HIV/AIDS Newsroom: December 6, 2000
Control of SIV Rebound Through Structured Treatment Interruptions During Early Infection
11/24/00; Vol. 290, No. 5496, P. 1591; Lori, Franco; Lewis, Mark G.; Xu, Jinqing; et al.
Researchers studying macaques with acute SIV infection found that highly active antiretroviral therapy (HAART) and fixed-schedule structured treatment interruption (STI-HAART) were able to suppress the animals' viral load. STI-HAART consisted of alternating three weeks on and three weeks off drug therapy. In the treatment interruption cohort, T cell virus-specific immune response (VIR) and control of viral rebound rose during later interruptions. Meanwhile in the macaques receiving continuous HAART, there was no VIR increase and SIV rebounded after permanent treatment withdrawal. The researchers concluded that fixed-schedule STI-HAART may be an effective alternative to continuous HAART, although more studies are needed.
New statistics from the Centers for Disease Control and Prevention show that the incidence of gonorrhea is on the rise in the United States for the first time in more than two decades. After dropping nearly 75 percent between 1975 and 1996, the gonorrhea rate rose 9 percent between 1997 and 1999. According to the CDC's Ronald O. Valdiserri, the increase can be attributed, in part, to better tests and more widespread screening. However, he said that the rise may also be the result of better AIDS treatments, which could have resulted in some people mistakenly believing "that high-risk sexual behavior no longer carries the extreme consequences it once did." The new surge was first observed among high-risk gay men, and it appears to be extending to the general population; but it is still highly concentrated among certain regions, races, and age groups. While the national rate of gonorrhea infection is 133 cases per 100,000 people, the rate for African Americans is 849 cases per 100,000; for Hispanics, 75 per 100,000; and for whites, 28 per 100,000. Cities in the mid-Atlantic and South have particularly high rates of infection, and Baltimore came in at No. 1, with 949 cases per 100,000.
Other findings presented at the sexually transmitted disease (STD) conference in Milwaukee show that the nation's syphilis cases are continuing to fall. The rate of infection is 2.5 cases per 100,000, and 79 percent of the country's 3,115 counties reported no new cases in 1999. Last year, No. 1 Indianapolis' rate was 50 cases per 100,000, while third-ranked Baltimore had 38 cases per 100,000--down from 102 syphilis cases per 100,000 in 1997. The CDC also reported that chlamydia is more common than both gonorrhea and syphilis, with 254 cases per 100,000 last year. The CDC's Dr. Judith Wasserheit noted, however, that the incidence "grossly underestimates the true burden of [the disease] in this country." Human papillomavirus, meanwhile, is the most prevalent STD, and one strain, HPV-16, is responsible for about half of all cervical cancers.
A new report in the Journal of the American Academy of Pediatrics indicates that there were significant public health gains during the 20th century. The report, prepared by researchers at Johns Hopkins and the Centers for Disease Control and Prevention, found that a better standard of living, immunization programs for children, and better medical practices and medications have resulted is substantially improved health for Americans. While a person born at the beginning of the last century was only expected to live about 49 years, life expectancy at the end of the century was 76.5 years. Furthermore, the rate of death dropped nearly 75 percent between 1900 and 1998, with the leading causes of death shifting from infectious respiratory diseases like tuberculosis and pneumonia to heart disease and cancer.
The Brazilian government has found a way to reduce the price of AIDS medicines so far that it can afford to cover the cost for its 90,000 HIV-positive citizens, though the practice has enraged the multinational drugmakers that developed the medicines. Brazil reduced the cost of HIV-fighting regimens from $12,000 per year to $4,500 per year by reverse-engineering the medicines and changing the production method very slightly, a practice that is legal in some developing nations but illegal in most developed countries. The result is that pharmaceutical companies in Brazil, Thailand, and India make the same drugs at much lower prices than are charged by the drugs' creators and undercut those prices, taking business away from the original maker. While industry groups like the Pharmaceutical Research and Manufacturers of America and individual drug companies like Abbott Laboratories of Brazil are concerned about the profit that is being taken from the companies and the quality of the marked-down drugs, activist groups and government organizations note that, in the end, it is the patient who benefits and the greater good of the public is maintained.
In a joint statement, UNAIDS, UNICEF, and the World Health Organization (WHO) said that aggressive measures are needed to stem the spread of HIV in Eastern Europe and Russia. The U.N. agencies called on European nations for support in the battle. New statistics from UNAIDS and the WHO indicate that the number of HIV infections in Eastern Europe soared to 700,000 from 420,000 one year ago, and the nations most affected are Russia, Ukraine, Belarus, Moldova, and Kazakhstan. Participants at the U.N. agencies' meeting in Copenhagen made a number of suggestions to help control the epidemic in central and Eastern Europe, including needle exchange programs for drug addicts, treatment of sexually transmitted diseases at a general practitioner level, and condom promotion efforts.
More Evidence Supports Congo as the World's HIV-1 Epicenter
A team of researchers from France, Congo, and the United Kingdom has identified a high level of genetic diversity within HIV-1 group M in the Democratic Republic of Congo. The scientists studied 247 HIV-1 isolates from three parts of the country and characterized them for diversity within the HIV-1 envelope protein V3-V5 region. According to their report in the Journal of Virology (2000;74:10498-10507), the most common subtype was subtype A; however, all known HIV-1 group M subtypes were identified in the samples. The researchers, noting a high level of intrasubtype genetic diversity in the isolates and high levels of possible recombinant viruses, said the findings lend support to Congo being the epicenter of HIV-1 group M viruses.
UNICEF launched an effort this week to raise $207 million to help the world's most needy children. The funds will be used to provide immunizations, basic schooling, clean water and sanitation, AIDS education, mine awareness, and protection against exploitation. "We are making this appeal on behalf of children caught in the very worst of conditions," explained UNICEF Executive Director Carol Bellamy.
A study of laboratory-grown cells suggests that the human papillomavirus (HPV), which is associated with cervical cancer, may increase HIV progression. The researchers discovered that HPV-infected cells produced growth factors and proteins that stimulated the immune system that could reawaken latent HIV infection in immune cells. Their report in the December issue of Obstetrics and Gynecology (2000;96:879-885) notes that the HPV-induced growth factors spurred the HIV-infected cells to start producing more copies of the virus. The authors conclude, therefore, that active infection with HPV could speed HIV disease progression.
Japanese health officials reported Tuesday that 36 people died from AIDS in the first 10 months of 2000. In September and October alone, there were four AIDS deaths, 62 new cases of AIDS diagnosed, and 88 new HIV infections. The Health and Welfare Ministry said that there are now more than 7,000 people with HIV or AIDS in Japan.
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.