HIV/AIDS Newsroom: September 19, 2000
Estrogen Protects Against Vaginal Transmission of Simian Immunodeficiency Virus
Journal of Infectious Diseases Online (www.journals.uchicago.edu/JID)
09/00 Vol. 182, No. 3, P. 708; Smith, Stephen M.; Baskin, Gary B.; Marx, Preston A.
Researchers from New Jersey Medical School and Tulane Regional Primate Research Center evaluated the role of sex hormones in vaginal transmission of HIV. The scientists looked at ovariectomized female macaques who were given either progesterone or estrogen after SIVmac infection. The six untreated control monkeys and all but one of the progesterone-treated animals became infected after intravaginal SIV inoculation. None of the estrogen-treated animals developed infection, suggesting that women who lack estrogen are at higher risk for HIV infection. Topical vaginal estrogen therapy could provide a way to reduce vaginal HIV transmission in some individuals.
Scientist Eric Renard of Montpelier University in France reported Monday a new type of diabetes in people infected with HIV. Speaking before the conference of the European Association for the Study of Diabetes, Renard suggested the new diabetes could be linked to antiretroviral drugs given to treat AIDS patients. Scientists have seen increasing numbers of HIV patients with diabetes develop lipodystrophy, or fat deposits, on their abdomens. Renard's study of 102 HIV patients revealed that the fat deposits appear to be associated with two drugs, d4T and 3TC, while the diabetes may be triggered by use of protease inhibitors, although only in individuals who already had lipodystrophy.
HIV Infection Misdiagnosed as Spotted Fever
United Press International (www.upi.com)
09/18/00; Susman, Ed
Patients who have symptoms of early HIV infection are sometimes misdiagnosed with spotted fever, according to Dr. Ferran Segura Porta, chief of infective disease at the Hospital of Sabadell in Spain. Because of this, doctors lose a chance to start fighting HIV during a critical stage. Segura, who reported his findings Monday at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Toronto, noted that HIV infection causes fever and skin eruptions similar to Rocky Mountain or Mediterranean spotted fever. He described the cases of four patients misdiagnosed with Mediterranean spotted fever, which is frequently found in the Barcelona area during summer. The patients were diagnosed with HIV one month to seven years later.
Prostitutes are moving westward in Europe, as the wealth of the western nations beckons many of those in Central and Eastern Europe. Many women end up in the Czech Republic because it is easier to get a visa there than in a European Union nation. A five-mile sex strip along the Czech-German border is home to numerous bars with names like "Kiss" or "Alibi," and about 70 percent of the prostitutes there are foreign. The women come from Bulgaria, Belarus, Ukraine, and Russia, making more than theaverage $110 a month found in Russia. Some of the women are tricked into the trade, promised jobs as baby-sitters or gardeners, but are then forced by gangs to give their passports and money to men who have them work as prostitutes. The women are too afraid to leave or to go to police, and many have children to support. Dr. Hana Duchkova, an expert on sexually transmitted diseases at Usti Hospital, notes that disease transmission is a problem. Already, the hospital has recorded 134 syphilis cases this year, compared to 59 last year.
A report in a recent issue of the Journal of Acquired Immune Deficiency Syndrome (2000;24:211-217) shows that HIV-infected individuals often die from liver failure. Dr. Massimo Puoti of the Azienda Spedali Civili in Brescia, Italy, and colleagues studied nearly 1,900 HIV-infected patients for eight years, during which time there were 467 deaths. Among the 308 in-hospital deaths, AIDS was a key factor in 89 percent of the deaths, while liver failure was the primary cause of death for 5 percent of the patients and a concurrent cause of death in an additional 6 percent. Puoti -- who also found that 80 percent of the patients who died in the hospital tested positive for antibodies to hepatitis C -- said that key strategies to prevent liver failure among HIV-infected individuals include working to prevent hepatitis B, treating existing hepatitis B infections, and reducing alcohol use.
Dr. Richard T. Davey Jr. of the National Institutes of Health reports that a brief interruption of highly active antiretroviral therapy (HAART) can help restore healthy lipid levels in HIV-infected patients. Davey and colleagues studied the effects of a brief HAART interruption on 26 HIV-infected men who had viral loads under 500 copies after taking HAART for a year. The short break significantly lowered total cholesterol and low-density lipoprotein cholesterol and increased 24-hour urinary free cortisol; however, it did not improve glucose metabolism or fat distribution. The results of the study are published in the journal AIDS (2000;14:1935-1942).
The South African labor federation COSATU, the Congress of South African Trade Unions, has challenged President Thabo Mbeki to admit that HIV causes AIDS. At COSATU's annual meeting on Monday, union leader Willie Madisha criticized the government's policy on AIDS and called for Mbeki to stop wasting time speculating about other causes of the disease. Madisha said thatthe link between HIV and AIDS is clear, and questioning that relationship could confuse people. Mbeki, who was in the audience during Madisha's speech, did not address the issue when he spoke to the group.
The World Bank plans to distribute a $48 million credit on January 1, 2001, to help fund tuberculosis (TB) treatment efforts in Russian prisons. Another $2 million reportedly will be spent for HIV-infected prisoners in Russia. The credit will be used to buy tuberculosis drugs and equipment and train personnel. There are approximately 100,000 TB patients in Russia's prison system, and nearly one-third of those cases are resistant to drug therapy.
The International Monetary Fund (IMF) reported in its latest World Economic Outlook that southern Africa will experience severe economic loss due to AIDS unless international help arrives. The IMF said the economic costs will lead to poverty and other problems, as the countries now struggle to deal with the epidemic. The IMF also forecast that gross domestic product per capita in the most-affected nations may be 5 percent lower in 10 years than it would be if AIDS were not a factor.
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.