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December 30, 2010

Open letter to prime minister David Cameron and health secretary Andrew Lansley

British Medical Journal: "Neurologists and paediatricians call for action on “massive” rises in the prices of orphan drugs.

"We are writing to you as a group of clinicians treating patients with so called “orphan” diseases (and one representative of a patients’ group) to express our concern at an unintended effect of the European Union’s regulations on orphan drugs. The original purpose of this legislation, passed in 1999, was to encourage drug companies to conduct research into rare diseases and develop novel treatments. However, as the rules are currently enacted, many drug companies merely address their efforts to licensing drugs that are already available rather than developing new treatments. Once a company has obtained a licence, the legislation then gives the company sole rights to supply the drug. This in turn allows the company to set an exorbitant price for this supply and effectively to bar previous suppliers of the unlicensed preparation from further production and distribution.

December 27, 2010

[Forced HIV medication] Sotomayor protests court's refusal of appeals "She forcefully dissented when the justices refused to hear the appeal of a Louisiana prisoner who claimed he was punished for not taking his HIV medication. He said prison officials subjected him to hard labor in 100-degree heat. Writing alone, she said the inmate had a persuasive claim of cruel and unusual punishment."

Also see New York Times, "The prisoner, Anthony C. Pitre, had stopped taking his H.I.V. medicine to protest his transfer from one facility to another. Prison officials responded by forcing him to perform hard labor in 100-degree heat. That punishment twice sent Mr. Pitre to the emergency room."

December 24, 2010

Prompt treatment and better screening could prevent many cancer deaths in patients taking HIV therapy

Aidsmap: "Many cancer-related deaths in patients taking antiretroviral therapy are potentially preventable, a US study published in the online edition of AIDS suggests.

"A low CD4 cell count, detectable viral load, late diagnosis of cancer, and not receiving cancer treatment were all associated with an increased risk of mortality.

"'Our findings could be explained by poor cancer awareness, inadequate screening practices, or lack of prompt therapy,' write the investigators."

Bristol-Myers Squibb buys festinavir, new NRTI active against MDR HIV

Aidsmap: "Bristol Myers-Squibb will pay up to $286 million for development rights to festinavir, a new once-daily nucleoside reverse transcriptase inhibitor that is active against viruses resistant to both tenofovir and abacavir, the company announced on December 20th.

"Festinavir is a derivative of d4T (stavudine), but its developers say it is far less toxic than that drug."

Nevirapine rather than efavirenz-based HIV treatment more likely to suppress viral load to zero

Aidsmap: "The inclusion of nevirapine rather than efavirenz in an HIV treatment combination was more likely to suppress viral load in the blood to completely undetectable levels, French investigators report in the online edition of AIDS.

"A total of 81% of patients taking nevirapine (Viramune) had a viral load below 1 copy/ml compared to 55% of individuals treated with efavirenz (Sustiva). The study involved 165 patients and was retrospective. All the patients had had an undetectable viral load for at least six months and were taking either nevirapine or efavirenz in combination with FTC (emtricitabine, Emtriva) and tenofovir (Viread, the two drugs are usually combined in a single pill, Truvada, and are also available co-formulated with efavirenz in Atripla)."

Beneficial Effects of a Switch to a Lopinavir/ritonavir-Containing Regimen for Patients with Partial or No Immune Reconstitution with Highly Active...

AIDS Research and Human Retroviruses: "Switching patients to an LPV/r-containing regimen improved CD4+ counts in patients with prior immunologic failure, and this may be due to an effect of LPV/r on apoptosis."

Identification of Three Immunologic Correlates for HIV Type 1 Pathogenesis in Youth

AIDS Research and Human Retroviruses:: "Overall, circulating IL-10, IL-18, and soluble CD30 could partially track unfavorable responses to HIV-1 infection in youth. These markers of persistent immune activation are individually and collectively indicative of HIV-1 pathogenesis."

New Drug Shows Promise in Fighting HIV

Doctors Lounge: "A new drug based on a compound produced by the human body appears to block fusion peptides and halt an early stage of HIV infection by thwarting interaction between the virus and host cells, according to research published in the Dec. 22 issue of Science Translational Medicine."

University of Minnesota discovery suggests a new way to prevent HIV from infecting human cells

University of Minnesota media release: "Researchers at the University of Minnesota have discovered how HIV binds to and destroys a specific human antiviral protein called APOBEC3F. The results suggest that a simple chemical change can convert APOBEC3F to a more effective antiviral agent and that shielding of a common feature shared by related proteins may yield a similar outcome.

"This discovery highlights the potential for a novel approach to combating HIV/AIDS that would seek to stabilize and harness the innate antiviral activity of certain human proteins, according to lead author John Albin, a researcher in the laboratory of Reuben Harris, associate professor of biochemistry, molecular biology and biophysics in the College of Biological Sciences.

"The finding was published in the Journal of Biological Chemistry."

December 16, 2010

“Legalise and regulate drugs” says UK’s former drugs and defence Minister

Transform Drug Policy Foundation Blog: "Leaving the drugs market in the hands of criminals causes huge and unnecessary harms to individuals, communities and entire countries, with the poor the hardest hit. We spend billions of pounds without preventing the wide availability of drugs. It is time to replace our failed war on drugs with a strict system of legal regulation, to make the world a safer, healthier place, especially for our children. We must take the trade away from organised criminals and hand it to the control of doctors and pharmacists."

December 15, 2010

Cutting Through the Hype Surrounding One Man’s HIV “Cure”

Discover Magazine: "But doctors commenting on the research are careful to point out that a treatment that was seemingly effective in one man does not equal a cure for the 33 million people living with HIV worldwide."

FDA Approves Prezista/Ritonavir Once-Daily Dosing for HIV-1 Treatment-Experienced Adults With No Darunavir Resistance-Associated Mutations

Tibotec Therapeutics: "...the U.S. Food and Drug Administration (FDA) has approved a revision to the dosing recommendation to include once-daily dosing of PREZISTA® (darunavir) tablets in combination with ritonavir for the treatment of human immunodeficiency virus (HIV-1) in treatment-experienced adult patients with no darunavir resistance-associated mutations (DRV RAMs)."

December 14, 2010

Big Pharma caught spying on the WHO - Wikileaks

Wikileaks, Dec. 10, 2009: "Confidential documents related to the World Health Organization Expert Working Group on innovative financing for research and development surfaced today, revealing the group’s thinking as well as pharmaceutical industry thinking about the WHO process. The documents immediately raised concern about possible undue access to the process by industry; the WHO told Intellectual Property Watch the industry group was not supposed to have the documents.

"The documents appear to have come from the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), and include draft reports on innovative financing mechanisms from the working group as well as an analysis by the IFPMA on the reports’ contents. They were released on Wikileaks, a website that anonymously publishes sensitive documents."

Stem cell transplant has cured HIV infection in 'Berlin patient', say doctors

Aidsmap: "Doctors who carried out a stem cell transplant on an HIV-infected man with leukaemia in 2007 say they now believe the man to have been cured of HIV infection as a result of the treatment, which introduced stem cells which happened to be resistant to HIV infection.

"The man received bone marrow from a donor who had natural resistance to HIV infection; this was due to a genetic profile which led to the CCR5 co-receptor being absent from his cells. The most common variety of HIV uses CCR5 as its ‘docking station’, attaching to it in order to enter and infect CD4 cells, and people with this mutation are almost completely protected against infection.

"The case was first reported at the 2008 Conference on Retroviruses and Opportunistic Infections in Boston, and Berlin doctors subsequently published a detailed case history in the New England Journal of Medicine in February 2009.

"They have now published a follow-up report in the journal Blood, arguing that based on the results of extensive tests, “It is reasonable to conclude that cure of HIV infection has been achieved in this patient.”"

Note: See lots of comments on Twitter (you do NOT need a Twitter account):!/search/HIV-positive. As noted above, this cure has been discussed for some time. The new article in the journal Blood reported the latest failure to find any evidence of HIV in the patient. And the bone-marrow stem-cell transplant has permanently changed the Berlin Patient's blood to that of the donor, who has a fairly rare mutation that gives almost complete immunity to HIV infection.

High triglycerides increase risk of neuropathy for patients with HIV

Aidsmap: "HIV-positive patients with high triglycerides have an increased risk of neuropathy, according to US research published in the online edition of AIDS. The association between triglyceride levels and neuropathy was independent of any other risk factor."


Using Twitter at the HIV Prevention Leadership Summit "Part of NPIN’s mission is to “provide timely information and resources to prevention partners through innovative approaches to knowledge/information transfer”. To help further that mission, NPIN will be using Twitter at the HIV Prevention Leadership Summit next week in Washington, DC. We’ll be using Twitter to support and encourage attendees’ conversations and provide virtual attendees with up-to-the-minute updates on the conference, plenaries, and workshops."

Comments: This conference ends tomorrows, December 15. But anyone can follow it DURING OR AFTER the conference at (you do NOT need a Twitter account).

However, most of the "tweets" from this conference that we've seen so far are not very useful to the general public outside the meeting. In our experience, Twitter works well for certain specific purposes -- for example, informing people about some resource -- often on a Web page, or at a certain event or location in the conference (for people who are there). Announcements often work; for example, the most famous tweet of all time consisted of a single word, "arrested" (sent by a U.S. journalist in Egypt). But except for certain kinds of uses, where Twitter can work extremely well, it's hard to say much in 140 characters.

Going Viral Against HIV [social media and HIV/STIs]

Pew Research Center's Internet & American Life Project: "speaker after speaker talked about the power of small groups to make a difference: ..."

Governments Remove Sexual Orientation from UN Resolution Condemning Extrajudicial, Summary or Arbitrary Executions

IGLHRC, Nov. 17: "The International Gay and Lesbian Human Rights Commission (IGLHRC) and ARC International are deeply disappointed with yesterday’s vote in the Third Committee of the United Nations General Assembly to remove a reference to sexual orientation from a resolution on extrajudicial, summary or arbitrary executions. The resolution urges States to protect the right to life of all people, including by calling on states to investigate killings based on discriminatory grounds. For the past 10 years, the resolution has included sexual orientation in the list of discriminatory grounds on which killings are often based.

"The removed reference was originally contained in a non-exhaustive list in the resolution highlighting the many groups of people that are particularly targeted by killings - including persons belonging to national or ethnic, religious and linguistic minorities, persons acting as human rights defenders (such as lawyers, journalists or demonstrators) as well as street children and members of indigenous communities. Mentioning sexual orientation as a basis on which people are targeted for killing highlights a situation in which particular vigilance is required in order for all people to be afforded equal protection.

"The amendment removing the reference to sexual orientation was sponsored by Benin on behalf of the African Group in the UN General Assembly and was adopted with 79 votes in favor, 70 against, 17 abstentions and 26 absent.

"'This vote is a dangerous and disturbing development,' said Cary Alan Johnson, Executive Director of IGLHRC. 'It essentially removes the important recognition of the particular vulnerability faced by lesbian, gay, bisexual and transgender people - a recognition that is crucial at a time when 76 countries around the world criminalize homosexuality, five consider it a capital crime, and countries like Uganda are considering adding the death penalty to their laws criminalizing homosexuality.'

"This decision in the General Assembly flies in the face of the overwhelming evidence that people are routinely killed around the world because of their actual or perceived sexual orientation, and renders these killings invisible or unimportant. The Special Rapporteur on Extrajudicial, Summary or Arbitrary Executions has highlighted documented cases of extrajudicial killings on the grounds of sexual orientation including individuals facing the death penalty for consensual same-sex conduct; individuals tortured to death by State actors because of their actual or perceived sexual orientation; paramilitary groups killing individuals because of their actual or perceived sexual orientation as part of “social cleansing” campaigns; individuals murdered by police officers with impunity because of their actual or perceived sexual orientation; and States failing to investigate hate crimes and killings of persons because of their actual or perceived sexual orientation."

Comment: Big money goes a long way in poor countries.

Pending Trade Deal Worries AIDS Activists

Voice of America: "Katy Athersach is a policy advisor for Doctors Without Borders in Geneva.

"'The reason why this is so important to us is that 80 percent of the medicines we use to treat people living with HIV and AIDS across our projects in the developing world come from generic companies in India,' says Athersach. 'And these drugs are vastly cheaper than alternatives because of the competition that has allowed these Indian companies to compete together and lower prices.'

"Among other concerns, Athersach says Doctors Without Borders is worried a trade agreement will strengthen European patent protections, denying Indian companies immediate access to new drug developments. Similar concerns sparked a demonstration by AIDS activists last week in Nairobi.

"Activists have also rallied in India, Thailand and London, says Athersach.

"'We are very hopeful that our arguments will be heard, that our voices will be taken into account and that these provisions will be removed from the agreement. But of course this is by no means certain,' she says."

December 13, 2010

Berlin Patient Follow-Up 'Strongly Suggests' HIV Cure - by Tim Horn

AIDSmeds: "The “Berlin Patient”—a man living with HIV who underwent a transplant involving HIV-resistant stem cells in 2007 for the treatment of leukemia—has been classified as cured of his HIV, according to an update of the patient’s experience published online, ahead of print, on December 8 by the journal Blood. The man has remained off HIV treatment for three-and-a-half years with normal CD4 counts and no evidence of HIV replication.

"Though it was initially suspected that HIV archived in the man’s cells would begin proliferating once his immune system began to recover from pre- and post-transplantation treatment, this was not observed and the team monitoring the patient now conclude, 'our results strongly suggest that cure of HIV has been achieved in this patient.'"

Development of a Low Bias Method for Characterizing Viral Populations Using Next Generation Sequencing Technology

PLoS ONE: : "The goal of this work is to develop a novel method for amplifying viral RNA into large quantities of DNA suitable for processing into Illumina (or other) libraries without relying on PCR and primers that assume specific sequences are present within the sample. By avoiding the use of virus-specific primers, one can reduce the bias associated with this step and potentially amplify the entire 9709 base pair HIV genome with unprecedented levels of coverage."

Note: This study is using new genetic techniques to better understand how HIV becomes resistant to drugs.

December 12, 2010

HIV/AIDS at WikiLeaks: 10 cables have AIDS news (so far)

As of today WikiLeaks has released only about 0.5% (1344 cables out of 251,287 total) of the leaked State Department cables, creating headlines around the world. Only 10 of the 1344 already released include the word HIV (a good search term for finding AIDS-related information). If you click on a cable, you can use the local search in your browser (often control-F) to find the HIV references quickly.

Here are the 10 cables that mention HIV, starting with the most recent:

Best estimate of the total number of cables with HIV/AIDS information but not yet released: about 1800.

Also see our news blog of WikiLeaks tweets, at (in a green box on the right of that page).

Note: Please let us know of sites that include a search of all the released cables at once. To find the 10 above, we had to download a copy of the cables into a folder, then search locally for 'HIV'.

Too long a wait for housing

Philadelphia Inquirer: "We represent a group of 80 medical and public-health professionals who have authored a consensus statement on this crisis. The group includes experienced physicians such as Ellen Tedaldi, the director of Temple's comprehensive HIV program and the doctor who treated Carlos when he was first diagnosed.

"We present the scientific documentation for the effectiveness of subsidized housing in HIV prevention and treatment and urge city government to recognize that providing housing for people living with HIV and AIDS is an essential public-health intervention (see Our city must house everyone on the waiting list and expand the reach of the federal housing program to include people before they become so sick that they are on the verge of very painful deaths. These small steps, which will cost the city approximately 0.1 percent of its current budget, are necessary components of any plan to effectively combat our alarming HIV epidemic.

"Unlike too many others, Carlos Gonzalez was fortunate enough to see his condition improve. After two years on the waiting list, Carlos began receiving rental subsidies in early 2010. He now lives in a one-bedroom apartment in South Philadelphia. Because he is able to take all scheduled treatment doses, the HIV virus cannot be detected in his blood. As a result, his immune system is much stronger, and he no longer spends two weeks each year in a hospital bed.

"Today, Carlos is a certified HIV counselor. He gives back to the community and provides hope to others going through the same struggles he successfully overcame. Because he knows that so many of the people he reaches out to on the streets will not survive the wait for housing, Carlos has become a tireless advocate. We stand with him in asking Mayor Nutter and City Council to end the waiting list for housing assistance for people living with HIV and AIDS."

December 10, 2010

India-EU generic drug row 'resolved' at Brussels summit

BBC News: "A row between the EU and India over the transit of generic drugs through Europe has been resolved, negotiators told Reuters news agency.

"As a result of the deal at an India-EU summit in Brussels, an Indian complaint to the World Trade Organization will be suspended, India's trade minister said."

Note: We seem to have been wrong in the comment below. See the Daily Nation [Kenya]: Deal Spells Doom for Our Chronically Sick.

Comment: This has been an AIDS issue for some time. If Indian companies make generic drugs legally and ships them to African countries (for example) where they are also legal, can EU stop the shipments in transit -- in Amsterdam, for example, because the drugs do not meet European intellectual-property requirements? The European Union has done so, presumably at the request of multinational pharmaceutical companies.

We don't know the details of this new deal. It's probably a victory, since India would never be happy with letting that interference continue.

December 8, 2010

Aspirin Helps Reduce Cancer Deaths, Study Finds "Many Americans take aspirin to lower their risk of heart disease, but a new study suggests a remarkable added benefit, reporting that patients who took aspirin regularly for a period of several years were 21 percent less likely decades later to die of solid tumor cancers, including cancers of the stomach, esophagus and lung.

"As part of the new study, published online Monday in the journal Lancet, researchers examined the cancer death rates of 25,570 patients who had participated in eight different randomized controlled trials of aspirin that ended up to 20 years earlier."

Note and comment:

Abstract available at

Sorry, The Lancet charges $31.50 to non-subscribers just to download a full-text copy of this article -- though The Lancet contributed nothing to the cost of doing the research. Many other medical journals do the same (and many others don't). Our (conservative) estimate of The Lancet's profit margin for this transaction is 100,000% -- yes, one hundred thousand percent -- assuming a cost of 3 cents for its server to download the article (it's probably much less).

Researchers don't like this system because it reduces the usefulness and impact of their work. Often they put up with it only because they do not have a couple thousand dollars to pay expenses for peer-reviewed online open-access publication, for example in PLoS (Public Library of Science) journals. (If researchers just uploaded their work to a blog, the medical/scientific/academic/media world would seldom take it seriously -- because it's so hard to judge credibility, when even full peer review frequently gets is wrong). How different from the worlds of mathematics or astronomy, for example, where there is much less money attached, making transparency and effective collaboration far easier, since there's so much less motive to keep secrets or to scam.)

Our point is not that The Lancet is mercenary, but that we have a harmful, long-time public-policy failure. While the funding of this research is listed as "none" (welcome, in our view, since funding introduces very serious corruption in medical research -- but unwelcome in that the lack of explicit Federal funding will let The Lancet restrict the article for decades) taxpayers largely pay for the research infrastructure which made this research possible. And Congress creates the intellectual-property laws for the benefit of the very rich and the largest corporations, in return for campaign contributions and other favors -- without regard to the public interest.

Meanwhile, off to the drugstore for low-dose aspirin. Ask your doctor first, if you have serious medical problems.

December 5, 2010

Alicia Keys, Other Celebs “Kill” Social Media Identities for HIV/AIDS Charity

The Afro-American Newspapers: "To support Keys’ Keep a Child Alive charity, the stars signed off of social media sites such as Twitter and Facebook. Their Twitter and Facebook sites will remain active with information on how to donate, but the stars themselves will refrain from posting personal updates or new information to their social media profiles while the campaign is underway.

"Supporters can donate $5 or $10 through text messages or through the Keep a Child Alive Web site. Once the charity’s $1 million goal is reached, the stars will resume posting on the sites.

"Just two days after the campaign’s Dec. 1 launch, fans had contributed more than $200,500 to bring their favorites back to 'life.'"

Top 50 Blogs About HIV and AIDS

LPN to RN Blog

December 1, 2010

Presidential Proclamation--World AIDS Day

The White House: "On this World AIDS Day, as we approach the thirtieth year of the HIV/AIDS pandemic, we reflect on the many Americans and others around the globe lost to this devastating disease, and pledge our support to the 33 million people worldwide who live with HIV/AIDS.  We also recommit to building on the great strides made in fighting HIV, to preventing the spread of the disease, to continuing our efforts to combat stigma and discrimination, and to finding a cure."

AIDS Activism Growing on Campuses "Mr. Messac, the University of Pennsylvania medical student, explored the origins of Mr. Bush’s AIDS program in a 120-page paper, 'Lazarus at America’s Doorstep,' for his Harvard undergraduate thesis. Mr. Carel, who spent last summer working at a hospital in the rural South African village of Tugela Ferry, now studies Zulu and persuaded a visiting professor from South Africa to let him take her upper-level course on 'the political economy of AIDS.' (He had to skip Zulu class for the Emanuel protest; he said his professor understood.)

"The students have also befriended a longtime veteran of the AIDS wars, Gregg Gonsalves, who at 47 is completing his undergraduate degree in evolutionary biology on a full scholarship at Yale. Mr. Gonsalves often lectures public-health classes on what he calls “ancient history” — the work of groups like Act Up in the 1990s.

"'Theirs is not a first-person commitment, in the sense that none of them is living with H.I.V.,' Mr. Gonsalves said of the new AIDS protesters. 'It’s all based out of a sense of solidarity and social justice. I used to wonder where the next generation would come from. They’re here.'

"Inside the White House, Dr. Emanuel, for one, is not impressed. He says the students are serving up tired arguments about dollar amounts that ignore the Obama administration’s emphasis on spending money more efficiently and offering services, like circumcision, that can reduce the spread of H.I.V. While Mr. Bush emphasized AIDS and malaria, Mr. Obama is promoting a six-year, $63 billion 'global health initiative' that seeks to address a range of diseases, with emphasis on women and children."

World AIDS Day funeral at the White House

ACT UP Philadelphia: For 1.8 million who died this year without treatment. Excellent photos by ACT UP photographer Katie Riek -- click the title above.

On World AIDS Day, activists renew push for a cure

WHYY, Philadelphia: "Last year, the AIDS Policy Project launched a campaign to get more money to fund research for a cure. Kate Krauss, executive director of the project, said she was surprised to learn that very little money was available -- she estimates only 3 percent of the AIDS budget at the National Institutes of Health goes toward finding a cure. But, she said, the research that is happening is promising.

"'So, it's actually a really exciting time, a pivotal time. And it's a question of whether this epidemic ... what we do now, is going to determine whether this epidemic lasts for five or 10 years, or whether it lasts 30 or 40 years,' she said. 'Can we break down these research obstacles? Can we get researchers new money?'

"Krauss, who launched a letter-writing campaign out of her home in West Philadelphia, wants to quadruple the funding that the NIH directs toward finding a cure. Her work has garnered national attention from advocates and researchers.

"'This has not escalated into a demand for a cure, or research for a cure,' said Larry Kramer, the founder of ACT-UP, an activist group that has pushed for AIDS prevention and treatment since 1988. 'And what this group from Philadelphia has done on their own is to reignite this issue and try and run with it.'"