HIV/AIDS Newsroom: November 22, 2000
Boosting Immunity to HIV: Can the Virus Help?
11/03/00; Vol. 290, No. 5493, P. 946; Autran, Brigitte; Carcelain, Guislaine
French researchers discuss a recent study from Walker and colleagues who found that interrupted drug therapy has benefits for HIV-infected patients. Brigitte Autran and Guislaine Carcelain, both of the Laboratoire d'Immunologie Cellulaire et Tissulaire Hopital Pitie-Salpetriere in Paris note that early treatment with highly active antiretroviral therapy (HAART) can reduce HIV replication and save CD4 T cells from eradication. Evidence suggests that giving HAART within three days of HIV diagnosis and discontinuing it after one to two years can control the virus long-term. Walker's trial treated eight HIV patients with HAART, stopping therapy when viral load was suppressed and the CD4 cell response was detected. Three of the subjects kept the virus at a low rate while off therapy, and five had viral rebound which returned them to HAART. The authors suggest that progressive exposure to HIV -- versus intense stimulation -- could help form protective responses from T cells, enough to keep the virus in check. The researchers also note, "The new findings confirm that virus-specific T(H)1 cells -- in the absence of a stronger or more prolonged exposure to HIV -- are not capable of stimulating an intense, broad, and durable CD8 cytotoxic response." Questions remain, however, including those regarding the number of treatment interruptions necessary to achieve a low viral load and whether the "treatment manipulations will be manageable in real life," Autran and Carcelain point out. Thus far, the benefits of interrupted treatment occur only during early HIV infection. The researchers also warn that the results of Walker et al.'s study should not be applied to chronic HIV infections without further study.
Fertility experts report that a shortage of donor sperm in Canada is sending many women who want to be artificially inseminated into the United States. Health Canada quarantined tens of thousands of frozen semen samples after a study last year revealed extensive problems in donor screening. The investigation was launched after a woman contracted chlamydia after being inseminated with sperm from a clinic. Now, all sperm stock must undergo two HIV tests at six-month intervals, which makes it at least a year before the sperm can be used. Also, the government has required chlamydia tests on the frozen sperm, but that test has not yet been developed. Roger Pierson, former president of the Canadian Fertility and Adrology Society, notes that Canadian orders to the United States for sperm has soared in the past year.
UV Light to Lock TB Out of Jail; Shelby First County to Get System That Kills Bacteria in Air
Memphis Commercial Appeal (www.memphis.com)
11/21/00; P. B1; Charlier, Tom
Tennessee health officials announced this week that inmates in the Shelby County jail will be protected from airborne bacteria, such as tuberculosis (TB), using new ultraviolet light technology. The Ultraviolet Germicidal Irradiation System, manufactured by Commercial Lighting Design Inc. of Memphis, recycles the indoor air flow through several ultraviolet lights that kill TB-causing bacteria. The system, which is used in water-purification and food-processing systems to reduce the risk of contamination, is being installed in the jail's heating and air-ventilation system. The Shelby County jail will be the first county facility in the nation to have the new system, which costs an estimated $180,000. The project is being sponsored by the Tennessee Valley Authority, the Memphis Light, Gas & Water Division, county government, and the Electric Power Research Institute.
A report presented at last week's American Public Health Association conference in Boston said that an office policy for HIV counseling and testing that includes steps to eliminate stigma can help lower resistance to testing among pregnant women. Kathleen A. Sherrieb of the Dartmouth-Hitchcock Family HIV Program in Lebanon, New Hampshire, noted that only about one-third of obstetric practices in Vermont and New Hampshire screen 95 percent of their pregnant patients for HIV. Based on a survey of 60 such practices, Sherrieb learned that 37 percent had acceptance rates no more than 50 percent and just 22 percent have a written office policy for HIV testing and counseling. According to Sherrieb, however, a team approach in which all providers in the practice coordinate their efforts to reach all patients can help reduce the stigma related to risk-targeted screening.
German drug giant Bayer AG announced that developing new AIDS treatments will be among its new drug-research activities. Although the company did not reveal how much in planned to spend on AIDS research, it budgeted about $852 million for 2000. The company said it hopes to identify the first products for preclinical HIV testing within 24 months.
The head of South Africa's Medical Research Council (MRC) warned Tuesday that unless aggressive measures are taken to keep HIV from spreading further, the country faces potential catastrophe. Malegapuru William Makgoba noted that new MRC estimates support data from various organizations that AIDS could take the lives of 5 million to 7 million South Africans over the next decade. He said that the United Nations, the United States, and the South African Actuarial Society have all come up with these estimates independently. Also, the South African insurance industry estimates that more than 2,000 HIV infections occur every day and life expectancy could fall from 63 years now to 41 by 2010.
Speaking on the "Day of Affirmation" for people living with AIDS in Zambia, President Frederick Chiluba said the effects of the disease in the country were devastating, with many children becoming orphans after watching their parents die. An estimated 20 percent of Zambian adults are infected with HIV. Chiluba noted that the high cost of traditional drug therapies has forced some AIDS patients in his country to try untested alternative products, including herbal medicines, some of which are useless or even extremely toxic. Zambian officials recently estimated that they need more than $550 million for HIV prevention, care, support, and impact mitigation efforts over the next three years.
An official from Lithuania's AIDS Center announced Tuesday that early prevention programs have helped Lithuania keep its HIV infection rate the lowest in central Europe, at 6.8 cases per 100,000 people. In nearby Poland there are 15.2 HIV infections per 100,000, while the rates in Estonia, Latvia, and Russia's Kaliningrad region are 26.1, 33.08, and 350 cases, respectively. "Based on the data we have from most of central and eastern Europe, we can even say that [Lithuania's] number of HIV-positive cases per 100,000 is the lowest in all the region," said Giedrius Likatavicius, a physician at the center. Also, the center's director, Saulius Caplinskas, noted that while the prevention efforts were somewhat difficult to implement at first, "now we see the results." A total of 257 HIV cases have been recorded in Lithuania, including 56 new infections reported so far this year.
The Association of Southeast Asian Nations (ASEAN) forum will discuss this week the AIDS epidemic and drug abuse. Prior to the meeting, ASEAN experts gathered in Vietnam to work out a joint strategy to stem the spread of HIV. Vietnamese Health Minister Do Nguyen Phuong noted that information sharing and joint monitoring by ASEAN member states are critical. A recent World Bank report said that injection drug use was rising in the region as the result of cheap heroin supplies, increasing poverty and helping to spread HIV.