HIV/AIDS Newsroom: September 28, 2000
Genetic Epidemiology of Hepatitis C Virus Throughout Egypt
Journal of Infectious Diseases Online (www.journals.uchicago.edu/JID)
09/00 Vol. 182, No. 3, P. 698; Ray, Stuart C.; Arthur, Ray R.; Carella, Anthony; et al.
Researchers from Johns Hopkins University School of Medicine, the National Institutes of Health, and the World Health Organization studied blood samples from donors in 15 governorates of Egypt in an effort to characterize the hepatitis C virus (HCV) epidemic in the country. The seroprevalence of HCV infection is 10 to 20 times higher in Egypt than it is in the United States. The results of reverse transcription-polymerase chain reaction and phylogenetic tree construction showed evidence of three new subtypes. The researchers concluded, "Analysis of genetic distance between isolates was consistent with the introduction of multiple virus strains 75 to 140 years ago, and no clustering was detected within geographic regions," indicating that widespread dispersal has taken place since then.
Researchers from the Department of Dermatology at Erasme University Hospital in Belgium write of the effects of 23-valent pneumococcal polysaccharide vaccination upon HIV concentrations in patients. They conducted a study of 12 HIV-1 infected patients, nine HIV-2-infected patients, and eight HIV-negative subjects. After collecting blood samples, the researchers found that immunoglobulin G (IgG) concentrations doubled in four of the HIV-1 carriers, six of the HIV-2 carriers, and seven of the healthy subjects. There were no harmful virological effects of the vaccine upon the HIV-infected patients. Greek researchers from the Institute for the Study of Genetic and Malignant Disorders in Childhood in Athens, Greece, evaluated 11 children in a similar study. The children, infected with HIV-1, were given the 23-valent pneumococcal polysaccharide vaccine. The results indicated that there were no increases in antibody concentrations. In fact, the study revealed declining antibody avidity after vaccination with the pneumococcal shot. This suggests that the vaccine could make the children more susceptible to pneumococcal disease. The data shows that guidelines for the vaccine should be re-evaluated.
Some HIV Patients Can Be Weaned Off Drugs
Washington Post (www.washingtonpost.com)
09/28/00; P. A2; Brown, David
A new report published in Nature shows that people with HIV who are treated with antiviral drugs quickly after infection can teach their immune systems to suppress the virus without using drugs, indicating that there is a way for a small number of people to take drug holidays or stop treatment and still control their HIV infection, according to Eric Rosenberg, chief author of the study and an instructor at Harvard Medical School. Researchers will now try to find a way to help chronically infected HIV patients fight the virus using highly active antiretroviral therapy, or HAART, a combination of three or more antiviral drugs that can stop HIV from replicating; quick treatment with HAART has been shown to suppress the virus to undetectable levels. Rosenberg and colleagues studied 16 patients who were recently infected with HIV, and two of eight patients who chose to stop HAART maintained low enough levels of the virus to stay off antiviral drugs through two respites from the regimen, though the other six showed returns to detectable levels of HIV. Bruce Walker of Harvard supervised the research, and is cautious, saying that they must monitor the lives of the eight patients and see if they live longer, but the study's authors are optimizing because they believe the patients benefited from treatment interruption before the regimen caused permanent damage to the immune system, indicating that stopping and restarting treatment could allow the body to produce enough CD4 cells to keep HIV under control for years.
Newton County, Georgia, middle-schoolers will soon be offered free hepatitis B vaccines, dependent on parental consent. The virus is spread through sex and dirty needles, similar to HIV transmission. Rockdale County may consider a similar program, said Julie Sosebee, director of Rockdale's Health Department. The vaccine program is a preventive plan, although the county has not seen rising cases, with no known cases in the school system. The inoculations should begin in October, with funding from the state. Hepatitis B is transmitted more easily than HIV, and can cause liver cancer.
Lawrence Livermore National Laboratory has received a $4 million research grant from the National Institutes of Health to help fight tuberculosis (TB) worldwide. The lab is one of 13 that was given funding to study proteins used by TB to infect cells. The five-year project will be overseen by Los Alamos National Laboratory. Lawrence Livermore lab will focus on determining the shapes of large TB proteins by using X-rays and computer analysis. The University of California at Berkeley also received $2 million to study TB proteins.
A study conducted by Dr. Barbara Turner of the University of Pennsylvania shows that some people who are diagnosed with HIV delay treatment for months. Turner and colleagues interviewed 3,500 HIV-infected patients diagnosed by February 1993 or February 1995, and found that one-third of the group delayed treatment by an average of one year. The author reports in the Archives of Internal Medicine (2000;160:2614-2622) that 21 percent in group A waited over six months to seek treatment, allowing enough time for serious AIDS-related complications. Latinos were more likely to delay treatment than whites, and those who had a regular source of care or Medicaid were less likely to delay treatment.
Findings published in the journal AIDS (2000;14:1785-1791) reveal that more strains of HIV-1 are emerging in South America. Dr. Kevin Russell of the Naval Medical Research Center in Lima, Peru, found that new HIV-1 genotypes are appearing, including genotype F and genotype A. A total of 232 blood samples given by HIV-infected people from Peru, Ecuador, Uruguay, and Paraguay were studied. Russell and colleagues say that the results confirm there are several HIV-1 genotypes in South America.
A letter from the European Commissioner for Development and Humanitarian Aid highlights the opportunity for the European Commission to hold a Round Table meeting with the World Health Organization and UNAIDS. The meeting will provide a chance to discuss ways to fight malaria, tuberculosis, and HIV/AIDS among poverty-ridden areas. Mr. Nielson stresses the need for prevention of disease, with quick action needed to help deliver products that prevent the ailments. Improvements in medicine and research are necessary to help developing countries, he said.
The OraQuick HIV-1/2 rapid HIV test, produced by Epitope Inc. of Beaverton, Oregon, could receive approval from the Food and Drug Administration (FDA) within a few months. Earlier this year, the FDA granted Epitope an investigational device exemption, and the company plans to file a pre-market approval application early next year for HIV-1 and HIV-2 testing using the new product. For the test, the user swabs his or her gums with the device and then places it into a container of developer solution. In less than 20 minutes, a colored line will appear to demonstrate that the test was conducted properly, and a second line appears if the individual has HIV. According to Lt. Hassan Zahwa of the HIV Diagnostic Laboratory at Walter Reed Army Institute of Research in Rockville, Md., the test's "sensitivity is 100 percent; its specificity is greater than 99.5 percent, and it is very easy to use since it works on serum, plasma, or saliva, and it requires no reagents to be added, and all material are included in the kit." Zahwa suggested that the U.S. Army could use the rapid HIV test to help healthcare workers who may experience accidental needle sticks, potentially even in the field or in foreign countries, and also possibly to test pregnant servicewomen for HIV before they give birth, so physicians could administer antivirals, if needed.
Today the Institute of Medicine (IOM) released a report providing a visionary framework for national HIV prevention activities. The report -- No Time to Lose: Getting More from HIV Prevention -- makes it clear, first and foremost, that HIV prevention works. Dr. Helene Gayle, Director of the CDC National Center for HIV, STD, and TB Prevention, said that "CDC applauds that central finding, as it lends further support for the fact that scientifically based prevention is core to winning our nation's battle against HIV and AIDS." Dr. Gayle also pointed out that CDC is nearing completion of a new five-year national prevention plan -- currently available in draft for public comment -- that addresses many of the issues in the IOM report.
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.