HIV/AIDS Newsroom: September 27, 2000
Intrauterine Device and Upper-Genital-Tract Infection
09/16/00 Vol. 356, No. 9234, P. 1013; Grimes, David A.
The risk of upper-genital-tract infection prevents many from using intrauterine devices (IUDs). Women with symptomless gonorrhea or chlamydial infection with an IUD have a higher risk of salpingitis, tubal infertility, than women having an IUD placed without gonorrhea infection. The study included 4,031 women in China who had IUDs inserted. Another trial of 445 women receiving the IUD with the presence of chlamydia infection showed that none developed pelvic-inflammatory disease (PID). Women with gonorrhea had a greater risk for PID when inserting an IUD. The use of IUDs in women with HIV infection is another concern. A study in Nairobi, Kenya showed that women with HIV infection had IUD complication rates similar to uninfected women. There is little information regarding the acquisition of gonorrhea or chlamydia after IUD insertion. Early studies show that IUD use does not increase the risk of chlamydia. Modern IUDs are safer than ever before, and women without cervical infections have the lowest risk of upper-genital-tract infections related to IUD use.
A study of 54 men with AIDS wasting evaluated the effects of testosterone therapy and progressive resistance training upon the men's body weight and muscles. The men were recruited through the HIV practice at Massachusetts General Hospital in Boston. The patients were grouped according to their ideal body weight. They were randomly assigned to receive injections of testosterone or placebo, and to take place in resistance training for 12 weeks or no training at all. The patients in strength training performed 20 minutes of exercise three times a week. The results of the study reveal that lean body mass and muscle increased in those undergoing training and testosterone therapy. The levels of high-density lipoprotein (HDL) cholesterol increased in those training but fell in those taking hormones. The viral load fell in those taking testosterone. Therefore supervised exercise can significantly increase muscle mass and offer higher HDL cholesterol levels to men with AIDS wasting, offering a way for men to change muscle loss into gain.
U.S. Parents, Teachers Want More Covered in Sex Ed
09/27/00; Zabarenko, Deborah
A study on sex education from the Kaiser Family Foundation shows that federal abstinence-based sex education programs differ little from programs that offer information on homosexuality, abortion, and birth control methods. Eighty-five percent of parents in the survey said that teens should be taught how to use condoms, and 94 percent of them wanted schools to address teen pressure to have sex and its consequences. Students surveyed said they need more information on how to deal with rape, HIV testing, and sexually transmitted diseases. The report showed that in 1999, 58 percent of secondary schools offered comprehensive sex education, and 34 percent recommended abstinence only.
Harvard Medical School researchers, led by Bruce Walker, have found that early treatment with a cocktail of AIDS drugs can boost the immune system and its T-cells. A study of eight HIV patients aged 30 to 44 who stopped taking triple medications showed increases in CD4 and CD8 T-cell counts even after five remained off therapy while three others resumed highly active antiretroviral therapy (HAART). Walker stated that the T-cell responses were encouraged by early treatment. The results are published in the weekly Nature. Anthony Fauci of the National Institutes of Health reported earlier this year that interruptions of HAART for a week or two could help patients avoid side effects and maintain low HIV levels. Treatment interruptions would also save thousands of dollars for AIDS patients.
A report in the Journal of Virology (2000;74:7824-7833) reveals that latent HIV reservoirs form when the virus infects activated T-cells that can enter a resting state. Dr. Robert Siliciano of Johns Hopkins University School of Medicine reports that the latent HIV reservoir stems from R5 viruses, which do not enter resting T-cells. The authors believes that the latent reservoir continues to infect other cells that also become resting cells.
Bayer Corporation has asked patients to apply for a new drug for hemophiliacs through a corporate program, instead of going to a pharmacy. The new drug, Kogenate FS, will be given to patients whose applications are approved first. The drug is a genetically engineered version of a protein missing in people with hemophilia A. According to Dr. Stephen Schondelmeyer of the University of Minnesota, the Bayer program uses an approach that companies conducted with early AIDS drugs, when drugs were given in limited number to mail-order companies. However, the system is to be used only in the short-term. Kogenate FS is a new version of a synthetic clotting factor, which is preferred to human blood used for clotting, because it carries the risk of hepatitis C and HIV infection.
In Japan, 63 new AIDS cases were reported in July and August, according to the Health and Welfare Ministry. Eighty-two people were confirmed with HIV during the two-month span, and seven people died from AIDS. The total number of AIDS/HIV cases in Japan is 6,937 since 1984.
Maryland Gov. Parris Glendening (D) has created a task force to study discrimination against gays, hoping to introduce legislation against the practice. Glendening proposed a gay rights bill two years ago though the measure was defeated. The governor's brother, who was gay, died of AIDS.
The 13th International AIDS Conference, held earlier this summer in Durban, South Africa, brought together over 15,000 physicians and scientists from all over the world. During her address to conference participants, Chiron Corp.'s Margaret Liu said that creating an HIV vaccine that would prevent infection is a daunting goal. "For a pathogen such as HIV that is capable of entering the genome of cells, the challenge to make a vaccine that would prevent any infection at all is indeed great and may be too big a first step," she noted. While there have been many advances in virology and cell biology, more knowledge is needed about the various strains of HIV and their pathogenesis. Liu warned researchers to follow proven scientific data and to make no assumptions about the best path to follow. Progress made in the study of immune responses among prostitutes has helped provide clues to why some people are lifelong nonprogressors. More is known about the structure of HIV as well, Liu said. Several vaccine candidates are being put into development, including a gene-based vaccine. Liu highlighted the study of natural immunity and efforts to learn about cellular responses and not just antibody response. Using certain proteins from different strains could create a vaccine that tackles several strains of HIV. The many faces of cellular immunity must also be taken into account, as killer T cells release molecules that have a potential role in a vaccine. Liu said that in the war against AIDS, "we must understand HIV, what its structure is like, and how it infects and causes diseases in order to be able to defeat it."
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.