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January 10, 2010)
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By Catherine Hood 10/01/2010
January is a time to
review your lifestyle - lose a few pounds, take up more exercise or simply eat a
healthier diet. But after the excesses of the party season, New Year is also a
time to give your sex life a check-up.
Every year too much
festive spirit results in thousands of revellers catching sexually transmitted
infections.
The most common in the
Recent research A RECENT
survey of young adults has turned up some worrying results about awareness of
chlamydia and STI testing.
Despite all the hype
almost two-thirds of the 15- to 24-year-olds surveyed failed to use condoms with
every new sexual partner. But condoms are the only way to prevent yourself from
catching an STI. In the survey 78 per cent said they were aware of chlamydia but
only 10 per cent got tested before a new relationship. But most infected people
have no symptoms. Without testing and getting treated they could pass the
infection on to others.
Getting tested IT has
never been easier to get tested for STIs - and chlamydia in particular.
You can get a full check
up for all infections including chlamydia, HIV and gonorrhoea from the genito-urinary
or sexual health clinic at your local hospital or ask your GP.
But thanks to the national
chlamydia screening programme your GP or family planning clinic may offer you
chlamydia testing even if you go to see them about a completely different
matter. Testing is simple and confidential - all you'll need to do is give a
urine sample or provide a swab.
So if you're offered a
chlamydia test this year, don't stick your head in the sand. Anybody who has sex
without a condom can catch chlamydia so look after your health in 2010 and say
yes to testing
04 Jan 2010 Source:
SciDev.Net
Sharon Davis
[
PRO 2000, a vaginal
microbicide gel, had been hailed as the most promising microbicide in a decade
of research on female-controlled prevention methods.
But the results of a
clinical trial published this week (14 December) found no evidence that PRO 2000
reduces the risk of HIV infection �
infection rates were similar in both groups.
The trial, in
Salim Karim, director of
the Centre for the Aids Programme of Research in South Africa (CAPRISA), said
the results were "deeply disappointing" and called for more research
to find a means for women to protect themselves from HIV.
Gita Ramjee, director of
She said that studies are
now focusing on more potent products; specifically exploring the use of
antiretrovirals in pill, and vaginal gel and ring form for prevention (see
Antiretroviral microbicides enter clinical trials).
"The need for a
woman-controlled HIV prevention technology is critically important to turn the
tide of the epidemic, especially in southern
CAPRISA is testing the
antiretroviral gel tenofovir and the results are expected in July 2010, said
Karim.
Ramjee said that there are
several trials underway using antiretroviral drugs in prevention, including a
pilot study comparing tenofovir with a placebo at the University of KwaZulu-Natal,
and the VOICE (Vaginal and Oral Interventions to Control the Epidemic) study
being run the Microbicide Trials Network in South Africa, Uganda, Zambia and
Zimbabwe.
The VOICE study also
involves testing rectal antiretrovirals for prevention of HIV transmission
between men.
The PRO 2000 trial was
carried out by the Microbicides Development Programme, a not-for-profit
partnership of 16 African and European research institutions.
The reduction in HIV
infection risk after circumcision may be the result of a decline in bacteria on
the surface of the penis that assist the process of infection, according to
findings from the research team that helped establish the evidence base for
using male circumcision as an HIV prevention strategy.
If this is the case, and if the bacteria can be eliminated without removing the
foreskin, such a procedure might provide an important non-surgical alternative
to circumcision in settings where the procedure is culturally unacceptable or
difficult to implement.
The recent study, which appears in the January 2010 edition of PLoS ONE,
analysed penile swabs taken from twelve participants in the Rakai,
The twelve members of the follow-up study cohort were randomly chosen from the
subset of men who had undergone circumcision and were still HIV-negative one
year after the procedure.
Many different types of bacteria live on and in the human body, and changes in
levels of these bacteria may affect health through complex pathways that are not
well understood.
The Rakai study team used penile swabs taken before circumcision and one year
after circumcision to examine how the twelve men’s bacterial make-up had
changed. They found that the samples contained more than 40 distinct bacterial
families, including both aerobic (oxygen-requiring) and anaerobic
(non-oxygen-requiring) bacteria.
The most notable difference between the pre-circumcision and post-circumcision
samples was a major reduction in anaerobic bacteria. The researchers proposed
that the removal of the foreskin may have eliminated a micro-environment that
fosters the growth of anaerobic bacteria.
Their hypothesis is bolstered by the observation that the female partners of
circumcised men are less likely to develop bacterial vaginosis, a vaginal
infection associated with the presence of a higher-than-normal level of
anaerobic bacteria.
The specific way in which anaerobic bacteria may facilitate HIV transmission is
hypothesised to involve Langerhans’ cells, a component of the immune system
that functions in two different ways in relation to HIV. When inactivated
Langerhans’ cells encounter particles of HIV, they work against HIV. However,
Langerhans’ cells that have become activated play a role in helping the virus
infect the body.
Anaerobic bacteria may activate Langerhans’ cells in the genital area, which
would help explain why circumcision bestows partial protection against HIV.
Removal of anaerobic bacteria via circumcision may result in less Langerhans’
activation, leaving the virus with a smaller gateway to infection.
The researchers believe that their discovery may have significant public health
implications, in part because of the limited demand for male circumcision, which
is thought to reduce a man’s risk of acquiring HIV through heterosexual sex by
about 60%.
“Large-scale population-based male circumcision programs may not always be
feasible due to cultural, logistical, and financial barriers,” they write.
“Thus, it is important to better understand the biological mechanisms by which
male circumcision reduces the risk of HIV infection as this may lead to the
development of novel, non-surgical prevention strategies.”
According to a press release announcing the article’s publication, 70% of men
worldwide are estimated to be unlikely to undergo circumcision.
The press release noted that the reduction in anaerobic bacteria is only one of
multiple proposed explanations for why circumcision makes it harder for HIV
infection to occur. Following circumcision, the top layer of the inner foreskin
becomes thicker, perhaps providing a more effective barrier against HIV.
Also, reducing the amount of mucosal tissue exposed to vaginal secretions could
result in fewer opportunities for HIV to interact with the immune cells that it
targets.
“These potential explanations are not mutually exclusive and may work in
concert to reduce HIV risk,” said Dr. Lance Price, one of the article’s
authors.
The research team plans to look for specific bacteria associated with greater
HIV risk, and to explore how such bacteria might be eliminated.
Reference
Price LB et al. The effects of circumcision on the penis microbiome. PLoS ONE 5:
e8422, 2010.
* Says regimen of drugs
not inferior to Atripla
* Says discontinuations
comparable in both study arms
* Shares up as much as 4
pct (Recasts, adds analyst comments; updates share movement)
BANGALORE, Jan 6 2010
(Reuters) - Gilead Sciences Inc <GILD.O> said top-line results of a
mid-stage study showed that its experimental drug regimen to treat HIV infection
met the main goal, sending its shares up as much as 4 percent.
Based on 24-week data from
71 patients,
"The data are
important since the quad is a potential remedy for
"In our view, the
quad program is the key pipeline program for Gilead, since we view the quad's
pricing strength and hugely improved margins as having the potential to
transform the Gilead profit and loss," J.P. Morgan analyst Geoffrey Meacham
said in a note.
The current study was
testing the drug combination of Truvada with elvitegravir -- an experimental
drug to fight HIV infection -- and the "boosting" agent GS 9350.
"We believe the quad
needs to demonstrate at least comparable efficacy to Atripla and superior
tolerability to gain meaningful market share," Leerink Swann analyst Joshua
Schimmer said.
Analysts noted that the
central nervous system side-effect profile was comparable in both arms, and any
sign of liver enzyme elevations in the full dataset would be important.
Full study results will be
submitted for presentation at a scientific meeting in early 2010,
Jan 4 2010
By David Douglas
In absolute terms, the
reduction in death rate translated into a 5 percent increase in 5-year survival
for those who started combination HIV therapy compared with those who did not.
The introduction of
combination therapy for HIV infection in 1996 has greatly improved immune
function in patients infected with the virus. The impact of HIV therapy on
overall survival, however, remained unclear, Dr. Miguel A. Hernan, of the
Harvard School of Public Health, Boston, and colleagues note in the latest issue
of the journal AIDS.
To test whether combined
HIV therapy was actually saving lives, the team examined data from 12 European
and US studies involving 62,760 HIV-infected patients new to HIV therapy who
were followed for an average of 3.3 years.
During follow up, a total
of 2039 patients died. After the researchers allowed for factors that might
influence death rates, they found that the risk of death was 52 percent lower in
those who initiated combination HIV therapy relative to those who did not.
Combined HIV therapy, the
investigators note, "halved the (death) rate of HIV-infected individuals in
developed countries, and...the absolute reduction in (death) was stronger in
those with worse prognosis at the start of follow-up."
This finding, the team
concludes, "demonstrates the benefits of being treated even at the most
advanced stages of (disease)."
The current findings,
Hernan added in an email to Reuters Health, "can be used to inform policy
models and cost-effectiveness calculations in Western populations."
SOURCE: AIDS, January 2,
2010.