana — a substance far less harmful than alcohol or tobacco — is widespread in this country and nothing the government can do will ever stop that. The only question is how we structure the market for marijuana so that it is best for society. Will we have marijuana sold in licensed, tax-paying and regulated stores or will we continue to have it sold in a completely unregulated market that makes it more available to teens? Will we impose standards so that purchasers know the quality and purity of the marijuana they are buying or will we keep it in a far less safe unregulated market? Will we have the profits from the sale of marijuana go to legitimate taxpaying American business owners or will they go to underground dealers and cartels who will pay no taxes and defend their interests through violence? ...

"States are the laboratories of our democracy. California voters have an opportunity this November to choose an alternative to the failed policies of marijuana prohibition. Sadly, Attorney General Holder is trying to deny them that chance before the election even takes place."

ViiV Healthcare Expands HIV Drug Access Programs

POZ: "First, the company has promised to extend its co-pay assistance program for two more years. The co-payment program covers the first $100 of a person’s co-payment for each ViiV medication.

"The program will now also be available to people residing in Puerto Rico.

"Second, the company’s PAP will now be available to people with higher incomes than before. Previously, the program was only available to a rather small segment of uninsured people who made just a bit too much to qualify for Medicaid. ViiV is raising the income limit to join the program from 250 percent of the federal poverty level (FPL)—about $13,000 per year for a single person—to 500 percent of FPL.

"Third, ViiV has joined, on a pilot basis, a joint program between the nonprofit Welvista organization and the pharmaceutical industry to easily and quickly provide free HIV medications to people on ADAP waiting lists. The Welvista program was built to ensure that these people don’t fall through the cracks and forgo needed ARV treatment."

People with HIV not developing cancers at younger age than rest of population

aidsmap: "People with AIDS are not developing most non-HIV-related cancers at a younger age than individuals in the general population, US investigators report in the October 5th edition of the Annals of Internal Medicine.

"The investigators noted significant structural differences in the ages of those with AIDS and patients in the general population. Once adjustment was made for these differences, the investigators found that the age at which individuals with AIDS developed many non-HIV-related cancers was broadly comparable to that observed in the general population."

Persistence of Racial Differences in Attitudes Toward Homosexuality in the United States

JAIDS Journal of Acquired Immune Deficiency Syndromes: "Among MSM, twice as many black MSM reported that homosexuality is 'always wrong' compared with white MSM (57.1% versus 26.8%, P = 0.003). MSM with unfavorable attitudes toward homosexuality were less likely to report ever testing for HIV compared with MSM with more favorable attitudes (relative risk, 0.50; 95% confidence interval, 0.31 to 0.78).

Conclusions: US attitudes toward homosexuality are characterized by persistent racial differences, which may help explain disparities in HIV infection rates between black and white MSM."

Low prevalence of end-stage kidney disease in European HIV patients

[September 15]aidsmap: "Only 0.5% of patients had irreversible kidney damage requiring dialysis or transplant. Most of the patients were young, black men. Only a third of patients on dialysis were considered candidates for a kidney transplant. The most common reason for exclusion was poor control of HIV."

Federal Employees Can Purchase Health Insurance For Their Pets, But Not Their Same-Sex Partners

WonkRoom: "The insurance is a handsome perk for those who can afford it, but what’s illuminating about the ad is that while federal employees can buy pet insurance 'in these challenging economic times,' LGBT workers are still prohibited from purchasing policies for their partners or spouses by the Defense of Marriage Act (DOMA) — a federal law which denies federal benefits to legally married same sex couples."

How HIV Prevention Has to Change

amfAR: "Domestic HIV prevention receives only about 3% of total federal HIV spending."

New look at multitalented protein sheds light on mysteries of HIV

EurakAlert!: "'A better understanding of Gag's behavior might allow researchers to develop antiviral drugs that target the HIV assembly process, which remains unassailed by medical science,' says Hirsh Nanda, a postdoctoral researcher at the NIST Center for Neutron Research (NCNR) and a member of the multi-institutional research team. 'Our method might reveal how to inhibit new viruses as they grow.'"

WHO Updates HIV Treatment Guidelines for Women and Infants

AIDSmeds: "The new WHO guidelines recommend that HIV-positive women who received single-dose regimen be subsequently treated with a regimen that doesn’t contain Viramune. However, because the danger for Viramune treatment failure diminishes over time, the guidelines also state that a Viramune-based regimen may be used in such women—if they start that regimen at least one year after receiving single-dose Viramune during the birthing process.

The new guidelines also give recommendations for treating infants who contract HIV despite receiving single-dose Viramune immediately after birth. In these infants, a subsequent treatment regimen should include Kaletra (lopinavir plus ritonavir) rather than Viramune."

Low CD4 cell count associated with heart attack in patients with HIV

aidsmap: "“We demonstrate that decreased CD4 cell count is significantly associated with an increased risk of myocardial infarction and is second only to hypertension in terms of its effect size as a risk factor”, comment the investigators. They add that a CD4 cell count below 200 cells/mm3 was a much more important risk factor for heart attack than treatment with any antiretroviral drug. Indeed, the investigators failed to find a significant relationship between any antiretroviral and an increased risk of heart attack."

The MMP1 (-16071G/2G) single nucleotide polymorphism associates with the HAART-related lipodystrophic syndrome

AIDS:"MMP1 SNP, which induced increased serum levels of this protein, was associated with lipodystrophic syndrome."

Comment: This genetic test might be able to tell in advance who is more susceptible to lipodystrophy from HAART.

Virologic and immunologic response to HAART, by age and regimen class

AIDS: "We found no evidence of an interaction between age and initial antiretroviral regimen on virologic or immunologic response to HAART; however, decreased immunologic response with increasing age may have implications for age-specific when-to-start guidelines."

Clinical presentation and prognosis of the 2009 H1N1 influenza A infection in HIV-1-infected patients: a Spanish multicenter study

AIDS: "In HIV patients, well controlled on HAART, the pandemic influenza virus AH1N1 had a similar clinical outcome and prognosis to that of non-HIV patients."

Effect of raltegravir-containing intensification on HIV burden and T-cell activation in multiple gut sites of HIV-positive adults on suppressive antiretroviral therapy

AIDS: "Most HIV RNA and DNA in the blood and gut is not the result of ongoing replication that can be impacted by short-term intensification with raltegravir. However, the ileum may support ongoing productive infection in some patients on ART, even if the contribution to plasma RNA is not discernible."

Comment: Basically a negative result, but it adds to our knowledge of HIV.

B cells in early and chronic HIV infection: evidence for preservation of immune...

Blood: "At one year post-ART, the percentage of resting memory B cells remained higher in early compared to chronic HIV-infected individuals. This difference translated into a better functional profile in that memory B-cell responses to HIV and non-HIV antigens were superior in early- compared to chronic-treated HIV infected individuals. These findings provide new insights on B cells in HIV infection and how early initiation of ART may prevent irreversible immune system damage."

New Guidelines Issued on Menstrual Disorders in HIV-Positive Women

POZ: "The New York State Department of Health AIDS Institute has published new guidelines on menstrual disorders in HIV-positive women. The guidelines, created in collaboration with Johns Hopkins University in Baltimore, review the prevalence of and the potential causes of menstrual disorders in HIV-positive women. The guidelines also provide recommendations for care."

Race Against Time: Activists Call for More Research on Aging and HIV - by David Evans

POZ Exclusives: "With the ranks of HIV-positive people older than 50 growing rapidly, AIDS activists with the Coalition for HIV and Aging Research and Policy Advocacy (CHARPA) are demanding that the National Institutes of Health (NIH) devote more attention and resources to the issue of aging and HIV."

Low CD4 cell count associated with heart attack in patients with HIV

aidsmap: "A low CD4 cell count is associated with an increased risk of heart attack for patients with HIV, US investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes. Even after taking into account traditional risk factors for cardiovascular disease, a CD4 cell count under 200 cells/mm3 was associated with a significantly increased risk of incident heart attack."

Does 'real world' study cast doubt on use of HIV treatment as prevention?

aidsmap: "Treatment with antiretroviral drugs did not reduce the rate of HIV transmission in serodiscordant heterosexual couples in the Henan province of China, investigators report in the October edition of the Journal of Acquired Immune Deficiency Syndromes.

"The transmission rate in couples where the HIV-infected partner was taking antiretroviral treatment was 5% compared to a rate of 3% in other couples. ...

"However, increasing the number of patients taking HIV therapy in routine care has already been credited with falls in HIV incidence in San Francisco and British Columbia."

High risk of virus-associated cancer death for those with AIDS

aidsmap: "Death was caused by a non-AIDS-defining cancer in 7% of patients. The most common cancers were those of the lung (58 cases), liver (28), Hodgkin lymphoma (28), and head and neck (18).

Overall, patients with HIV were seven times more likely to die of a non-AIDS-defining cancer than age and sex matched individuals in the general Italian population.

Moreover, the investigators noted that mortality rates due to cancers caused by viral infections were especially high in those with AIDS.

For example, the mortality rate for anal cancer, caused by certain strains of the genital wart virus HPV, was 240 times higher in those with AIDS. Hodgkin lymphoma is caused by Epstein-Barr virus, and the mortality rate attributable to this cancer was 174 times higher for patients with AIDS than individuals in the general population. Infection with hepatitis C virus can lead to liver cancer, and patients with AIDS were eleven times more likely to die of this malignancy than those in the wider population."

First patient treated in Geron stem cell trial

Reuters: "Geron, whose shares were up 6.4 percent on the Nasdaq late on Monday afternoon, has the first U.S. Food and Drug Administration license to use the controversial cells to treat people, in this case patients with new spinal cord injuries. It is the first publicly known use of human embryonic stem cells in people."

Schwarzenegger splits the baby on syringe sales

San Jose Mercury News: "Gov. Arnold Schwarzenegger vetoed a bill that would have let pharmacies all over California sell sterile syringes to an adult without a prescription, something health experts called a key protection against the spread of HIV, hepatitis and other blood-borne diseases. ...

"SB 1029's supporters included anti-AIDS groups, the American Civil Liberties Union, California Hepatitis Alliance, California Nurses Association, California Psychiatric Association, California Retailers Association, County Alcohol & Drug Program Administrators, Drug Policy Alliance Network, California Medical Association, California Pharmacists Association and Health Officers Association of California. It was opposed by the California Narcotic Officers' Association -- which also opposed Chesbro's bill -- as well as the California Peace Officers' Association, California Police Chiefs Association and the League of California Cities."

NIH joins patent pool for AIDS drugs

Reuters: "The United States National Institutes of Health said on Thursday it will share intellectual property rights on some AIDS drugs in a patent pool designed to make treatments more widely available to the poor.

"The NIH is the first research institution to join an HIV medicines patent pool launched by UNITAID, a health financing system funded by a tax on airline tickets which was co-founded by Brazil, Britain, Chile, France, and Norway in 2006."

New depression guidelines favor tailored treatment

Reuters: "We are hopeful these guidelines will lead to improved lives for many patients."