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The
antibiotic is not available in many places |
News (Updated
April 4, 2010)
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The
antibiotic is not available in many places |
The opportunity to save
tens of thousands of HIV patients with a simple, cheap, drug treatment is being
missed, say researchers.
Giving some
newly-diagnosed patients an antibiotic would significantly reduce the death toll
in the early stages of the disease, they say.
A major study in The
Lancet medical journal found it halved mortality.
The World Health
Organization already endorses the treatment, but specialists say many people are
not given the drug.
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Much of the focus of the
pharmaceutical battle against HIV has been on antiretroviral drugs, which can
greatly extend life.
However, many patients are
at greatest risk in the first weeks after diagnosis, with a variety of
infections ready to take advantage of their weakened immune systems.
Studies have estimated
that as many as a quarter of people who enter antiretroviral drug treatment
programmes in sub-Saharan
But the addition of co-trimoxazole,
an inexpensive antibiotic, to the long-term treatment plan of those with the
worst affected immune systems appears to prevent many of these deaths.
The Lancet study, carried
out among 3,179 Ugandan patients, suggested a fall of 59% over the first 12
weeks, and 44% between 12 and 72 weeks.
Call for action
Its authors, from the
Medical Research Council Clinical Trials Unit and
They say their findings
reinforce the need for swifter action by those responsible for drug treatment
programmes.
Professor Charles Gilks,
who led the study, said any arguments over the effectiveness of the antibiotics
were now "well and truly answered".
He said: "Tens of
thousands of lives can be saved by more universal use of the drug, costing just
a few pence a day."
Co-author Professor Diana
Gibb, from the Medical Research Council, said the availability and supply of the
drug needed to be "ramped up", and offered to all new patients for the
first 18 months.
"There is a
significant benefit now - waiting to be grasped," she said.
In addition to preventing
bacterial infections in HIV patients, the drug had a another welcome benefit -
it cut the incidence of malaria by a quarter.
Dr Sarah Walker, also from
the MRC, said: "The benefits of using this drug are huge, and it's so
simple and cost-effective to administer."
However, Dr Alvaro Bermejo,
the executive director of the International HIV/AIDS Alliance, said access to
antiretroviral treatment remained an even bigger problem.
"We need to remember
that there are still millions of people in
"In
"As the study
confirms, antiretroviral treatment cuts the risk of death by more than 90% -
with co-trimoxazole reducing the risk still further.
"We have the
knowledge available to save lives but we need to increase efforts to make sure
that everyone who needs treatment can actually access it."
THURSDAY, April 1 (HealthDay
News) -- Four anti-HIV drugs inhibit a retrovirus recently linked to prostate
cancer and chronic fatigue syndrome (CFS), say
If further investigation
proves that the retrovirus xenotropic murine leukemia virus-related virus (XMRV)
causes prostate cancer or CFS, these HIV drugs may be an effective treatment for
the two conditions.
In this study, researchers
from the
"Our study showed
that these drugs inhibited XMRV at lower concentrations when two of them were
used together, suggesting that possible highly potent 'cocktail' therapies might
inhibit the virus from replicating and spreading," Raymond F. Schinazi, a
professor of pediatrics and chemistry and an investigator with the Center for
AIDS Research at the Emory University School of Medicine and the Atlanta VA,
said in a news release.
"This combination of
therapies might also have the added benefit of delaying or even preventing the
virus from mutating into forms that are drug-resistant," Schinazi added.
"These results offer
hope to infected persons, but we are still at the early stages of our
understanding of the potential link between XMRV and these diseases," Dr.
Ila R. Singh, an associate professor of pathology at the University of Utah
Medical School, said in the news release.
The study was published
April 1 in the journal PLoS One.
Sunday, April 4, 2010
BY SIMEON BENNETT AND TOM
RANDALL
Wire Service
BLOOMBERG NEWS
Gilead Sciences Inc. may
learn this year whether its drugs for treating HIV can also stop people from
catching the virus in the first place.
The approach may help curb
the AIDS pandemic in poor countries. Researchers are compiling the first data
from 10 trials involving more than 20,000 people, and initial results may be
available in July.
If the strategy works, the
pills from Foster City, Calif.-based
Skeptics say the approach,
called pre-exposure prophylaxis, or PrEP, may be too costly and impractical in
sub-Saharan
Though doctors regard
"People have a high
tolerance for side effects if it's saving their life," said Mitchell
Warren, executive director of the New York-based AIDS Vaccine Advocacy
Coalition, a non-profit advocacy group. "It may be harder for healthy
people to accept the side effects that come with prevention."
The trials involve giving
A further three studies
coordinated by the Centers for Disease Control and Prevention, based in Atlanta,
are testing PrEP among gay men in the United States, drug users in Thailand and
heterosexuals in Botswana.
The studies are also
designed to measure whether people receiving the drugs become less careful in
their behavior, in the belief they're protected against the virus.
If the tests are
successful, PrEP distribution programs could begin in developing countries in
2012, said Bill Gates, co-founder of Microsoft and the Bill & Melinda Gates
Foundation. The Gates Foundation is sponsoring three PrEP trials.
"PrEP is the next big
thing," said
Gilead Sciences Inc. may
learn this year whether its drugs for treating HIV can also stop people from
catching the virus in the first place.
The approach may help curb
the AIDS pandemic in poor countries. Researchers are compiling the first data
from 10 trials involving more than 20,000 people, and initial results may be
available in July.
If the strategy works, the
pills from Foster City, Calif.-based
Skeptics say the approach,
called pre-exposure prophylaxis, or PrEP, may be too costly and impractical in
sub-Saharan
Though doctors regard
"People have a high
tolerance for side effects if it's saving their life," said Mitchell
Warren, executive director of the New York-based AIDS Vaccine Advocacy
Coalition, a non-profit advocacy group. "It may be harder for healthy
people to accept the side effects that come with prevention."
The trials involve giving
A further three studies
coordinated by the Centers for Disease Control and Prevention, based in Atlanta,
are testing PrEP among gay men in the United States, drug users in Thailand and
heterosexuals in Botswana.
The studies are also
designed to measure whether people receiving the drugs become less careful in
their behavior, in the belief they're protected against the virus.
If the tests are
successful, PrEP distribution programs could begin in developing countries in
2012, said Bill Gates, co-founder of Microsoft and the Bill & Melinda Gates
Foundation. The Gates Foundation is sponsoring three PrEP trials.
"PrEP is the next big
thing," said
In addition, the scientists from California Institute of Technology demonstrated
that a particular antibody to gp120 makes contact not only with the protein, but
with CD4 receptor that gp120 uses to gain entrance into the body's T cells.
This three-dimensional understanding of how gp120 is built is more than just a
basic scientific advance, they say. "There's a tremendous continuing effort
to develop a vaccine for HIV and most of those efforts use gp120. Having more
structural information will facilitate better vaccine design," said lead
scientist Ron Diskin.
The team looked specifically at gp120 from what is known as clade C HIV-1. To
explain what that means, here's a brief HIV family history: Most people who get
HIV and proceed to AIDS are infected with a member of the HIV-1 family of
viruses. HIV-1 is divided into groups; most AIDS-related strains of the virus
come from group M. The groups are further subdivided into what are known as
clades.
Clade B is the form of group M HIV-1 most often found in the
In order to uncover the structure of clade C gp120--and determine if the
hypothesis about its similarities was indeed true — the Caltech team needed to
crystallize the protein. That was no easy task. Turns out, says Diskin, the
protein itself is not stiff enough for crystallization. And so the researchers
created a complex of molecules consisting of a gp120 monomer, a CD4 receptor,
and an anti-HIV antibody known as 21c.
Thursday, April 1, 2010
Researchers are studying a
new approach that arms the immune system with an intrinsic defence against HIV.
While speaking at the
Society for General Microbiology's spring meeting in
In the absence of an
effective vaccine, daily administration of anti-retroviral drugs is the most
effective treatment for HIV. However, low patient compliance rates combined with
the virus's ability to easily mutate has led to the emergence of drug-resistant
strains that are difficult to treat.
Professor Berkhout from
the
The therapy involves
extracting and purifying blood stem cells from the patient's bone marrow.
Antiviral DNA is transferred to the cells in the laboratory, after which the
cells are re-injected into the body. The DNA encodes tiny molecules called small
RNAs that are the mirror image of key viral genes used by HIV to cause disease.
The small RNAs float around inside the immune cell until they encounter viral
genes which they can stick to like Velcro(tm). This mechanism, called 'RNA
interference' can block the production of key viral components from these genes.
Transferring the antiviral
DNA to stem cells would help to restore a large part of the patient's immune
system. "Stem cells are the continually dividing 'master copy' cells from
which all other immune cells are derived. By engineering the stem cells, the
antiviral DNA is inherited by all the immune cells that are born from it,"
explained Professor Berkhout.
25 Mar 2010
Chembio Diagnostics, Inc. (OTCBB: CEMI), which develops, manufactures, markets
and licenses point-of-care diagnostic tests, announced that its DPP® Oral HIV
1&2 Screen Assay for use with oral fluid or blood samples has been approved
by the U.S. Agency for International Development ("USAID") for
inclusion on the list of approved rapid HIV tests. This approval makes the test
eligible for procurement with funds provided by the United States President's
Emergency Plan for AIDS Relief, or PEPFAR. Recent international field studies,
including one undertaken by the U.S. Centers for Disease Control Global AIDS
Program ("CDC-GAP") on behalf of the USAID for purposes of this
approval, indicate that the product's accuracy exceeds that of certain other
rapid HIV tests that are widely used by PEPFAR. Chembio has initiated clinical
trials in the
The DPP® Oral HIV 1&2 Screen Assay was recently evaluated by CDC-GAP in
Mozambique, performing with 100% sensitivity and 99.8% specificity, a
performance which exceeded that of each of the other three tests (two blood
tests and one oral fluid test) that were included in the study, two of which are
leading tests widely used by PEPFAR and other international HIV/AIDS programs.
The CDC-GAP study involved 1674 patients (517 positive and 1157 negative). In a
second study, sponsored by Chembio and conducted through the National Hospital
in Abuja, Nigeria in which a total of 645 patients participated (223 positive
and 422 negative), the Chembio DPP® oral fluid assay performed with 100%
sensitivity and 100% specificity. These two international studies provide strong
evidence of outstanding performance for this assay.
Chembio is now registering and establishing distribution for the DPP® oral
fluid HIV test in developing world markets where there is expected demand for
this unique product. Once Chembio receives the PMA approval currently
anticipated to be during 2011, it intends to market the product through its own
sales organization in order to provide its customers with optimal pricing and
support. Chembio also then intends to pursue Over-the-Counter (OTC) approval of
this product. The regulatory pathway for OTC approval was significantly
clarified on November 17, 2009 by the FDA's Blood Products Advisory Committee.
Lawrence Siebert, Chembio's Chief Executive Officer, commented, "We are
very pleased with the performance of our product in these studies and our USAID
approval. Complemented by our patent-pending oral fluid collection system and
24-month room temperature stability, we believe our DPP® oral fluid HIV test
can have a significant impact on HIV prevention efforts globally."
Mr. Siebert continued, "We believe that there is a significant market
opportunity for our oral fluid HIV test in the
The DPP® Oral HIV 1&2 Screen Assay is a simple point-of-care diagnostic
test for the detection of antibodies to HIV 1&2 which incorporates Chembio's
patented dual path platform (DPP®) rapid diagnostic test technology. It
provides the convenience and flexibility of being equally accurate with blood
matrices as with oral fluid samples, and uses a similar procedure in all cases.
The oral fluid sample is collected by means of a separate oral fluid swab
collection system. This patent-pending system provides a convenient closed
system for the preparation and storage of the sample solution prior to its being
applied to the test strip. Chembio's patented DPP® point-of-care technology
allows for the incubation of samples with the capture reagents on a test strip
before introduction of the labeling reagent, thereby allowing for a more
sensitive binding reaction to take place between the sample and capture
reagent(s). Data show that this achieves more consistent results than oral fluid
tests that utilize lateral flow technology, which must mix viscous oral fluid
samples with labeling reagents before the reaction with the capture reagent(s)
can occur. The Chembio collection system also enables users the option (with
oral fluid or blood samples) to store samples before the test is run for
extended periods, and/or to retain samples for further testing.
The DPP® Syphilis Screen & Confirm rapid test is the first simple rapid
test which can detect the two markers (treponemal and non-treponemal) that must
be present in order to confirm that there is an active, untreated case of
syphilis. Although there is no assurance, regulatory clearance for this product
is being planned for 2011.
25 Mar 2010
A study by the Barcelona Public Health Agency has revealed those sections of the
population that are most vulnerable to tuberculosis. The research, published in
the journal Respiratory Research, shows that the highest death rates from this
disease are among those aged over 50 or infected with HIV.
"Some patients give up their tuberculosis treatment (which lasts for a
minimum of six months), resulting in a danger of them infecting other people,
worsening their own state of health or even dying", Joan A. Caylŕ, lead
author of the study and a researcher at the Barcelona Public Health Agency (ASPB),
tells SINC.
The study, published in the journal Respiratory Research, identifies the factors
linked to people giving up tuberculosis treatment and deaths from the disease.
Researchers from the Spanish Society of Pneumology and Thoracic Surgery (SEPAR)
analysed a sample of 1,490 people with the illness in
The results of these studies show that abandoning tuberculosis treatment is
usually related to having undergone previous treatment for the disease, being an
injecting drug user (IDU), living with a large number of people, and also the
doctor's perception that the patient does not have a good understanding of the
treatment.
The authors from the ASPB, meanwhile, stress that deaths are associated with
failure to understand the treatment, being an IDU, being in directly-observed
treatment (DOT), and also being over the age of 50 or being infected with HIV.
One-third of the world population
The World Health Organisation (WHO) declared 24 March as World Tuberculosis Day,
to commemorate the day in 1882 when the biomedic Robert Koch announced the
discovery of the bacillus that causes the disease. This was the first step
towards being able to diagnose and cure it.
Each year, eight million people contract tuberculosis worldwide, and two million
die from it. Although tuberculosis is still endemic in
The WHO aims for the tuberculosis prevalence and death rates to have fallen to
half their current levels by 2015. Today, around two billion people - one-third
of the entire world population - are infected with tuberculosis.
Source: Plataforma SINC
31 Mar 2010
Co-infection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV)
poses a treatment challenge. In Western Europe and the
A research article published in the World Journal of Gastroenterology addresses
this problem. The research team from
Of the 5681 HIV infected patients in the cohort, 355 patients were HIV and HBV
co-infected and were evaluated. Of these, 226 patients with more than 12 mo
follow-up were included in the further analysis to better estimate factors
associated with loss of HBsAg in the long-term follow-up. The patients were
observed for a mean duration of 45.6 mo (range, 20.8-.1 mo). During the
follow-up period, 21 patients lost HBsAg.
In the univariate analysis, baseline CD4 cell count was associated with loss of
HBsAg (P = 0.052). Other factors, including baseline ALT, presence of hepatitis
C virus co-infection, baseline HIV viral load, HIV viral load at end of
follow-up, CD4 cell count at end of follow-up, CD4 cell count gain, and
treatment with dually active antiretrovirals were not related to loss of HBsAg .
Cox regression analysis revealed that baseline CD4 cell count > 500 cells/mm3
was associated with loss of HBsAg.
The study showed an interesting association of HBsAg loss in HIV-HBV co-infected
patients with higher CD4 cell count, suggesting that T-cell cytolytic activity
against HBV may still be effective in clearing HBV infection.
Reference:
Psevdos G Jr, Kim JH, Suh JS, Sharp VL. Predictors of loss of hepatitis B
surface antigen in HIV-infected patients. World J Gastroenterol 2010; 16(9):
1093-1096
Source:
Jin-Lei Wang
World Journal of Gastroenterology
Mercy Adhiambo
31 March 2010
WHO/TDR/Crump
[
The new vaccine protects
against Streptococcus pneumoniae which causes pneumonia and, when it invades the
bloodstream and brain, causes septicaemia and meningitis.
Adults in the
The new conjugate vaccine
was tested using nearly 500 HIV-infected adults who had recovered from a bout of
pneumococcal disease. Three quarters of the patients remained free from the
disease, according to the researchers at the Malawi-Liverpool-Wellcome Trust
Clinical Research Programme, based at the University of Malawi College of
Medicine.
The vaccine worked even
when the number of CD4 cells in a patient's blood — an indicator of immune
strength — was less than 200, the level that indicates AIDS.
Unlike the polysaccharide
vaccine the new conjugate vaccine contains a protein that helps the body’s
immune system recognise the pneumococcus bacteria, said Neil French, of the
Liverpool School of Hygiene and Tropical Medicine, in the
"The general view on the use of any vaccine in HIV is that low CD4 counts
make the vaccine useless. We've shown that conjugate technology overcomes the
profound immune deficiency at these low counts. This gives hope for the possible
use of conjugate technology in other vaccines targeting important HIV associated
bacterial infections, most notably non-typhoidal Salmonella," he said.
"If conjugate vaccines are found to confer protection against invasive
pneumococcal disease, this will be a major breakthrough, to reduce the morbidity
and mortality of HIV infected persons from pneumococcal disease," said
French.
Jeremiah Chakaya, a chest specialist at the Kenya Medical Research Institute
welcomed the vaccine but said it will only be a breakthrough when the price —
US$40 — is brought down.
"If the cost of the
conjugate vaccine is about US$40 per dose, then it is going to be very difficult
for most African governments to purchase it, and even if they do, then the
people who need it will have to buy it at a very high price. This would make the
vaccine a preserve of the few rich people in the countries."
Tens of
thousands of lives can be saved by more universal use of the drug, costing
just a few pence a day 