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News & Notes

January 2001


Bristol-Myers Says US OKs New Version of HIV Drug

The Food and Drug Administration has granted Bristol-Myers Squibb permission to sell a new once-a-day formula of its HIV treatment Videx that causes fewer adverse events, such as diarrhea. According to Bristol-Myers representative John Kouten, Videx EC is the only HIV treatment currently available in a once-daily formula. Providing simple HIV dosing schedules has become increasingly important, as patients are required to take several drugs at different times of the day and non-compliance can result in increased drug resistance, Kouten notes. (Reuters (www.reuters.com), 10/31/00)

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Teens Unaware of Cervical Cancer Virus Risks

A study from Dr. Diana Dell of Duke University Medical Center shows that high school students know little about human papillomavirus (HPV), which is linked to cervical cancer. Approximately 15 percent of sexually active adults in America and Canada have HPV, said Dell, who interviewed 523 inner-city students in Toronto. According to a report in the November issue of the journal Obstetrics and Gynecology (2000;96: 653-656), 87 percent of the students had not heard of HPV. The researchers also note that only 39 percent of the sexually active young women knew who should get a Pap smear, which can detect abnormal cells. (Reuters Health Information Services (www.reutershealth.com), 10/31/00)


Teenagers Bounce Back Quickly After HIV Assault

Researchers in Philadelphia have found evidence that the immune systems of HIV-infected teenagers can rebound quickly after highly active antiretroviral therapy (HAART). "The research suggests adolescent patients have a more robust immune system, and we should start treating them very aggressively early on," said Dr. Steven D. Douglas, of The Children's Hospital of Philadelphia. "But that's just speculation." The study included 192 HIV-positive and 78 HIV-negative youths. Compared to the uninfected group, the HIV-infected individuals had lower CD4 cell counts; but one surprising discovery was that the infected teenagers had much higher CD8 cells counts than the HIV-negative teens. The finding reinforces a theory that HIV-positive adolescents have functioning thyroid tissue and stronger immune systems than HIV-infected adults, so they, thus, may have better cytotoxic T-lymphocyte and other responses than both HIV-infected adults or children. (AIDS Alert (www.ahcpub.com) (10/00) Vol. 15, No. 10, P. 127)


HIV Also an Issue for Older People

Susan McCollum, counselor for Planned Parenthood of Stark County, Ohio, helps teach people over 50 about the risks of HIV. Older people are not immune to the virus, and must know its methods of transmission. The Centers for Disease Control and Prevention estimates that 10.9 percent of men with HIV and 9.4 of HIV-infected women are 50 or over. Older people -- who may be newly alone after divorce or widowing -- may not be informed about or comfortable with condom use, McCollum explains. In addition, the executive director of Planned Parenthood in Stark County, Bonnie Bolitho, notes that some older people incorrectly think that HIV only affects homosexuals or young people, and many are not comfortable talking about sexuality. (Akron Beacon-Journal Online (www.ohio.com/bj), 10/30/00)


Sexual Abstinence Measure [in N.J.] Receives Criticism After Study

Legislation proposed by New Jersey Assemblywoman Marion Crecco (R-Essex) has been criticized after a survey by Rutgers University found that most parents are satisfied with the present curriculum. Currently, students are informed about abstinence and contraception; however, Crecco's measure would have schools emphasize abstinence during sex education. The lawmaker noted that while discussion of contraception would not be prohibited under her bill, abstinence would be stressed as the only sure way to prevent pregnancy and sexually transmitted diseases. To support her position, Crecco cited a Chicago study which found that teenagers who have abstinence-based education delay their first sexual encounter longer. The Rutgers survey found that 88 percent of New Jersey residents wanted a balanced approach to sex education and only 8 percent favored abstinence-only classes. (Bergen Record Online (www.bergen.com) (10/30/00); Cannon, Kathleen)


Cervical Shedding of CMV, HSV Higher Than Expected in HIV-Infected Women

A report in the October issue of the American Journal of Obstetrics and Gynecology (2000;183:948-955) shows that the rate asymptomatic of shedding of herpes simplex virus (HSV) and cytomegalovirus (CMV) DNA from the genital tract of HIV-1-infected women is higher than once thought. The researchers, from the University of Washington at Seattle, said the results are significant, since asymptomatic shedding can transmit HSV and CMV. PCR tests were used to detect shedding in cervical swabs of 17 women infected with all three viruses. A total of 10 percent of the 450 cervical specimens had detectable HSV. (Reuters Health Information Services (www.reutershealth.com), 10/27/00)


HIV Antibodies in Perinatal HIV-1 Infection: Association with Human HIV Transmission, Infection, and Disease Progression

A study of anti-HIV-1 antibodies involved 242 pregnant women and 238 infants, comparing perinatal transmission and infant disease progression. The researchers found that maternal anti-p24 and anti-gp120 antibodies were inversely associated with vertical transmission rates, independent of the mother's hard drug use, CD4 cell count, and serum vitamin A levels and other factors. Maternal plasma immune complex dissociated p24 and HIV-1 RNA copy number were strongly correlated with antibodies, however. The researchers also note that starting from birth, infants with fast disease progression had lower levels of anti-p24 than infants who did not have rapid progression. ( Journal of Infectious Diseases Online (www.journals.uchicago.edu/JID) (10/00) Vol. 182, No. 4, P. 1243; Pitt, Jane; Henrard, Denis; FitzGerald, Gordon; et al.)


HIV-Infected May Get TB Again and Again

HIV-infected people who contract tuberculosis (TB) are more likely to have relapses than individuals without HIV. A study of 233 patients, including 142 who were HIV-positive, found that those with HIV were more likely to have a relapse of TB, unless they were taking isoniazid. Researchers found that there were 7.8 reinfections per 100 HIV-infected people per year who were not taking isoniazid, versus 1.4 infections per 100 HIV-infected people per year who were taking the treatment and 0.4 cases per 100 HIV-negative individuals per year. Dr. Daniel Fitzgerald of Cornell University Medical College in New York reports in the October 28 issue of The Lancet (2000;356:1470-1474) that six months of rifampicin and 12 months of isoniazid could reduce the risk of recurrent TB among these patients. (Reuters Health Information Services (www.reutershealth.com), 10/27/00)


Pioneers of HIV, Gallo and Montagnier, Hope for Vaccine in Seven Years

A vaccine for HIV could be available in seven years, said HIV co-discoverers Robert Gallo and Luc Montagnier. Drs. Gallo and Montagnier were in Oviedo, Spain, to receive the Prince of Asturias prize for Scientific and Technical Research. According to Gallo, although it is not yet certain how or when an HIV vaccine will be developed, the current rate of research suggests that a definitive vaccine could be found by 2007. The researchers' teams, from the University of Maryland and the Pasteur Institute in Paris, have been collaborating on a transactivator (TAT) protein-based vaccine. (Agence France Presse (www.afp.com), 10/26/00)


HIV Levels in Semen Are Independent of Blood HIV

A new study from Dr. Ann Anderson Kiessling of the Beth Israel Deaconess Medical Center in Boston shows that HIV levels in semen are independent of blood HIV levels. Kiessling and colleagues measured virus levels in semen specimens from 12 HIV-infected men, two of whom were not taking antiviral therapy. The researchers, who reported their findings earlier this week at the American Society for Reproductive Medicine's annual meeting in San Diego, concluded that semen HIV comes from a different part of HIV infection and may react to antiviral treatment differently than blood HIV. According to Kiessling, while the majority of reverse transcriptase inhibitors crossed into the semen compartment, not all of the protease inhibitors fared as well. (Reuters Health Information Services (www.reutershealth.com) (10/26/00); Patten-Hitt, Emma)


Sperm Washing' Screens Out HIV

In Canada, six newborns have been born after their fathers took part in a procedure to "wash" HIV from their semen, an Italian doctor announced this week. The technique, invented by Dr. Augusto Enrico Semprini in Milan, claims to allow a woman to have a baby with an HIV-positive partner without passing on the infection. Semprini said the oldest Canadian child born after the procedure is now seven. He claims to offer parents a way to remove HIV-infected cells from semen, using a fluid called percol that is mixed with a semen sample in a test tube. A centrifuge helps force infected semen through the fluid, to the top of the test tube. The infected cells are filtered out, the sample is checked for HIV, and if clear, the woman undergoes artificial insemination with the "washed" sperm. (Calgary Herald (www.calgaryherald.com) (10/26/00) P. A5; Kirkey, Sharon I)



Antiretroviral Resistance During Successful Therapy of HIV Type-1 Infection

Researchers from Massachusetts General Hospital and elsewhere evaluated antiretroviral resistance in individuals for whom antiretroviral therapy was successfully suppressing HIV-1 RNA to less than 50 copies. The five subjects showed new resistant mutant subpopulations with evidence of residual virus replication during highly active antiretroviral therapy (HAART). The researchers, who based their findings on transient episodes of plasma HIV-1 RNA greater than 50 copies and virus env gene sequence changes, note that each patient received a suboptimal regimen before commencing HAART. (Proceedings of the National Academy of Science Online (www.pnas.org) (09/26/00) Vol. 97, No. 20, P. 10948; Martinez-Picado, J.; DePasquale, M. P.; Kartsonis, N.; et al.)


Lesbians Not Immune to Sexually Transmitted Infections

Australian researcher Dr. Katherine Fethers has reported that lesbians are just as likely as heterosexual women to contract sexually transmitted diseases like hepatitis and genital herpes. Fethers and colleagues from the Sexual Health Unit in Alice Springs found a higher prevalence of bacterial vaginosis, hepatitis C, and HIV risk factors in lesbians compared with a control group. The researchers, who report their findings in the journal Sexually Transmitted Infections, compared the histories of 1,408 lesbians to 1,423 heterosexual women between 1991 and 1998. Seven percent of women with female sex partners never had sex with a man; however, they were more likely to have had a relationship with a gay or bisexual man and were also more likely to have had more partners than other women. (Reuters (www.reuters.com), 10/24/00)


Incidence of AIDS-Related Lymphoma Remains Steady

Findings presented by Dr. Mark Bower and colleagues, from Chelsea and Westminster Hospital in London, show that the incidence and survival of AIDS-related lymphoma has not significantly changed since the advent of highly active antiretroviral therapy (HAART). A study of 7,840 HIV-positive patients showed a decline in AIDS-related illnesses besides lymphoma. According to their report in the journal Blood (2000;96:2730-2734), however, the researchers believe that HAART could eventually lead to a drop in the incidence of non-Hodgkin's lymphoma. The study found that the incidence of non-Hodgkin's lymphoma ranged from 3 to 7 cases per 1,000 patients both before and after HAART was introduced. (Reuters Health Information Services (www.reutershealth.com), 10/20/00)


A Proposed National Policy on Health Care Workers Living with HIV/AIDS and Other Blood-Borne Pathogens

In 1991, the Centers for Disease Control and Prevention recommended that all healthcare workers (HCWs) with HIV inform all patients of their HIV status before performing exposed procedures. Since 1991, new evidence shows that the risk of transmitting blood-borne pathogens in healthcare areas is very low, suggesting a change in national policy is necessary. Lawrence O. Gostin of the Georgetown University Law Center writes that a change in CDC guidelines would cause statewide reforms and help set a national standard of care. Studies have shown that the likelihood of transmitting hepatitis B is much greater than the risk of transmitting HIV during invasive procedures and other patient-related situations. HIV test results from over 22,000 patients and 63 HCWs with HIV found no cases of transmission as of July 1999, according to the CDC. The question of whether HIV-infected health workers put their patients at risk is crucial to these recommendations. The courts have determined that a theoretical risk of transmission is enough to be discriminatory. Hospitals should provide infection control and training for any workers with HIV. As for privacy rights, most Americans believe patients have a right to know about their doctors. However, Gostin does not believe the law should make healthcare workers disclose their HIV status to any patients, given the low risk of transmission and lack of behavioral risk factors. Gostin asserts, "A new national policy, focused on management of the workplace environment and injury prevention, would achieve high levels of patient safety without discrimination and invasion of HCW privacy." He proposes that a program to prevent bloodborne pathogen transmission include policies addressing universal precautions like gloves and gowns, sterilized equipment for each patient, infection control training, prevention methods, and exposure prevention during surgical procedures. (Journal of the American Medical Association (www.jama.com) (10/18/00) Vol. 284, No. 15, P. 1965; Gostin, Lawrence O.)


Age Important in Interpreting Surrogate Markers of HIV Infection in Treated Children

An analysis of five studies from the Pediatric AIDS Clinical Trials Group by Dr. Jane Lindsey of the Harvard School of Public Health in Boston shows that age can affect clinical outcomes of children treated with antiretroviral drugs. The researchers found that lower virologic markers at baseline were independent predictors of survival in children over age one. Dr. Lindsey explained that surrogate markers in adult studies cannot always be applied to infants and children. The scientists, who report their findings in the November issue of the Journal of Infectious Diseases (2000;182:1385-1393), suggest that doctors consider baseline and treatment-caused changes in HIV RNA before making decisions on medication. (Reuters Health Information Services (www.reutershealth.com), 10/19/00)


Care of HIV-Infected Inmates Benefits Public

HIV-infected drug users in prison need to receive prevention education and treatment that continues when they are released. John Miles, special assistant for corrections and substance abuse for the Centers for Disease Control and Prevention, explained that many people do not realize that when an inmate goes from a controlled environment into the free community, it can be difficult for that individual to find healthcare services. The parole system alone cannot do follow-up healthcare for inmates who leave, because most inmates leave without receiving parole. Some models for follow-up HIV care are seen in the correction systems of Rhode Island, New York, and Massachusetts. Rhode Island's prison system works with Miriam Hospital and Brown University to provide HIV care to prisoners. The state's small size makes it easy to provide a continuum of care for inmates, often with the same physician caring for the individual during and after his time in jail. The New York correction system works with community-based organizations to provide counseling to incarcerated HIV patients. Lester Wright, deputy commissioner and chief medical officer for New York State Department of Correctional Services, says these organizations also help prisoners who are discharged from jail and need medication upon their release. He notes that while most of the state's inmates are from New York City, special arrangements must be made for individuals in upstate New York. Meanwhile, the Hampden County Correction Center's HIV program for inmates in Ludlow, Mass., is a role model because it helps plan for housing, child care, and other services that former inmates with HIV need. Both the Centers for Disease Control and Prevention and the Soros Foundation have provided the Hampden County with research funding for the effort. (AIDS Alert (www.ahcpub.com) (10/00) Vol. 15, No. 10, P. 121)


Concurrent and Sequential Acquisition of Different Genital Human Papillomavirus Types

While coinfection with many types of human papillomavirus virus (HPV) has been reported, it is now known how frequently this happens. A study of 518 women conducted by scientists at the University of Washington at Seattle followed women for about three years, collecting cervical samples every four months to test for the virus. According to the authors, no two types were more or less likely to be seen concurrently, although concurrent acquisition of multiple types was seen more frequently than expected. The authors conclude that, in terms of sequential acquisition of HPV types, the "risk of acquiring a new HPV type was not decreased among those with prior infection by a phylogenetically related or unrelated type." (Journal of Infectious Diseases Online (www.journals.uchicago.edu/JID) (10/00) Vol. 182, No. 4, P. 1097; Thomas, Katherine K.; Hughes, James P.; Kuypers, Jane M.; et al.)


New Kind of Vaccine, Made of DNA, Controls AIDS Virus in Early Tests on Monkeys

A new vaccine made of DNA has shown promising results in controlling HIV in monkeys. Initial results from a study by Dr. Norman Letvin of Harvard Medical School and colleagues indicate that the vaccine was able to keep the monkeys healthy after they were infected with HIV, maintaining a low viral load so that HIV was undetectable in their blood. Dr. Letvin emphasizes the data only relates to monkeys, but hopefully it can be used to create a human vaccine in the future. Dr. Letvin's study, published today in the journal Science, details how his team injected eight rhesus monkeys with DNA that included two HIV genes and then infected them with HIV. The eight control monkeys that received a sham vaccine became ill within weeks, while the vaccinated monkeys lived for 140 days -- the duration of the test -- with no detectable virus in their blood, no immune system deterioration, and no indications of poor health. Dr. Gary Nabel, director of vaccine research at National Institutes of Health, which funded the study, said that although caution is needed when applying these findings to humans, the study "shows for the first time that by vaccinating in an appropriate way we can alter the course of HIV infection in terms of its ability to cause disease." A key discovery that led to the vaccine research was the discovery that killer T-cells, or CD8 cells, attack not a virus, but cells that have been infected by the virus. Letvin used this knowledge to induce monkeys to produce CD8 cells through the DNA vaccine. The new vaccine, which included components provided by Merck & Co., prompted the infected monkeys to use up to 30 percent of their CD8 cells to fight HIV, instead of between 5 percent and 10 percent. (New York Times (www.nytimes.com) (10/20/00) P. A18; Kolata, Gina)


Surgeon General Warns of New AIDS Casualties in Communities of Color

Surgeon General David Satcher warned Thursday that HIV cases are soaring among African Americans and Hispanics. Speaking at a conference on "AIDS and Communities of Color" in San Antonio, Satcher said that African Americans and Hispanics account for 69 percent of new HIV cases, even though they make up just 23 percent of the U.S. population. The disease is increasingly affecting women -- particularly minority women -- although they still account for less than one-third of all cases. Satcher asserted that AIDS must receive proper funding and attention and that prevention efforts are needed to help minority communities better understand the disease. (United Press International (www.upi.com), 10/19/00)


Battling a Silent Disease, Summit Focuses on Getting the Word Out About Hepatitis C

The Washington Hepatitis C Coalition met on Wednesday, discussing the topics of prevention, treatment, and counseling for people with hepatitis C virus (HCV). Awareness of the infection is crucial, as health officials estimate 200 people in the state will die from HCV infection this year, the majority unaware of their infection. Dr. Maxine Hayes, state health officer, explained that symptoms of the blood-borne infection can take 20 years to show. Dr. Robert Carithers of the Liver Transplantation Program at the University of Washington fears that millions of people are spreading HCV unknowingly. He also noted that most people with HCV have no long-term problems; however, if they are not aware of their infection, these individuals could unknowingly transmit the virus to others. (Seattle Post-Intelligencer (www.seattle-pi.com) (10/19/00) P. B1; Heckman, Candace)


Prison Study Discovers HIV Resistant to Medicines

Research from William O'Brien of the University of Texas Medical Branch at Galveston shows that HIV-infected inmates in Texas often have drug-resistant strains. The scientists found that the resistant virus could be spread within Texas prisons, posing a dual problem, for when prisoners are released, they can infect others in the community. Tests indicate that 48 percent of HIV-positive inmates studied had resistance to the drug 3TC, compared to 35 percent among patients at the medical school's clinic. Resistance to AZT, however, was lower among the prisoners. Approximately 3 percent to 4 percent of Texas inmates have HIV, and infection rates are higher among women in female inmates than male inmates. O'Brien's research also uncovered what he believes to be the first known case of drug-resistant HIV that was transmitted in prison. The individual tested HIV-positive in 1997 after several negative tests, and within a year, physicians identified nine genetic mutations that indicated resistance to some drugs. At that point, the individual had not taken any drugs for his infection. (Dallas Morning News (www.dallasnews.com) (10/03/00); Beil, Laura)


Patient Makes Anti-HIV Immunity Cells in Enzo Trial

Enzo Biochem, a biotechnology company, reported Monday that a patient involved in a Phase I trial has generated new immunity cells to fight HIV. The company said that after nearly 10 months, cells it engineered have engrafted to the individual's bone marrow and are producing new anti-HIV cells. Enzo is still collecting data on the other five patients in the study, but the company said it hopes to begin Phase II tests of the HGTV-43 treatment soon. (Reuters (www.reuters.com), 10/02/00)


HIV-Positive Refugees Find a Home: INS Program Allows 14 to Settle in Boston

Thousands of refugees with HIV await entry into the United States, many denied after U.S. Health and Human Services health workers test them for the virus. A change in immigration policy has allowed 14 HIV-positive refugees to enter and settle in Boston this year. Many of the refugees contract HIV during torture or in crowded cells created for demonstrators in Africa who oppose the government. All refugees admitted into the United States must be tested for diseases like tuberculosis, leprosy, sexually transmitted infections, HIV, and mental problems. Thus far, 123 HIV-infected refugees have been allowed to enter the country. The Immigration and Naturalization Service test program allows a small number of these HIV patients to enter and get treatment through Medicaid or the Refugee Medical Assistance Program. (Boston Globe (www.boston.com/globe) (10/17/00) P. F3; Rodriquez, Cindy)


Articles abstracted by the National Prevention Information Network (NPIN) of the U.S. Centers for Disease Control and Prevention (CDC).


Back to the January 2001 Issue of Body Positive Magazine.


  
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