HIV/AIDS Newsroom: January 31, 2001
Prevalence and Correlates of Anemia in a Large Cohort of HIV-Infected Women: Women's Interagency HIV Study
Journal of Acquired Immune Deficiency Syndromes (www.jaids.com)
01/01/01; Vol. 26, No. 1, P. 28; Levine, Alexandra M.; Berhane, Kiros; Masri-Lavine, Lena; et al.
Researchers studied a cross section of HIV infected women, to compare the prevalence and correlation of anemia occurring in patients with asymptomatic HIV infection versus clinical HIV. Test subjects included racially mixed 2,056 HIV-positive and 569 HIV-negative women who were categorized demographically and clinically, as their immunological and virological relationships to anemia were studied. In overall comparison between all test subjects regardless of race, the data concluded that anemia was more prevalent among HIV-positive patients at 37 percent compared to 17 percent of HIV negative women. Among the HIV positive women, 44.9 percent of black women showed a stronger incidence of anemia with hemoglobin levels of <12 g/dl, followed by 25.7 percent of whites and 24.8 percent of Hispanics. Using mean corpuscular volume (MCV) as another standard for testing revealed that women with low MCV were more susceptible to anemia regardless of HIV status.
This study was designed to examine the current policies regarding the global allocation and distribution of HIV drugs. The rational behind the current distribution program by the AIDS Drugs Assistance Programs (ADAPs) in many states is because of the high cost of the drugs and decreased funding assistance. Using a questionnaire venue with a five-point Likert scale system, researchers ascertained responses to seven statements reflecting current state drug rationing programs. The survey responses of the 100 patient participants and 101 other volunteers highlighted the fact that current official policies do not reflect the desires and preferences of patients and public. Researchers concluded that the present ADAP systems would be critically challenged should the views of patients and others, ever be considered during the plan design.
Counterfeiters Hit Serono
Boston Globe (www.boston.com/globe)
01/31/01; Aoki, Naomi
The quiet appearance of a counterfeit drug designed to treat weight loss in HIV patients has alarmed the Serono drug manufacturing company and the U.S. Food and Drug Administration (FDA) with many unanswerable questions. The fake drug is packaged very similarly to the real drug -- called Serostim -- and has been found in legitimate distribution outlets throughout several states. As yet, the Serono Company nor the FDA have any idea who is manufacturing the drug, what its contents are, or how it is being marketed to legitimate vendors. Serono records show that patients began calling the drug company last fall concerned with side affects, which may be indicative of exactly when the fake drug began showing up on drugstore shelves. A current theory of AIDS advocates is that someone is switching the drugs to sell the real thing on the black market and replacing it with the counterfeit. Serostim, a human growth hormone used by HIV patients to fight the extreme weight loss caused by AIDS, costs on average, $21,000 for a 12 week dosage.
The South African government has backed away from its earlier stance on restricting the availability of Nevirapine, an expensive anti-AIDS drug for HIV-infected pregnant women. The cost of the new two-year program is estimated at US$3.18 million annually, and will benefit at least 20,000 women per year. Monthly, there are an estimated 5,000 babies born HIV-positive, caused by mother-to-infant transmission. South Africa has one of the fastest infection rates of HIV, with nearly one in every 10 individuals living with the disease.
HIV infection rates appear to have decreased among injecting drug users (IDUs), although they remain in the high risk category for HIV infection. Researchers from the University of Illinois at Chicago found that of the nearly 800 IDUs they interviewed and tested for the study, baseline HIV seroprevalence was 18 percent or below those levels usually found on the East Coast, but higher than the rate found in the western and southern regions. In comparing the current incidence rate of seroconversions in over six hundred of the IDUs, which was at 1.1 per 100 person-years of risk, to the 1992 rate of 2.4 in a similar population, researchers concluded that the rate of infection among Chicago's IDUs has declined. It was noted that other researchers have found that newer IDUs seroconvert more frequently than do long-term IDUs.
Researchers from Vanderbilt University School of Medicine, Nashville, recently concluded a study of the effects of efavirenz in several hundred nucleoside analogue reverse transcriptase inhibitor (NRTI) experienced patients. They discovered that the addition of indinavir plus the nonnucleoside reverse transcriptase inhibitor (NNRTI) efavirenz, results in a significantly lower viral count after more than 24 weeks as compared to strictly the indinavir alone. The positive response was maintained for another 24 weeks. In the final study published in the February 1st issue of the Journal of Infectious Diseases (2001; 183:392-400), Dr. David W. Haas and associates concluded that NRTI experience patients should be treated with efavirenz, indinavir, and two NRTIs as a standard by which alternative treatments should be compared.
Recent studies indicate that HIV-infected pregnant women who receive combination antiretroviral therapy (ART) that includes protease inhibitors run the risk of having a premature birth. In the study published in the December issue of AIDS magazine (2000;14:2913-2920), researchers documented a 1.82 premature birth incidence ratio among women who received combination therapy including nucleoside reverse transcriptase inhibitors. The ratio increased to 2.60 when a protease inhibitor was introduced during therapy. Researchers concluded by recommending that combination therapy be delayed until after the first trimester in those women whose immunological status does not indicate a need for immediate treatment.
AIDS is on the rise in Asia, the world's most populous continent. One-third of the world's population lives in China and India, with 1.3 billion and 1 billion residents, respectively. In India, there are an estimated 4 million people with HIV; however, the country's huge population means that the national average of infection is just 0.4 percent, only slightly more than the U.S. national level, at 0.3 percent. But marked regional disparities indicate rates of up to five times the national average, with widespread prostitution -- a multi-billion dollar industry in the country, according to the Centre of Concern for Child Labour -- fueling the spread. In China, an estimated 500,000 to 1 million people are infected with HIV, which has been reported in each of the country's 31 provinces. The epidemic in China has spread, in large part because of injection drug use; however, HIV is also being spread through black-market blood sales. China banned blood sales in 1998 but the practice continues on the black market. The business of selling blood is a common way for poor people to earn money, but the unsanitary conditions used often puts the blood donor in jeopardy for HIV, as well as the recipient. Sexual contact is also a primary mode of HIV transmission in China. Author Ann Hwang asserts that open discussion about safe sex is necessary to help stem the AIDS epidemic; however, confidential and voluntary HIV testing programs are also needed. What may be the greatest challenge, Hwang says, is establishing long-term support for people in marginalized, high-risk groups to help keep them from becoming infected.
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.