HIV/AIDS Newsroom: September 20, 2000
Antigen-Specific T Cells Localize to the Uterine Cervix in Women With Genital Herpes Simplex Virus Type 2 Infection
Journal of Infectious Diseases Online (www.journals.uchicago.edu/JID)
09/00 Vol. 182, No. 3, P. 662; Koelle, David M.; Schomogyi, Mark; Corey, Lawrence
Reinfection with genital herpes simplex virus type 2 (HSV-2) is rare in humans, but scientists note that the mechanism of acquired immunity is not clear. Researchers from the University of Washington measured antigen-specific T cell responses to HSV in the cervix, a site of exposure to the virus, during both lesional and nonlesional instances. They found proliferative and cytotoxic responses to HSV in most specimens. The authors report that natural infection with HSV-2 is associated with a persistent cervical mucosal cellular immune response, which may help limit the clinical effects of secondary HSV-2 infection.
Federal District Court Judge Sterling Johnson Jr. said Tuesday that New York City's Division of AIDS Services and Income Support has provided inadequate services for people with AIDS, and he placed the agency under federal watch for three years. Johnson said the division, formed in 1985, had chronically and systematically postponed or ended benefits like housing, rent assistance and food stamps, sometimes without notifying recipients. Attorney Armen Merjian for Housing Works Inc., an AIDS awareness group that has brought a class-action lawsuit against Mayor Rudolph Giuliani's administration for New York's AIDS policies, said the administration has failed HIV and AIDS patients. Under the new ruling, which takes effect immediately, clients with complaints will now take them to a federal magistrate judge, Cheryl Pollak, who will monitor the city agency and may recommend penalties. While New York City's corporation counsel, Michael Hess, said the decision would be appealed, Merjian said the ruling was gigantic victory for the Americans With Disabilities Act. In his decision, Judge Johnson noted that the city took over 30 days to provide emergency benefits that were required within 72 hours and did not meet deadlines for housing applications.
HIV Patients Face a New Epidemic
Boston Globe (www.boston.com/globe)
09/19/00 P. D1; Saltus, Richard
As new drug therapies help HIV and AIDS patients to live longer, more of them are dealing with chronic hepatitis C virus (HCV) infection and liver failure. Patients with HIV are approaching normal lifespans [because of the new drugs] and they're dying of liver disease instead of the AIDS virus, notes Dr. Douglas Dieterich, head of gastroenterology and liver disease at Cabrini Medical Center in New York. Hepatitis-related liver failure generally takes 15 to 20 years; however, HCV infection moves about two times as fast in HIV-infected individuals. At Lemuel Shattuck Hospital in Boston, 50 percent of HIV patients' deaths in 1998 were from liver disease, up from 11 percent in 1991. HIV and HCV are spread in similar ways -- including injection drug use and blood transfusions before 1992 -- and about 40 percent of all HIV patients are co-infected with HCV. A single exposure is enough to transmit both viruses, as in the case of Karen Daley, president of the Massachusetts Nurses' Association, who was accidentally stuck with a needle when treating a patient. Doctors now believe both viruses should be treated aggressively at the same time. However, the strict drug regimens for each disease can be difficult, with the HIV drugs possibly having toxic effects on the liver the HCV drugs are fighting to safeguard. A number of medical institutions, including Lemuel Shattuck and the New England Medical Center, are beginning a new study of co-infected patients and will, among other things, investigate the value of pegolated interferon, which lasts longer than the standard form of the drug.
Health officials in New Mexico want to alter the state's Controlled Substances Act in order to allow pharmacists to legally sell syringes to injection drug users. The plan, an effort to fight HIV and hepatitis, is backed by the state Pharmacy Board but still requires approval from the state legislature and the governor.
A San Francisco television station, KGO Channel 7, has refused to run an HIV prevention ad during the daytime that shows bare-chested men and a transgender woman with her arms crossed over her bare chest. KGO offered to place the ad, paid for by the San Francisco Department of Public Health, after 10 p.m. The ads target HIV-positive gay and bisexual men, encouraging them to practice safe sex and inform their partners of their HIV status. The advertising agency A Better World had wanted the spot -- which carries the slogan HIV stops with me -- to run during afternoon talk shows, which researchers have found are popular with some gay and bisexual men. Les Pappas, president of A Better World, said the television station's decision is absurd, noting that the commercial will not offend anyone. Studies show that new HIV infections are on the rise among the city's gay men.
An ingredient used in shampoos and toothpaste could act as a vaginal microbicide to prevent HIV in women. Results of a test-tube study presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Toronto showed that sodium lauryl sulfate could be a potential candidate. Jocelyne Piret, a biologist at Laval University in Quebec, said the ingredient kept HIV from binding to cells and also prevented herpes simplex type 2 infection among mice. A vaginal microbicide would empower women who cannot negotiate condom use with men, including commercial sex workers.
Abbott released data from an ongoing Phase III clinical trial of its new HIV medication Kaletra that suggests the recently FDA-approved drug may be better at lowering levels of HIV in the bloodstream than a competing drug, Agouron's Viracept. Announced at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) in Toronto this week, the findings showed that HIV in the bloodstream dropped to undetectable levels in 79 percent of the patients taking Kaletra for 40 weeks, while 64 percent of those taking Viracept had undetectable HIV levels. University of Toronto professor Sharon Walmsley and member of the team conducting the study said that all of the 653 patients involved in the trial, all of whom had never received an AIDS drug regimen, were given the same basic anti-HIV regimen of 3TC and d4T, then randomized to receive either the twice-per-day Kaletra or three-times-daily Viracept. Walmsley said she believes the easier dosing schedule and longer half-life of Kaletra, which combines lopinavir and ritonavir, were two factors in the better results, as patients were not only more compliant with Kaletra but the drug stayed longer in the body if they skipped a pill.
Bristol-Myers Squibb's investigational compound BMS 232632, a once-daily HIV medicine, appears to be safe and easily tolerated by patients involved in an ongoing Phase II clinical trial. The protease inhibitor, potentially the first once-daily drug in that class, did not affect patients' cholesterol or triglyceride levels, a common problem among existing protease inhibitors. After 24 weeks of the trial, University of Witswatersrand Clinical HIV Research Unit head Ian Sanne said that the compound seems to be effective while remaining safe and tolerable. Presented at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) in Toronto, the study results showed that the 98 HIV-positive patients given BMS 232632 in combination with didanosine and stavudine had results similar to another protease inhibitor, nelfinavir.
In South Africa, the Communist Party has added its voice to the various groups, including the Congress of South Africa Trade Unions, which have declared that HIV causes AIDS. However, African National Congress leader, President Thabo Mbeki, and his cabinet members still believe that AIDS may also caused by factors such as poverty and poor nutrition.
Nigerian President Olusegun Obasanjo told a joint mission of the World Bank and UNICEF Tuesday that his government will hold a separate vote in the 2001 budget for HIV and AIDS funds. He said the funds, which would be controlled by the presidency, would be used to create a government action plan to fight the epidemic. Obasanjo said the government is working to make sure that sufficient AIDS-related funding is available, although he also noted the country would accept additional funding from donor agencies.
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.