HIV/AIDS Newsroom: October 9, 2000
Effect of HIV-1 and Increasing Immunosuppression on Malaria Parasitaemia and Clinical Episodes in Adults in Rural Uganda: A Cohort Study
09/23/00 Vol. 356, No. 9235, P. 1051; Whitworth, James; Morgan, Dilys; Quigley, Maria; et al.
Researchers from Uganda and London's School of Hygiene and Tropical Medicine evaluated the association between HIV-1 infection and the immunosuppression of malaria. A total of 484 subjects -- 222 of whom were HIV-positive, 237 who were HIV-negative, and 25 who seroconverted during the study -- enrolled to attended a clinic every three months for eight years. It is believed that HIV-1 infection suppresses the immune system and prevents a response to malaria. The study recorded the absence or presence of parasitemia and clinical malaria, and the CD4-cell counts of the subjects. The risk of parasitemia was higher for HIV-infected individuals. There was also a significant difference which showed that individuals with HIV-1 infection were at greater risk for clinical malaria compared to HIV-negative individuals. Those with lower CD4-cell counts also had greater odds for developing clinical malaria. Patients with advancing HIV infection were more at risk for clinical malaria as the onset of AIDS approached. The researchers concluded that clinical malaria is more common in HIV-positive patients compared to individuals without HIV. HIV-1 infection seems to lead to more severe cases of malaria in immuno-compromised adults, which suggests a growing public health problem for Africa.
Researchers from London's Imperial College School of Medicine compared HIV-1-specific proliferative responses to HIV-1-induced intracellular cytokine production in a both HIV nonprogressors and individuals with progressive infection. According to the investigators, HIV-1-specific proliferative responses in the clinically nonprogressing group related to significant numbers of circulating HIV-1 specific CD4 T cells. The proliferative responses were not found in the majority of subjects with progressive HIV. Based on the data, the researchers suggest that most HIV-infected individuals may have "an inability of HIV-1-specific CD4 memory T cells to proliferate in response to HIV antigens rather than an absolute loss of circulating virus-specific CD4 T cells.
World Partnership Launched to Develop Faster TB Drugs
USA Today (www.usatoday.com)
10/09/00 P. 7D; Sternberg, Steve
The Global Alliance for TB Drug Development will launch today at the First International Conference on Health Research for Development in Bangkok. Giorgio Roscigno, the acting chief executive officer of the group, stated, "Our mission is to accelerate the discovery and development of new anti-[tuberculosis] drugs and have them on the market in 2010, at prices that are affordable in developing countries." Every day, tuberculosis takes the lives of 5,500 people worldwide, and 8 million people contract the disease. While the treatment strategy of directly observed therapy -- in which healthcare workers watch patients take their drugs every day for six to nine months -- has been successful, faster-acting drugs would be useful for poor countries. The alliance has received $40 million in funding from Bill Gates Foundation and Rockefeller Foundation.
Heroin addiction is growing in the Pacific Northwest region of the United States, stretching from Seattle to Portland, Oregon. An estimated 20,000 heroin addicts reside in the Seattle area, and deaths from heroin overdoses in King County -- which includes Seattle -- have more than doubled in the past 10 years. In Portland, heroin use has become one of the leading causes of death for white men between the ages of 25 and 54. Treatment facilities in the two cities report being flooded with heroin cases, and needle exchange programs say demand has also increased. The reasons behind the surge in heroin use in the Northwest include the drug's availability -- smuggled across the border from nearby Vancouver -- and its lower price, now only about $20 a dose. In Seattle, the Stonewall Recovery Services clinic counsels some 400 addicts a month and distributes 36,000 clean needles each month in an effort prevent HIV infection and hepatitis. Public health officials from both cities report that recent efforts to expand treatment and needle exchanges appear to be promising, with even a slight decline in overdose deaths, although the crisis is not expected to end any time soon.
Animal rights activists are angry that researcher Michael Podell of Ohio State University has received a $355,000 grant from the National Institute on Drug Abuse to infect 120 cats with a feline version of HIV and then give them methamphetamine to study the effects. Podell explained that he wants to use the animal model to better understand the effects of drug abuse and HIV and also to see the effects of methamphetamine on the nervous system. The drug is a stimulant that can cause hyperactivity and neurological degeneration. However, Peter Wood -- a spokesman for People for the Ethical Treatment of Animals -- called the research "cruel, wasteful, and bizarre," and he noted that HIV and FIV are not close enough for the study to be useful to humans. He also pointed out that the reasons behind why a person might take methamphetamine cannot be studied in cats. A spokesman for AIDS Action suggested that the funds could be better used.
David Baltimore, president of the California Institute of Technology and former leader of the National Institutes of Health AIDS Vaccine Research Committee, writes that an editorial in the Post from Sept. 25 did not address the lack of scientific knowledge hindering the effort for an HIV vaccine. Because HIV can mutate to become insensitive to antibodies, a vaccine based on "killer T cells" is necessary. Baltimore notes that the U.S. government, working with private organizations "has developed a research program now funded at more than $200 million a year to bring along both scientific knowledge and its application to an HIV vaccine." The program has helped the International AIDS Vaccine Initiative reach further trials. "To take the government to task for not supporting HIV vaccine research through the Initiative ignore the huge contribution that it makes to vaccine research and testing," Baltimore asserts.
The "Declaration of Helsinki," a document tracing inhumane Nazi research and considered the basis for ethical research, has been revised to state that placebos are unethical in virtually all studies that involve diseases with already proven treatments. Placebos remain ethical for use where "no proven [treatment] exists." However, the revision could put thousands of clinical trials outside the line of ethical acceptability. The declaration is not a legal binding document in America, but it does set the standard for medical research worldwide. The document was produced in 1964 and has been revised four other times. The latest revision stems, in part, from a controversy over the use of placebos in research attempting to find an inexpensive and easy way to reduce HIV transmission from pregnant women to their infants. Studies in Ivory Coast, Uganda, and Thailand gave HIV-positive pregnant women either placebos or short regimens of AZT prior to delivery. The revision in the declaration aims to treat participants in poor countries the same as richer countries do. Thus if a treatment is available, it would be unethical to give a placebo. However, some defenders of the placebo-controlled AIDS studies said the real issue was whether the short-course of AZT was better than nothing, which is generally what was available to the African and Thai women, instead of whether the regimen was as good as a longer AZT regimen, which none of the women typically would have received.
The National Council of Negro Women has released a report called "A Devastating Tragedy: AIDS in Africa," calling for more effort to help women in sub-Saharan Africa fight AIDS. According to the report, 40 percent of HIV-infected pregnant women in the region transmit the virus to their babies during birth. The group, based in Washington D.C., called for more debt forgiveness and better access to health care for African women. Improving attitudes towards AIDS patients and promoting the use of condoms are necessary to help empower women.
Speakers at a conference of orthopedic surgeons in Hobart, Australia, have cited the threat of antibiotic resistance as a public health crisis in the making. Vaccines are one of few ways to prevent infectious disease outbreaks. Professor William Cole of the University of Toronto stated that prevention is now the main focus instead of a cure, and he noted that "tuberculosis is one of the biggest or most common infections worldwide." Cole said that the sequencing of the tuberculosis bacterium has led to new strategies for vaccine development.
Over two-thirds of births in Russia have complications, and many newborns who are discharged from maternity clinics have health issues. According to Olga Frolova, head of statistics at Russia's Academy of Medical Science, normal birth rates have fallen due to increased drinking and drug abuse and also complications from sexually transmitted diseases. The nation's overall poor health and lack of medical equipment translates into 53 percent of newborns leaving the hospital with a chronic ailment or disease that requires extended treatment.
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.