Researchers
found high rates of TB and HIV, seen here in scanning electron microscope
images.Janice Haney Carr-CDC / CDCNews (Updated
June 27, 2010)
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New study doubles known
rate of infection at a South African hospital.
Amy Maxmen
Researchers
found high rates of TB and HIV, seen here in scanning electron microscope
images.Janice Haney Carr-CDC / CDC
Huge and hidden levels of
tuberculosis discovered in a South African province devastated by HIV are
increasing concerns about the prevalence of drug-resistant tuberculosis in
As reported in PLoS
Medicine, when researchers examined newly deceased patients at Edendale hospital
in the province of KwaZulu-Natal, they discovered that 50% were infected with
the bacterium M. tuberculosis, the causal agent of tuberculosis, with 17% of the
infected individuals carrying a multi-drug resistant (MDR) strain.
Among those with TB, only
58% had been diagnosed and started on treatment before their death. A previous
study had found that only 28% of patients admitted to the same hospital were
diagnosed with active tuberculosis.
In the new study, 96% of
those positive for M. tuberculosis were also HIV positive, and the alarming
prevalence of tuberculosis may reflect the situation in other low-income
countries plagued by HIV. With weakened immunity, HIV-positive individuals are
extremely vulnerable to other infections.
"This report is
extremely serious," says Mario Raviglione, director of the WHO Stop TB
Department in
According to the World
Health Organization,
Douglas Wilson, head of
medicine at Edendale and an author on the PLoS Medicine paper, hadn't expected
such staggering rates of tuberculosis. "When you drive to my hospital, you
see a number of funeral parlours along the road," he says. "At least
we now know why they are in business."
The new study looked at
240 adults aged between 20 and 45 who died from any cause excluding trauma or
childbirth. Many of these patients might have survived had their tuberculosis
been detected earlier, as 42% of them were not being treated for it.
Tuberculosis slips under
the radar because many patients admitted to hospitals never get tested. Even if
they do, the cheapest and most commonly used diagnostic tests, which involve
examining sputum under a microscope, often miss cases. In particular,
HIV-positive people typically suffer from forms of tuberculosis that sputum
tests don't detect.
By culturing samples drawn
from organs and the respiratory tract, this team diagnosed the presence of MDR
M. tuberculosis with greater accuracy than less invasive tests can.
Drug-resistant danger
Although too little
information exists to tell if MDR tuberculosis is on the rise globally, Peter
Cegielski, at the US Center for Disease Control's Division of Tuberculosis
Elimination in
"As drugs are used
more and more, they will create new cases of MDR TB as predictably as the sun
will rise tomorrow," he says. "That's the nature of evolution. When we
put tremendous selective pressure on those bacteria, the drug-resistant mutants
are going to survive."
Poor-quality drugs or
incomplete drug regimens also give resistant TB bacteria time to arise,
multiply, and infect others.
On June 15, the non-profit
Center for Global Development in
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Rachel Nugent, deputy
director of global health at the organization, says long-term savings from such
moves will vastly exceed up-front costs, as standard tuberculosis treatments
cost US$20 whereas those for the drug-resistant form of the disease start at
$3,500.
Yet
In the meantime he's
turned to HIV prevention as a means to slow the tuberculosis epidemic. "You
can chose to have safe sex," he says, "but you can't chose not to
breathe."
References
Cohen, T. et al. PLoS Med.
7, e1000296 (2010).
2008 Report on the Global
AIDS Epidemic (UNAIDS, 2008).
23 Jun 2010
The UK's National Physical Laboratory (NPL) is involved in a collaborative
project that is helping to further the understanding of HIV viral protein
structure which could lead to new molecular medicines.
In May 2010 the project team, comprising biotechnology experts from NPL, the
The article sets out to resolve controversy over how part of an HIV protein is
structured. The research team present a definitive structure of the protein,
which was obtained using experimental techniques and computer simulation. It is
important to know exactly how viral proteins are structured so that drug
developers can target weaknesses within it, and therefore devise better
treatments for people.
NPL's Eleonora Cerasoli says: "In this research, we were looking at a part
of the HIV virus that helps it fuse with, and then infect, healthy cells within
the human body. By confirming the structure of this tiny, but significant,
fragment of the HIV-1 protein we are helping to shed more light on its infection
mechanism. Further work in this area will hopefully lead to a full understanding
of exactly how it works, and therefore lead to better treatments for HIV."
To continue their efforts to understand the interactions between human cells and
the HIV virus proteins, the research team will also be using the unique
synchrotron facility available at Diamond Light Source. The insight this
provides may help enable the next steps towards rational drug design and
commercial exploitation.
This study is the first outcome of different investigations the research team
are carrying out on biomedically important model systems. The overall scope,
therefore, goes beyond understanding HIV's structure alone. The team are working
on establishing structure-activity relationships which will further our
understanding and treatment of other diseases, such as Alzheimer's.
This work is part of the project 'Multiscale measurements in biophysical
systems' which is funded by NPL's Strategic Research programme.
Source:
Joe Meaney
National Physical Laboratory
Anand Basu
Jun 25, 2010
The approval of the device
to detect HCV antibodies in unmodified blood specimen collected from the vein
raises hopes of the test getting the nod for multiple specimen types such as
oral fluid and fingerstick whole blood sample types.
"It is the first step
of the approval process. The main market is going to be the oral fluid
test," said Needham & Co analyst Sameer Harish.
Oral fluid test is usually
preferred by patients over whole blood test as specimens can be collected easily
and don't require blood samples.
Harish, who has a
"buy" rating on OraSure shares, expects the FDA to approve the oral
fluid HCV test this year.
OraSure already has one
FDA approved HIV test, OraQuick Advance Rapid, in the
Last year, the U.S. Food
and Drug Administration declined to approve the company's HCV rapid antibody
test OraQuick on concerns of potential bias in data interpretation.
In the
The company, which has
partnered with Merck & Co for the HCV test, said Merck will provide
promotional support, including detailing the test in the physicians' office
market.
(Reporting by Anand Basu
in
Fri Jun 25 2010
Scientists at National
AIDS Research Institute (NARI) are keen on finding out how H1N1 infection can
affect ‘immuno -compromised’ and high risk group of people living with HIV.
Last year six persons living with HIV had fallen prey to swine flu and related
complications.
From January this year
when the epidemic was not at its peak, a total of 2,360 HIV patients were
examined at NARI’s six clinics in the city and 40 were identified with severe
symptoms like cough, fever and cold. However, the prevalence of infection among
HIV positives was nil.
Cases are likely to rise
due to changing weather conditions and now scientists at NARI are planning to
examine HIV patients at the clinics and collaborate with National Institute of
Virology to test the throat swabs. Dr RS Paranjape, director, NARI, told The
Indian Express that World Health Organisation (WHO) had listed people living
with HIV as one of the high risk groups who are susceptible to various
infections. Hence NARI will conduct a battery of tests and identify those who
are at a risk due to the virus.
“How does H1N1 virus
contribute to the morbidity in an already immuno-compromised HIV patient? Are
they going to be seriously ill, how many get better and recover with Tamiflu are
just a few of the research aspects that will be looked into,” said Dr Sheela
Godbole, assistant director, NARI. During the period of six months we conducted
a pilot study (January-June) the transmission of the H1N1 virus was low and not
spreading like before during the period of August -December 2009. So the
threshold of transmission is also one of the aspects that will be looked into,
said Paranjape.
According to the NARI
director preliminary findings have shown there were no H1N1 cases among HIV
infected patients when the transmission was low. Hence the monsoon period will
be critical. The institutions will also collaborate with Pune Municipal
Corporation (PMC) where doctors have been told to send HIV patients with
symptoms of swine flu to NARI clinics for examination. The clinics are located
at NIV, Gadikhana, Ganesh Peth,
Swine flu scare still
haunts city, officials get ready to tackle monsoon ailments
EXPRESS NEWS SERVICE
While HINI virus is a
cause of concern for health officials who have registered over 200 cases in Pune
district from April this year with 33 deaths, they are also focusing on viral
diseases that crop up during monsoon every year. With 97 cases of malaria being
registered in Pune district from April till June this year, state and district
health officials have urged that spraying of pesticides is not enough to control
the mosquitoes menace. There is an increasing need for people to adopt
preventive measures.
Dr V D Khanande, joint
director, health, told media persons on Thursday as part of the national vector
borne disease control programme, the government has launched awareness campaigns
to control the spread of diseases like malaria, dengue, Japanese encephalitis,
chikungunya and Chandipura virus. Anti-malaria month is observed every year in
June throughout the country, prior to the onset of monsoon and transmission
season to enhance the level of awareness and encourage community participation
through mass media campaigns.
At present, about 2
million cases and 1000 deaths are reported in
Meanwhile, there were a
total of 7,339 cases of dengue in 2009-10 in the state. Out of this there were
92 positive cases of dengue in Pune Municipal Corporation area, while 788 were
from Pimpri Chinchwad area. In 2009-10, there were 20 deaths due to dengue,
Khanande said. While there were 575 cases of chikungunya in the state last year,
health officials have registered 109 patients with the virus till May this year.
Dr Pradeep Awate, state
surveillance officer said,16 sentinel centres have been set up for dengue and
chikungunya in various parts of the state. Pertaining to the HINI virus, he said
health officials are trying to create more awareness among people about the need
for early treatment. Dr DB Kadam, one of the members in the technical committee
that is formulating the guidelines for treatment of swine flu, said various
experts gave their views on clinical presentation of the HINI virus, hence
health department is planning fresh guidelines on the treatment.