News (Updated March 28, 2010)

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TB clinics boost HIV testing for couples

24 Mar 2010

Source: IRIN

NAIROBI , 24 March 2010 (IRIN) - The Kenyan government is using national tuberculosis screening programmes to persuade married couples - at high risk of HIV, according to research - to get tested for the virus.

About half of all Kenyan TB patients are co-infected with HIV, so HIV testing has become routine in TB clinics, with 83 percent of TB patients also screened for HIV.

"We have encouraged health facilities to not only test TB patients for HIV but also to reach out to their partners to bring them along for counselling and testing for HIV together," Joseph Sitienei, the head of leprosy, TB and lung disease at the Ministry of Health, told IRIN/PlusNews. "The uptake of TB screening across the country has been impressive; it provides the best avenue to encourage partners to test together for HIV."

According to the latest Kenya AIDS Indicator Survey[http://www.aidskenya.org/public_site/webroot/cache/article/file/Official_KAIS_Report_20091.pdf], 10 percent of married couples have at least one HIV-infected person, but just 22 percent of couples know the HIV status of their sexual partners. An estimated 44 percent of new HIV infections in Kenya occur among married or cohabiting couples; HIV discordance is also a problem, with 6 percent of couples - or 344,000 - having at least one HIV-positive partner.

In many African countries where multiple concurrent partnerships are blamed for high HIV incidence, couples counselling is now being recommended. Experts suggest reaching couples through partner testing in home- and facility-based treatment and care programmes, the integration of partner testing into provider-initiated testing and counselling and prevention of mother-to-child transmission programmes, as well as door-to-door testing and bio-medical interventions such as medical male circumcision.

"[Couples counselling and testing] does not only help them know their status but it provides an opportunity to identify discordant couples and then helping them to know better how to manage themselves," said Andrew Suleh, medical superintendent of Mbagathi District Hospital, one of the model sites for TB diagnosis/screening and couples counselling and testing in the capital, Nairobi. "Safe sex and reducing risky sexual behaviour is heavily emphasized... those who test positive are made to appreciate the need for positive living."

Currently, there are 1,200 TB diagnostic sites in the country, 80 percent of which also offer counselling and testing for HIV; Kenya has an estimated 110,000 new TB infections every year.

"[Couples counselling and testing] also provides an opportunity to screen partners for TB together because TB is very infectious - it wouldn't be rare to find a situation where both partners are infected," Sitienei said.

He noted that couples testing was also helping to debunk myths about HIV and TB co-infection within the population, and to de-stigmatise the two conditions.

"Because of the correlation between TB and HIV infection, many people believe that a TB infection is a sure sign of HIV infection," he said. "Efforts are being put in place to debunk this kind of myth; one can have TB and not be infected with HIV just like one can be HIV infected and not be infected with TB."

 

Medicare to pay for "fillers" in HIV patients

WASHINGTON

Mar 23, 2010

WASHINGTON (Reuters) - The U.S. Medicare program will pay for the use of facial filling treatments in certain HIV patients with sunken cheeks and other similar problems who are also depressed, the government said on Tuesday.

The move impacts dermal fillers such as BioForm Medical's Radiesse and Sanofi-Aventis SA's Sculptra. Merz GmbH & Co acquired BioForm last month.

The U.S. Centers for Medicare and Medicaid Services said its review of current data found use of the products helped benefit HIV patients with facial lipodystrophy syndrome (LDS) who also experienced depression. Other HIV patients with the fat-wasting syndrome will not be covered.

CMS oversees healthcare coverage for 45 million elderly and disabled Americans. While HIV is "quite rare" in Medicare patients, who are 65 and older, patients who are disabled could qualify for the coverage, the agency said.

 

Patent pool decision heralds era of cheap HIV drugs

22 Mar 2010

Source: SciDev.Net

M. Sreelata

[ NEW DELHI ] A not-for-profit patent pool will be set up later this year to allow developing countries to manufacture cheaper HIV drugs.

The pool, to be based in Switzerland , is scheduled to start operating in June after formal approval by the executive board of UNITAID, the international drug purchase facility. The board met last month (5 February) to agree the broad guidelines to be followed while setting up the pool.

In a patent pool, patent-holding drug companies volunteer to forgo their patent rights in selected countries, which allows local companies to make medicines generically at mutually-agreed licence fees.

UNITAID which procures cheap drugs for HIV, malaria and tuberculosis has start-up funding of US$4 million for a year and officials expect that developing countries will save more than US$1 billion a year by having access to cheaper HIV drugs.

The February meeting took into account concerns raised by humanitarian groups, including the international medical charity Mdecins Sans Frontires (MSF) and Indian public health organisations, in December 2009 that middle income countries, especially Brazil , China , India , Peru , South Africa and Thailand , would be barred from accessing the pool.

UNITAID allayed the fears, saying that both low and middle income countries would benefit.

Ellen 't Hoen, senior advisor at the UNITAID patent pool, told SciDev.Net that the February meeting also outlined the next legal and administrative steps needed to set up and operate the pool.

The board agreed to put in place technology transfer mechanisms, capacity building and local manufacturing in developing countries.

The board also said it would try to ensure it worked in a way that was consistent with other multilateral mechanisms that provide access to medicines - such as the World Trade Organization declaration on the Trade-Related Aspects of Intellectual Property Rights agreement and public health; the World Intellectual Property Organization development agenda, and the WHO strategy on public health innovation and intellectual property.


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