The Newsline section recalls the pioneering HIV/AIDS publication of the same name produced by the People with AIDS Coalition of New York (PWAC-NY).
A 47-year-old AIDS patient gained 15 pounds after six months of being treated with insulin injections, according to a new report. Researchers from the University of Arizona College of Medicine and the VA Medical Center in Phoenix found that the man, who had lost 20 pounds and was increasingly fatigued despite the fact that he was receiving antiviral drugs and receiving B12 and testosterone injections, weighed 140 pounds after three months of daily insulin shots and 147 pounds after six months. In addition, the patient's CD4 cell count rose while he received the insulin; his CD4 cell count dropped after the shots stopped. The researchers report in AIDS Patient Care and STDs (2000;14:575-579) that the patient reported no adverse effects from the insulin and he asked to resume treatment with the drug because he felt much better. (Reuters Health Information Services (www.reutershealth.com), 12/12/00)
Researchers at Quest Diagnostics and the Stanford University School of Medicine have identified an HIV-1 strain that has reduced susceptibility to reverse transcriptase inhibitors. Quest noted that the discovery of this new mutation will provide doctors with information to better select HIV-1 treatments for their patients. The company is using the findings, which are published in the November issue of the Journal of Virology (2000;74:10707-10713), to report lab results for its HIV-1 genotyping test. (Reuters (www.reuters.com), 12/12/00)
The research head for Merck, the nation's second-leading drug maker, said Tuesday that he was encouraged by ongoing early-stage human HIV vaccine studies at the company. Dr. Edward Scolnick told Wall Street analysts that Merck's vaccine candidates use specific HIV genes that are common to the virus' many strains, stimulating antibodies to work against the virus and prompting cellular immune-system cells to attack. The International AIDS Vaccine Initiative's Wayne Koff noted that animal studies reported by Merck in October -- in which monkeys were given a gene-based vaccine containing SIV and HIV DNA -- were also promising, showing that the vaccine stopped the animals from developing symptoms of HIV infection, although it did not keep them from contracting the disease. Meanwhile, Greg Gonsalves of the Treatment Action Group praised Merck's researchers and history of designing AIDS treatments; however, he said he would like to see more details for the vaccine. (Reuters (www.reuters.com) (12/12/00); Michaud, Chris; Pierson, Ransdell)
Participants at an AIDS conference in Houston on Saturday said that prevention awareness is slowly taking hold among African Americans in the city and more religious leaders have joined in the fight against AIDS. Roy Delesbore, a health program specialist with the Texas Department of Health, noted that while some religious leaders have been hesitant to discuss the disease, that is starting to change, although he said more religious leaders could help. Approximately 300 people attended the conference, which was sponsored by Houston's Health and Human Services Department and City Councilman Jew Don Boney Jr. Boney reported that in the year since Houston Mayor Lee Brown declared an AIDS state of emergency, more than 2,500 new HIV cases have been reported in the city. Sixty-one percent of those cases were among African Americans, he said, and 78 percent of the cases among 13- to 19-year-olds were in African-American females. (Houston Chronicle (www.chron.com) (12/10/00) P. A40; Asher, Ed)
Researchers from the Centers for Disease Control and Prevention and Emory University in Atlanta recently reported that consistent condom use may rely on how assertive a girl is and how well she can negotiate. To determine the factors associated with consistent condom use, the authors studied more than 500 sexually active African-American females between the ages of 14 and 18. The researchers reported at the National STD Prevention Conference in Milwaukee that girls who had little or no fear of negative reactions from their partners were more than two times as likely to use the prophylactics consistently. In addition, compared to girls with older partners, those with partners of similar age were also more likely to use condoms regularly. (Reuters Health Information Services (www.reutershealth.com), 12/08/00)www.reutershealth.com), 12/08/00)
A new survey of more than 15,000 high school students from around the United States indicates that only 43 percent of teenage girls and 26 percent of teenage boys discuss pregnancy prevention or sexually transmitted diseases (STDs) with their doctors during routine exams. "Health care providers are missing very important opportunities," notes the Centers for Disease Control and Prevention's Dr. Judith Wasserheit. The CDC's survey also found that older teens and those who are sexually experienced are more likely to have discussed STDs and/or pregnancy with their physicians, compared to younger teens or those who have not yet had sex. The study was discussed Wednesday at the CDC and American Social Health Association's National STD Prevention Conference in Milwaukee. Dr. Sheldon Wasserman, a gynecologist in Milwaukee and a speaker at the conference, says he makes it a point to discuss sex with each of his teen patients, and he had found that most are relieved to have the subject brought up. "They want you to" begin the discussion, he notes. "They're there for a reason." (Milwaukee Journal-Sentinel (www.jsonline.com) (12/07/00) P. 3B; Marchione, Marilynn)
The Centers for Disease Control and Prevention reported this week that almost 18 percent of women in the United States and 8 percent of American men carry the human papillomavirus (HPV). More than 95 percent of cervical cancer cases are caused by the virus, and the HPV-16 strain causes half of those cases. According to the research, the highest rates of HPV-16 infection were among African-American women between the ages of 20 and 29. In all, about 12.5 percent of whites and 19.1 percent of African-Americans carry HPV-16. Dr. Judith Wasserheit, director of the STD Prevention Program at the CDC, said that HPV is the most common sexually transmitted disease among young people who are sexually active. (Deseret News (www.deseretnews.com) (12/07/00) P. A9)
The AIDS epidemic in Africa faces many obstacles, but the chief one is finding affordable antiretroviral drugs to prevent HIV transmission to newborns and to treat those already infected. Most developed nations now routinely offer antiviral therapies to HIV-infected mothers; however, there are few clinics in Africa that can offer the drugs to these women. Cost is a determining factor, as the drugs often cost more than many Africans' salaries. Five companies have agreed to cut their drug prices to Africa by 80 percent, but that alone will not be a solution. According to David Bloom, a professor at Harvard University School of Public Health, AIDS is tied into poverty and a lack of health infrastructure. Lower drug costs must be accompanied by testing to measure the drugs' success in each patient. Rampant poverty in South Africa makes the drug AZT unattainable. With the help of a discounted price, AZT costs 40 cents for each 100-milligram pill. Nevirapine is another drug that offers hope to prevent HIV transmission to infants. It requires only three doses and has been shown to reduce transmission to 14 percent for a trial of 652 pregnant women. AZT, by contrast, requires months of treatment. South Africa has not accepted an offer of nevirapine from Boehringer Ingelheim, as Health Minister Manto Tshabalala-Msimang said they do not believe the only answer to AIDS is antiretroviral therapy. The government's plan to prevent HIV is to treat AIDS-related infections, and form home-based care, she said. Tshabalala-Msimang noted that even an 80 percent reduction in price would still not be affordable for the 4.2 million HIV-infected individuals in South Africa. If the issue of price is ever overcome, patients would then face the need for resistance testing. HIV's ability to mutate quickly requires careful monitoring of a patient's therapy. Testing CD4 cells and viral load is expensive, however, and not stressed in places like Thailand. Christopher Ouma, a worker for Doctors Without Borders in Nairobi, Kenya, believes Africa cannot wait for viral load testing to become the norm, since they need the drugs now. And even after antivirals become widely available to Africa, the trick will be adhering to the difficult therapy, which requires a strict timetable and food requirements. (Scientific American (www.sciam.com) (11/00) Vol. 283, No. 5, P. 98; Ezzell, Carol)
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. Whilethe 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. (Washington Post (www.washingtonpost.com) (12/06/00) P. A3; Brown, David)
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. (Christian Science Monitor (csmonitor.com) (12/06/00) P. 6; Downie, Andrew)
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. (Reuters Health Information Services (www.reutershealth.com), 12/05/00)
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. (Reuters Health Information Services (www.reutershealth.com), 12/05/00); McKinney, Merritt)
Many HIV-infected individuals are at risk for depression, as many feel overwhelmed by the substantial changes in their lives. Growing research shows that HIV patients have more negative effects from depression. Jane Leserman, a research associate professor of psychiatry at the University of North Carolina School of Medicine at Chapel Hill, notes that data shows that "psychological factors affect disease progression in HIV." Over 50 percent of older adults with HIV have depression, said Tim Heckman of Ohio University. Doctors, therefore, must be aware that older patients are at risk. Meanwhile, Gail Ironson, psychology professor at the University of Miami in Coral Gables, has found that HIV patients are vulnerable for depression right after diagnosis and also when symptoms first begin to show. Jerry Durham, a nurse and dean at Barnes College of Nursing in St. Louis, explained that HIV comes with an expectation of loss. Not treating depression can have stark results and can cost more in the long run. Depression is associated with low immune response, disease progression, decreased survival, and lower quality of life as well. Leserman's research showed that psychological factors can lead to faster HIV progression to AIDS.
Her study of adult gay men and the stresses in their lives found that some patients prefer to remain stoic under stress. Blood samples showed that cortisol levels appeared to predict which men would progress more rapidly to AIDS could lower the immune system. Leserman said that although there is little research available on cortisol, "our own findings showed that cortisol was not a very beneficial hormone for these men." (AIDS Alert (www.ahcpub.com/ online.html) (11/00) Vol. 15, No. 11, P. 129)www.afp.com), 11/30/00) www.washingtonpost.com) (11/30/00) P. A1; Stepp, Laura Sessions)
Researchers report in the Proceedings of the National Academy of Sciences that a new tuberculosis (TB) vaccine could be ready for human tests next year. According to Dr. Marcus Horwitz, a professor at the University of California at Los Angeles and the lead author of the study, the new vaccine is very potent and protected all the guinea pigs tested against TB; guinea pigs develop TB similarly to humans. The scientists genetically engineered the existing BCG vaccine so that it produced the major secretory protein of the organism that causes TB. Horwitz noted that the new vaccine would be inexpensive and easy to administer, and UCLA is in talks with drug manufacturers to produce and test the product in humans. (Reuters (www.reuters.com) (11/29/00); Fox, Maggie)
Researchers investigated the risk factors behind the United States' growing rate of primary liver cancer associated with hepatitis B virus (HBV), hepatitis C (HCV), and alcoholic cirrhosis. Between 1993 and 1998, more than 1,600 patients in the Department of Veterans Affairs Medical Center's Patient Treatment File were diagnosed with primary liver cancer. The researchers note that the age-adjusted proportional hospitalization rate for primary liver cancer rose from 36.4 per 100,000 between 1993 and 1995 to 47.5 per 100,000 between 1996 and 1998. During these periods, there was also a significant increase in the age-adjusted rates for primary liver cancer associated with HCV. The age-adjusted rates for HCV-associated primary liver cancer also shifted toward younger patients during this time. Meanwhile, the age-adjusted rates of primary liver cancer associated with HBV or alcoholic cirrhosis remained stable during the study period, as did the rates of primary liver cancer without risk factors. (Archives of Internal Medicine Online (archinte.ama-assn.org) (11/27/00) Vol. 160, No. 21,; El-Serag, Hashem B.; Mason, Andrew C.)
A new report in the Journal of Infectious Diseases (2000;182:1588-1594) indicates that approximately 25 percent of Chicago-area injection drug users are infected with the hepatitis C virus (HCV). Researchers found that the risk of contracting the disease is greater the longer and more frequent a person uses injection drugs. The study of 700 drug users, primarily heroin addicts, between the ages of 18 and 30 revealed that individuals who had been using drugs for one to four years had three times the likelihood of being infected as people who had used for under 12 months; the risk of infection was even higher for drug users of more than four years. The researchers determined that 27 percent of the subjects had HCV, and most of the users were not familiar with the risks of the virus. (Reuters Health Information Services (www.reutershealth.com), 12/13/00)
UNICEF reported Wednesday that included among the 34.3 million people living with HIV or AIDS in the world are 1.3 million children under the age of 15. The organization's annual report noted that most of the children contracted HIV from their mothers during birth or via breastfeeding, and most will die from AIDS before they become teenagers. HIV and AIDS are taking a toll on sub-Saharan Africa, the report found, with 70 percent of the world's HIV cases, 80 percent of AIDS deaths, and 90 percent of AIDS orphans. The epidemic is also affecting the economies of countries in the region, and UNICEF estimated that the expense of treatment and care for HIV and AIDS will likely make up 33 percent of all government health spending in Ethiopia within five years and almost 66 percent in Zimbabwe.(Reuters Health Information Services (www.reutershealth.com), 12/14/00)
New research presented at the recent meeting of the American Public Health Association indicates that frequent discussions between parents and children about sex-related issues could keep African-American female teenagers from participating in dangerous sexual activities. Researchers, led by Dr. Richard Crosby of Emory University, surveyed 522 sexually active African-American adolescent females and found that subjects who did not talk about sex with their parents very often were more likely to engage in risky sexual behavior than those who regularly discussed sex with their parents. The girls who discussed sex issues less often were nearly two times as likely as the others to report that they did not use a condom the last time they had sex. Furthermore, the girls who did discuss sex with their parents were much more likely to bring up pregnancy and sexually transmitted disease/HIV prevention with their current sex partner. (Reuters Health Information Services (www.reutershealth.com), (12/14/00); Huggins, Charnicia E.)
Investigators compared plasma HIV RNA load between patients infected with HIV-1 and HIV-2 in Guinea Bissau, which has a high prevalence and incidence of infection with the two viruses. The study involved 102 individuals, including 19 HIV-1 and 29 HIV-2 seroincident cases tested at a median of less than two years after seroconversion. There were also seroprevalent cases with single (nine HIV-1 cases and 31 HIV-2 cases) or dual (14 cases) infections. The authors determined that the viral set point was 28 times lower in individuals who recently seroconverted to HIV-2 than in recent HIV-1 seroconverters, even in symptomatic stages of the infections. People with dual infection had lower plasma HIV-1 RNA levels than singly infected subjects, the researchers found. (Archives of Internal Medicine Online (archinte.ama-assn.org) (11/27/00) Vol. 160, No. 21,; Andersson, Soren; Norrgren, Hans; Da Silva, Zacarias; et al.)
The best way to delay the onset of AIDS in HIV-positive people is to use a mix of antiretroviral drugs, but the cocktail required can be impossibly expensive, particularly for those who live in developing nations. The Brazilian government, however, authorized state laboratories to make generic copies of seven of the 12 cocktail drugs, which cut the cost of annual production by almost two-thirds. In addition, the government distributes the drugs for free to 90,000 people. The program shows that Third-World governments can have a deep impact on fighting AIDS, and that the high cost of the drugs does not make an impassable barrier. Brazil passed a patent law in 1997 that made those seven drugs' patents public property, among other patents, and then decided that it would be less expensive to make the drugs itself. It will begin making the eighth such medicine early next year and is in negotiations with private companies for another four, but Brazilian authorities have told the companies that if they do not lower the cost of those four drugs, the government will invoke a constitutional provision and break the patent licenses. Abbott Labs head of institutional relations Irapuan Oliveira expresses concern about loss of market share and possible quality problems in the substitution of government-made drugs for the company's. Brazil officials say, however, that the first two years of the program have kept 146,000 people out of the hospital and saved Brazil $472 million. It has also helped slow the spread of AIDS. Brazil has tried to enlist the aid of international agencies to share its program, but they have refused. So the nation says it will post the information on its Web site and give away the technology free of charge. (Houston Chronicle (www.chron.com) (12/17/00) P. A28; Downie, Andrew)
Researchers at the University of Colorado Health Sciences Center say that a natural body protein usually associated with cystic fibrosis could be used to fight AIDS because it appears to prevent the AIDS virus from infecting cells. Alpha-1 antitrypsin (AAT) works in several ways against the virus, including blocking the ability of the virus to infect healthy cells and virtually halting the virus' ability to spread out of the cell. Dr. Leland Shapiro says that it could be possible to give extra AAT to HIV-infected patients. AAT is currently used to treat patients with cystic fibrosis and other genetic defects, and it is grown in the milk of genetically engineered animals. (Reuters (www.reuters.com), 12/15/00)
Records from the Adult and Adolescent Spectrum of HIV Disease Surveillance Project, reviewed by Dr. Patrick S. Sullivan and other investigators with the Centers for Disease Control and Prevention, showed that there is a slight decrease in the progression to AIDS-defining opportunistic disease among patients who were vaccinated against influenza. The study involved information from more than 25,000 patients between 1990 and 1999 at 113 clinics in 10 U.S. cities, with the review published in the journal AIDS. Among the 42 percent of patients immunized against influenza, the hazard was 0.93, with a time to death hazard of 0.97, but investigators could not determine whether the improvements were a result of the vaccination itself or a factor related to increased preventive care or overall interest in physical health. While other studies have demonstrated that CD4 cell counts have lowered or HIV RNA levels have increased with the use of an influenza vaccine, this most recent study, with the benefit of a larger sample size, determines that there is no increased risk in giving influenza vaccines to AIDS patients. (Reuters Health Information Services (www.reutershealth.com), 12/15/00)
Hepatitis B virus (HBV) is a particular threat to unaware international travelers. A new study done by researchers at the University of Zurich Institute of Social and Preventive Medicine found that almost 75 percent of the 9,000 survey participants exhibited risk factors for contracting HBV. However, only about half knew the virus' routes of transmission, and only 17 percent had been vaccinated against HBV. Travelers should be more aware of the potential risks of infection through deliberate careless behavior and also involuntarily, through exposure to contaminated medical equipment or blood because of automobile accidents or unintentional injuries. (Journal of the American Medical Association (www.jama.com) (12/13/00) Vol. 284, No. 22, P. 2863)
An article published in the current issue of Family Planning Perspectives discusses facts found regarding the promiscuity of adolescent males and the risk factors for sexually transmitted diseases (STDs). The national survey reveals the statistics related to the types of sexual activities being pursued by teenaged boys, including oral and anal sex. Among other things, the report brought to light the confusing perceptions of what activities teenagers consider is not sex or is abstinence. "While 55 percent of teenage males say they've had vaginal sex, two-thirds have had experiences with noncoital behaviors like oral sex, anal sex, or masturbation by a female," says Freya L. Sonenstein, director of the Population Studies Center at the Urban Institute and one of the study's authors. "These behaviors put kids at risk of getting sexually transmitted diseases, which compromise their health." Linda Alexander, the president of the American Social Health Association, notes there is growing concern about STDs, as evidenced by the 400,000 hits her group's Web site for teenagers, www.iwannaknow.org, receives each month. The results, Alexander and others say, indicate that parents and clinicians should take a broad view of sexual activity when discussing sex with young people. Indeed, Ward Cates, the head of the Family Health Institute and former director of the Division of STDs at the Centers for Disease Control and Prevention, notes that "the most important message of these findings is to encourage communication about the whole range of sexual behavior, and to get away from the dichotomy we've set up between sex and abstinence, the view that sex is vaginal intercourse and abstinence is nothing more than holding hands." (New York Times (www.nytimes.com) (12/19/00) P. A18; Lewin, Tamar)
Starting January 1, injection drug users in New York will be allowed to purchase syringes without a prescription. Previously, new syringes were only available with a prescription, which made them expensive on the black market and resulted in needle sharing among addicts. The new law is a public health effort intended to reduce needle sharing and to stem the spread of blood-borne diseases, including HIV and hepatitis C. New York State Assemblyman Richard Gottfried (D-Manhattan), who has pushed for the law for over a decade, estimated that the HIV epidemic would be only half what it is were it not for the practice of needle sharing. "We are talking about tens of thousands of lives," he said. According to supporters of the new measure, the success of similar programs in other states was critical to the passage of the New York bill. After a needle law was adopted in Connecticut, needle sharing dropped by 50 percent and HIV infections fell by 33 percent in 1992 and 1993. Under the new measure, individuals will be able to buy up to 10 needles at a time from state-registered pharmacies, healthcare facilities, and professionals.
Back to the March 2001 issue of Body Positive magazine.
This article was provided by Body Positive. It is a part of the publication Body Positive.