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August 24, 2006

In This Update:
  • The XVI International AIDS Conference
  • Exclusive Podcasts From AIDS 2006
  • HIV Treatment
  • HIV Transmission & Prevention
  • HIV Outside the U.S.

    From Podcasts to Photos, The Body Offers Full Coverage of AIDS 2006
    The XVI International AIDS Conference (AIDS 2006), the largest HIV conference in history, has ended. Over the past week, the conference captured news headlines throughout the world not only for the research that was presented, but also for the people, events and protests that make it so much more than what many believe is just a large gathering of medical professionals.

    The Body is proud to offer extensive, frequently updated, multimedia coverage of this massive conference, including:

    More coverage will arrive over the days to come, so be sure to revisit our AIDS 2006 home page for the latest!



    A Father Lost, a Mission Gained: A Young, Jamaican Woman's Life Is Framed by HIV
    Kerrel McKay has a lot to be happy about: The 21-year-old AIDS advocate is a globally recognized youth leader, speaks for UNICEF and has established a strong non-governmental group in her homeland of Jamaica. However, behind the smiles and boisterous laughter simmers the story of a young woman who lost her father six years ago to AIDS. Kerrel was 9 years old when her mother told her that her father was HIV positive. With no initial understanding of the virus or the discrimination that would come along with it, Kerrel stood by her father and helped in any way she could, even after he moved out of the family home. In this touching and tearful interview, Kerrel recounts her father's story, as well as her decision to advocate for young people who are infected and affected by HIV around the world.

    What Makes HIV Nonprogressors Tick? An Interview With Bruce Walker, M.D.
    With the search for an HIV vaccine seemingly stalled, researchers are seeking new avenues in which they can find clues to the mystery of how to prevent HIV infection. Noted HIV researcher Bruce Walker, M.D., is currently recruiting people for a study on HIV-positive "elite controllers" and long-term nonprogressors, two types of people who are able to stay healthy for many years despite never taking HIV medications. Dr. Walker hopes his research can open a new door to the development of an effective HIV vaccine.

    Getting to Know an Elite HIV Controller: An Interview With Loreen Willenberg
    Only a small percentage of HIV-positive people are as fortunate as landscape designer Loreen Willenberg. She is what HIV researchers have termed an "elite controller," which is someone who has had HIV for many years, but has never had a detectable viral load. Since becoming infected with HIV 14 years ago, Loreen has had an undetectable viral load and an extremely high CD4 count. She was flown to AIDS 2006 by Dr. Bruce Walker, who wanted to publicize an ambitious study that aims to recruit 1,000 elite controllers and 1,000 long-term nonprogressors over the next six months. In this interview, Loreen talks with The Body about living with HIV as an elite controller, as well as her participation in Dr. Walker's study.

    Body Fat Changes in People With HIV: A Talk With Todd Brown, M.D.
    Todd Brown, M.D., is an HIV researcher with the Johns Hopkins School of Medicine; his research focuses on metabolic and skeletal problems in HIV-positive people. In this interview with The Body's David Wohl, M.D., Dr. Brown discusses the research he presented at AIDS 2006 regarding body fat changes in people with HIV.

    Many more podcasts are available from The Body's Podcast Central at AIDS 2006!



    48-Week POWER Results Show Continued Strength for TMC114
    The newly approved protease inhibitor TMC114 (darunavir, Prezista) has shined in 24-week clinical trials involving people with resistance to all three major HIV drug classes. Can it still hold up after 48 weeks against comparator protease inhibitors? Graeme Moyle, M.D., reports for The Body on the latest data from the POWER studies, which were presented at AIDS 2006. The data show that TMC114 + ritonavir (Norvir) continues to yield a viral load and CD4 count response that is superior to that of other protease inhibitors.

    Is Fosamprenavir as Good as Kaletra for First-Line Therapy?
    Fosamprenavir (908, Lexiva, Telzir) is at least as potent as Kaletra (lopinavir/ritonavir), which has long been considered the standard of care in first-line therapy, according to results from a large, industry-sponsored, head-to-head study presented at AIDS 2006. As Edwin DeJesus, M.D., reports for The Body, this new data should clear the way for fosamprenavir to be added to the list of recommended first-line therapy options in the U.S. treatment guidelines.

    Truvada Appears to Best Combivir in Head-to-Head Study
    The fixed-dose combination drugs Combivir (AZT/3TC) and Truvada (tenofovir/FTC) are both very popular as first-line HIV treatment. But does one drug actually work better than the other? In an industry-sponsored trial comparing the two drugs head to head, researchers found that Truvada not only caused fewer side effects, but also caused a significantly higher number of people to achieve a viral load below 400, and even yielded a higher CD4 count increase. Mark Nelson, M.B.B.S., reports for The Body from AIDS 2006.

    For much more news and research on first-line therapy from AIDS 2006, click here.

    Expanded Access Program to Begin for Integrase Inhibitor MK-0518

    MK-0518, an HIV medication in development that's part of a new class known as integrase inhibitors, may be available to treatment-experienced HIVers through an expanded access program within the next several months, according to an announcement by Merck & Co. at AIDS 2006. The decision to expand access to MK-0518 came after a 24-week study found that 90 percent of the HIV-positive, multidrug-resistant people in the trial, who took the prescribed amount of MK-0518 in combination with 3TC (lamivudine, Epivir) + tenofovir (Viread), reduced their viral load to undetectable. The expanded access program would make MK-0518 available internationally to HIV-positive people who have limited or no treatment options remaining.

    Studies Suggest That One or Two Meds Might Work as Well as Three
    According to several preliminary studies showcased at AIDS 2006, single- and dual-drug HIV therapy may be making a comeback in specific situations. As HIV meds become more powerful and medication costs increase, studies such as these have begun to investigate whether simpler regimens can suppress viral loads and maintain CD4 counts as effectively as traditional triple-drug regimens. Although the small studies presented at AIDS 2006 were positive, many physicians still worry that these simplified drug regimens could breed resistance. At any rate, much more study is needed before the strategy can be regularly used. As Scott Hammer, an infectious diseases specialist at Columbia University Medical Center, put it, single-drug therapy is "potentially viable for the future, but I wouldn't use it routinely in practice now."

    HLA Testing May Help Predict Abacavir Hypersensitivity
    Hypersensitivity reaction is a severe allergic reaction that strikes as much as 8 percent of HIVers who take abacavir (Ziagen) in clinical trials. When hypersensitivity reaction occurs, it's almost always shortly after abacavir treatment is started, and can put a person's health -- and potentially even his or her life -- at risk. But abacavir can also be a pivotal component of many people's HIV treatment regimen, which raises an interesting question: Is there any way in which we can predict who is least likely to develop abacavir hypersensitivity? As Margaret Hoffman-Terry, M.D., reports for The Body from AIDS 2006, a relatively inexpensive method known as "HLA testing" may improve the diagnostic accuracy of predicting this dangerous side effect.



    HIV Superinfection May Be More Common Than Previously Thought, Researchers Say
    Cases of HIV superinfection, when an HIV-positive person is infected with more than one strain of the virus, may be more common than previously believed, according to researchers at AIDS 2006. A recent study of 57 HIV-positive women in Mombasa, Kenya, has found eight cases of superinfection -- a rate of 14 percent, which is dramatically higher than any previous estimates made within the United States. The researchers believe that many of the women contracted the second HIV strain within a year of their initial infection. However, even though this new study is the largest of its kind, researchers note that the findings are still only preliminary, and the overall risk of superinfection is still uncertain.

    New Prevention Methods Offer Hope and Challenges, According to Report
    A range of HIV prevention methods could be available within a few years, but many countries are not prepared to implement them, according to a new report presented by the Global HIV Prevention Working Group at AIDS 2006. The report assesses the state of several new, experimental HIV prevention strategies, including: male circumcision; cervical barriers, such as diaphragms; pre-exposure prophylaxis; treatment to suppress herpes, which increases HIV transmission risk by threefold; and HIV vaccines. According to UNAIDS, about $11.4 billion annually will be required for HIV prevention by 2008, which is more than twice the amount currently being spent. In addition, more than 80,000 clinical trial volunteers will be needed throughout the world to test these new prevention methods.



    Oppressive Treatment of HIVers in Nigerian Society, HIV-Positive Woman Explains
    HIV-positive Nigerians are "treated like dogs," says Maryam Tamakloe, an HIV-positive mother of two living in Nigeria. If you're a woman, protecting yourself from HIV is next to impossible, she asserts: "If a woman talks about a condom, people will think she is a prostitute." Disclose that you're HIV positive in Nigeria, she adds, and "your colleagues, your landlord and your people stop having anything to do with you. Your family may even build a separate room for you and leave you there to die." In this interview with BBC Network Africa, Maryam discusses HIV stigma and her hope that AIDS 2006 will result in less talk and more action. (Web highlight from BBC News)

    South African Government Condemned at Conference and at Home
    During the closing session of AIDS 2006 on Aug. 18, United Nations Special Envoy for HIV/AIDS in Africa Stephen Lewis and conference co-chair Mark Wainberg, Ph.D., broadly condemned the South African government for promoting alternative remedies like lemons and garlic over HIV medications. Lewis said, "The [South African] government has a lot to atone for. I am of the opinion that they can never achieve redemption." Meanwhile, 8,000 miles away at government offices in Cape Town, South Africa, 44 protesters were arrested for staging a sit-in to protest Health Minister Manto Tshabalala-Msimang's response to the country's HIV epidemic. Tshabalala-Msimang came under direct fire at the conference, as well: Mark Heywood, head of the AIDS Law Project in South Africa, called on Tshabalala-Msimang to resign her post. "People who follow her advice in late-stage HIV infection and take garlic and lemons will die," Heywood said.

    On Aug. 24, South Africa's Treatment Action Campaign announced it had launched a coordinated series of mass protests in South Africa and at South African embassies in Canada and the United States to demand the resignation of Tshabalala-Msimang. Click here to read the Treatment Action Campaign press release on the protests.

    This story, of course, is only one of many coming out of the AIDS 2006 conference regarding HIV in developing countries. Click here for a listing of many more articles, research summaries and Webcasts from AIDS 2006 on the epidemic outside the United States.

    Also Worth Noting

    Exclusive Images From
    AIDS 2006

    Image from The Body's AIDS 2006 Photojournal
    Condom Mascots From Mexico
    The Body's exclusive AIDS 2006 Photojournal features dozens of images of the many people, protests and unique sights of the XVI International AIDS Conference. The Photojournal is meant to give the millions who couldn't attend the conference a sense of what it's like to be there. From world leaders to HIVers in the developing world; from press conferences to protests; and from the conference center to downtown Toronto, we'll give you a glimpse of what it was like to attend the largest gathering on HIV in history.

    Connect With Others
    t The Body's Bulletin Boards

    HIV-Positive Foreigners in the U.S.: Were You Able to Leave (and Then Re-Enter) the Country?
    (A recent post from the
    "Living With HIV" board)

    "I was just wondering if there are any foreign nationals/immigrants that are working and living here in the United States, who were tested here in the United States, and have managed to travel outside and back inside the United States, getting past customs or immigration at the airport without any problems in terms of your status being revealed on the computer system. ... I am from South Africa and have been working here for four years and was tested here in the United States. Now I need to go and visit my family [in South Africa for one week], but I am so scared: What if I am not allowed back in the country when I come back to work?"

    -- Travelworry

    Click here to join this discussion thread, or to start your own!

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the August 2006 Visual AIDS Web Gallery
    "Tony From the Writing Group," 1996; Albert Winn
    Visit the Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The August gallery is entitled "Between Ten"; it showcases the work of seven artists spanning the 10 years since the introduction of combination HIV treatment in 1996. This Web gallery highlights some of the works in a larger exhibit that was on display last week at the XVI International AIDS Conference in Toronto, Canada.