HIV/AIDS Newsroom: November 6, 2000
Preventing AIDS But Not HIV-1 Infection With a DNA Vaccine
10/20/00 Vol. 290, No. 5491, P. 463; Shen, Xuefei; Siliciano, Robert F.
Xuefei Shen and Robert F. Siliciano, scientists from the Department of Medicine at Johns Hopkins University, discuss a recent study by Barouch and colleagues about a vaccine to control AIDS. Although it is not known if a vaccine can prevent HIV infection, Barouch's study found that it is possible to control the virus to prevent clinical AIDS. An HIV vaccine cannot work by inducing antibodies to stop infection, because few antibodies recognize the protein variation of the virus. Scientists instead have focused on increasing the ability of CD8 cytotoxic T lymphocytes (CTLs), which can control HIV replication. Using rhesus monkeys, researchers have found that SIV is not controlled when monkeys have depleted lymphocytes. Barouch used rhesus monkeys to immunize them with a DNA vaccine. The group of monkeys used as controls experienced disease progression, with half dying within 140 days of exposure to the virus. Meanwhile, monkeys given doses of the vaccine suppressed viral replication to an undetectable level, keeping solid T cell counts. The results of the study indicate a strong probability that the vaccine helped induce CTLs to control viral replication of HIV. Shen and Siliciano stress that "it is important to keep in mind that the authors have used an animal model in which there is very rapid depletion of CD4 T cells in control infected monkeys that are not immunized ... [and there was] not the prolonged asymptomatic period characteristic of HIV-1 infection in humans." Further study is, of course, needed to determine if the benefits will be seen in humans as well. The researchers note that the study's results also help to illuminate possible reasonable expectations of AIDS vaccines currently being developed.
The China Daily reported that over 8 million Chinese have sexually transmitted diseases (STDs), according to experts, but the country lacks the health training and facilities to control the infections. Official statistics show that there are 840,000 cases of STDs in China. Zhang Guocheng, deputy head of the health ministry's STD and Leprosy Control Center, noted, "China's medical services on the prevention of STDs and their control is trailing behind the swift spread of the diseases." The China Daily also said there were at least 500,000 HIV cases in the country, although government statistics show just over 17,300 as of year-end 1999. However, gonorrhea is the most widespread STD, with syphilis coming in second. Prostitution is fueling the spread of STDs, as are the millions of young women who make up part of China's "floating population" who travel the country in search of more money. The China Daily noted that many Chinese hospitals have no specialized hospitals or physicians, so service is often of poor quality and at a high price. The Health Ministry plans to fight the problem with a State Diseases Control Center.
Millions Fail to Get Vital AIDS Medicines; UCSF Finds Medicaid Isn't Delivering in 4 Big States
San Francisco Chronicle (www.sfgate.com)
11/04/00 P. A1; Levy, Dan
A study conducted by the University of California at San Francisco's (UCSF's) AIDS Policy Research Center has found that millions of poor and uninsured AIDS patients are not receiving treatments through federal drug programs. Millions of low-income people covered by Medicaid in four major states are not receiving AIDS drugs, including residents of Texas, California, Florida, and New York. According to the report, the worst of the four states was Texas, where almost two-thirds of eligible AIDS patients did not receive proper treatment. The UCSF researchers noted that Texas places more barriers between poor AIDS patients and drug treatment than there are in other states, including a $5 copayment per prescription. AIDS advocates also note that Texas and Florida limit patients to three prescriptions per month. The report was slated for release in March; however, a copy of it was leaked to a wire service reporter on Friday.
The head of the World Health Organization, Dr. Gro Harlem Brundtland, has called on Russia to take action against tuberculosis (TB) and AIDS. The official noted Friday that aggressive measures are needed, as the number of recorded HIV infections in the country has doubled each year since 1995, for a total of 60,000 this month. She said that Russia's prisons are at the center of the country's TB epidemic, and approximately 10 percent of the 1 million inmates in the country have contracted the disease. Brundtland also called for strategies against alcohol and drug addiction, including placing an 80 percent tax on tobacco.
U.S. Surgeon General David Satcher urged for a global effort to fight HIV/AIDS, speaking at the international AIDS conference in Nashville, Tenn., over the weekend. Over 20 million of the 35 million people infected with HIV live in Africa, said Satcher, who asserted that the world has a responsibility to help with the problem. The United States has passed a bill to end racial disparities in health care, which is one step forward. The AIDS Marshall plan for Africa should hopefully get support through former congressman Ronald Dellums, who is chairman of Clinton's advisory council on AIDS. Dellums also discussed the AIDS epidemic in developing nations, noting that it was a security threat to the United States, too.
The United Nations General Assembly has decided to hold a special session on HIV/AIDS next June as part of an effort to secure a global commitment to fight AIDS. The meeting, to be held from June 25 to 27, will focus on AIDS in Africa, international funding and cooperation, and human rights and AIDS. Statistics from the Joint United Nations Program on HIV/AIDS show that AIDS has taken the lives of nearly 19 million people worldwide, and an estimated 34.3 people are now living with HIV.
Researchers, led by Dr. Paul Klotman of the Mount Sinai School of Medicine in New York, have found that HIV can directly infect human kidney cells. Klotman and colleagues discovered the infected kidney cells in HIV-positive African Americans who had kidney disease related to their immunocompromised status. There was evidence of HIV activity in the patients' kidneys, even when the virus was suppressed to undetectable levels in the blood using antiretroviral therapy. If other cells besides T cells carry HIV, finding other treatments will be more difficult, the researchers reported in the Journal of the American Society of Nephrology (2000;11).
A colorful 32-foot van in Dobbs Ferry, New York, works as a street outreach center for young people. Luz Bovell is the outreach director for the Children's Village residential treatment center, which is a nonprofit youth home for children with severe needs. The Street Wise van teaches teens about contraception, disease prevention, and pregnancy. Bovell runs the van most nights and has met hundreds of youths while working. The workers hand out condoms, along with education about HIV and other sexually transmitted diseases.
The Panara tribe of western Brazil has slowly recovered its cultural traditions, after being displaced in the 1970s to make way for a huge national park. Government officials in the country recently upheld a ruling to provide the Panara with 1 million forested acres to live on, hopefully allowing them to thrive and grow. In 1973, Brazil made contact with the Panara through airplanes, and then began to build a highway through the group's territory. After the construction began, many of the Panara began to die from such diseases as tuberculosis (TB), influenza, measles, and malaria. The Panara were moved to Xingu National Park in 1975, where they could not hunt or gather. Although the tribe's population began to increase again, disease still killed about 10 people a year. With the help of indigenous rights groups, the Panara were able to re-group and file a lawsuit in 1988. The group has returned to many of its hunting traditions. Survival continues to be a challenge, however, as eight Panara were recently diagnosed with TB. The individuals were flown to a nearby town for treatment, and all survived.
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.