HIV/AIDS Newsroom: October 5, 2000
Infections With Mycobacterium Tuberculosis and Mycobacterium Avium Among HIV-Infected Patients After the Introduction of Highly Active Antiretroviral Therapy
American Journal of Respiratory and Critical Care Medicine (www.ajrccm.atsjournals.org)
09/00 Vol. 162, No. 3, P. 865; Kirk, Ole; Gatell, Jose M.; Mocroft, Amanda; et al.
Members of the EuroSIDA Study Group evaluated the incidences of mycobacterial disease among HIV-infected patients after they began highly active antiretroviral therapy (HAART). EuroSIDA study is a multicenter cohort of over 7,000 patients. The results showed overall incidence of tuberculosis and mycobacterium avium complex (MAC) were 1.4 cases per 100 person years, and 0.2 cases per 100 years, respectively. The risk of MAC decreased with time, but not the risk of TB. Decreases in the incidence of TB were seen among HIV-infected patients during 1994 to 1999. The drop in TB was associated with the introduction of HAART and CD4 cell count changes.
A new report in the New England Journal of Medicine (2000;343:982-991) shows that treating HIV-positive pregnant women with AZT 28 weeks before delivery significantly reduces the amount of time their newborns have to be treated. This early AZT therapy enabled the doctors to reduce the babies' treatment time from six weeks to three days. The study, led by Marc Lallemant of the Harvard School of Public Health, provided AZT to all of the mothers and infants studied, prompting praise from critics of previous mother-to-child studies that involved placebos.
Minorities Lead in New HIV Cases
Baton Rouge Advocate (www.theadvocate.com)
10/04/00 P. 2A; Wyatt, Kristen
U.S. Surgeon General Dr. David Satcher said Tuesday that African Americans and Hispanics made up nearly 70 percent of new HIV cases between July 1999 and June. Satcher explained that this is, in part, because hard-to-reach groups for prevention efforts -- such as high school dropouts and former inmates--include many African Americans and Hispanics. "When the AIDS epidemic started in this country in 1981, it was viewed as epidemic of white gay men, and that was partially true. It is not true anymore," Satcher said. Efforts to educate minority groups about AIDS could reduce new infections and prompt more people to seek treatment.
Medecins San Frontiers has criticized the World Health Organization's (WHO's) new campaign against AIDS, tuberculosis, and malaria, asserting that the effort will not succeed without significant changes in access to effective drugs. The WHO's "massive effort" is not aggressive enough, the humanitarian group asserted. James Orbinski, president of MSF's international council, noted, "Many effective medicines are either too expensive or don't exist."
Although teenage pregnancy and child abuse in Tennessee have fallen slightly, the state still ranks poorly in terms of caring for children, new research shows. The annual Kids Count study, sponsored by the Annie E. Casey Foundation and the Tennessee Commission on Children and Youth, ranked the state 45th for children's well-being. According to the study, the rate of sexually transmitted disease (STD) in Tennessee has declined 20 percent since 1995. Linda O'Neal, executive director of the Tennessee youth advocacy group, attributed the drop to greater awareness of STDs, fear of HIV, and community efforts. O'Neal called for more early-childhood education programs and increased community prevention and intervention efforts for older adolescents. The report ranked Minnesota first and Louisiana 50th overall.
South Africa will begin testing an AIDS vaccine next year, according to Medical Research Council (MRC) head Malegapuru Makgoba. Phase I clinical trials will include monitoring of side effects for a year, followed by years more of trials, although the goal is still to have an AIDS vaccine available within five years. The MRC estimates that a successful AIDS vaccine could save 20 million lives in its first 10 years. The vaccine, which has been jointly developed by South African and U.S. researchers, is a clade C-based Venezuelan Equine Encephalitis vector vaccine.
The South African Medical Research Council has announced that boiling the breast milk of a woman with HIV can prevent transmission of the virus to her nursing baby. According to the group's annual report, the virus is killed if the milk is heated to 56 to 63 degrees Centigrade for 20 minutes, while still preserving 80 percent of the antibodies and other nutrients found in the milk. An estimated 1,700 new HIV infections occur in South Africa every day.
A study from Dr. Han Fennema from the Municipal Health Service in Amsterdam shows that two-thirds of people in Europe with a sexually transmitted disease (STD) have never received HIV testing. A total of 66,560 patients with STDs who were tested for HIV were reviewed between 1990 and 1996, including 2.4 percent who had had a previous positive HIV test result. According to a report in the journal AIDS (2000;14:1993-2001), the researchers found that 1.4 percent of the 41,727 patients who reported no previous HIV test had positive results, while 1 percent of those with a previous negative result and 4.9 percent of those without prior HIV test data available had HIV. The researchers found that 63 percent of the HIV-seropositive individuals knew of their HIV status, and they recommend all that all patients with STDs be offered HIV testing.
Experts from Australia's National Council on AIDS, Hepatitis C, and Related diseases believe that advances in HIV treatment may be leading to less concern about safe sex among such high-risk groups as gay men and prostitutes. The organization noted that the rate of HIV diagnoses in Australia decreased last year; however, the number of infections may rise as those most at risk become less vigilant. Council Chair Chris Puplick stated that most people at risk for HIV have not left safe sex practices, but there are signs of a slight rise in risky sexual practices among individuals in some groups. The council also reported that while the number of HIV diagnoses in the country dropped from 1,162 in 1991 to 680 in 1999, the rate of decline may be slowing.
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.