New issue of the Journal of the Association of Nurses in AIDS Care

Vol. 18, no 2, March/April 2007

Special Issue: Cultural Dynamics in HIV Prevention Among Young People

Cultural Dynamics in HIV/AIDS Prevention Research Among Young People
Hare ML, Villarruel AM
pages 1-4
Abstract

Scaffolded Interviewing With Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Youth: A Developmental Approach to HIV Education and Prevention
Welle DL, Clatts MC
pages 5-14
Abstract

Research Brief: The Need for Historically Grounded HIV/AIDS Prevention Research Among Native Americans
Lowe J
pages 15-17
Abstract

Childhood Abuse History and Risk Behaviors Among Teen Parents in a Culturally Rooted, Couple-Focused HIV Prevention Program
Lesser J, Koniak-Griffin D, Gonzalez-Figueroa E, Huang R, Cumberland WG
pages 18-27
Abstract

Research Brief: Sexual Communication and Knowledge Among Mexican Parents and Their Adolescent Children
Gallegos EC, Villarruel AM, Gómez MV, Onofre DJ, Zhou Y
pages 28-34
Abstract

Culture-Specific Factors Contributing to HIV Risk Among Jamaican Adolescents
Hutchinson MK, Jemmott LS, Wood EB, Hewitt H, Kawha E, Waldron N, Bonaparte B
pages 35-47
Abstract

Sexual Stigma, Sexual Behaviors, and Abstinence Among Vietnamese Adolescents: Implications for Risk and Protective Behaviors for HIV, Sexually Transmitted Infections, and Unwanted Pregnancy
Kaljee LM, Green M, Riel R, Lerdboon P, Tho LH, Thoa LTK, Minh TT
pages 48-59
Abstract

Early Adolescent Peer Leader Development in HIV Prevention Using Youth-Adult Partnership With Schools Approach
Fongkaew W, Fongkaew K, Suchaxaya P
pages 60-71
Abstract

Research Brief: Community Consultation to Develop an Acceptable and Effective Adolescent HIV Prevention Intervention
Kaponda CPN, Dancy BL, Norr KF, Kachingwe SI, Mbeba MM, Jere DL
pages 72-77
Abstract

Practice Brief: Adolescents and HIV Clinical Trials: Ethics, Culture, and Context
MacQueen KM, Karim QA
pages 78-82
Abstract

Contact the library for copies of articles. Please limit your requests to 5 articles.

Man with HIV gets life term for sex case

Source: SFGate.com

(05-07) 09:30 PDT DALLAS, (AP) --

An HIV-positive man who prosecutors say secretly videotaped sexual encounters with 131 young men was sentenced to life in prison for attempting to entice a 15-year-old boy to engage in sex acts.

During his trial, prosecutors alleged Willie Atkins knew of his condition yet endangered dozens of partners by rarely using condoms, and that there was no evidence that he warned anyone that he was HIV-positive.

Atkins was sentenced Friday for attempting to entice a minor for sex, which is punishable by up to 10 years in prison. Because Atkins had two previous felony convictions, for aggravated robbery and firearms possession, he was eligible for the life sentence.

According to authorities, Atkins lured young men to his apartment by offering them jobs to work for his landscaping company, but authorities have had difficulty identifying the men. Jurors at his trial saw clips from 90 hours of sexually explicit videotape.

His defense attorney, Richard Franklin, said Atkins was being unfairly targeted.

"They want to say Willie Atkins gave all these people AIDS, spread HIV all over the place," Franklin said. "They can't be living in some parallel universe where they've never heard of AIDS. It can't be his fault alone, if he has any fault at all."

The "dangerous activity" each side engaged in "cancels each other out," he said.

Brazil bypasses patent on HIV treatment

Source: Business day

BRASILIA — President Luiz Inacio Lula da Silva authorised Brazil at the weekend to break the patent on an HIV/AIDS drug made by Merck and import a generic version from India instead.

It is the first time Brazil has bypassed a patent to acquire cheaper drugs for its HIV/AIDS prevention programme, a step recently taken by Thailand. Other countries, including Canada and Italy, have also used a clause in World Trade Organisation (WTO) rules to flout drug patents in the name of public health.

Talks over the price of Merck’s drug, Efavirenz, broke off on Thursday when the health ministry rejected the New Jersey-based company’s offer to cut its $1,59-a-pill price by 30%. Brazil wanted to pay what Merck charges Thailand, or $0,65 a pill.

“The compulsory licensing of Efavirenz is a legitimate and necessary measure to guarantee that all patients have access to the drug,” Lula da Silva’s office said in a statement.

Representatives of about 200000 HIV/AIDS patients who receive state-sponsored antiretroviral drugs applauded the decision, but drug makers reacted angrily. Merck said it was “profoundly disappointed”, calling the decision a misappropriation of intellectual property that would stifle research.

But Michel Lotrowska, who heads HIV/AIDS treatment efforts in Brazil for Medecins Sans Frontieres, a humanitarian group, said: “This is certainly an important advance in terms of widening access. We are very happy that Brazil is moving in the right direction.”

Brazil’s health ministry has said it plans to import a generic version of Efavirenz from India, paying about 45c a pill, and may also start making its own copy of the drug.

Click here to read the article

Disadvantaged people with HIV feel healthcare discrimination

Source: Medscape

NEW YORK (Reuters Health) May 03 - Almost 40% of transitional housing residents with HIV infection report that they have experienced discrimination in their dealings with the healthcare system, researchers report in the May-June issue of Public Health Reports.

"Providers taking care of severely disadvantaged, HIV-infected patients, like those in our sample," lead researcher Dr. Nancy Sohler told Reuters Health, "should be aware that many of their patients may experience, perceive, and/or fear discrimination from within the healthcare system."

Dr. Sohler of City University of New York and colleagues surveyed 523 New York City area residents of temporary housing facilities for people with HIV.

Perceived discrimination was determined by asking participants if someone in the healthcare system had ever shown hostility or lack of respect toward them, ever paid less attention to them than others, or had ever refused them service.

In all, 39.6% responded positively, and were deemed to have experienced discrimination. Of this group, 59.8% concluded that an underlying reason was HIV infection, 49.8% cited drug use, 34.6% said it was because of homelessness, and race and ethnicity were implicated by 35.2%.

Perceived discrimination was significantly associated with the duration of infection, use of non-prescription opioids, being white, being female, and younger age.

Those who perceived discrimination were significantly more likely to give lower ratings of the quality of healthcare and for trust in HIV care providers.

"Our data," concluded Dr. Sohler, "show that perceived discrimination is a strong and consistent predictor of poor ratings of the healthcare system, which may negatively influence health behaviors. Thus, it is crucial for providers to address discrimination with their patients."

Public Health Rep 2007;122:347-355.

New issue of AIDS Patient care and STds, March 2007

Table of contents:

Multidrug-Resistant Tuberculous Meningitis in an HIV-Positive Patient: A Challenging Disease
Abstract

Changing Treatment Paradigms: Hepatitis C Virus in HIV-Infected Patients
Abstract

Western Blot-Indeterminate Results in Nigerian Patients HIV Serodiagnosis: The Clinical and Public Health Implication
Abstract

Utilization of Health Care Services in Hard-to-Reach Marginalized HIV-Infected Individuals
Abstract

Testing Practices and Knowledge of HIV Among Prenatal Care Providers in a Low Seroprevalence State
Abstract

Predictors of Delayed HIV Diagnosis in a Recently Diagnosed Cohort
Abstract

Urine-Based Asymptomatic Urethral Gonorrhea and Chlamydia Screening and Sexual Risk-Taking Behavior in Men Who Have Sex with Men in Greater Boston
Abstract

Improvement of Psychosocial Adjustment to HIV-1 Infection through a Cognitive-Behavioral Oriented Group Psychotherapy Program: A Pilot Study
Abstract

Antiviral Briefs

Drug Developments and STD News

Contact the library for copies of articles. Please limit your requests to 5 articles.

Green tea extract protects against brain damage in new mouse model of HIV-related dementia

Tampa, FL (May 1, 2007) — A compound derived from green tea greatly diminished the neurotoxicity of proteins secreted by the human immunodeficiency virus, suggesting a new approach to the prevention and treatment of HIV-associated dementia, also known as AIDS dementia complex. The disorder is the most severe form of HIV-related neuropsychiatric impairment.

University of South Florida neuroscientist Brian Giunta, MD, reported the findings May 1 at Experimental Biology 2007 in Washington, DC. His presentation was part of the scientific program of the American Society for Pharmacology and Experimental Therapeutics. The study was conducted using a new mouse model for HIV-related dementia developed by Dr. Giunta and Jun Tan, MD, PhD, director of the Neuroimmunology Laboratory at the Silver Child Development Center, USF Department of Psychiatry,

“These findings suggest that EGCG, the green tea-derived compound, may represent a new and natural compound for the prevention and treatment of this devastating disease,” Dr. Giunta said.

“This is a very important finding in the prevention and treatment of HIV-related dementia, which is usually observed in the late stages of HIV disease,” said Abdul S. Rao, MD, MA, DPhil, senior associate vice president for USF Health and vice dean for research and graduate affairs at the College of Medicine. “The neuroprotective effects of EGCG, the green-tea extract, may offer an alternative to existing mono or combination antiretroviral therapies that are known to have poor central nervous system penetration.”

Click here to read the press release

Drugs produced dramatic change in HIV patient

Tiko Kerr was at death's door in January 2006 when a new treatment was begun

Darah Hansen, Vancouver Sun
Published: Wednesday, May 02, 2007

The human immunodeficiency virus could have killed Vancouver artist Tiko Kerr 20 years ago, just as it claimed so many other promising lives.

Instead, his successful battle to live is now propelling him on a whirlwind world tour, talking to drug researchers, doctors and scientists about his story of survival and the two controversial AIDS drugs that helped him beat the odds.

"I've really come to the conclusion that the worse you have to go through, the greater the reward," Kerr says of his dramatic change in fortune.

The tour began in December, when Kerr, just shy of the one-year anniversary of his initial treatment with TMC114 and TMC125 as part of a small clinical trial at St. Paul's Hospital, travelled to New Jersey where he was invited to speak at the corporate headquarters of pharmaceutical giant Johnson & Johnson, and its subsidiary, Tibotec, which developed the two drugs.

Colouring his talk with a mini-retrospective of his paintings over 25 years, Kerr related his own sometimes desperate struggle with the virus since his diagnosis in the mid-1980s.

"You kind of lived your life in gulps," he said of his mindset at the time he was told he was HIV-positive.

He also told of his life-and-death fight with his own government in order to gain access to the drugs. (...)

Click here to read the article

A selection of new books available in the library

Stine, Gerald J.
AIDS update 2007 : an annual overview of Acquired Immune Deficiency Syndrome
San Francisco, McGraw-Hill, 2007
C 200 STI 2007
AIDS Update 2007 presents a balanced review of current research and information on HIV infection, HIV disease, and AIDS. AIDS Update 2007 places this discussion within a biological, medical, social, economic and legal framework, helping readers to more fully understand this modern-day pandemic.


Overberg, Kenneth R.
Ethics and AIDS : Compassion and justice in global crisis
Oxford, UK, Rowman & Littlefield, 2006
H 210 OVE 2006 (Click on call number to borrow this book!)
HIV and AIDS raise ethical questions that extend throughout the life cycle. Ethics and AIDS: Compassion and Justice in Global Crisis pulls together many of the these life issues in one book and carefully considers them in the context of the realities of the daily existence of people across the globe suffering from this terrible disease.


Lyon, Maureen E.; D'Angelo, Lawrence J.
Teenagers HIV and AIDS : Insights from youth living with the virus.
Westport, Ct, Praeger Publishers, 2006
C 620 LYO 2006 (Click on call number to borrow this book!)
"Teenagers, HIV and AIDS is an extraordinary collaboration among scientists, clinicians and teenagers. This book blends a clear and authoritative update on the biology, psychology, prevention and treatment of HIV infection with the experiences of teens, told in their own voices, who are coping with infection..."

Survey prompts HIV warning

More than a third of gay men with HIV have unprotected sex, according to a new survey.

Source: Channel 4 news

The poll by University College London revealed a fifth of gay men without HIV also shy away from using condoms.

Worried researchers are calling for more efforts to discourage such risky behaviour.

The latest poll questioned 2,640 men in Manchester, Brighton and London in gay clubs, bars and saunas between 2003 and 2004.

The rate of HIV infection was highest in Brighton, at almost 14%, and lowest in Manchester, at 8.6%.

Across the entire sample, one in three men who were HIV positive did not know they had the infection - a figure that tallies with previous research.

This was despite the fact that over two-thirds of these men said they had been to a sexual health clinic within the past year.

Some 18% of HIV negative men and 37% of HIV positive men said they had had unprotected sex with more than one partner in the past year.

Over the same period, one in five HIV negative men and four out of 10 HIV positive men said that they had had a sexually-transmitted infection.

Lead researcher Dr Danielle Mercey said: "This research shows we have to renew our efforts to ensure people with HIV get an early diagnosis and curb any risky behaviour. This involves expanding the number of venues where testing is done and increased focus on sexual health education."

Stephanie Nolen - This Wednesday at UBC

Wednesday, May 2, 7:30 to 9:00 p.m
Frederic Wood Theatre
6354 Crescent Road, UBC Point Grey Campus

Join moderator Hal Wake and his guest Stephanie Nolen, author and journalist as they discuss her newly released book 28: Stories of AIDS in Africa.

A description from the publisher's web site:
From one of our most widely read, award-winning journalists comes the powerful, unputdownable story of the very human cost of a global pandemic of staggering scope and scale. It is essential reading for our times.

In 28, Stephanie Nolen, the Globe and Mails Africa Bureau Chief, puts a human face to the crisis created by HIV-AIDS in Africa. She has achieved, in this amazing book, something extraordinary: she writes with a power, understanding and simplicity that makes us listen, makes us understand and care. Through riveting anecdotal stories -one for each of the million people living with HIV-AIDS in Africa- Nolen explores the effects of an epidemic that well exceeds the Black Plague in magnitude. It is a calamity that is unfolding just a 747-flight away, and one that will take the lives of these 28 million without the help of massive, immediate intervention on an unprecedented scale. 28 is a timely, transformative, thoroughly accessible book that shows us definitively why we continue to ignore the growth of HIV-AIDS in Africa only at our peril and at an intolerable moral cost.

28 stories are much more than a record of the suffering and loss in 28 emblematic lives. Here we meet women and men fighting vigorously on the frontlines of disease: Tigist Haile Michael, a smart, shy 14-year-old Ethiopian orphan fending for herself and her baby brother on the slum streets of Addis Ababa; Alice Kadzanja, an HIV-positive nurse in Malawi, where one in six adults has the virus, and where the average adult's life expectancy is 36; and Zackie Achmat, the hero of South Africas politically fragmented battle against HIV-AIDS.

28 also tells us how the virus works, spreads and, ultimately, kills. It explains the connection of HIV-AIDS to conflict, famine and the collapse of states; shows us how easily treatment works for those lucky enough to get it and details the struggles of those who fight to stay alive with little support. It makes vivid the strong, desperate people doing all they can, and maintaining courage, dignity and hope against insurmountable odds. It is in its humanity, beauty and sorrow a call to action for all who read it.

Admission is free but please pre-register at info.talkofthetown@ubc.ca or by phoning 604-827-3491.

Teachers want to know which students have AIDS

Surrey teachers' controversial resolution one of several to be debated at union annual meeting
Janet Steffenhagen, with files from Darah Hansen, Vancouver Sun

Teachers in Surrey, B.C.'s largest school district, want laws changed to ensure classroom teachers are informed when any of their students has HIV, AIDS, hepatitis or other diseases that can be transmitted through blood or body fluids.

The Surrey teachers say it's a matter of safety and later this month they will ask the B.C. Teachers' Federation to back their position and lobby the provincial government for action.

The resolution is one of several controversial proposals to be debated by hundreds of teachers from around the province when they gather in Vancouver for the union's annual meeting, starting March 18.

"Young children often cut themselves using scissors or pins, bite or scratch each other, or throw up," the Surrey Teachers' Association says in written comments supporting the resolution.

"Diseases such as hepatitis and HIV-AIDs are becoming more common and we as teachers need to be informed enough to protect ourselves and our students."

Surrey president John Wadge said his members were sufficiently concerned about the issue that they voted to send it to the general meeting for debate.

But he said the BCTF will have to balance safety concerns with student privacy rights.

"I think the right-to-privacy issues are very valid and may win the day," he said in an interview Tuesday.

Paul Lewand, chairman of the BC Persons with AIDS Society, said a child's HIV status should remain a private matter between the child's family and the family's physicians. The virus still carries a huge social stigma, and could put the child at risk of serious discrimination, he said.

"School is a tough enough time to get through if you can blend in, and if that ability to blend in is taken away it will be hell [for the student]," he said. "It would change their whole school experience and would be something that could never be taken back."

Lewand said his organization could think of no case where HIV has been transmitted in a school, prompting members to question why the discussion has cropped up. "Someone is pushing a personal, private agenda that has nothing to do with the welfare of the children or the school system," he said.

(...)
Click here to read the article

International Women's Day: some resources on women and HIV

Sexual and reproductive health of women living with HIV/AIDS : Guidelines on care, treatment and support for women living with HIV/AIDS and their children in resource-constrained settings
J 220 SEX 2006
Available online! Click here to access the resource.
"The sexual and reproductive health of women living with HIV/AIDS is fundamental to their well-being and that of their partners and children. This publication addresses the specific sexual and reproductive health needs of women living with HIV/AIDS and contains recommendations for counselling, antiretroviral therapy, care and other interventions. Improving women's sexual and reproductive health, treating HIV infections and preventing new ones are important factors in reducing poverty and promoting the social and economic development of communities and countries. Sexual and reproductive health services are uniquely positioned to address each of these factors."

A woman's story : overcoming the shame of HIV
Homewood, Kingdom Publishing, 2005
Call numer: J 210 BYT 2005 ((Click on call number to borrow this book!)
"HIV/AIDS is on the increase among Black women, yet there is a silence that speaks volumes in the community, the nation and the church about this epidemic. Have we forsaken our mothers, daughters and sisters in order to hide the shame of our own lack of involvement? What price will we pay for our detachment from the most indiscriminate health crisis of our time? Perhaps there is hope, if we begin to look at HIV/AIDS through the eyes of those who have been there."

HIV, pregnancy and women's health
London, HIV i-Base, 2005
Available online! Click here to access the resource.
"This booklet aims to help you get the most out of your own HIV treatment and care if you are considering pregnancy or during your pregnancy."



DVD
In women's hands : A film on women, HIV, and hope
Washington, D.C., Program for Appropriate Technology in Health (PATH), 2005
Call number: VJ 210 INW 2005 ((Click on call number to borrow this DVD!)
"Kimberly was 21 and in college in the U.S. Little did she know that her boyfriend was HIV positive. After donating blood she learned that her decision to not use a condom with him one night would change her life forever.
Just across the ocean in the U.K., a similar decision would leave 18 year-old Hyshana with an STI – a reality that many adolescents now face.
In South Africa, Virginia lives in rural Kwazulu Natal with her two children, and waits for her husband for months at a time to return from his job hundreds of miles away. When he returns, she can’t possibly ask him to use a condom. He is her husband after all.
These stories, more powerfully articulate the potential role of microbicides and the importance of public and private sector leadership as well as citizen involvement in this issue. It was this demand and these personal stories that inspired the Global Campaign for Microbicides to produce short film on the need for microbicides.
In Women’s Hands will be an important tool for creating discussion and awareness around the HIV/STI epidemic among women, how microbicides could make a difference and the importance of advocacy for microbicides." (from website)

Circumcised partner may boost women's HIV risk

Source: Canada.com

MARIA CHENG, Associated Press
Published: Wednesday, March 07, 2007

Circumcision may reduce men's chances of contracting HIV by up to 60 percent — but early results suggest the procedure may put women at increased risk of infection, according to preliminary data presented Tuesday.

Early results announced at a U.N. consultation in Switzerland on the potential impact of male circumcision on AIDS in Africa suggested that if HIV-positive men do not abstain from sex while healing from circumcision surgery, their female partners might have a higher chance of catching HIV from them.

However, experts said the results were not conclusive — and highly susceptible to other factors, such as condom use — demonstrating the difficulties of utilizing circumcision in HIV prevention in sub-Saharan Africa, where more than 60 percent of those with AIDS are women.

Previous studies have confirmed the dramatic impact circumcision has in cutting men's HIV infection rates, but a big question has been the resulting effect on women.

The first evidence — though very preliminary — suggests there is a period immediately following surgery when men may more easily transmit the virus to their female partners.

"Women are already so vulnerable in this epidemic," said Jennifer Kates, an AIDS expert at the Kaiser Family Foundation who is not connected to the study. "We need to be particularly careful about anything that could put them at even greater risk."

Click here to read the article

Safe injection site breaks treaties, UN agency says

Source: Vancouver Sun

Federal health minister will be urged to shut down initiatives
Steven Edwards, with files from Darah Hansen, CanWest News Service; with files from Vancouver Sun
Published: Friday, March 02, 2007

UNITED NATIONS -- The United Nations drug control agency is expected to warn Health Minister Tony Clement at a conference later this month that Canada is flouting international drug control treaties by enabling illicit drug use at a supervised injection site in Vancouver.

Clement will be urged to shut down the initiative, which the agency says effectively condones the use of drugs that Canada has agreed in an international forum are banned substances outside prescription.

"In a way, [Canada] is encouraging illicit trafficking," Zhu Li-Qin, chief of the Convention Evaluation Section of the UN's International Narcotics Control Board, said in an interview from the agency's headquarters in Vienna, Austria.

"Traffickers are searching for markets, and a [supervised site] serves as a small market where people go and legally inject drugs."

Officials will notify Clement of the board's findings through established contacts at Health Canada and directly to a Canadian delegation at the annual meeting of the Commission on Narcotic Drugs in Vienna March 12-16.

Article Four of the 1961 Single Convention on Narcotic Drugs says countries will pass laws to make sure drugs are used only for medical and scientific purposes.

"Generally, in international law, when you sign a treaty, you are supposed to conform both your domestic legislation and your domestic behaviour to the obligations you have under the treaty," said Melvyn Levitsky, a retired U.S. ambassador on the board.

"Although we understand the compulsion behind these sites, the convention says drugs are supposed to be used for medical or scientific purposes -- not for getting public nuisances off the streets."

Other countries facing board criticism for operating supervised injection sites are Australia, Germany, Luxembourg, Netherlands, Norway, Spain and Switzerland.

"The board regrets that no measures have been taken to terminate the operation of such facilities in the countries concerned," says the report.

The board noted in its 2003 report that the Canadian government, then under the Liberals, had approved the establishment of the Vancouver facility, called Insite, and billed as a "safe, health-focused place where people can go to inject drugs."

Click here to read the article.

See also : UN report unwittingly makes the case for prescribing drugs to addicts, Vancouver Sun, published March 3

and Safe injection site illegal, says UN, Today's family news, March 7

AIDS: New trial shows needs for caution in adopting circumcision strategy

Source: Yahoo news

Early data from a trial in Uganda shows that policymakers must be prudent when including circumcision among their tactics for fighting AIDS, researchers said on Tuesday.

Last year, three groundbreaking studies conducted in Africa found that male circumcision halved a man's risk of being infected by the human immunodeficiency virus (HIV).

That discovery ignited hopes that the flagging quarter-century-old war against AIDS in Africa could be transformed by a simple, low-cost operation.

The new trial, funded by the Bill and Melinda Gates Foundation, explores a different angle of the circumcision story -- to see whether men who are infected with HIV and are circumcised are any less likely to infect their female partner.

US and Ugandan researchers are following 997 HIV-infected men in Rakai, Uganda. Some of them have been given circumcision, while the others have remained uncircumcised to act as a comparison.

A proportion of volunteers in both groups had uninfected long-term female partners at the start of the study. These women were also enrolled and monitored.

A review at the study's six-month mark looked at 70 couples in the "circumcised" group and found that 11 of the women had become infected. Among 54 couples in the "uncircumcised" group, four women had become infected.

The study is still underway and the data is not considered conclusive.

But the researchers said they were concerned, as several of the infections had been transmitted by men who had had sex before their wounds had fully healed from the circumcision surgery.

The AIDS virus can be carried in the blood, as well as in semen.

This means that, before circumcision can be universally endorsed as a prevention strategy, men and women have to be fully aware about the need to refrain from intercourse for a month or so while the penile wound has healed, the researchers said.

Both partners must be fully versed in safe-sex awareness, especially in condom use.
(...)

Click here to read the article.

New books in the library!

The February list of new acquisitions is now available!
New books and reports, journal articles and educational videos are listed by subject. Links to online publications are also provided.

Print copies are available in the library. If you want to receive the list by email, it's easy! Just call us at 604-893-2248 or send us an email. You can also subscribe and receive the list every month.

UBC researcher finds new way to treat devastating fungal infections

Source UBC

VANCOUVER, CANADA -- Devastating blood-borne fungal infections that can be lethal for HIV/AIDS, cancer, and organ transplant patients may be treated more successfully, thanks to a new drug delivery method developed by researchers at the University of British Columbia in Vancouver.

Pharmaceutical Sciences Prof. Kishor M. Wasan has created a liquid preparation that incorporates drug molecules in fat (lipid-based formulation) so that Amphotericin B, a potent anti-fungal agent, can be taken by mouth with minimal side effects. The agent, used for about 50 years, is currently administered intravenously and has significant toxic side effects, notably severe kidney toxicity as well as serious tissue damage at the intravenous injection site.

Wasan and his research team have discovered that the oral preparation triggers a different molecular interaction than intravenous delivery. The lipid-based system attacks fungal cells only while inhibiting the drug’s interaction with kidney cells – boosting effectiveness and dramatically reducing toxicity.
(...)

Click here to read the media release.

Natural HIV barrier snares AIDS virus

Source: WebMD

Protein in Specialized Skin Cells Traps and Destroys HIV
By Daniel J. DeNoon
WebMD Medical NewsReviewed by Louise Chang, MDMarch 5, 2007 -- A natural barrier to HIV snares and destroys the AIDS virus, Dutch researchers report.

The newly discovered barrier is a powerful first line of defense against HIV infection. But at least one new strategy for preventing HIV transmission may breach this barrier, inadvertently opening the door to infection.

HIV targets T cells, a type of immune cell. It gets to T cells via a type of skin cell called a dendritic cell. Dendritic cells are supposed to warn T cells about foreign invaders. But HIV subverts this line of communication and uses dendritic cells to carry an infectious virus to the T cells.

That doesn't happen if HIV first encounters a specialized kind of dendritic cell called a Langerhans cell. It's hard for HIV to infect Langerhans cells -- and now scientists know why. It's because the cells carry a special molecule, dubbed Langerin.

Langerin grabs HIV and throws it in a kind of garbage disposal within the Langerhans cell, find Lot de Witte of Vrije University, Amsterdam, and colleagues. When the researchers disabled the Langerin molecule, HIV easily infected Langerhans cells.

"Thus Langerin is a natural barrier to HIV infection," de Witte and colleagues conclude.

HIV Prevention Method Has Flaw
As the AIDS epidemic rages on, researchers are looking for ways to prevent HIV infection. One powerful method would be a vaginal microbicide -- an easy-to-apply gel that would block HIV and protect women from being infected by their sex partners.

Because dendritic cells carry HIV to T cells, one promising vaginal-gel ingredient is a molecule called mannan. Mannan breaks the tether that dendritic cells use to haul HIV across mucous membranes.

But de Witte and colleagues find that mannan also disables Langerin, breaching this natural barrier to HIV.

"Inhibitors such as mannan have an unwanted and completely counteractive effect on Langerhans cells -- namely, they negate the protective function of Langerhans cells and enable [HIV] transmission by dendritic cells," they warn.

Instead, the researchers suggest using another molecule that keeps dendritic cells from latching on to HIV without affecting Langerhans cells.

De Witte and colleagues report their findings in the advance online issue of the journal Nature Medicine.

HIV transmission risk highest early in infection-study

Source: Reuters

WASHINGTON, March 5 (Reuters)
People may be most likely to transmit the AIDS virus when they are first infected -- before they start showing symptoms and even before many screening tests detect the virus, Canadian researchers reported on Monday.

This may help explain why the HIV epidemic moves so quickly, they report in the Journal of Infectious Diseases*.

Their genetic analysis of HIV-infected patients in Quebec showed that nearly half of all transmissions occurred when patients were in the early stages of the disease.

"The early infection stage can be entirely asymptomatic," said Dr. Mark Wainberg, of the McGill AIDS Center in Montreal, who led the study.

"This is why people who are recently infected may not know it, and will probably often test negative by conventional antibody screening," Wainberg said in a statement.

Early on, the body has not yet mounted an immune defense against the virus. It does not produce many antibodies -- which is what most quick screening tests look for.

"Hence, we must do a much better job of identifying recently infected people if we are to be able to counsel them to modify high-risk sexual behavior and desist from transmitting the virus," Wainberg added.

Wainberg and colleagues from several hospitals and health clinics in Canada studied HIV transmission through phylogenetic analysis, which is a way to draw the family tree of the virus.

Viruses mutate when they live inside a person's body, and the mutations can be steadily clocked to estimate the first date of infection.

The study found that 49 percent of early infections appeared to cluster in a way that would suggest that most new infections were transmitted by people who themselves were in the early stages of infection, before the virus had time to mutate much.

This is in part because people have many copies of the virus in their blood when they first become infected. The more virus there is -- a measure called viral load -- the more people are likely to infect someone else.

The AIDS virus infects 39 million people globally and has killed more than 25 million since it was first identified in the early 1980s. There is no cure, although drug treatment can keep symptoms at a minimum and extend life.

* High Rates of Forward Transmission Events after Acute/Early HIV-1 Infection, The Journal of Infectious diseases, 1 April 2007, Volume 195, Number 7. Free access!

New HIV/AIDS Resource Center for Women at The Body

The Body, one of the most comprehensive online sources of information on HIV/AIDs recently launched a new website: the HIV/AIDS Resource Center for Women.

As stated in the overview, "After more than 25 years and 25 million deaths, the world has yet to realize that HIV isn’t just a man’s problem. Although it has escaped the notice of most media -- and even many in the health care and health policy fields -- HIV has quietly become the third most-deadly disease for women in the United States, behind only cancer and heart disease. It’s also the leading cause of death for African-American women between the ages of 25 and 34."

In Canada, "Women account for a growing proportion of positive HIV tests reports with known age and gender among adults in Canada. The proportion of females each year has risen, from 12.0% in the years between 1985 and 1997 to 24.9% of adult positive HIV test reports between 1999 and 2002. In 2005, this proportion again increased, though only slightly to 25.4%." (Public Health Agency of Canada, EPI update 2006).

The HIV/AIDS Resource Center for Women offers basic information on HIV/AIDS for women, personal stories of women, interviews with experts, news and links to other resources.

Life support on HBO

Inspired by a true story, this HBO Films presentation uses a mix of actors and real people from the HIV/AIDS community to tell the story of an HIV-positive Brooklyn woman named Ana (Queen Latifah), who channels her energy and regret over past drug addiction into working for Life Support, an AIDS outreach group. When Kelly's HIV-infected gay friend Amare (Evan Ross) disappears, Ana, looking to connect with her daughter while helping a lost soul, throws herself into searching for him. She embarks on a dangerous but necessary journey, and as she seeks to save one life and heal another, Ana learns a poignant lesson about loving and letting go.

Premiere Saturday March 10 at 8PM. Click here to watch preview.

*********************************

About Life support in the Washington Times

"Black women are the No. 1 people getting [the disease], and I wanted to create a film that would give black women a voice," said Nelson George, producer and writer of "Life Support." The multigenerational story is based on Mr. George's real-life experiences with his sister, Andrea Williams. She is a recovering drug addict who has been living with the virus for a decade, and who became an activist in a community service organization in Brooklyn, N.Y., called Life Support.
This project began as a way to deal with "the fears my family had," Mr. George said. However, "She evolved and gained knowledge ... and what we thought was a negative thing that would destroy her and be tragic for us turned to a positive, and she became focused and centered, and this was good and inspirational."
Mr. George, along with actress Gloria Reuben, will attend at the D.C. screening of "Life Support" tonight sponsored by the National Cable & Telecommunications Association. It was released at the Sundance Film Festival in January and debuts March 10 on HBO.
"The purpose of this [film] is to reignite the dialogue about this virus," he said.
Walter Smith, executive director of D.C. Appleseed, which publishes a report card on the D.C. government's ability to deal with HIV/AIDS, spoke on the film. Though he has seen only trailers for "Life Support," Mr. Smith said that "the more that's out there [about HIV/AIDS] the more people will know. ... Leaders across the board have to speak out." In our past conversations, Mr. Smith often suggested that the biggest problem in eradicating HIV/AIDS is the community's unwillingness to talk about the disease.
"There has to be more frank, public talk about this issue at the highest levels," Mr. Smith said. "It's a sad situation. Some of it is so closeted that some people would rather die than get tested."

Read the article A breath of fresh dialogue in HIV/AIDS fight, by Adrienne Washington.

14th Conference on Retroviruses and Opportunistic Infections

From 26th February to 5th March 2007, aidsmap produces a daily email with the latest updates from the 14th Conference on Retroviruses and Opportunistic Infections (CROI), which is being held in Los Angeles, USA.

To sign up and receive this daily email, click here and enter your details in the online form provided.

To find more information about the Conference, visit CROI 2007. Don't miss the webcast sessions!

New medications aid drug-resistant HIV patients

Source: Los Angeles Times

The findings bring "the opportunity for a new life," one doctor says.
By Jia-Rui Chong, Times Staff Writer

In what some are hailing as the most important development in HIV therapy in a decade, two new classes of drugs have been found to block virus replication in patients resistant to existing drugs, researchers said Tuesday.

The two new classes, called integrase inhibitors and CCR5 inhibitors, doubled the number of patients in a group of studies whose infections could be brought under control, researchers said at the Conference on Retroviruses and Opportunistic Infections at the Los Angeles Convention Center.

This is "a pivotal moment" for patients who have become resistant to most AIDS drugs, said Dr. Eric Daar, chief of HIV medicine at Harbor-UCLA Medical Center in Torrance. Daar, who was not involved in the research, estimated that about 20% of his patients are resistant to the existing classes of drugs.

Given the serious problems in treating drug-resistant patients, Daar said, the findings bring "the opportunity for a new life."

Dr. John Mellors, chief of infectious diseases at the University of Pittsburgh, said the new findings hearken back to the introduction in the 1990s of the powerful drugs that converted HIV infection from a mostly fatal disease to one that could be managed for long periods of time.

"This is really a remarkable development in the field," said Mellors, who was not involved in the studies.

Closest to federal approval is maraviroc, developed by Pfizer Inc. The drug binds to a receptor on the surface of human cells known as CCR5, preventing HIV from locking on and entering the cells.

Maraviroc represents the first class of HIV drugs to target the human immune system rather than the virus itself.

Other companies have attempted to bring out CCR5 inhibitors, but with little success. Trials with GlaxoSmithKline's candidate, aplaviroc, were halted in 2005 because the drug caused liver toxicity.

Dr. Howard Mayer of Pfizer reported on studies of maraviroc in 1,049 patients in 13 countries: 840 received the experimental drug in combination with their regular drug regimen, while the rest received a placebo and their regular drugs.

About 44% of the patients receiving maraviroc saw their blood HIV concentrations fall to undetectable levels after 24 weeks of therapy, Meyer said, compared with 23% of those receiving the placebo.

Experts think the drug could be approved by the Food and Drug Administration by the end of the year.

The second new drug is Merck & Co.'s raltegravir, formerly known as MK-0158. It blocks an HIV enzyme called integrase, one of three enzymes used by the virus to copy itself in immune cells.

Dr. David Cooper from the University of New South Wales in Australia and Dr. Roy Steigbigel from State University of New York at Stony Brook reported on two studies involving 699 patients, two-thirds of whom received raltegravir in addition to their regular HIV drugs. Both studies were funded by Merck.

About 62% of the patients receiving raltegravir saw the HIV in their blood fall to undetectable levels after 16 weeks, compared with 35% of those receiving the standard drugs alone, the researchers said.

The drug, which has been fast-tracked by the FDA, was well tolerated by patients.

Gilead Sciences Inc. also has an integrase inhibitor in earlier stages of testing and will present results today.

"The big question now is how will these drugs be used in practice," said Dr. John Bartlett, an epidemiologist at Johns Hopkins University, who was not connected to the studies. "If they become first-line drugs, that could mean a paradigm shift."

Two studies of adult male circumcision to prevent HIV

Source: Medical News Today

WHAT: In December 2006, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, announced an early end to two clinical trials of adult male circumcision in Kenya and Uganda because an interim review of trial data showed that medically performed male circumcision significantly lowered a man's risk of acquiring HIV through heterosexual intercourse.

Two papers in The Lancet provide detailed analyses of these NIAID-funded trials. In the trial of 2,784 HIV-negative men in Kisumu, Kenya, the investigators found the rate of HIV acquisition in circumcised men to be 53 percent lower than in uncircumcised men. Investigators in the trial of 4,996 HIV-negative men in Rakai, Uganda, report that HIV acquisition was reduced by 51 percent in circumcised men.

ARTICLES:
"Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial," by R Bailey et al. The Lancet 369: 643-56 (2007). This trial was conducted by researchers from the University of Illinois at Chicago, the University of Manitoba and the University of Nairobi, Kenya.

"Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial," by R Gray et al. The Lancet 369: 657-66 (2007). This trial was conducted by scientists from The Johns Hopkins University School of Public Health, Baltimore, and Makerere University, Kampala, Uganda.

Copies of these articles are available in the library.
Online access is also possible on the Lancet's Website (free registration required)

Smith gets jail in HIV sex case

Ex-Roughrider sentenced to six years: `I just want to say sorry for everything'

Source: Toronto Star

Feb 27, 2007 04:30 AM

REGINA–An apology to the Saskatchewan Roughriders, his children, his wife and his lovers wasn't enough to spare an HIV-positive former Canadian Football League linebacker a prison term for aggravated sexual assault.

Trevis Smith was sentenced yesterday to 5 1/2 years behind bars for knowingly exposing two women to the virus that causes AIDS by having unprotected sex with them and not revealing his condition.

Provincial court Judge Kenn Bellerose added another six months to the sentence for two bail violations Smith pleaded guilty to earlier in the day, making the sentence an even six years.

"For this, I apologize to this province and to the team that I represented the last seven years," Smith said from the prisoner's box in a barely audible voice before Bellerose made his ruling.

"I also want to apologize to the women that I've been involved with during this time and my wife for my actions and I ask that she'd forgive me for me committing adultery.

"I just want to say sorry for everything."

But Bellerose didn't waver.

"As far as I'm concerned, Mr. Smith was very deceitful and very dishonest," he said.

"I'm satisfied he displayed, throughout this whole time – from when he learned he had HIV in November of 2003 until the time of his arrest in October 2005 – a very indifferent attitude with respect to the expectations that the law required on his part to basically come clean with respect to his sexual partners."

Smith showed no reaction as the judge ruled. His wife, who had stood behind her husband throughout the entire trial and could be heard crying as he apologized, left court without talking to reporters.

His lawyer, Clemente Monterosso, also refused comment. An appeal of the conviction has already been filed.

[...]
To read the entire article, click here

Herpes treatment helps infected women also fight HIV

Source: Medical News Today

Levels of HIV come down in HIV-positive women who are also infected with herpes simplex and are being treated for it with the antiviral drug valacyclovir.

These are the findings of a study published in today's New England Journal of Medicine.

The research was conducted in Burkina-Faso in Africa and took the form of a randomized, double-blind placebo-controlled trial.

Valocyclovir is marketed by GlaxoSmithKline as Valtrex.

Dr Nicolas Nagot of the London School of Hygiene and Tropical Medicine and colleagues found that treating herpes simplex 2 (HSV-2) infections with valocyclovir reduced levels of HIV-1 RNA in both the blood plasma and the genital mucosa, with the latter being more significant.

And this effect seemed to get stronger over the three months of the study.

Once a woman has herpes, the risk of getting HIV is increased and other research studies have shown that when HSV-2 is present it increases the amount of HIV-1 in plasma and genital mucosa.

(...)

Health Canada examining information linking antiviral drug to development of treatment-resistant HIV

Source: Health Canada

February 21, 2007
For immediate release

OTTAWA - Health Canada is informing Canadians of new information submitted by the manufacturer of the antiviral drug Baraclude that suggests the drug may be linked to the development of a treatment-resistant strain of HIV in one patient with HIV.

Baraclude (the brand name for the drug entecavir) has been authorized in Canada since June 2006 for the treatment of active chronic infection with Hepatitis B virus in adults. This new information consists of a U.S. report of a patient, infected with both HIV and Hepatitis B virus, whose HIV infection became resistant to one of the more commonly used HIV treatment drugs while the individual was taking only Baraclude. In addition, this is one of three U.S. reports submitted by the manufacturer, Bristol-Myers Squibb Canada, concerning HIV patients who experienced a decrease in their HIV virus levels while using Baraclude, despite not being treated with HIV drugs. To date, studies of Baraclude do not suggest that the drug has any activity against HIV. Drugs which have activity against HIV may be associated with increased risk of developing treatment-resistant forms of HIV.

Health Canada is following up on this information and will provide Canadians with any new safety recommendations which may be warranted for the use of Baraclude when the review is completed.

Canadians taking Baraclude should consult with their physician if they have any questions or concerns.

Consumers requiring more information about this Information Update can contact Health Canada’s public enquiries line at (613) 957-2991, or toll free at 1-866-225-0709.

Any serious or unexpected adverse reactions in patients receiving Baraclude or any other drug should be reported to the Canadian Adverse Drug Reaction Monitoring Program (CADRMP) of Health Canada by one of the following methods:

Telephone: 1-866-234-2345
Facsimile: 1-866-678-6789

CADRMP
Marketed Health Products Directorate
Tunney's Pasture, AL 0701C
email: cadrmp@hc-sc.gc.ca

The CADRMP adverse reaction reporting form, including a version that can be completed and submitted online, is located on the MedEffect portal of the Health Canada Web site.

Failure of HIV microbicide raises concerns

Source: The scientist

By Andrea Gawrylewski

A microbicide designed to ward off HIV is unexpectedly linked to an increased risk of infection, prompting speculation about the future of microbicides against HIV.

Researchers shut down an HIV microbicide clinical trial last month in Africa and India after early data indicated microbicide users had a higher rate of infection than women using a placebo. The discouraging results have surprised and disappointed researchers, and may ultimately have a negative impact on the future role of microbicides in preventing the spread of the virus.

Several other microbicides are in the pipeline for testing and development, but this trial failure may push some researchers in the direction of other HIV prevention options, predicted Daniel Kuritzkes, director of AIDS research at Brigham and Women's Hospital. "The field is moving towards more specific approaches -- use of topical applications of antiviral drugs, as opposed to true microbicides," he told The Scientist. "The [closed trial's] results would make me less enthusiastic about pursuing other [microbicides]. I would be a bit leery about getting into microbicide studies."

Enrollment for the phase III trial for the cellulose-sulfate compound, called Ushercell, began in 2005. When it was stopped, the trial's preliminary analysis included 1,333 women in India, Uganda, Benin, and South Africa. Initial results showed that 35 women had contracted HIV while using the compound, a higher rate of infection than that seen in women using a placebo. CONRAD, the Arlington, Va.-based nonprofit reproductive health organization that funded the development and testing of Ushercell, halted the trial immediately.
(...)

New UNAIDS Report

Just released!
UNAIDS at country level. Supporting countries as they move towards universal access
C 500 UNA 2007
Geneva, UNAIDS, 2007.
This report is available online. Click here to download it. There's also a copy in the library.

Excerpts from the introduction:
"In 2005 and early 2006, the landscape of the AIDS response shifted dramatically. Global pessimism over the unchecked spread of the disease in the developing world receded in the face of impressive efforts to expand access to treatment. Signs that prevention efforts were bearing fruit were seen in a growing number of countries from the hardest-hit regions, which started to report drops in HIV rates, particularly among the young. (...)
During this period, the Joint United Nations Programme on HIV/AIDS (UNAIDS) focused its country support work on two main areas. The first was improving the architecture of the AIDS response in the face of increasing complexity, growing resources and the involvement of new actors.(...) The second priority of country work was securing political commitment to a dramatic expansion of services for prevention, treatment, care and support. Through the universal access process, countries and regions assessed the current state of the epidemic, identified barriers preventing the expansion of services and began to develop roadmaps to considerably expand key services."

How much do you know about HIV?

Test your knowledge about HIV by taking a quiz!

- amfAR, the Foundation for AIDS Research: Test your AIDS I.Q.

- AVERT: Quizzes page. Several quizzes on HIV, HIV statistics, HIV and women, World AIDS Day, Sex, Pregnancy, Condoms.

- The Body: HIV/AIDS Quiz

- The World Bank: What do you know about World AIDS Day?

- CDC - Business responds to AIDS / Labor responds to AIDS: HIV/AIDS Workplace tools - AIDS 101 Quiz

- PBS, The age of AIDS: Quiz

Indonesia faces growing AIDS woes, Papua big worry: WHO

Source: Reuters

JAKARTA (Reuters) - Indonesia faces a growing AIDS problem -- particularly among drug users and prostitutes -- while a recent survey shows two percent of the Papua population infected with HIV, the World Health Organization said on Saturday.

The sprawling, developing nation of 220 million people also faces constraints and lack of resources to cope with the problem, Bjorn Melgaard of the WHO said at the release of the report.

"Indonesia has one of the fastest growing HIV epidemics in Asia. Although the HIV prevalence among adults is still generally low, it has reached high levels among specific populations like injecting drug users and sex workers," the report said.

Indonesia is the world's most populous Muslim nation but many of its citizens have a liberal attitude toward sex and prostitution is a thriving part of the economy in many areas.
(...)

See also WHO 2006 update - Indonesia

Resources on HIV/AIDS and gender

Working with men, responding to AIDS : gender, sexuality and HIV - a case study collection
Brighton, UK, International HIV/AIDS Alliance, 2003
C 500 WOR 2003
Available online! Click here to download the document.
"Across the world, people working on HIV/AIDS now recognise the importance of developing their work with men in order to have a real impact on the epidemic. There is a growing interest in identifying strategies that will be effective in reaching out to different groups of men and enabling them to change their attitudes and behaviour. The International HIV/AIDS Alliance (the Alliance) shares this interest. (...)
The Alliance has produced this case study collection in order to help projects to conduct this work with men on HIV/AIDS. It presents experiences and lessons from a range of different projects (some supported by the Alliance and some not) that are working with men. By showcasing experiences and lessons from the field in the form of case studies, this collection offers inspiration, ideas and models for working with different kinds of men in a range of contexts."

The Gender and HIV/AIDS electronic library: A collection of resources including research, publications, training tools, and multi-media advocacy materials from the UNIFEM/UNAIDS Gender and HIV/AIDS Portal.
United Nations Development Fund for Women (UNIFEM), 2005.
J 200 GEN 2005 (Click on call number to borrow this CD-ROM!)
"UNIFEM, with support from UNAIDS, has released a Gender and HIV/AIDS Electronic Library on CD-ROM that compiles resources from the UNIFEM Web Portal. It includes research and studies, training resources and tools, and multimedia advocacy materials on the gender dimensions of the HIV/AIDS epidemic produced by a variety of organizations. The Gender and HIV/AIDS Electronic Library is fully searchable by keyword and includes an easy-to-use tool called "e-Course Builder," which supports the creation of a tailored training course using the resources on the CD-ROM. The Library will be a useful resource for academics, policymakers, practitioners, journalists, students and others interested in the gender dimensions of the epidemic."

Gender, HIV/AIDS and rights : Training manual for the media
Rome, Inter Press Service, [2002]
H 230 MAD 2002
Available online! Click here to download the document.

Ottawa, Gates join in Canadian HIV vaccine search

Source: Reuters

OTTAWA (Reuters) - The Canadian government and the Bill & Melinda Gates Foundation announced C$139 million ($118 million) in funding on Tuesday for a Canadian initiative in the search for an HIV/AIDS vaccine.

Prime Minister Stephen Harper and Microsoft Corp. founder Bill Gates told a news conference that the money would go to an initiative that would try to accelerate development of a vaccine and address critical research gaps. Under the plan, a facility will be set up in Canada to manufacture and test HIV vaccine candidates.

Canada will provide up to C$111 million and the Gates Foundation up to C$28 million.

New book in the library: AIDS in Africa: Three scenarios to 2025

AIDS in Africa: Three scenarios to 2025
Geneva, Joint United Nations Programme on HIV/AIDS (UNAIDS), 2005
Call number: C 510 AID 2005 (Click on call number to borrow this book!)
AIDS in Africa: Three scenarios to 2025 presents three possible case studies for how the AIDS epidemic in Africa could evolve over the next 20 years based on policy decisions taken today by African leaders and the rest of the world. The scenarios set out to answer one central question: 'Over the next 20 years, what factors will drive Africa's and the world's responses to the AIDS epidemic, and what kind of future will there be for the next generation?'...

This report is also available online

AIDS virus weakness detected, could help vaccine

Source: Reuters

By Will Dunham

WASHINGTON, Feb 14 (Reuters) - Scientists have captured an image of the AIDS virus in a biological handshake with the immune cells it attacks, and said on Wednesday they hope this can help lead to a better vaccine against the incurable disease.

They pinpointed a place on the outside of the human immunodeficiency virus that could be vulnerable to antibodies that could block it from infecting human cells.

U.S. National Institutes of Health researcher Peter Kwong said the study, published in the journal Nature, may reveal HIV's long-sought "site of vulnerability" that can be targeted with a vaccine aimed at preventing initial infection.

"Having that site and knowing that you can make antibodies against it means that a vaccine is possible," Kwong said in a telephone interview.

"It doesn't say we've gotten there. But it's taken it off the list from an impossible dream and converted it to something that is a (mere) technical barrier."

Experts agree that a vaccine is the only hope of stopping the pandemic of AIDS, which has killed more than 25 million people since it was first recognized in 1981. About 40 million people now live with HIV, with sub-Saharan Africa hardest hit.

But while dozens of potential vaccines are in development, only two AIDS vaccine candidates are in advanced human trials -- one made by Merck and Co. and another by Sanofi-Aventis SA .

Because the virus attacks immune system cells, it has been especially difficult to design a vaccine to fight it.

The team at the National Institute of Allergy and Infectious Diseases, part of the NIH, made atomic-level images of the virus.

They revealed the structure of a protein on the surface of HIV as it looks while the protein is bound to an infection-fighting antibody. They said this protein, called gp120, seems susceptible to attack by this antibody, which is called b12 and is capable of broadly neutralizing the virus.

An antibody is an immune system protein that helps seek and destroy invaders like viruses and bacteria.
(...)

Merck cuts price on AIDS drug Efavirenz

Source: Reuters

By Nopporn Wong-Anan

BANGKOK, Feb 15 (Reuters) - Merck & Co. announced on Thursday price cuts for its HIV-AIDS drug, Efavirenz, in poor countries and those hard hit by the disease, including Thailand which plans to make copycat versions of the medicine.

Thailand, which shocked Merck in November when it announced plans to break the company's patent for Efavirenz, would see its price drop to 700 baht ($19.59) per patient per month.

Merck had previously sold Efavirenz at a non-profit price of 1,300 baht per treatment per month in Thailand, which plans to import Indian-made versions of the drug for 800 baht per month until it is available from Thailand's state-owned drug maker.

"Merck is lowering the price of the 600 mg formulation of Efavirenz due to efficiencies resulting from improved manufacturing processes," the company said.

A spokesman for Merck's Thai subsidiary also attributed the lower Thai price to a more favourable exchange rate.

Last month, the Health Ministry issued compulsory licences for the heart disease drug Plavix, made by Bristol-Myers Squibb and Sanofi-Aventis and Abbott Laboratories' Kaletra to treat HIV/AIDS after a similar move on another AIDS drug last year.

The licences, which Thai health officials said would save the country up to 800 million baht ($24 million) a year, drew praise from AIDS activists but flak from Washington and the drug industry, which are urging the ministry to rescind them.
(...)

Pfizer's AIDS drug to get faster review

Source: Reuters

NEW YORK (Reuters) - Pfizer Inc. said on Tuesday its HIV treatment maraviroc will receive an accelerated review from regulators in the United States and Europe.

If approved by the regulatory agencies, maraviroc would be the first in a new class of HIV/AIDS treatments called CCR5 antagonists that work by blocking viral entry, the drug maker said.

Most existing HIV drugs work inside the body's immune cells, after the virus has infected a patient.

Rather than fighting HIV inside white blood cells, CCR5 antagonists prevent the virus produced by infected cells from entering uninfected cells by blocking its predominant entry route, the CCR5 co-receptor.

The U.S. Food and Drug Administration grants accelerated reviews to potential medicines that could represent a major improvement over current treatments. The expedited process means the agency will decide whether to approve the drug within six months, rather than the more typical period of up to one year.

More information:
Trading Markets.com

HIV sceptics beyond stupid, says top scientist

Source: The Australian

Jeremy Roberts
February 13, 2007

THE man jointly credited with discovering HIV has blasted the Supreme Court of South Australia for wasting time hearing a case that questions the existence of the killer virus.
Robert Gallo, the American scientist who established the link between HIV and AIDS in 1984, appeared for the prosecution yesterday in the application for an appeal by an HIV-positive man convicted of exposing three women to the virus.
"I can't believe that it occupies the time of the court - it is that absurd," Professor Gallo said.

Defence witnesses - medical physicist Eleni Papadopulos-Eleopulos and emergency doctor Val Turner - have testified that the science behind HIV is flawed, that the virus has not been purified, that tests for it are indirect and unreliable, and that it is not sexually transmitted or the cause of AIDS.

They appeared for Andre Chad Parenzee, 36, who was convicted in February last year on three counts of endangering life.

Professor Gallo said he had reviewed much of the defence testimony and rejected it as "misunderstanding" at best, and "misrepresentation" of HIV and AIDS research, at worst.

He called on numerous medical fields and his vast research experience to describe HIV, its first laboratory isolation in the 1980s, its attack on the immune system, and the success of treatments and blood screening.

Professor Gallo's testimony was a coup for prosecutors, who have fought Parenzee's application in more than three weeks of hearings since March last year. (...)


Read also:
25 million dead people can't be wrong. Or can they?
HIV discoverer blasts doubters in SA court

Malaysia's HIV/AIDS epidemic rising and spreading fast

Source: All Headlines

February 12, 2007 10:59 a.m. EST

Patricia Shehan - All Headline News Staff Writer
Malaysia (AHN) - Malaysia's HIV/AIDS epidemic is rising and spreading fast. The number of HIV infections could rise to more than 300,000 by the year 2015 if something isn't done. That would be more than fourfold the current status, according to a top health official's warning to the public as reported on Sunday.

Although high-risk groups, such as drug addicts are spreading the disease quickly, the health ministry has indicated that those infected with the HIV virus are now expanding. The disease is infecting many women, fisherman, lorry drivers and factory workers, according to a recent Australian news report.

The heterosexual infectious transmission is rising, causing a "worrying trend," especially among women, according to Malaysia's government health official.

Currently there are approximately 73,000 Malaysians who have been infected with HIV. Although a great majority - about 75 percent - of infected Malaysians are IV drug users, the percentage of women in particular is quickly rising.

Although the government took a stance to fight the disease beginning with a five-year strategy that began in 2006, the Malaysian government indicates their success will depend on public cooperation.

According to the Malaysian Health Ministry, every day there are three people who die from an AIDS-related illness in the country, the AP reported.

New compound shows promise in halting HIV spread

Source: Medical News today

A new compound has shown promise in halting the spread of HIV by preventing the virus from replicating. Developed by Temple University researchers, 2-5AN6B could someday work as an effective treatment for HIV especially in conjunction with current drug treatments. Their work is published in the January issue of AIDS Research and Human Retroviruses.

A nucleic acid, 2-5AN6B inhibited HIV replication in white blood cells from a group of 18 HIV infected patients by up to 80 percent, regardless of the patients' treatment regimens.

"A cure for HIV infection remains an elusive goal despite the significant impact of current treatments because of the virus' ability to adapt to and resist those treatments, and bypass the immune system's natural defenses," said Robert J. Suhadolnik, Ph.D., prinicipal investigator and professor of biochemistry at Temple University School of Medicine. "This compound prompts the body to restore its natural antiviral defense systems against the invading virus."

Current drugs for HIV work by blocking one of the steps toward virus replication.

"This new anti-HIV compound works by a very different mechanism, and would appear to offer the promise of someday being combined with existing anti-viral therapies for a much more effective treatment. It is also very important that this compound is much less likely to be defeated by the ability of the virus to mutate, a problem often encountered with existing anti-viral drugs," said Thomas Rogers, Ph.D., co-author and professor of pharmacology at Temple.

This work builds on decades of research by the Temple team which was recently awarded a grant from the National Institutes of Health to continue pre-clinical studies on a larger scale. They'll be investigating the molecular mechanisms of 2-5AN6B as a potential weapon against HIV, and continue work on a new therapeutic approach involving gene therapy for the treatment of HIV infection.

Topics in HIV Medicine, Vol. 14, issue 5, Dec 06 / Jan 07

Perspectives

Immunizations for HIV-infected Adults: Indications, Timing, and Response
David H. Spach, MD
Link to full-text (free access)

Prioritizing Primary Care in HIV: Comorbidity, Toxicity, and Demography
Amy C. Justice, MD, PhD
Link to full-text (free access)

Renal Disease and Toxicities: Issues for HIV Care Providers
Derek M. Fine, MD
Link to full-text (free access)

Hepatitis B Virus Treatment in HIV-infected Patients
Chloe L. Thio, MD
Link to full-text (free access)

A print copy is also available in the library.

Washington men get hard-to-treat HIV strain

The Advocate

A hard-to-treat strain of the virus that causes AIDS has been found in four gay men in King County, Washington, and authorities fear it could spread to more. There is no evidence that the troublesome strain of HIV is spreading rapidly, but its appearance underscores the need for renewed emphasis on safe sex practices, officials in the Seattle-King County public health department said Thursday.

"There may be more cases we don't know about," said Dr. Bob Wood, the agency's HIV-AIDS program director. "We are still working to learn more about these individuals and the virus they have contracted," said Dorothy F. Teeter, interim director of the department. "We are concerned for these individuals and their partners and are continuing our investigation."

The same genetic strain of HIV was found over a 15-month period in all four men, methamphetamine users who each had multiple partners, but none is known to have had sex with any of the other three, officials said. "That's highly unusual," said Dr. Peter Shalit, who treats HIV-AIDS patients and directs HIV-AIDS research at Swedish Medical Center.

One possibility is that there is a new strain of multi-drug-resistant HIV that is spread more easily than previous drug-resistant strains, "definitely a scary prospect," Shalit said.

"There's no evidence that this has spread outside of King County," said Dr. Patrick Sullivan, chief of the behavioral and clinical surveillance branch at the Atlanta-based Centers for Disease Control and Prevention. But the center also hasn't compared this strain with ones outside of King County because the center studies disease from a population, not an individual, perspective, he said Friday in a telephone interview.

One man in New York, diagnosed with HIV in December 2004, was found to have a multi-drug-resistant type of HIV and he too had multiple, anonymous sexual partners, a history of methamphetamine use, and had sex with men, according to the CDC. (...)

2nd International Conference on HIV treatment adherence

International Association of Physicians in AIDS Care IAPAC
Hyatt Regency Hotel, Jersey City, NJ - March 28-30, 2007

Adherence to medical treatment for HIV/AIDS is an essential determinant of treatment success or failure. Yet, we have much to learn about measurement and intervention for adherence - it is a complex challenge that requires multidisciplinary cooperation among providers, researchers, government agencies, and patients.

The goal of this conference is to provide an international forum for the presentation and discussion of state-of-the-science HIV treatment adherence research, as well as current behavioral and clinical perspectives in practicum. Our ultimate hope is that this dialogue translates into evidence-based implementation of approaches for real world clinical and community settings.

This activity is targeted to physicians, nurses, pharmacists, psychologists, psychologists, social workers, researchers, and other healthcare professionals with an interest in the treatment of HIV/AIDS.

Program, registration:
http://www.iapac.org/home.asp?pid=7973

AIDS Epidemic Update - December 2006

Published by UNAIDS (The joint United Natiosn Programme on HIV/AIDS), the annual AIDS epidemic update reports on the latest developments in the global AIDS epidemic. With maps and regional summaries, the 2006 edition provides the most recent estimates of the epidemic’s scope and human toll, explores new trends in the epidemic’s evolution.
A copy of the AIDS Epidemic update is available in the library and online.

Tests of drug to block HIV infection are halted over safety

By LAWRENCE K. ALTMAN, The New York Times

Efforts to develop a topical microbicide to prevent H.I.V. infection during sex suffered a surprising setback yesterday when researchers announced that they had stopped two full-scale trials for safety reasons.

The trials, in Africa and India, involved a chemical, cellulose sulfate or Ushercell, and were the second failure of a potential microbicide in a full-scale trial in recent years. In one of the latest trials, a standard check by an independent scientific committee found an increased risk of H.I.V. infection among women who used cellulose sulfate compared with those who used a placebo gel.

In 2000, a large full-scale trial showed that the only other microbicide candidate, nonoxynol-9, was unsafe when it had been expected to be effective. Subjects in that trial developed a higher incidence of H.I.V. infection, presumably through ulcers caused by chemical irritation.

Yesterday, AIDS researchers at the World Health Organization, the United Nations AIDS program and other organizations expressed hope that at least one of three other potential microbicides undergoing full-scale testing would prove to be safe and effective. The others are Pro 2000 by Indevus Pharmaceuticals, BufferGel by ReProtect and Carraguard, whose trademark is held by the Population Council.

“While the closing of these trials is a profound disappointment for the microbicide field, we cannot let it paralyze us,” said Dr. Zeda Rosenberg, chief executive of the nonprofit International Partnership for Microbicides in Silver Spring, Md.

In the absence of an AIDS vaccine, specialists say development of a microbicide is a public health priority, mainly to protect the many women in poor countries whose partners refuse to use condoms. Such protection could take the form of a gel, cream, film, tablet or sponge that could be inserted into the vagina or rectum.

The study that led to stopping the trials involved 1,333 participants in Benin, South Africa and Uganda. Conrad, a health research organization in Arlington, Va., conducted the study.

Conrad said the independent committee found more new H.I.V. infections among those who used cellulose sulfate than among those who used an inactive gel, but did not report any numbers. Final numbers are expected in March, a spokeswoman for Conrad said.

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http://www.nytimes.com/2007/02/01/health/01aids.html?ref=world

Over 50's more likely to have elevated lipids and glucose during HIV therapy

AIDSMAP, Michel Carter.
http://www.aidsmap.com/en/news/0CC9C076-C428-4925-9744-D3AA67BF586F.asp

Older HIV-positive patients are more likely than HIV-positive individuals under the age of 35 to experience increases in blood sugar, cholesterol and triglycerides after a year of antiretroviral therapy, Italian investigators report in the November edition of HIV Medicine. The study also revealed that older patients have a greater risk than younger patients of developing certain co-morbidities such as heart disease or diabetes after taking HIV treatment. However, the investigators found that anti-HIV therapy had a similar virological and immunological effect in older and younger patients.

With prompt diagnosis and appropriate treatment there is increasing optimism that HIV-positive individuals will survive into old age. The demographics of the HIV-positive population are already changing. In Italy in 1985, for example, the median age for male HIV-infected individuals was 29 and 24 for female patients. By 2004, these ages had increased to a median of 41 and 38 years.
Although older age has been associated with faster HIV disease progression and increased mortality, HIV treatment guidelines do not make any specific recommendations regarding the use of antiretrovirals in older patients.

Therefore, doctors in Milan conducted longitudinal analysis comparing treatment outcomes, the rate of metabolic complications, and the incidence of side-effects and new co-morbidities after the first year of HIV therapy in patients aged over 50 years and those aged between 25 and 35 years.

A total of 159 older patients and 118 controls were included in the investigators’ analysis. The older patients had a mean age of 59 years compared to 30 years in the younger patients.
(...)

Reference
Orlando G et al. Antiretroviral treatment and age-related comorbidities in a cohort of older HIV-infected patients. HIV Med 7: 549 – 557, 2006.