HIV/AIDS Newsroom: September 14, 2000
Mother-to-Child HIV-1 Transmission
09/09/00 Vol. 356, No. 9233, P. 945; Cates, Willard, Jr.; Allen, Melissa
In a letter to the editor, researchers from Family Health International respond to Mofenson and McIntyre's recent overview of HIV-1 transmission to newborns. They suggest that avoiding perinatal transmission is possible by preventing unwanted pregnancies in HIV-positive women. The authors note that clinicians should be aware of the contraceptive options that provide the best balance of effectiveness and safety. They write, "The goal of choice of contraceptive method is high contraceptive effectiveness, low risk of women-to-partner transmission of sexually transmitted diseases." This can be achieved with male condoms; however, they also require the cooperation of the male sexual partner. Other possibilities include female condoms and intrauterine devices. In conclusion, the authors point out that an HIV-1-infected woman should be referred to a family planning program if she does not wish to become pregnant; she should be informed about available prenatal services and ways to reduce mother-to-child transmission if she does choose to become pregnant; and for those who are already pregnant, they should be offered antiretroviral therapy.
A small study published in the New England Journal of Medicine (2000;343:759-766) shows that infants whose mothers had received AZT to help prevent HIV transmission to their babies had no evidence of heart damage. Other studies have suggested that prenatal exposures to the drug might affect babies' hearts. The study, which involved 48 infants exposed to AZT, was led by Dr. Steven Lipshultz of the University of Rochester.
World Bank Approves AIDS Help
Minneapolis Star Tribune Online (www2.startribune.com)
The World Bank has approved $500 million in credits to help Africa fight AIDS and has recommended that another $85 million to $100 million in loans be given to help the Caribbean. Ethiopia and Kenya will be the first two African nations to benefit from the credits and will receive $59.7 million and $50 million, respectively. World Bank President James Wolfensohn said, "We hope this program will help break the silence and inspire every country that needs help to ask for it." The funds will be used for HIV prevention campaigns, treatment programs, and other efforts.
Living4Life, a Los Angeles program founded by Oasis Clinic at King Drew Hospital director Wilbert Jordan, received a $1 million donation from Glaxo Wellcome on Wednesday. The program encourages HIV-infected individuals to bring in friends whose behavior puts them at risk for infection by providing both with nominal gifts, such as free movie tickets. Since the pilot program was launched, 38 percent of the 230 individuals tested have been identified as HIV-positive, as compared to previous community programs that only had about a 3 percent rate of identifying infected individuals. U.S. Surgeon General Dr. David Satcher notes that "as many as 30 percent of people who are HIV-positive are unaware of their status, and many more are aware but not in treatment."
Ellis Reinherz, a professor of medicine at Harvard University and head of immunobiology at Dana-Farber Cancer Research Institute in Boston, had an idea that helper T cells could be manipulated to target cancer cells and germs. His friend, actor William Hurt, and others helped raise $150 million for the Molecular Immunology Foundation that was created to do the research. Reinherz believes that thymic vaccination can prevent AIDS, hepatitis, prostate cancer, and other autoimmune diseases. Researchers discovered that T cells learn how to distinguish illness-causing peptides from good ones in the thymus. Reinherz and colleague Jia-Huai Wang showed that T cell recognition is a function of peptide shape. Commenting on the plan, National Institute of Allergy and Infectious Disease Director Dr. Anthony Fauci said, "It's a brilliant idea, but it's unclear whether it can be translated into reality." The institute will decide next month whether or not to grant $6.3 million over three years to Reinherz's group.
The Food and Drug Administration (FDA) will investigate whether Schering-Plough Corp. stayed within agency rules that define advertising and promotion actions when the drug company formed groups to call attention to hepatitis C and increase sales of its drug Rebetron. FDA spokeswomen Laura Bradbard said the FDA will look into the educational activities of Schering to see if they crossed into promotional activity. The agency hopes to learn how much Schering controlled the coalitions' material and whether they ignored any rules. Alan Brownstein, president of the American Liver Foundation, one of the coalitions' most active groups, said he is glad the FDA is investigating and urged the agency to better explain the rules regarding industry-funded educational efforts. Rebetron sales grew 60 percent in the last two years.
A committee of South Africa's African National Congress (ANC) has called on President Thabo Mbeki to admit that HIV causes AIDS, according to newspaper reports. Quoting a confidential document leaked to the Cape Times newspaper, newspapers of the IndependentGroup said the appeal noted, "The predominant scientific view that HIV causes AIDS is the view that the ANC and its leadership and its membership have to publicly express." The Congress of South African Trade Unions also asked Mbeki to recognize the link to help efforts aimed at changing risky sexual behavior. In a recent interview with Time, Mbeki said that while HIV could be one cause of AIDS, it is not the only factor behind the condition.
Dr. Peter Piot, the director of UNAIDS, has called attention to the plight of AIDS orphans, who he says are "so neglected and so ignored by the international community." According to estimates, 16 million children are without one or both parents because of AIDS, and that number could soar to 30 million within 10 years. Piot, speaking earlier this week at a session organized by the private Global Health Council, noted that "this [issue] is going to have major consequences for the stability of societies," as the children often leave school to care for or support sick relatives. The children are also faced with the trauma of watching their mothers and fathers die. Several organizations have been established to provide orphans with shelter and education, while another, PLAN International in Kenya, makes "memory books" to help children remember their families.
Scientists from the Pasteur Institute in Paris have detected and sequenced a gene fragment from three ape viruses that are related to the herpes virus KSHV, which causes Kaposi's sarcoma. Herpes viruses in humans can cause a number of illnesses, including cold sores, chicken pox, and genital herpes. The researchers note that while they do not think the herpes viruses originated in apes, as HIV may have crossed over from monkeys, the great apes from central Africa could harbor new herpes viruses that could potentially be transmitted to humans. The findings are reported in the science journal Nature.
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.