AIDS/HIV
Extended Infant Antiretroviral Prophylaxis Reduces HIV Risk During Breastfeeding
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In many resource-poor countries, infants born to mothers with HIV receive a single dose of nevirapine (NVP) and a one-week dose of zidovudine (ZDV) to prevent transmission of HIV from the mother to her newborn. The results of a randomized trial led by researchers at the Johns Hopkins Bloomberg School of Public Health and the University of Malawi College of Medicine found that extending the routine antiretroviral regimen can significantly reduce the risk of mother-to-child HIV transmission. The study is available in the June 4 online edition of New England Journal of Medicine and will appear in the June 10 print edition.
The Malawi trial, known as PEPI (post-exposure prophylaxis of infants), followed 3,016 infants born to HIV-positive mothers. The infants and mothers were followed for 2 years. All infants received the standard care of a single dose of NVP and a one-week dose of ZDV to prevent HIV infection. One group received an additional 14-week prophylaxis with NVP, while another received 14-week regimens of both NVP and ZDV.
Throughout the trial, the children who received the extended prophylactic regimens had consistently lower rates of HIV infection compared to children who received the standard care. At 9 months, 5.2 percent of infants receiving extended NVP, and 6.4 percent of infants receiving extended NVP and ZDV contracted HIV, compared to 10.6 percent of infants receiving the standard of care regimen. The frequency at which the mothers breastfed their children was similar between all three treatment groups.
Vast distances a barrier to combating HIV/AIDS in India
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Vast distances are a major hurdle to India’s efforts to curb its soaring HIV rate.
India, which has the world’s third largest HIV-positive caseload, gives drugs for free to HIV/AIDS patients. But doctors say this is not enough to stop the spread of HIV which is making inroads in rural India, especially among women infected by itinerant husbands, and also children.
For three days a month, Sambit squeezes into a crowded and often filthy train for a three hour journey to Delhi to receive HIV treatment.
Byrne, Feist join ‘Red Hot’ AIDS compilation
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David Byrne will join indie rockers including Feist, Sufjan Stevens and the Decemberists on the new “Red Hot” charity album for AIDS research.
The former Talking Heads frontman will collaborate on two tracks with the Dirty Projectors, a combo headed by prolific singer/songwriter Dave Longstreth.
“I’d been told more than once that we should all work together, and it seems the suggestion was fated to be realized,” Byrne wrote on his blog (http://journal.davidbyrne.com), adding that he revived lyrics he wrote in “maybe ‘75 or ‘76” for the project.
Cancer risk soars in HIV-infected people: study
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People with HIV have a much higher risk for many cancers, including anal cancer, but a lower risk for prostate cancer, researchers said on Tuesday.
Some types of cancers like Kaposi’s sarcoma and non-Hodgkin lymphoma have long been associated with people infected by the AIDS virus.
The study focused on trends from 1992 to 2003, finding that these two types of cancer became relatively less common among HIV-infected people in the United States. But other cancers are on the rise among these patients, who are living longer thanks to anti-HIV drugs.
Major shift in HIV prevention priorities needed
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According to a new policy analysis led by researchers at the Harvard School of Public Health (HSPH) and the University of California, Berkeley, the most common HIV prevention strategies—condom promotion, HIV testing, treatment of other sexually transmitted infections (STIs), vaccine and microbicide research, and abstinence—are having a limited impact on the predominantly heterosexual epidemics found in Africa. Furthermore, some of the assumptions underlying such strategies—such as poverty or war being major causes of AIDS in Africa—are unsupported by rigorous scientific evidence. The researchers argue that two interventions currently getting less attention and resources—male circumcision and reducing multiple sexual partnerships—would have a greater impact on the AIDS pandemic and should become the cornerstone of HIV prevention efforts in the high-HIV-prevalence parts of Africa.
The paper appears in the May 9, 2008 issue of the journal Science.
“Despite relatively large investments in AIDS prevention efforts for some years now, including sizeable spending in some of the most heavily affected countries (such as South Africa and Botswana), it’s clear that we need to do a better job of reducing the rate of new HIV infections. We need a fairly dramatic shift in priorities, not just a minor tweaking,” said Daniel Halperin, lecturer on international health in the HSPH Department of Population and International Health and one of the paper’s lead authors.
Search for an HIV Vaccine Must Go On Says Expert in Light of Recent High-profile Merck Failure
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According to a recent article published in The Independent (UK), most scientists involved in AIDS research believe that a vaccine against HIV is further away than ever with some admitting that effective immunization against the virus may never occur, according to an unprecedented poll conducted by the paper.
The article describes a mood of deep pessimism that has spread among the international community of AIDS scientists after the trial failure of a promising Merck vaccine last year. This was only the latest in a series of setbacks in the twenty-five-year struggle to develop an HIV vaccine. The article authors, Steve Connor and Chris Green, cite one of the major conclusions to emerge from the failed clinical trial of Merck’s promising prototype vaccine, is that an important animal model used for more than a decade in preclinical HIV testing on monkeys does not in fact work.
“The passion for an HIV vaccine resonates strongly among small pharma, whose often-overlooked approaches may now take center stage as the search for a viable HIV vaccine continues,” says Sylvain Fleury, PhD, Chief Scientific Officer and Director at Mymetics, a vaccine company focused on malaria and the human immunodeficiency virus (HIV/AIDS).
Study shows promising new approach to thwart HIV
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Researchers have pinpointed a protein contain within key human immune system cells that is needed for the AIDS virus to infect the cells, and found that turning it off can greatly slow down the deadly virus.
Inactivating a protein called ITK in immune system cells called T cells reduces HIV’s ability to enter these cells and replicate itself, the researchers said on Monday.
A drug based on this approach could be useful as a complement to existing drugs used to treat HIV infection, said Andrew Henderson of Boston University, one of the researchers.
Some people may transmit weaker AIDS virus: study
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People with a genetic variation that slows down HIV may also be causing a mutation to the AIDS virus that makes it less potent if transmitted to others, researchers said on Friday.
The human immunodeficiency virus that causes AIDS attacks immune system cells. Like other viruses, it cannot replicate on its own but must hijack a cell and turn it into a virus factory. HIV must evade several genes to do this, including an immunity gene called HLA.
“Some people have versions of the HLA gene that are known to force HIV to tolerate mutations that damage its ability to reproduce,” Carolyn Williamson and Salim Abdool Karim at the Centre for the AIDS Program of Research in South Africa wrote in the Public Library of Science journal PLoS Pathogens.
Second study finds treating herpes won’t stop HIV
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Another study has found that treating genital herpes infections does not protect people from the AIDS virus.
The study, published on Wednesday in the New England Journal of Medicine, casts even more doubt on the once hopeful idea that treating the common infection might help put a dent in the AIDS pandemic.
Dr. Deborah Watson-Jones of the London School of Hygiene and Tropical Medicine and colleagues reported on 659 workers aged 16 to 35 at recreational facilities in Tanzania.
A new more effective tuberculosis screening test for HIV victims
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World Health Organization (WHO) figures show that each year an estimated 9 million new cases of tuberculosis (TB) arise in the world. The growth of this disease remains particularly strong in Africa owing to a high proportion of HIV patients (nearly 13% compared with less than 1% in Asian countries for example). This region of the world is experiencing accelerating advance of a deadly combination of AIDS and TB, developed because the virus weakens the immune system of TB-infected individuals. A person infected by HIV who is also contaminated with Koch’s bacillus bears a greater risk of developing active TB than a non HIV-infected individual. Latent TB infection diagnosis has for several decades been founded on a positive response to the tuberculin skin test (TST). However, TST’s reliability is limited in highly TB-endemic geographical settings because the presence in the environment of mycobacteria similar to that which causes TB plus the BCG vaccination people receive in early infancy can skew the results. Moreover, in HIV-carrying patients, the sensitivity of the test is drastically reduced owing to their inability to develop an allergic reaction, the very basis of the skin test. TB is a strong contributing factor to HIV mortality, therefore it is of crucial importance to be able to diagnosis latent infection early in order to adopt an appropriate treatment and prevent the development of the full disease.
The development of new IGRA3 tests is based on in vitro measurement of T-cells secretion of interferon- when challenged with antigens specific to Mycobacterium tuberculosis, the bacterium causing tuberculosis.
Breast-Feeding Now Safer for Infants of HIV-Infected Mothers
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First solid evidence that viral transmission through breast milk can be prevented by a drug (Oral presentation #43, Rooms #302-304, Hynes Convention Center, Boston, Mass.)
An antiretroviral drug already in widespread use in the developing world to prevent the transmission of HIV from infected mothers to their newborns during childbirth has also been found to substantially cut the risk of subsequent HIV transmission during breast-feeding.
In a study presented Feb. 4 at the 2008 Conference on Retroviruses and Opportunistic Infections in Boston, an international team of AIDS experts reports that nevirapine given once daily to breast-feeding infants from 8 to 42 days old decreased by almost half the rate of HIV transmission via breast-feeding at 6 weeks of age. The decrease occurred in comparison to a single dose of nevirapine given to infants at birth, the current standard of care. At 6 months of age, the risk of postnatal HIV infection or death in infants who received the six-week regimen was almost one-third less than the risk for infants given only a single dose. The study was led by three teams of investigators at The Johns Hopkins University in collaboration with investigators in Ethiopia, India and Uganda.
New insights into vaccination for HIV
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A group of Australian researchers at the Universities of Melbourne and New South Wales have developed new tools and paradigms to understand immune evasion from HIV. The study, published Friday, January 25 in PLoS Pathogens, shows that both prior vaccination and timing influence the rates of immune escape, providing further insight into the effectiveness of T cell immunity to HIV.
An HIV vaccine is urgently needed. A major hurdle is the rapid evolution of HIV and its ability to mutate to escape effective immunity. Low levels of mutant virus cannot be detected with standard techniques, making it difficult to study the evolution of mutant viruses.
The group, led by PhD student Liyen Loh and Dr. Stephen Kent, developed highly sensitive assays to track mutant viruses. They show that vaccination of macaques against SIV (a simian AIDS virus) results in the rapid selection of mutant viruses. In contrast, escape mutants evolve much more slowly when they appear later during infection.
Love, hope for shunned kids in India AIDS school
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In a smart blue tunic and red ribbons in her hair, 12-year-old Komal’s laughing eyes hide a fear of death that stalks every student in her village school.
Within months or years she could be dead, but while she lives she is fulfilling a dream—of going to school again after she was expelled from her previous one because she was infected with HIV.
Ingredient in human semen may enhance HIV infection
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An ingredient in human semen may actually help the HIV virus infect cells, German researchers said on Thursday.
They said naturally occurring prostatic acidic phosphatase or PAP, an enzyme produced by the prostate, can form tiny fibers called amyloid fibrils that can capture bits of the human immunodeficiency virus and usher it into cells.
Researchers present unique program aimed at HIV prevention in runaway youth
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Researchers at Wake Forest University Baptist Medical Center are the first in the U.S. to develop an HIV prevention and intervention program for adolescent runaways that focuses on their strengths.
Liz Arnold, Ph.D., assistant professor of psychiatry and behavioral medicine, presented the details of this 15-month pilot program at the National HIV Prevention Conference today in Atlanta.
