Advanced technology for the earliest detection.

Traditional methods for detecting HIV (HIV antibody test) and other STDs may require a waiting time of as long as 3 months. Early detection of HIV by advanced HIV PCR technology can greatly reduce the time you have to wait for reliable test results. This means you no longer have wait 3 months to know your HIV status. We also provide testing for early detection of STDs like chlamydia, N. gonorrhea and even genital herpes.

Original Articles

Hypothesis of snake and insect venoms against Human Immunodeficiency Virus: a review

Abstract

Background

Snake and insect venoms have been demonstrated to have beneficial effects in the treatment of certain diseases including drug resistant human immunodeficiency virus (HIV) infection. We evaluated and hypothesized the probable mechanisms of venoms against HIV.

Methods

Previous literatures published over a period of 30 years (1979-2009) were searched using the key words snake venom, insect venom, mechanisms and HIV. Mechanisms were identified and discussed.

Results & Conclusion

With reference to mechanisms of action, properties and components of snake venom such as sequence homology and enzymes (protease or L- amino acid oxidase) may have an effect on membrane protein and/or act against HIV at multiple levels or cells carrying HIV virus resulting in enhanced effect of anti-retroviral therapy (ART). This may cause a decrease in viral load and improvement in clinical as well as immunological status. Insect venom and human Phospholipase A₂ (PLA₂) have potential anti-viral activity through inhibition of virion entry into the cells. However, all these require further evaluation in order to establish its role against HIV as an independent one or as a supplement.

The complete article can be found at AIDS research and Therapy.

Students dismiss the importance of sexual health

When dealing with teeth or eyes, most people do not hesitate to see a dentist or optometrist at the first sign of trouble.

The same can’t be said for sexual health, especially involving college students.

Pam Hux, Nurse Practitioner and Head of the Women’s Clinic at the Student Health Clinic, would like to see people change their view on sexual health from being a taboo topic to an essential one.

“Reproductive health and sexual health is like a sore throat or cough. It needs to be treated just like a checkup or dental visit,” Hux said.

Hux further encourages students not to be apprehensive or shy about dealing with any questions or concerns involving their sexual health, saying that no question should go unanswered.

There are many myths about sexually transmitted diseases or STDs that can cause those who are sexually active to fear learning more about the facts and keep them from getting tested.

5 Myths about STDs

1) If I get tested for STDs, my parents or friends might find out.

• FALSE. All STD testing at the Student Health Clinic (and other health services) are completely confidential. All information will stay between the patient and the healthcare provider.

2) STD testing can be painful and intrusive.

• FALSE. STD testing is minimally invasive. One can be tested for almost every STD except for Human papillomavirus (HPV) simply by giving a urine and blood sample.
• *Editor’s note: I went to the Student Health Clinic to see firsthand what it is like to have a typical sexual health consultation including STD testing. I can testify that the medical staff is very knowledgeable and helpful and the STD testing is virtually pain free. The only thing that someone looking to get an STD test may be uncomfortable with is having blood drawn for the blood sample. It involves a small needle and about 20 seconds of collection. It was much easier than even I thought it would be. A walkthrough of a typical STD appointment can be found at the end of the article.*

3) Once I get an STD, I will have it for the rest of my life.

• FALSE. All STDs can be treated. Most STDs can be cured if caught early enough (another reason to get tested-the earlier, the better). Curable diseases include:
  • Syphilis
  • Chlamydia
  • Gonorrhea
  • Trichomoniasis

• STDs that have no cure, but can be treated and controlled:
  • Human immunodeficiency virus (HIV)
  • Herpes

• Treatment includes the use of medication and the process of education for affected individuals. The Student Health Clinic can treat all STDs.
• Once a patient has been successfully treated and cured of an STD, they are at no more risk than any normal person of contracting an STD. They are no longer carriers or infected and are just like any other person.

4) I haven’t had sex, so I can’t have an STD.

• FALSE. STDs can be spread through three different kinds of contact: oral sex, and vaginal and anal intercourse. It only takes one sexual interaction to contract an STD.

5) I don’t have any symptoms of an STD, so I’m probably not infected.

• FALSE. Often STDs can go unnoticed and common signs aren’t apparent. Testing is still important in this case, because treatment becomes more difficult the longer an infected person waits from the time of contraction. Also remember that some sexual partners may have or have had other sexual partners with unknown sexual histories. It is always better to be safe.

“Reproductive health and sexual health is like a sore throat or cough. It needs to be treated just like a checkup or dental visit.”

Condoms are the only method of protection that prevents the spread of STDs. Be aware of where any STD symptoms or outbreaks occur. Often outbreaks occur in areas that aren’t protected by a condom and any contact with these areas can spread an STD even if a condom is being used.

HPV is also a treatable STD but it is different than most STDs in that males can only be carriers of the disease-they cannot develop any serious problems by carrying. If infected, women can develop cervical cancer. Both genders can develop genital warts from having HPV.

Herpes is a lot different than you probably think

There are two types of herpes: Type 1 and Type 2. They are different strains, but the lines between the two are often blurred. Herpes typically comes and goes with symptoms of sores and blisters in affected areas.

• Type 1 is less severe and more common. Typical symptoms are fever blisters and cold sores. It is widely known as “the cold sore virus.” Herpes Type 1 has affected most people without them knowing it. It is normal to show symptoms such as cold sores and nothing to be alarmed about. Type 1 is more dangerous than Type 2 in terms of spreading the virus because most people do not think twice about these common symptoms. Pay attention to all cold sores (even normal ones) because these are considered a herpes outbreak and any contact with the affected area can spread herpes Type 1. Kissing someone with a cold sore presents the same exposure as sexual activity when someone has an outbreak.
• Type 2 is typically only a sexual disease affecting the genitals. This type is known for more frequent outbreaks that are more severe than Type 1.

STDs and Relationships

Dealing with an STD within the context of a relationship can be difficult. Here are some tips for being healthy in a relationship with an STD.

“Treat your body like you treat your toothbrush-don’t share it with everybody,” Thomas said. “STDs are equal opportunity employers. They don’t discriminate.”

• Both partners need to be tested and treated if infected.
• Research the STD you have contracted. The more knowledgeable you are about what you have, the better the decisions you make will be.
• Counseling is available for those who are struggling with an STD. Treatment is designed to minimize the duration of outbreaks.
• Suppressive therapy can also help deal with STDs. This therapy can suppress the number of outbreaks.
• Remember that once and STD is cured, you are no different than a normal person.
• If the STD you have contracted is incurable, have a conversation with any potential partners. It is your duty to inform them of what they should be aware of before sexual contact occurs.

Anyone who contracts an STD has the responsibility to notify all current or previous sexual partners.

Walking through an STD Consultation

First, make an appointment with the health provider. Expect the person you talk with to ask about the nature of the appointment.

Be upfront about everything you are concerned about. This helps the healthcare staff plan ahead for your visit to make it go as smoothly as possible and allow enough time to accommodate you (minimum 30 minutes). No personal questions will be asked at this time.

During the appointment you will be asked to fill out confidential information forms. These forms are short (one page) and give the staff a better understanding about what they need to look for. This also serves as your first opportunity to share your concerns.

Most STDs can be tested for by either a urine sample or a blood sample–both of which are quick and painless.

The forms also help the staff assess your risk factors for STDs based upon the information you provide.

Some question topics you can expect to see on these forms include your symptoms, sexual history, medications, allergies, pregnancy, and risk factors (i.e. inconsistent condom use or multiple partners, etc.). The date you think you think you may have been exposed is also important information to provide.

Based on the answers you give, your symptoms, your concerns, and your lifestyle practices, the staff will give you advice on what STDs to test for.

After you and the staff member agree about what tests to take, you will take them. The actual tests are very short (the shortest part of the consultation) and are nothing of which to be afraid.

Most STDs except for HPV can be tested for by either a urine sample or a blood sample–both of which are quick and painless (the blood sample is taken with a small needle and lasts about 20 seconds).

HPV can be detected during a pap smear and the staff will instruct you on what to do if they feel you may have been infected.

After the tests, the staff should provide you with handouts and information on any diseases you are concerned about.
If you think you may have contracted HIV, wait before getting tested because tests administered immediately after expected contact will be negative even if you are infected. For accurate results, wait six months after the expected contact date.

After your appointment, the healthcare provider will call or set up a new appointment to share your results with you no matter the outcome. All tests except cultures should be available within a week.

If your results are negative…congratulations! If your results are positive, the healthcare provider will talk with you about treatment options.

Some STDs have to be reported to the local Public Health Department.

The Student Health Clinic can provide treatment for you if you test positive.

Rosa Thomas, Wellness Coordinator at the Student Health Clinic shared her favorite tip to students who choose to be sexually active.

“Treat your body like you treat your toothbrush–don’t share it with everybody,” Thomas said. “STDs are equal opportunity employers. They don’t discriminate.”

Source: CDC

Obama urges HIV testing

President Obama Urges Americans to Take the Test and Take Control on National HIV Testing Day

President Obama issued the following statement regarding National HIV Testing Day:

On this 14th commemoration of National HIV Testing Day, I urge Americans to take control of their own health – and protect those they love – by getting tested for HIV and working to reduce HIV transmission.

One in five Americans currently living with HIV – more than 230,000 people – do not know they have the disease, and the majority of sexually transmitted infections are spread by people who are unaware of their status. But studies show that once people learn they are infected, they take steps to reduce the risk of transmitting HIV to others.

Despite advances in treatment, HIV remains a major threat to the health of our nation. While its impacts are not evenly spread – infection rates are particularly high among gay and bisexual men, African Americans and Latinos – when one of our fellow citizens becomes infected with HIV every nine-and-a-half minutes, the epidemic affects all Americans.

That is why I have pledged to develop and implement a comprehensive National HIV/AIDS Strategy (NHAS) that will focus on reducing HIV incidence, increasing access to care, and reducing HIV-related health disparities. The National HIV/AIDS Strategy will also increase awareness, and promote greater investment in preventing and treating HIV/AIDS in the U.S. And it will include measurable goals, timelines, and accountability mechanisms; rely on sound science; and build on programs and practices that work.

But government can only do so much. Each of us must take responsibility for reducing our risk of acquiring or transmitting HIV and for supporting affected individuals and communities. This means getting tested for HIV and working to end the stigma and discrimination people living with HIV face. It means embracing all of our neighbors, gay and straight. And it means responding with compassion to people dealing with addictions and others issues that place them at increased risk for HIV infection. Working together, I am confident that we can stop the spread of HIV and ensure that those affected get the care and support they need.

Source: Sun Times

Wife sues for ‘life of hell’ after HIV error

An Eastern Cape woman is suing a pathology laboratory in Port Elizabeth for R400 000 following three years of “emotional hell” after it incorrectly said her husband was HIV positive. After finding out in 2005 that her spouse, Mongesi Mtana, had been diagnosed as HIV positive, Noluthando Mtana suffered severe depression and exhaustion and was constantly angry and distrustful of him.

 

 

According to papers before the Grahamstown High Court, she also became obsessed with the fear that she had also been infected with HIV and would die of Aids.

 

Due to her depression, she could no longer work.

The hell began for Mongesi a month after he paid for an HIV test at Prime Cure Laboratories, better known as Prime Lab, in Port Elizabeth in July 2004.

In August he was informed that the test results indicated he was infected with HIV.

He kept the news to himself for almost a year. According to a medico-legal assessment, during that year he harboured thoughts of suicide, was constantly preoccupied, became isolated and sometimes cried at work.

 

 

He began using a condom when having sex with his wife, which she found “strange”, assuming he did not really “want her anymore”.

He finally informed his wife in 2005 of the test results and, according to the particulars of claim, it had a “profound effect” on her, particularly
with regard to her relationship with him.

She had threatened divorce, but they managed to stay together. However, she was constantly distrustful and they had sex infrequently and always with a condom. She would often cry, had poor concentration and suffered from insomnia.

She had eventually given up her job as a domestic worker. She also suffered such anxiety that she went for regular HIV tests.

In July 2008, Mongesi again went for a test, this time with another laboratory and found out he was HIV negative and had never been infected. Clinical psychologist Dr Mark Eaton said that the couple had suffered “extreme emotional pain and suffering” as a result of the incorrect diagnosis.

He said once the relief of hearing that Mongesi was actually not infected with HIV had worn off, he and his wife would have to “mend the brokenness” it had caused in their marriage.

This would require individual psychological therapy as well as couples therapy and support.

Court papers said that in making the incorrect diagnosis Prime Lab had acted “negligently”. The lab had conducted only one test, the HIV Qualitative test, and failed to carry out a second, vital test called the HIV Elisa.

“It is standard protocol that, the HIV Qualitative test having been positive, (Prime Lab) was obliged to conduct the HIV Elisa test which is a far more sensitive test, in order to confirm or refute the first test, but (Prime Lab) failed to do so.”

 

 

Teacher sentenced for not revealing HIV

A former South Carolina teacher has been sentenced to six years in prison for not telling his ex-wife he had HIV and exposing her to possible infection.

Joel L. Bedenbaugh, 47, married in 2002 and in the five years he was married, never told his wife of his HIV, the Aiken Standard reported Thursday. He told her he took medication for a blood disease.

His ex-wife was not infected with the disease.

State law makes it illegal to knowingly engage in sexual intercourse with another person without first informing them of an HIV infection.

Bedenbaugh was convicted of inappropriate contact with a 13-year-old girl in November 2006, the Standard reported

His medical history came to light when he was investigated for an alleged sexual assault on a juvenile in 2008 and charged with three counts of first-degree criminal sexual conduct.

In addition to the prison sentence, Judge Paul Burch ordered Bedenbaugh to register as a sex offender.

Source: UPI

California: County Sued Over Porn Industry STDs

The AIDS Healthcare Foundation on Thursday asked a court to order the Los Angeles County Department of Public Health to enforce rules requiring the use of condoms during the production of adult movies, or to take other reasonable steps to prevent STD transmission in the industry. AHF’s petition to the Los Angeles County Superior Court comes a month after it was disclosed that an adult-film actress tested HIV-positive. At that time, county health officials said 18 HIV cases and more than 3,700 chlamydia, gonorrhea, and syphilis cases had been reported since 2004 by the Adult Industry Medical Healthcare Foundation (AIM), a clinic that screens performers for STDs. Officials also criticized AIM for not cooperating with health officials and urged film producers to do more to protect employees. AHF’s petition cites state health and safety codes that task the county health department with taking “all measures reasonably necessary to prevent the transmission of infection.” Adult-video performers are 10 times more likely to acquire STDs, and many contract numerous infections in a year, according to county health data. Since 2004, 2,378 county patients who self-identified as adult-video performers contracted chlamydia, 1,357 tested positive for gonorrhea, and 15 for syphilis. “The county continues to strongly support state legislation and the regulatory role of Cal/OSHA as the most appropriate means to regulate the practices of the adult-film industry that expose performers to unnecessary and preventable occupational risks of acquiring and transmitting these diseases,” the county department said in a statement Thursday. “The department does not believe that litigation is the best means to deal with this issue.” California’s Division of Occupational Safety and Health is investigating the latest HIV case and has issued subpoenas seeking AIM’s medical records. The investigation is ongoing.

Source: LA Times

HIV Antibody Tests Unreliable for Early Infections in Teens

A previously healthy teenager shows up at the doctor’s office with a sore throat, fever, aches and general malaise. Routine blood tests are normal, an HIV test comes back negative, and the pediatrician sends the patient home with a diagnosis of acute viral infection.

Two weeks later, the teen returns complaining of lingering symptoms and persistent high fevers. This time, a repeat HIV test comes back positive. What happened?

The most commonly used rapid HIV test resulted in a false negative the first time around, which happens quite often during the earliest – and most contagious – stages of HIV infection, known as acute retroviral syndrome (ARS), explains Allison Agwu, M.D., a pediatric infectious disease specialist at Johns Hopkins Children’s Center.

Because the rapid HIV screening tests are designed to detect antibodies to the virus, not the virus itself, such tests will only pick up infection in those who have developed antibodies, which most people don’t make until several weeks to several months after infection.

Agwu cautions that “if a teen engages in risky behaviors and has symptoms of flu or mononucleosis, pediatricians should look further and not be lulled into a false sense of security by a negative rapid HIV test.” Because an estimated 14 teenagers become infected with HIV every day in the United States, because ARS is both under-reported and underdiagnosed and because early infections are highly contagious, ARS should be on every pediatrician’s radar screen, Agwu says.

To rule out HIV in teens deemed to be at high risk for sexually transmitted infections, Hopkins HIV experts recommend the use of polymerase chain reaction (PCR) tests, which directly detect the virus’ genetic markers, rather than antibodies to the virus.

PCR tests, while more expensive than standard antibody tests, can detect the virus within two to three weeks after it enters the body.

“Am I suggesting that every teen with flu-like symptoms should get a PCR? No. But I am suggesting that pediatricians take an extra minute to ask probing questions about risk behaviors and exposures in the last two months,” Agwu says. “If the answers make you suspicious, then order the PCR.”

Consider ordering a PCR test if the patient is sexually active or has used injectible drugs and has two or more of the following symptoms:

– enlarged lymph nodes, a particularly telling sign

– night sweats, another key finding

– malaise, fatigue, headaches or a rash

– fever and chills

– persistent or recurrent sore throat and/or cough.

Source: Ascribe Newswire

Thailand: Call for Cheap Access to Female Condoms

At the recent 12th National AIDS Conference, advocates said female condoms can play a key role in Thailand’s HIV prevention strategy.

“Female condoms could help women have more power to negotiate with their partner to have safe sex,” said Tissadee Sawangying, a health coordinator. “The government should work hard to increase alternative options for women to protect themselves from HIV/AIDS infection.”

Dr. Taweesap Siraprapasiri of the UN Population Fund said the FC Female Condom has been available since 1988, but a newer version, FC2, is now on the market. The condom’s manufacturer addressed complaints about noise and difficulty of use, creating the FC2 from nitrile rubber that makes it more comfortable, said Taweesap.

In the last four years, production volume has risen from 12 million to 26 million, and female condoms are now distributed in 90 million countries. Thailand could make the FC2 available, though it would be expensive due to importation costs.

According to Taweesap, the government began studying the use of female condoms as part of the country’s HIV/AIDS plan in 1990 but the project was suspended and eventually ended last year. The government should revisit efforts to improve access to the prevention device, he said.

“The point is how to make female condoms become another option for women to prevent them from getting HIV,” said Taweesap.

Source: The Body

An Annual STD Test?

Getting screened for certain common sexually transmitted diseases once a year might make sense now more than ever.

Illinois Attorney General Files Lawsuit Against HIV/AIDS Nonprofit

The Illinois attorney general on Thursday filed a lawsuit against the Center for AIDS Prevention for unlawful fundraising and falsifying official documents, ProPublica reports (Weaver, 7/27). Attorney General Lisa Madigan said the state revoked the organization’s registration 20 years ago, but its director, Steve Neely, also known as Morrell Neely, has continued to solicit donations in the state. “The state says the group tried to reregister as a nonprofit using a phony Chicago address, though its boss, … lives in Riverside, Calif.,” Courthouse News Service reports (Freeland, 7/27). “If the suit is successful, Illinois could seize money illegally raised there, bar Neely and others involved with the center from future charitable work in the state, freeze their assets, force them to pay back donations they may have ‘misused and/or wasted’ with interest, and attempt to shut the group down for good by revoking its corporate status,” ProPublica reports (7/27).

Source: Medical News Today

Researchers Decode HIV Genome

Scientists have made a major advance in the field of AIDS research; they have decoded the entire structure of an HIV genome.  The investigators say the work offers clues as to the behavior of the AIDS virus and could lead to the development of new drugs to treat the disease.

The AIDS virus has proved to be a daunting foe to scientists who, for decades, have tried to understand HIV’s ability to evade the body’s immune system so drugs can be developed to stop progression of the disease.

Now, scientists at the University of North Carolina Chapel Hill (UNCCH) have decoded the entire HIV genome, a feat experts say should make it easier for AIDS researchers to understand the behavior of the AID’s virus and could lead to the development of new, anti-viral drugs.

Kevin Weeks, a professor of chemistry at UNCCH, led the effort to decipher the HIV genome, comprised of a ribbon-like RNA strand made up of intricate patterns or genetic structures that instruct the virus on how to behave.

“The HIV genome is chock full of RNA structures,” he said.  “And these RNA structures have major biological roles.  There are many, many structures and these structures regulate the genome that we had just not appreciated prior to this work.”

For Weeks, the most striking discovery is the vast number of RNA structures that influence that virus’s lifecycle, controlling how HIV infects humans and how rapidly it reproduces itself.

Unlike DNA – which contains sequences of genetic building blocks that regulate the biological functions of living organisms – viruses are not living.  They get their genetic instructions from RNA, which folds into intricate patterns that form complex structures.

The HIV genome is enormous compared to the polio and hepatitis C viruses. It contains two strands of ten thousand building blocks each.

Until now, Weeks says only small portions of the complex loops and patterns that make up HIV’s huge genome could be studied.

So, after isolating RNA from trillions of viral particles grown in the laboratory, Weeks and colleagues used a technology they’d developed that gave them an aerial view of the viruses’ genome.

“You know, it’s a little bit like the famous story of several people who investigated the elephant,” Weeks explained.  “Sometimes if you look at only pieces of something you miss the big picture.  So, the fact that the genome is [a] pretty large size means it was hard to get a big picture view, and the technology that we created for this work made it possible to get a whole, holistic view of the genome at the same time.”

Weeks says there are both short-term and long-term implications of having the entire HIV genome sequence in hand.

“When we have a good understanding of these structures, it makes it a lot easier to interfere with how these structures function,” he added.  “And when we are able to interfere with how these structures function with say small molecules or bio-deliverable molecules, we call those drugs.  So, this work does not create any drugs for next month or next year.  But I think this kind of structural information will motivate exploration of whether it’s possible to make drugs directed directly at the genome of RNA viruses.”

Hepatitis C, polio and influenza viruses are also programmed by an RNA genome, raising the possibility that researchers could use the same technology to better understand the biology of these diseases.

Source: Nature

East Texas Health Organization Sees Increase In HIV Cases

Officials at an East Texas health care organization, Health Horizons, which provides HIV testing and other services to people in 12 counties, “has seen more East Texans test positive for [HIV] so far this year than it did for all of 2008,” the Lufkin Daily News reports. Executive Director Wilbert Brown said, “We’ve had eight people out of more than 800 test positive for HIV in the first seven months of this year. Most of those have been African-American men. Last year we had a total of six out of more than 1,000. I expect us to see two or three more positives before the year is out. The state average for testing positive is one in 100, and we’re getting close to that number.” According to the article, “Brown said he attributes the increase to Health Horizon’s aggressive outreach program targeting high-risk groups and to people realizing the importance of getting tested.” The Daily News article also profiles a client of Health Horizons (Cooley, 8/2)

Source: Medical News Today

HIV report sheds light on race

A new report from the Chicago Public Health Department (CDPH) reveals—not for the first time—stark disparities in HIV-infection rates between different racial and ethnic groups. The report finds much higher rates of infection in communities of Black men who have sex with men (MSM) than in communities of white and Latino MSM—though Black MSM do not appear to engage in significantly riskier sexual practices.

Co-authored by CDPH epidemiologists Nikhil Prachand and Britt Skaathun Livak, the report is the result of a survey conducted last fall among various communities of men who have sex with men. Men were asked to participate in the survey at places where MSM congregate; the 57 locations, dispersed geographically throughout the city of Chicago, included gay bars and clubs; bathhouses and other public-sex venues; and social organizations such as athletic leagues.

Survey participants—who, in the results, were broken down primarily into demographics of race and age—were tested for HIV antibodies and asked questions about their sexual practices. According to Christopher Brown, Assistant Commissioner in CDPH’s STI/HIV/AIDS Division, similar surveys occur regularly, for MSM as well as other high-risk demographics such as injection drug users. Though past surveys have been limited to questions about sexual behavior and HIV status, this is the first in which participants were actually tested for HIV.

The report, Brown told Windy City Times, “shows that the epidemic in Chicago continues to grow and spread.” And MSM continue to have infection rates higher than other at-risk groups. In similar surveys over the past several years, CDPH found that HIV prevalence among injection-drug users was 8-10%; rates among heterosexual men and women from at-risk neighborhoods was 1.8%.

By contrast, the prevalence rate among MSM was 17.4%, or 91 positives among 524 men tested. The rate of HIV prevalence among Black survey participants was nearly three times higher than that of white participants, and two and a half times higher than Latino participants.

The prevalence rate was especially pronounced among Black MSM under the age of 35, who were found to have a 30% prevalence rate—a statistic that Brown called “staggering.” In comparison, white MSM in the same age group had a rate of 4%, and Latino men a rate of 11.6%.

At the same time, the CDPH report found that Black MSM do not engage in riskier sexual behavior than their white or Latino counterparts, and in some cases engage less frequently in risky sexual behaviors than other survey participants: for instance, Black MSM reported less drug and alcohol use before or during sex than others.

A theory put forth in the report to explain higher infection rates among Black MSM is that simply HIV prevalence is higher in all Chicago’s Black communities. While Black people make up 35% of Chicago’s population, they make up 54% of known HIV cases. The report posits an idea of infection based on “assortative mixing”—the notion that when people are more likely to have sex within their own communities, a higher prevalence of HIV within a community will express itself through high, or increasing, rates of infection.

Brown also expressed concern about the number of people who, previous to taking the survey, had not known their HIV-positive status: fully half of people who tested positive when taking the survey had been unaware of their status. This finding, too, broke down along racial lines: 66% of Black MSM who tested positive were unaware of their status, as compared to 50% of Latino MSM and 23% of white MSM. Though testing habits seemed to be consistent across groups, the survey found that 66% of Black MSM who tested positive had acquired the infection within the past 12 months—as opposed to 33% of white MSM.

Alicia Ozier, executive director of Task Force Prevention and Community Services, said that public-health workers and service agencies need to take a holistic approach to HIV infection, identifying broad risk factors that go beyond sexual behavior. She cited economic status, education levels and overall access to healthcare as correlates to HIV infection.

Intervention, she said, needs to happen far beyond basic HIV testing and education, starting with: “How are they getting their basic needs fulfilled?

Brown echoed her comments. Though there are some things “we know are working,” he said—such as widespread condom distribution and accessible HIV testing—a more “multi-pronged approach” is needed. Brown said that researchers have begun to analyze how root causes of behaviors function: “adverse childhood experiences,” he said, have been correlated to higher sexual risk behaviors.

Ozier, too, acknowleged the successes in terms of testing, but said the same thing demonstrated by the new report: it’s not nearly enough. “It’s like sticking pieces of gum in a wall that has many leaky spots,” said Ozier. ” [ We have to ] resurface the wall.”

Source: Windy City Times

Woman found carrying new strain of HIV from gorillas

A woman who tested positive for HIV has been found to be carrying a new strain of the virus which is thought to have originally been passed to humans by gorillas.

The new strain was identified in a 62-year-old woman who moved to Paris after living in Yaounde, the capital of Cameroon. Three other strains of HIV-1 have previously been identified and are all thought to have derived from a similar virus carried by chimpanzees.

The discovery of the new virus dramatically strengthens evidence that HIV was transmitted to humans from both chimpanzees and gorillas. Researchers from the Anglo-French team that identified the fourth type of HIV-1 said it more closely related to the recently discovered gorilla version of simian immunodeficiency virus, SIVgor, than the varieties associated with chimpanzees.

It is almost certain that other people have the new variety of HIV-1 as the virus appears well-adapted to the human system and the woman it was found in told researchers she’d had no contact with live gorillas or bushmeat. However, scientists are uncertain how widespread the variety is and have yet to establish how dangerous it is. The Cameroonian woman tested HIV positive in 2004, but has yet to show any signs of AIDS.

The researchers reported their findings in the journal Nature Medicine and concluded: “The discovery of this novel HIV-1 lineage highlights the continuing need to watch closely for the emergence of new HIV variants.”

Source: The Independent

How Is HIV Different in African Americans?

Introduction

People say that HIV is color blind — and they’re right. But let’s not kid ourselves: HIV may be the same virus even if you’re African American, but having it doesn’t always mean the same thing.

How is the HIV epidemic different if you’re black than if you’re white? How do you separate myth from reality? Why do blacks seem to get HIV more, get sicker more quickly, and get access to HIV get treatment later than other ethnic groups in the United States? Does the U.S. health care system discriminate against black people with HIV? Does HIV treatment itself work differently if you’re black?

The answers to these questions are varied and interesting. The Body brought together a distinguished panel of HIV specialists who not only treat many African Americans with HIV, but who also conduct research and are advocates for their patients. Read on to find out what these specialists had to say about what makes the African-American HIV epidemic different from the United States’ HIV epidemic as a whole.

Does It Take Longer for African Americans to Get Tested for HIV?

In a word: yes. “Many African Americans have very limited resources,” Dr. Pablo Tebas says. “This means less access to medical care in general and less access to preventative medicine in particular. Early screening is critical — not just for HIV, but for other illnesses that complicate life for people who have HIV, such as hepatitis C, diabetes and cardiovascular disease. Across the board, African Americans tend to be diagnosed later in the disease. So with HIV, the likelihood that they’re going to get an optimal response to HAART [highly active antiretroviral treatment] is lower because they have more advanced disease [when they are diagnosed].”

Health experts agree that early detection is the best policy when dealing with any serious illness. Unfortunately, an estimated 56% of all “late testers” — people who are diagnosed with AIDS within one year of an HIV diagnosis — are African Americans. There are many reasons that people wait too long to find out their HIV status: Fear, denial and stigma are all barriers to testing. The fact that the symptoms of HIV disease may take 10 years or more to show up is another. But no matter the cause, a late HIV diagnosis is bad news: It not only means that treatment may not be as effective, but it also makes the virus more likely to spread to others, since people who don’t know they’re positive may not be as safe when it comes to having sex or using injection drugs. Studies show that people who know they are infected with HIV protect others by increasing their use of condoms and using clean needles when injecting drugs.

Is HIV Disease Worse in African Americans?

Many African Americans with HIV are leading healthy, happy lives many years after their diagnosis. But half of all people with HIV who died in 2004 were black — that’s stark evidence that all too many African Americans don’t get the health care they need. Less access to health care, later diagnosis and delayed treatment are widely viewed as the main reasons African Americans get sicker more quickly than white people with HIV.

However, a few researchers wonder if HIV disease actually develops faster in African Americans.

“Researchers are looking at whether HIV infection is much more aggressive in African Americans than in others,” nurse practitioner Bethsheba Johnson says. “Since many African Americans who are infected are living in poverty, it could be just their living conditions and factors related to poverty that have made the HIV appear to be more aggressive.”

“Researchers are looking at whether HIV infection is much more aggressive in African Americans than in others,” nurse practitioner Bethsheba Johnson says. “Since many African Americans who are infected are living in poverty, it could be just their living conditions and factors related to poverty that have made the HIV appear to be more aggressive. When it comes to HIV pathogenesis [how the disease develops over time in a person’s body] — and especially when it comes to genetics and the effect of genes on disease — there is a lot we still don’t know.”

What health workers have begun to understand, though, is that some of the health problems already associated with HIV may be more of a concern in black people than other ethnicities. Take hepatitis C, for instance: Many people with HIV, especially those who were infected by sharing needles, also have hepatitis C, a virus that can damage a person’s liver. Because the liver is the organ that processes those powerful HIV meds, coinfection with HIV and hepatitis C, in Dr. Cargill’s words, “presents a double whammy.”

Hepatitis C itself also appears to have its own unique dangers for African Americans. In the past, Dr. Cargill says, doctors believed that hepatitis C affected black and white people in the same way. “Then all of a sudden it was, ‘Um, well, it seems that perhaps it is a little bit different.’ And now we’re at the point where it’s, ‘Oh, gee! Not only is it “a little bit different,” but it’s a whole different genotype’” — a unique strain of the disease. This strain, Cargill says, was found to be less responsive to hepatitis C treatment than other strains, presenting a special problem for African Americans — especially those who are infected with HIV as well.

Unfortunately, this means that for African Americans, “when you undergo this [hepatitis C] treatment regimen, which in and of itself is no day at the beach, there is a little bit of a deck stacked against you until we get better therapies,” Dr. Cargill says. However, she points out that people shouldn’t avoid treatment because of these findings — it’s just that the unique aspects of being black and hepatitis C positive complicate matters.

The same holds true for obesity, a U.S. epidemic in its own right. “Obesity is very common among all Americans, but it is especially acute in the black community,” Ms. Johnson says. “Studies have questioned whether we have a genetic predisposition toward obesity — for example, by looking at people in West Africa, where most African Americans originated from. But what they’re finding is it’s primarily lifestyle — our diets, smoking, family history.”

Obesity can cause an increase in “lipids,” or body fats like cholesterol and triglycerides, which can in turn increase a person’s risk for heart disease. Given that some HIV meds also increase these lipid levels (you can read more on this in the Do HIV Meds Work Differently in African Americans? section), this makes obesity all that much larger a concern for African Americans with HIV.

Does the Health Care System Discriminate Against HIV-Positive African Americans?

Many HIV-positive African Americans report being happy with the quality of care they get from their doctors. Almost all of the folks in our Profiles in Courage section, for example, say they’re getting the best care possible. Sure, they’re mostly a group of empowered, informed HIVers, but they didn’t start out that way — they put in hard work and overcame high barriers to get there.

Unfortunately, according to a pioneering report, “HIV/AIDS: A Minority Health Issue,” written by two leading HIV specialists, Dr. Victoria Cargill and Dr. Valerie Stone (both of whom are black), African-American people with HIV generally report being less satisfied with their HIV care than their white counterparts, particularly when it comes to communication with their doctor. Black HIVers more often say their provider doesn’t listen to them, doesn’t ask them the right questions and doesn’t give them the time or the information they need to make important treatment decisions. In short, plenty of HIV-positive African Americans don’t feel they’re getting the care they deserve.

In their paper, Drs. Cargill and Stone write, “Surveys of HIV/AIDS providers have confirmed that [racial preconceptions,] … biases and stereotypes affect providers’ treatment decisions and result in a failure to prescribe HAART for some minority patients for whom HAART is indicated.” They cite a study that compared the number of days between HIV diagnosis and the start of HIV treatment. It found that when people received their care from someone of the same race, the length of that pre-treatment gap was almost identical: 348 days for African-American patients cared for by African-American providers, and 357 days for white patients cared for by white providers. But when African-American patients were cared for by white providers, the gap increased to 459 days. That significant difference, Drs. Cargill and Stone write, is mainly due to bias and stereotypes on the part of some white doctors about how “ready” their African American patients are to start treatment — and to take all of their meds on time once they’ve begun.

These prejudices can cut both ways: Not only do some doctors discriminate (consciously or not) against HIV-positive African Americans, but some African-American HIVers let their own biases cloud their relationship with doctors as well. “We know that some black people bring mistrust of the medical system into their clinic visits,” Dr. Adimora says. This makes it all the more important for African Americans to educate themselves about HIV, she adds: “It’s my job, as a provider, to give people information and to earn their trust, [but] it really helps people when they enhance their own learning and bring that into the clinic visits too.”

Are African Americans Less Likely to Take Their HIV Meds?

The ability to take all of your meds on time, nearly all the time — which is known as adherence — is one of the keys to ensuring that HIV treatment works. “All the studies say that you need to have greater than 95 percent adherence [to HIV meds] in order to reduce the risk of resistance,” points out nurse practitioner Bethsheba Johnson. When HIV develops resistance to meds, they may not work as well in a person’s body. “There are so many other diseases you can get by with a lower adherence rate — like high blood pressure, diabetes — but with HIV, adherence is extremely important.

“Unfortunately, we have a lot of indigent African Americans. If you don’t have the basic necessities in life, you’re not gonna be worried about taking a pill. It really is important to have food to eat, a place to shelter. Those are the basic needs of a human being before we can even talk about medication.”

Do HIV Meds Work Differently in African Americans?

Drs. Cargill and Stone report in their 2005 paper, “HIV/AIDS: A Minority Health Issue,” that in the early years of the epidemic, when Retrovir (zidovudine, AZT) was widely prescribed, some black HIVers experienced a disconcerting side effect: hyperpigmentation, or darkening, of the nails and skin. “This inadvertently [gave] credence to the belief that the drugs either do not work, or work differently in racial and ethnic minorities,” the doctors write. “As a result, the treatments may and have presented providers and their minority patients with side effects previously unappreciated or unanticipated. … And the health care system, already mistrusted, is further perceived as being unresponsive or hostile to the needs of the minority patient.”

In reality, HIV meds usually appear to work the same way whether a person is black or white. Some assumptions have been disproven entirely, like with lipoatrophy, or the loss of unusual amounts of fat in the face, arms, legs or butt. “It used to be thought that African Americans were not as affected by lipoatrophy or facial wasting,” nurse practitioner Bethsheba Johnson says, “but now that more and more are on these medications, I don’t [think] that is true. We’re seeing pretty much the same rate of lipoatrophy now.”

The real problem, health care workers seem to agree, is not that HIV meds themselves work differently in African Americans. Instead, it’s that African Americans are already at a higher risk for some of the health problems that HIV meds are known to cause or worsen.

The real problem, health care workers seem to agree, is not that HIV meds themselves work differently in African Americans. Instead, it’s that African Americans are already at a higher risk for some of the health problems that HIV meds are known to cause or worsen. Ms. Johnson explains: “African Americans in general have high [rates of] hypertension, diabetes and cholesterol. So given that baseline, they’re already at risk, and then you have the HIV meds, which makes it worse.”

However, there are cases in which HIV meds truly do appear to work differently in African Americans than in other ethnic groups. “There is some evidence that the bodies of African Americans metabolize — process — certain medications differently,” Dr. Cargill says. “We’re also beginning to understand that there may be gender and hormonal issues. So we’re just beginning to scratch the surface of all the gender and race differences that will influence these hormonal and metabolic effects.”

In their report, Drs. Cargill and Stone note that the HIV medication Retrovir often causes anemia, an important concern for African Americans because of the high prevalence of anemia already in the black population. And because a high proportion of African Americans are coinfected with HIV and hepatitis C, the potential liver problems that HIV meds can cause is another big red flag. (See the Is HIV Disease Worse in African Americans? section for more on this.)

Recently, much attention has also been paid to the HIV medication Sustiva (efavirenz, Stocrin) — a drug well known among HIVers for its tendency to cause sleeping problems and wild dreams. (Sustiva is also one of the medications included in the once daily combination drug of Atripla [efavirenz, tenofovir, FTC].) For most people, these side effects (if they occur at all) tend be mild and don’t last more than a few weeks. In other people — particularly African Americans — Sustiva side effects appear to be stronger and last longer.

Researchers think that differences in metabolism explain why African Americans may be more likely to have more intense side effects from Sustiva. “With Sustiva, African-Americans tend to be over-represented in the slow-metabolizer group — and that’s the group who have the drug accumulating in their bodies, and so they get the central nervous system side effects and the nightmares and all that,” Dr. Cargill says.

Dr. Tebas points out, however, that this doesn’t happen for all African Americans — or even for most of them. “As a group, African Americans tend to metabolize Sustiva a little slower. But studies suggest that this is so in only 20 percent of black people,” he explains. “So obviously there’s no way of knowing when initiating therapy whether one patient will be a slow-metabolizer or not.”

To make this complex relationship between HIV meds and race even more complicated, being African American can potentially protect a person from some of the side effects HIV meds are known to cause. In one large study, African Americans appeared to be at lower risk for hypersensitivity reaction (an allergic-like reaction) when taking Ziagen (abacavir) which is also contained in the combination drugs of Epzicom (abacavir/3TC, Kivexa) and Trizivir (AZT/3TC/abacavir).

Dr. Tebas pointed out a recent study that found African Americans on HIV treatment were less likely to develop high cholesterol and high triglycerides than HIV-positive people of other races. “That doesn’t mean that African Americans don’t get increased lipids, but on average the increases were less,” he explains. “So in that regard, being African American probably represents a benefit to you, because you are less likely to develop high cholesterol and high lipids when you start HIV medicines.”

Ultimately, although current signs suggest there are few differences when it comes to HIV meds and race, there are still many more questions than definitive answers. “We’ve done most of our drug studies in the United States in white men,” Ms. Johnson points out. “So now we’re starting to look in depth at how specific HIV medications affect African Americans differently by increasing the diversity of people enrolled in clinical trials. This will enable us to begin to get a grip” on some of these differences.

“But it’s very hard to tease out all the complicating factors — adherence, substance abuse, other medications — that contribute to the effectiveness of HIV meds in any single person,” Ms. Johnson warns. “It’s not a reason to withhold any particular antiretroviral therapy, such as Sustiva, in African-American patients, of course. We just have to monitor them more carefully — and work on making sure adherence is as high as it can be.”

These myths “have one common thread,” Dr. Cargill explains. “Black people have been consistently disenfranchised, poorly treated, always last in line to get anything — we won’t even talk about Rosa Parks and the bus — and based on that history, a reasonable assumption is, ‘When it comes to us, we’re the last ones to get care.’”

Are Any of the Other Myths About HIV and African Americans True?

“There are two huge myths about treatment that persist in our community,” Dr. Cargill says. “The first one goes something like this: ‘They have a cure for HIV disease and they aren’t telling us because we’re black. If you’ve got enough money, maybe you can get it — because look at Magic [Johnson], he’s okay and his wife said he was cured.’” Dr. Cargill is unequivocal in her response: “There is no cure for HIV disease,” she emphatically states. Magic’s wife also apologized not long ago for any statements she may have made that implied that Magic was cured.

“The second myth, which is equally troubling, is ‘They have some sort of vaccine or something out there, but they’re not going to give it to us,’” Dr. Cargill continues. She’s equally straightforward about her response: “There is no vaccine for HIV.”

Nurse practitioner Bethsheba Johnson has heard her own share of mistaken assumptions. “There are a lot of myths about where HIV comes from: mosquitoes, polio vaccines, a government plot to kill all African Americans. I hear those things repeatedly,” Ms. Johnson says. “I also hear that the HIV medications cause more harm than good, that they just help you die quicker.”

These myths “have one common thread,” Dr. Cargill explains. “Black people have been consistently disenfranchised, poorly treated, always last in line to get anything — we won’t even talk about Rosa Parks and the bus — and based on that history, a reasonable assumption is, ‘When it comes to us, we’re the last ones to get care.’”

The best way to overcome these assumptions, health care workers agree, is by urging African Americans to educate themselves about the virus and the medications used to treat it. “There are always the rumors that go around, misinformation between patients,” Ms. Johnson says. “We try very hard to educate patients on the benefits and the risks of taking medications, so that they’re not confused by hearing about side effects that someone else has had. That may frighten them from taking the medication in the first place.”

In Dr. Cargill’s mind, though, it’s not just about education: It’s about overcoming a deeply held mistrust that, she worries, may lead some black HIVers to avoid care that they urgently need. “It is one thing to experience overt individual or institutional racism, none of which is acceptable,” she said. “But it is another to be the architect of your own demise.”

Source: The Body

Data Call Into Question HIV Study Results

Researchers from the U.S. Army and Thailand announced last month they had found the first vaccine that provided some protection against HIV. But a second analysis of the $105 million study, not disclosed publicly, suggests the results may have been a fluke, according to AIDS scientists who have seen it.

The second analysis, which is considered a vital component of any vaccine study, shows the results weren’t statistically significant, these scientists said. In other words, it indicates that the results could have been due to chance and that the vaccine may not be effective.

The additional data were available to the researchers on Sept. 24 when they announced the trial results, but they chose not to disclose them, said Jerome Kim, a scientist with the U.S. Army who was involved in the study. News of the second analysis was first reported on the Web site of Science magazine, but the story didn’t provide specific data. Full details of the trial are to be aired at an AIDS meeting in Paris that starts Oct. 19.

The incomplete disclosure raises the question of whether the Army, the Thai government and the U.S. National Institutes of Health — which helped fund the study — rushed to give a positive spin to what may turn out to be another inconclusive AIDS-vaccine effort.

“We thought very hard about how to provide the clearest, most honest message,” Dr. Kim said. “We stand by the fact that this is a vaccine with a modest protective effect.” He called the trial results “complex.”

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, the part of the NIH that oversees AIDS research, declined to comment.

The study was criticized as pointless by some AIDS scientists when it was launched three years ago because it combined a failed vaccine with one widely thought to have little chance of success. It was the largest HIV vaccine trial ever conducted, with more than 16,000 participants in Thailand.

Some AIDS researchers and activists who have learned of the additional data still think the vaccine shows promise and should be investigated further. But they worry that not disclosing the study transparently will cause people to conclude the vaccine trial was a failure and undermine support for more research.

The results announced last month were based on a “modified intent to treat analysis,” which includes virtually everyone who enrolled in the study, regardless of whether they ended up getting the full course of the vaccine. It is a good stand-in for the real world, where people don’t always follow instructions properly. By this measure, the vaccine tested in Thailand reduced by 31% the chance of infection with HIV, the AIDS-causing immunodeficiency virus.

But the result was derived from a small number of actual HIV cases: New infections occurred in 51 of the 8,197 people who got the vaccine, compared with 74 of the 8,198 volunteers who got placebo shots. Statistical calculations showed there was a 3.9% probability that chance accounted for the difference. In drug and vaccine trials, anything above a 5% probability of a chance result is deemed statistically insignificant.

The second analysis is called “per protocol” and adheres strictly to how the trial was designed by only including the study participants who got the full regimen of vaccine shots at the right time. Because it excludes study participants who didn’t get the full vaccine regimen, it usually provides corroboration to the looser “intent to treat” findings.

Two AIDS scientists, who have seen the “per protocol” analysis, said it indicates there is a 16% chance the study results were a fluke — a far greater probability than is considered statistically acceptable. This analysis included 86 people who received either the vaccine or a placebo and were infected. The “per protocol” analysis also showed that the supposed effectiveness was lower, at 26.2%. Dr. Kim, of the U.S. Army, declined to comment on the data. It isn’t clear why the vaccine was seemingly ineffective among participants who followed the guidelines to the letter.

These anomalous results sparked discussion last week at a meeting of the Center for HIV-AIDS Vaccine Immunology in Durham, N.C. The group is made up of a team of universities and academic medical centers established by the NIH to help vaccine design and development.

“I think in general it’s best to lay out as much data as possible,” said Barton Haynes, director of the center and an HIV vaccine expert at Duke University, who was at the meeting. “This is a very difficult situation for everyone, and we’ll have to wait until all the data are released so we can drill down into it.”

When drug or vaccine trials results are disclosed, it is common for investigators to simultaneously provide “per protocol” and “intent to treat” data. For example, when Merck & Co. announced the details of its failed HIV vaccine trial in 2007, the Whitehouse Station, N.J., company provided both sets of statistics at the same time.

In September, the AIDS Vaccine Advocacy Coalition published a report in anticipation of the Thai results that noted: “The safest route is to report both PP [per protocol] and ITT [intent to treat] and to analyze the difference.”

In January 2004, a group of 22 scientists in article in the journal Science noted that one component of the Thai vaccine, a primer dose made by Sanofi Pasteur, a division of Sanofi-Aventis SA of France, was poor at triggering an immune response. They also pointed out that trials of the second component of the Thai vaccine, a booster component now licensed to Global Solutions for Infectious Diseases, of South San Francisco, Calif., had been proven “to be completely incapable of preventing or ameliorating HIV-1 infection.”

They added: “One price for repetitive failure could be crucial erosion by the public and politicians in our capability of developing an effective AIDS vaccine collectively.”

Source: Wall Street Journal

Federal Appeals Court Sides with Roche in HIV Test Kit Patent Spat with Stanford

Suspected AIDS Patient Allegedly Spit At Cops

A man is charged with assaulting a police officer with a rather odd weapon — his spit.

According to Cincinnati Police, the man tells them he is HIV positive, and they seem to believe his story.

Police arrested 48-year-old Ronald Crawford on Tuesday during a fight on East McMillan Street. During his arrest, officials say he tried to spit on the responding officers, telling them “he had AIDS”.

Crawford, who is thought to be homeless, is now charged with two counts of harassment with a bodily substance, which are felonies.

Many pieces of research claim that HIV is not carried in saliva.

Source: KYPost

HIV rates soar among young gays

JILL STARK

October 11, 2009

CDC Expands HIV Postexposure Prophylaxis Recommendations

Yesterday’s Morbidity and Mortality Weekly Report contains recommendations from the Centers for Disease Control and Prevention (CDC) on prophylaxis for people exposed to HIV outside of occupational settings.

As with occupational exposures, CDC now recommends prophylaxis, preferably with a three-drug regimen, beginning within 72 hours after exposure outside of the workplace to body fluids from a person known to be infected with HIV. If the HIV-infection status of the contact person is unknown but the exposure is thought to carry “substantial” risk of viral transmission, CDC recommends that the determination of whether to begin prophylaxis be made on a case-by-case basis.

If the 72-hour window passes before the patient seeks treatment, CDC recommends that prophylaxis not be given. But the agency noted that physicians may offer the treatment if they deem that the benefit to the patient is likely to exceed the risks.

CDC estimates that 40,000 new HIV infections occur each year in this country, many resulting from “unrecognized” or repeated exposures that make timely prophylaxis unlikely or ineffective. Situations in which people may know they have been exposed to the virus and might benefit from prophylaxis include sexual assault and injection-drug abuse.

“We definitely get questions from cases of sexual assault,” said Frank Romanelli, clinical specialist in HIV and AIDS at the University of Kentucky College of Pharmacy. “It’s a question that comes up all the time.”

Romanelli said clinicians mostly decide “case by case” and “patient by patient” whether to offer postexposure prophylaxis after nonoccupational exposure to HIV. He said he welcomes CDC’s guidance on the issue.

According to CDC, prophylaxis should consist of a 28-day course of highly active antiretroviral therapy, or HAART. The preferred nonnucleoside-reverse-transcriptase-inhibitor-based HAART regimen is efavirenz plus lamivudine or emtricitabine, plus tenofovir or zidovudine. For protease-inhibitor-based therapy, CDC recommends Abbott Laboratories’ lopinavir-and-ritonavir combination product, Kaletra, plus zidovudine, plus lamivudine or emtricitabine.

The agency stated that two-drug regimens could be used if toxicity issues are a major concern, but CDC emphasized that HAART with three drugs is likely to provide a better chance of preventing infection after exposure to HIV.

Patients seeking postexposure care should be tested for HIV seroconversion at baseline and again at 4–6 weeks, three months, and six months after exposure, according to CDC. During therapy, liver and kidney function should be monitored as recommended in the prescribing information for the antiviral agents or in accordance with antiretroviral treatment guidelines.

Romanelli noted that some clinicians fear patients will interpret the availability of postexposure prophylaxis as an “OK to have unprotected sex, because there’s this safety net” available.

“That’s not what it’s intended to do,” he said.

CDC stated that the limited data on how access to postexposure prophylaxis affects patients’ “risk behavior” indicate that patients do not engage in riskier behavior but also may not take action to reduce their exposure risks.

Source: ASHP

Healthcare Workers Exposed to HIV/AIDS

Background

The human immunodeficiency virus, also known as HIV infection, is a retrovirus that causes AIDS (acquired immune deficiency syndrome). The retrovirus primarily attacks the body’s immune system, making the patient extremely vulnerable to opportunistic infections (infections that occur in individuals with weakened immune systems).

HIV is transmitted from person to person via bodily fluids including blood, semen, vaginal discharge, and breast milk. It can be spread by sexual contact with an infected person, by sharing needles/syringes with someone who is infected, or, less commonly (and rare in countries, such as the United States, where blood is screened for HIV antibodies), through transfusions with infected blood. HIV has also been found in saliva and tears in very low quantities in some AIDS patients. However, contact with saliva, tears, or sweat has never been shown to result in HIV transmission.

Although healthcare workers are exposed to the virus at work, it is unlikely that they will acquire the virus from a patient, especially if they follow universal precautions, which should be taken with all patients. Healthcare personnel should assume that the blood and body fluids from all patients are potentially infectious.

Since December 2001, there have been 57 documented reports of healthcare workers acquiring HIV from a patient. To prevent transmission of HIV to healthcare personnel in the workplace, the U.S. Centers for Disease Control and Prevention (CDC) offers precautionary guidelines.

For healthcare workers, the main risk of HIV transmission is through accidental injuries from needles or other sharp medical instruments that may be contaminated with the virus. However, even this risk is small. Researchers estimate that about 0.3-1% of healthcare workers exposed to the virus by an accidental needle stick or puncture develop HIV.

This is largely because action can be taken to reduce the risk of transmission immediately after exposure. Healthcare workers who are exposed to the virus can receive post-exposure prophylaxis (PEP), which consists of antiretroviral therapy (ART) to prevent the individual from acquiring HIV. However, antiretrovirals can have serious side effects and patients should evaluate the risks and benefits with their healthcare providers.

Current antiretroviral drugs cannot cure HIV infection or AIDS, and they cannot reduce the risk of transmitting disease to someone else. They can suppress the virus, even to undetectable levels, but are unable to completely eliminate HIV from the body.

Risks Of Transmission

Most cases of HIV transmission in occupational settings occur after exposure to HIV-infected blood by a percutaneous injury on the skin. This is most commonly caused by needles, medical instruments, or bites that break the skin. Researchers estimate that about 0.3-1% of healthcare workers who were exposed to the virus via a needle stick or puncture develop HIV.

The virus can also be transmitted if blood from an HIV patient’s open sore or wound comes into contact with an open sore or wound on the healthcare provider.

There are a small number of instances when HIV has been acquired through contact with mucous membranes (like the eyes). For instance, if an HIV patient’s blood splashes into a healthcare worker’s eye, there is a chance of transmission. Research suggests that the risk of HIV infection after mucous membrane exposure is less than 1 out of 1,000.

Management Immediately After Exposure

Healthcare workers who are exposed or suspect they were exposed to HIV should follow the protocol of their healthcare facilities.

First Aid should be provided immediately after the injury. Wounds and areas of skin that were exposed to body fluids should be washed thoroughly with soap and water. Mucous membranes (like the eyes) that were exposed to the virus should be flushed with water.

The exposure should be evaluated for potential to transmit HIV infection, based on the severity of exposure (how much bodily fluid the person came into contact with) and specific bodily fluid that the individual was exposed to.

The exposed healthcare worker should be tested for HIV infection if he/she consents to testing. However, it generally takes about two to eight weeks for the body to produce antibodies to the virus, which is needed for an accurate test result. It may take some patients three months or longer to develop the antibodies. Therefore, a protocol called post exposure prophylaxis (PEP) should be provided within 72 hours of exposure if the individual was exposed to an HIV-infected patient or if it is strongly suspected that the patient is HIV-positive.

The patient who is suspected of having HIV should only be tested after obtaining informed consent. Testing should also include appropriate counseling and care referral. The test results must remain confidential.

Exposure risk reduction education should occur with counselors who are evaluating the events that preceded the exposure.

An exposure report should be made and sent to the U.S. Centers for Disease Control and Prevention (CDC).

Post‑exposure Prophylaxis (Pep)

Post-exposure prophylaxis (PEP) is short-term antiretroviral treatment that is administered to reduce the likelihood of HIV infection after potential exposure. Healthcare facilities should provide treatment to personnel as part of a universal precautions program that is designed to reduce staff exposure to infectious hazards at work.

It is estimated that PEP can reduce the rate of infection among exposed healthcare workers by as much as 79%. According to the World Heath Organization (WHO), availability of PEP to healthcare workers will help increase staff motivation to work with HIV-infected patients, and may help to retain staff who are worried about the risk of HIV exposure at work.

PEP should begin as soon as possible after exposure. While there is no time limit in most country recommendations, treatment is most effective when it is initiated within two to four hours of exposure. Combination therapy, usually with two or three antiretrovirals, is recommended because it has shown to be more effective than a single agent.

The specific regimen and dosage depends on the patient’s overall health, severity of exposure, availability of antiretrovirals, and known or possible cross-resistance to different drugs. In general, the recommended combination therapy is 250-300 milligrams of zidovudine (Retrovir®) twice daily with 150 milligrams of lamivudine (Epivir®) twice daily. If a third drug is needed, 800 milligrams of indinavir (Crixivan®) three times daily or 600 milligrams of efavirenz (Sustiva®) once daily (not recommended for pregnant women) is recommended.

Treatment should last a minimum of two weeks and no longer than four weeks. Healthcare workers should have access to one month’s worth of antiretroviral therapy.

There are many side effects of antiretroviral treatment, including dizziness, confusion, fatigue, headache, difficulty sleeping, nausea, vomiting, and diarrhea. Studies have shown that about 22% of those receiving PEP stopped taking the medications before the four-week course is completed because of the side effects. Treatment is less effective if discontinued prematurely.

Long-term side effects may cause serious medical problems, including changes in metabolism like abnormal lipid and glucose metabolism, which may cause changes in the body shape due to loss and/or accumulation of body fat.

Non‑occupational Post Exposure Prophylaxis (Npep)

In January 2005, the U.S. Department of Health and Human Services (DHHS) announced that non-occupational post exposure prophylaxis (nPEP) should be available to all individuals who are exposed to HIV, not just healthcare workers.

While the DHHS does not recommend for or against the use to nPEP, it encourages healthcare providers and patients to weigh the risks and benefits with individual patients who may have been exposed to HIV in the last 72 hours. When the risk of transmission is negligible or when patients seek care more than 72 hours after a substantial exposure, nPEP is not recommended because it is not usually effective. The sooner treatment is started, the more likely it will prevent HIV transmission.

However, healthcare providers might wish to consider prescribing nPEP for patients who seek care more than 72 hours after substantial exposure if the benefit of treatment outweighs the risks for side effects from treatment.

Treatment should last a minimum of two weeks and no longer than four weeks. Treatment is less effective if discontinued prematurely.

Diagnosis

General: As soon as the virus enters the body, the immune system produces antibodies, which are chemicals that locate invaders and fight off infections. While these antibodies cannot successfully destroy the virus, their presence can be used to detect whether HIV is in the body.

It can take some time for the immune system to produce enough antibodies for the antibody test to detect them. This time period, known as the “window period,” varies greatly among patients. Most people will develop detectable antibodies within two to eight weeks (the average is 25 days). However, some individuals might take longer to develop detectable antibodies. Ninety-seven percent of people develop antibodies in the first three months following the time of their infection. In very rare cases, it can take up to six months to develop antibodies to HIV. Therefore, if the initial negative HIV test was conducted within the first three months after possible exposure, repeat testing should be considered at a time longer than three months after the exposure.

Enzyme immunoassay (EIA): The most common HIV tests use blood to detect HIV infection. In most cases, the enzyme immunoassay (EIA) is used to look for antibodies to HIV. A positive (reactive) EIA must be used with a follow-up (confirmatory) test, such as the Western blot test, to make a positive diagnosis. A positive diagnosis means that a person is infected with HIV.

Western blot test: A Western blot test is typically used to confirm a positive HIV diagnosis. During the test, a small sample of blood is taken and used to detect HIV antibodies (not the HIV virus).

DNA/RNA test: DNA and RNA tests look for genetic material of HIV. These tests can be used to screen the blood supply and to detect very early infection in those rare cases when antibody tests are unable to detect antibodies to HIV.

Policies For Healthcare Facilities

Institutional guidelines: Institutional guidelines for post-exposure prophylaxis (PEP) should be well established in all healthcare facilities. HIV testing, counseling, and antiretrovirals must be available. All healthcare facilities should train personnel on proper infection control procedures and on the importance of reporting occupational exposures to HIV. These facilities should also develop a system to monitor reporting and management of occupational exposures.

Safety devices: Effective safety devices that can help prevent injuries from needles and other sharp objects used in the hospital should be available. For instance, some needles have built-in safety controls that help reduce the risk of needlestick injuries before, during, or after use. Proper and consistent use of such safety devices should be evaluated.

Monitor the effects of PEP: More data are needed about the safety and efficacy of PEP regimens, especially those regimens that include new antiretrovirals. Improved communication about potential side effects before PEP is started and close follow-up of healthcare workers who are receiving treatment are needed to increase compliance with the PEP.

Universal Precautions To Prevent Exposure

Universal precautions are precautions that are taken with all patients. Healthcare personnel should assume that the blood and body fluids from all patients are potentially infectious. Since everyone is treated the same, healthcare providers do not have to make assumptions about the risks of infection.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that healthcare providers routinely use barriers (like gloves and/or goggles) when contact with blood or body fluids is possible.

If the skin comes into contact with blood or other body fluids, the area should be washed thoroughly with soap and water.

Mucous membranes (like the eyes) that were exposed to the virus should be flushed with water.

Cuts, sores, or breaks on the exposed skin of both the caregiver and patient should be covered with bandages.

Needles and other sharp instruments should be used only when medically necessary and handled appropriately.

Medical instruments and other contaminated equipment should be disinfected.

Safety devices that have been developed to help prevent needlestick injuries should be used whenever possible. For instance, some needles have built-in safety controls that reduce the risk of needle stick injury before, during or after use. If used properly, these types of devices may reduce the risk of exposure to HIV.

Many skin injuries in healthcare settings are related to the disposal of sharp medical equipment. Strategies for safer disposal, including safer design of disposal containers and placement of containers, are currently being developed.

Source: Wellness.com

Now, an HIV blocking gel for women

Scientists have developed a “molecular condom”, which they claim is actually a vaginal gel that would help protect women from contracting the deadly HIV during sexual intercourse.According to them, before sex, women would have to insert the vaginal gel that turns semisolid in the presence of semen, trapping AIDS virus particles in a microscopic mesh so they can’t infect vaginal cells.

“The first step in the complicated process of HIV infection in a woman is the virus diffusing from semen to vaginal tissue. We want to stop that first step. We’ve created the first vaginal gel designed to prevent movement of the AIDS virus. This is unique. There’s nothing like it.

“We did it to develop technologies that can enable women to protect themselves against HIV without approval of their partner,” said lead scientist Prof Patrick Kiser of the University of Utah.

According to the scientists, due to cultural and socioeconomic factors, women often are unable to negotiate the use of protection with their partner.

“So we developed a vaginal gel that a woman could insert a few hours before sex and could detect the presence of semen and provide a protective barrier between the vaginal tissue and HIV. We wanted to build a gel to stop HIV from interacting with vaginal tissue.

“It flows at a vaginal pH, and the flow becomes slower and slower as pH increases, and it begins to act more solid at the pH of semen,” co-scientist Julie Jay said.

The scientists estimate that if all goes well, human tests of the gel would start in three to five years, and the gel would reach the market in several more years.

The findings of their experiment testing the behaviour of the vaginal gel and showing how it traps AIDS-causing HIV particles are to be published in the upcoming edition of the ‘Advanced Functional Materials’ journal.

Source: Washington / Press Trust of India

Benefits of HIV Post-Exposure Prophylaxis

 

Ozzy Osbourne ‘was told he could be HIV positive by doctors’

The former Black Sabbath singer said he was “devastated” to be told the news.

“I went to the doctor and had an Aids test and he told me it was positive,” he said, in an interview in this month’s Glamour magazine. “That was one of the worst days of my life.”

He was asked to do another test to confirm the diagnosis, which came back negative.

The doctor put the first, false diagnosis down to the heavy drinking and drug-taking lifestyle he used to enjoy tampering with his immune system.

“When I used to f—ing get loaded I would get myself into all kinds of situations,” said Osbourne, whose womanising was legendary before he settled into family life with wife Sharon.

“It turned out that because I was drinking and using drugs so much, my immune system had dropped so that it was a borderline result. When I went back to be tested again it was negative.”

Ozzy may have been the relative that his daughter Kelly was referring to when she broke down at an Aids charity benefit in London two years ago.

“This charity is really important to me because one of my family is HIV positive,” she said at the time. “And I’m so proud of him.”

The revelation is one of a series about Ozzy’s life that have emerged in recent weeks as he promotes his autobiography, I Am Ozzy.

Among others is the news that he still enjoys conjugal trysts with wife Sharon but struggles to bring the liaisons to a satisfactory conclusion.

Source: Telegraph.co.uk

Clarksville police make HIV arrest

First time in local police history for charge under 1994 state law

For the first time in Clarksville Police Department history, a Clarksville woman was arrested Thursday and charged with knowingly exposing a man to HIV.

Donyel Da’Shawn Brown, 29, who gave a 916 Kingbury Drive Apt. B address, was charged with criminal exposure to HIV. Her bond was set at $1 million.

Clarksville Police spokesman Officer Jim Knoll said it’s the first time local police have issued the charge.

According to an arrest warrant by Officer Christopher Nolder, a man reported Brown knowingly had unprotected sex with him for four years without telling him she was infected.

Also, Brown and the man had a child during the time she was diagnosed with HIV, the warrant said.

Whether the child and man were infected has not been determined, Knoll said.

The state law, which took effect in 1994, does not require “the actual transmission of HIV” for someone to be convicted, according to Gannett Tennessee archives. The law provides that an HIV-positive person can be acquitted if they can show a sex partner knew of the condition and had sex anyway.

If convicted, Brown could face jail time of three to six years.

She is set to have a General Sessions trial Oct. 12.

Source: The Leaf Chronicle

Vermont CARES makes a difference

Deb McCusker said she wasn’t sure how she contracted HIV 20 years ago.

“I was promiscuous, and a long time ago I did use needles,” she said. “It’s so hard to really say because of my lifestyle.”

McCusker didn’t take the diagnosis well.

“I was a mess,” she said. “It was a perfect excuse for me to do more drinking, drugs. I was going to die anyway. Thank God I had my sons or I would have given up a long time ago.”

McCusker, 54 of Williston said she’s been clean for a year. No alcohol or drugs, except those to treat her AIDS, the disease caused by the HIV virus. She has started looking for work.

Her two boys, now in their 30s, kept her going. When McCusker moved from Florida to Vermont seven years ago, she found additional support through Vermont CARES (Committee for AIDS Resources, Education and Services).

“I wouldn’t have made it without them,” she said.

For more than 20 years, the Burlington nonprofit has helped provide Vermonters with HIV/AIDS everything from a ride to the doctor’s office to a new home. The organization held a rally Saturday to show support for more than 450 Vermonters diagnosed with the disease. People at the rally wore red shirts and stood in a ribbon formation at the University of Vermont’s Redstone Campus.

“The nature of the work that Vermont CARES does has remained relatively consistent over the last 20 years,” Peter Jacobsen, the organization’s executive director said. “We’ve been able to create a pretty solid network of care for 150 people a year.”

When McCusker moved to Vermont the organization found her a place to live and paid her rent.

“I lived there for almost four years,” McCusker said. “It was a really, really good thing they did for me.”

Vermont CARES also helped McCusker pay for food and gave her rides to the grocery store. Vermont CARES, which has a budget of about $300,000, receives most of its funding from federal and state aid. In addition to caring for people with HIV/AIDS, the organization also screens about 1,200 people a year for the disease and conducts HIV/AIDS educational programs at businesses and schools.

“The baseline knowledge has improved,” he said. “The stigma has remained very consistent, unfortunately.”

Employers and landlords discriminate against people with HIV/AIDS despite anti-discriminatory laws, Jacobsen said.

“We’re still hearing stories of people being let go of their jobs because of HIV,” he said.

Many people still harbor unfounded fears regarding HIV/AIDS, Jacobsen said, citing a 2009 report by The Kaiser Family Foundation, a national nonprofit.

About half of the 2,554 American adults surveyed in the report said they would be uncomfortable having their food prepared by someone who is HIV positive. One-third of Americans wrongly believe, or are unsure whether the disease can be transmitted by sharing a drinking glass, and about one-fourth wrongly believe, or are unsure whether former NBA player Magic Johnson has been cured of AIDS, according to the report.

McCusker attested to the stigma of living with AIDS, but said she has overcome the prejudice.

“Everybody’s different,” she said. “As far as I’m concerned, the people that aren’t educated, I don’t have time for that.”

Still, the disease presents its fair share of social problems, “especially when it comes to dating,” McCusker said. When, before safe-sex, do you tell your partner you have AIDS? Up front? After you get to know the person a little better?

After her diagnosis, McCusker said she felt obligated to tell the men in her life she had AIDS.

“When you tell somebody, you feel like they’re pointing the finger at you,” McCusker said.

Medication to treat HIV/AIDS has improved in 20 years, and is readily available to people with the disease, Jacobsen said.

“HIV has been pretty well contained by the medications,” he said. “Access is pretty easy, and the care is very strong.”

McCusker takes seven pills a day to treat her AIDS.

“We used to have to take, three times a day, a big handful of pills, like eight of them,” she said. “If you’re away from the house at noontime, and you forget to take those pills, it really messes up your treatment.”

McCusker fell behind in her regiment five years ago and nearly died. She was hospitalized, lost 35 lbs. and ended up on life support.

“You need to take the medicine,” McCusker said.

Side effects of the medication, however, can lead to other, sometimes fatal diseases, Jacobsen said.

“The public perception tends toward a myth of a cure, as if taking the required medications basically cures you,” he said. “That’s not true at all. There is no cure. There is no vaccine. The treatment is not fun and the side effects can be extremely debilitating. The side effects have generally been what’s shortening life.”

While battling AIDS, McCusker contracted Hepatitis C. Combining the medication for both diseases for six months was “hell on wheels,” she said.

But McCusker beat back the Hepatitis. “So basically I’m just dealing with the AIDS,” she said. “And I feel pretty darn good lately.”

Source: Burlington Free Press

Pact inked with Clinton Foundation -treatment for HIV positive children to Expand

The local HIV and AIDS paediatric treatment programme is on the verge of expanding to include a steady supply of antiretroviral medication, CD4 testing, diagnosis and monitoring and nutritional supplements among other initiatives.

Minister of Health, Dr. Leslie Ramsammy yesterday signed an agreement with the Clinton Foundation HIV/ AIDS Initiative (CHAI) that will support the local programme in various areas. The drugs purchase aspect of the agreement falls under the recently established UNITAIDS.

Currently some 140 children are on the programme and an additional group is being closely monitored. There is a 1.5% prevalence of mother-to-child HIV transmission in Guyana.

Alfredo Idiarte of CHAI told reporters his organisation is committed to the local programme and will work along with local partners towards making it more comprehensive. He noted that the nutritional aspect of the agreement is likely to come on stream and that CHAI is also looking at providing deoxyribonucleic acid Polymerase chain reaction (DNA PCR) tests for infant diagnosis. The DNA PCR test is a blood test that looks for direct (DNA) evidence of the virus rather than the antibodies. The HIV antibodies test that is being done here at present does not detect evidence of the virus in children younger than 18 months and this delays early treatment which might be necessary.

Source: hiv.gov.gy

New HIV Test Approved by FDA

Each year, an estimated 56,300 people in the U.S. become newly infected with HIV, the virus that causes AIDS—in part because about one-quarter of the more than 1.1 million Americans believed to be living with HIV don’t know they are infected, according to the Centers for Disease Control and Prevention. HIV is transmitted primarily through sexual intercourse or contact with infected blood, semen, or cervical and vaginal fluids; injection-drug use; and perinatally from infected mothers to their infants. HIV transmission has also been reported in recipients of blood, blood-containing organs such as the kidney, liver, heart pancreas, bone, and skin or highly vascular tissues from HIV-infected donors. However, improvements in donor education, donor screening and blood testing has resulted in a continued decrease in the risk of transfusion and organ transplant transmission of HIV—improvements that now include a new test that detects the presence of antibodies for both types of HIV.

Approved by the U.S. Food and Drug Administration (FDA) on Friday, the Abbott Prism HIV O Plus assay is licensed for screening donated blood and blood specimens from other living donors, and for screening specimens from organ donors when specimens are obtained while the donor’s heart is still beating and from cadavers. Positive results from the test require confirmation from supplemental tests. The assay is one of five tests that run on Illinois-based Abbott’s Prism System, a fully automated instrument also used to test blood for hepatitis.

Both types of HIV have been detected in the United States and Europe. Type 1, which consists of various subgroups, including group M, the most common subgroup of the virus in the United States, and group O, found primarily in Cameroon and other areas of West Africa; and type 2, which is found primarily in West Africa. Once HIV enters the body, the body starts to produce cells and particles to fight the virus called antibodies. The HIV antibodies are different from antibodies for the flu, a cold, or other infections.

Before 1985, there were no tests to screen blood and organ donations for HIV. Today, blood and organ banks screen out most potential donors at risk for infection in advance through extensive testing. The risk of acquiring HIV from a blood transfusion today is estimated to be 1 in 4 for every 600,000 transfusions. The risk of acquiring HIV from organ transplantation is probably similar.

Most HIV tests look for these antibodies rather than the virus itself. Previously, the two primary blood tests used to detect the HIV antibodies were the enzyme-linked immunosorbent assay (ELISA), and the Western blot assay, used to confirm the results of a positive ELISA test. These tests do not tell how long a person has been infected, how sick they might be, or if they have AIDS (acquired immune deficiency syndrome), which is the final and most serious stage of HIV disease.

AIDS is the fifth leading cause of death among people aged 25-44 in the United States, down from number one in 1995. About 25 million people worldwide have died from this infection since the start of the epidemic, and in 2006, there were approximately 40 million people worldwide living with HIV/AIDS.

Source: Health News

HIV/AIDS Research: Potent HIV Antibodies Spark Vaccine Hopes

If HIV/AIDS researchers had a wish list, at the very top wouldsit a vaccine that could teach the body to make potent antibodiesagainst the many strains of the virus. Despite 25 years of effort,no such vaccine is in sight, but now they are a step closer.A large team of researchers has identified the most powerful,broad-acting antibodies yet against multiple strains of thevirus.

Finding good antibodies is a far cry from developing a vaccinethat prods the immune system to produce them. But “broadly neutralizingantibodies” (bNAbs) are rare: Researchers have identified onlya half-dozen to date. Now an international group funded mainlyby the International AIDS Vaccine Initiative (IAVI) has discoveredtwo new ones that have an unusual potency. “This has actuallymade me quite optimistic—for once,” says Dennis Burton,an immunologist at the Scripps Research Institute in San Diego,California, who led the research effort.

For many years, Burton says, he thought that if an antibodyhad a broader reach, it inevitably would be weaker. “I wonderedwhether there would be any antibody better than the ones wehad,” he says. “Well, these are.”

Burton, his graduate student Laura Walker, and 33 other researchersreport online 3 September in Science (www.sciencemag.org/cgi/content/abstract/1178746)that the two new antibodies have unusual characteristics thatopen new avenues of AIDS vaccine research. “It’s a great paperthat describes very novel antibodies,” says immunologist JohnMascola of the Vaccine Research Center at the National Instituteof Allergy and Infectious Diseases in Bethesda, Maryland.

The researchers first collected blood from some 1800 HIV-infectedpeople in Africa, Asia, Europe, and North America. Using noveltechniques, they identified 10% who had antibodies that couldderail more than a dozen different strains of the virus. Thispaper focuses on one sub-Saharan African donor; the person didnot benefit appreciably from the antibodies, which are no matchfor HIV once an infection is established.

The researchers sifted through a staggering 30,000 antibody-producingB cells from the donor and isolated two monoclonal antibodies,dubbed PG9 and PG16, that could prevent infection in more than70% of 162 viral strains tested in cell culture. Not only werethey broad acting, but the antibodies worked at minute levels—amagnitude lower than the four best characterized bNAbs so far.“It’s an enormous amount of work—a tour de force,” saysAIDS vaccine researcher Ronald Desrosiers, head of the New EnglandPrimate Research Center in Southborough, Massachusetts.

On a more sobering note, many researchers have tried to makevaccines that elicit previously identified bNAbs. “In the last5 years, there have been intensive efforts, and no one has succeeded,”Burton says.

Source: Science Magazine

New test to detect AIDS in children

 

Children below 18 months of age in India will no longer die of HIV for lack of proper diagnosis.India on Thursday became the first country in Asia to introduce DNA Polymerase Chain Reaction (PCR) test, a dry blood sampling method of testing for paediatric AIDS. The PCR method involves taking a few drops of a baby’s blood and blotting it on paper.

It requires no ice or cold-chain equipment to preserve blood. The dry blood samples can be transported miles away to a laboratory, where the paper is dissolved and the blood tested. Results are then available in as little as 16 hours.

The machine cost the National Aids Control Organisation (Naco) Rs 30 lakh. Naco plans to start six more regional centres with the PCR in Bangalore, Chennai, Hyderabad and Imphal.

Naco DG K Sujatha Rao told TOI,”Kalavati Saran Children’s Hospital became the first centre to offer free anti-retroviral therapy for children. We have also installed Asia’s first PCR here. Till now, we had no way to diagnose a newborn with HIV. It was just a guessing game. Now, with this test, we won’t have to bring the baby to the diagnosis centre. A dry bloodtest will confirm the HIV status. Once the child becomes 18-months-old, we will put him/her on treatment of ART. With proper treatment and nutrition, the child will be able to live a healthy life.”

According to Naco, every year an estimated 54,000 infected babies are born and an estimated 200,000 children are presently living with AIDS.

“It’s very appropriate because it’s easily transportable. It does not require any special transport medium, does not require any special time. It’s just got to be collected correctly. Dry blood sampling is also much easier to do. For children living with HIV, getting treatment as early as possible can make a difference between thriving and just surviving,” a health ministry official said.

India has also formulated the National Paediatric HIV/AIDS treatment protocol, which was launched by Congress chief Sonia Gandhi and former US President Bill Clinton on Thursday. The protocol clearly points out how diagnosis of HIV infection in children has to be carried out.

The protocol says,”For children below 18 months, born to an HIV positive mother, the first HIV DNA PCR shall be conducted at 6 weeks of age. If the test proves positive, it has to be repeated immediately for confirmation. If the first PCR is negative, confirm with a second PCR test at 6 months.”

The protocol has also given utmost importance to palliative care — an approach which improves the quality of life of patients.

Terming the initiative as an important step forward, Sonia said there were a number of populous states where prevalence of AIDS was low. But care should be taken as these are most vulnerable.

“Social ostracism is still prevalent,” she said, adding that there was a need to remove the stigma associated with the disease so that more people could be treated.

Source: New York Times