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November 28, 2010)
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Experts worry about
danger to partners but also that late diagnosis means there is less chance of
successful treatment
Sarah Boseley, health
editor
The Guardian, Friday 26
November 2010
Anti-retroviral drugs that suppress HIV. People diagnosed late because of
ignorance of the condition stand less chance of successful treatment.
Photograph: Krista Kennell/Zuma/Corbis
An estimated 86,500
people are living with HIV in the
"We're very
concerned that a large number of people in the UK are unaware of their HIV
status, and that half of all newly diagnosed people are diagnosed late, meaning
they may not benefit from very effective treatments," said Dr Valerie
Delpech, head of HIV surveillance at the Health Protection Agency which
published the figures.
They show that HIV is
more prevalent in certain areas of the country – particularly in
"The HPA would like
to see increased access to … testing in areas where rates of HIV infection are
high. Pilot studies have shown that in these areas testing all adults
registering at GPs or accessing certain hospital services can make an
impact," said Delpech.
"The evidence shows
that this testing is feasible to undertake and acceptable to patients. We would
like to see this rolled out in areas where HIV infection is more common to
reduce the number of people who are unaware of their HIV status and increase the
chances of early diagnosis, when treatment is more successful."
People who seek medical
help only when they have the symptoms of Aids are far more likely to die. In
2009, 547 people were diagnosed with Aids and hardly any of them had been for an
HIV test. Of the 516 people with HIV infection who died last year, 73% had been
diagnosed late, when the virus had already taken a big toll on their immune
system.
In 2009, 6,630 people
were newly diagnosed with HIV, 4,400 of whom were men and 2,230 women. This is a
decline in new diagnoses, for the fourth year in a row, but the agency says
there is no evidence of a drop in the numbers who are living in ignorance of
their HIV status.
Deborah Jack, chief
executive of the National Aids Trust, said the figures showed the need to
increase testing. "Prevention is an immensely cost-effective activity …
one HIV transmission is up to £360,000 in direct costs to the NHS."
The agency warned in July
that the number of new HIV infections among over-50s had more than doubled in
seven years.
(AP) – 3 days ago
In the nearly 30 years
the AIDS epidemic has raged, there has never been a more hopeful day than this.
Three striking
developments took place Tuesday: U.N. officials said new HIV cases are dropping
dramatically worldwide. A study showed that a daily pill already on pharmacy
shelves could help prevent new infections in gay men. And the pope opened the
way for the use of condoms to prevent AIDS.
"I don't know of a
day where so many pieces are beginning to align for HIV prevention and
treatment, and frankly with a view to ending the epidemic," said Mitchell
Warren, head of the AIDS Vaccine Advocacy Coalition, a nonprofit group that
works on HIV prevention research. "This is an incredibly opportune moment
and we have to be sure we seize it."
President Barack Obama
said the groundbreaking research on the AIDS drug "could mark the beginning
of a new era in HIV prevention."
The U.N. report said that
new cases dropped nearly 20 percent over the last decade and that 33.3 million
people are living with HIV now.
"We can say with
confidence and conviction that we have broken the trajectory of the AIDS
pandemic," said UNAIDS Executive Director Michel Sidibe in
Health officials credit
part of the decline to wider condom use, and on Tuesday, in a historic shift in
church teachings, the
Condoms remain the best
weapon against AIDS, and the new prevention pill is not the chemical equivalent.
But scientists called it a true breakthrough. The pill, Gilead Science's Truvada,
is already used to treat people with HIV. A three-year global study found that
daily doses cut the risk of infection in healthy gay and bisexual men when given
with condoms, counseling and other prevention services.
The drug lowered the
chances of infection by 44 percent, and by 73 percent or more among men who took
their pills most faithfully. Researchers had feared the pills might give a false
sense of security and make men less likely to use condoms or to limit their
partners, but the opposite happened — risky sex declined.
The results are "a
major advance" that can help curb the epidemic in gay men, said Dr. Kevin
Fenton, AIDS prevention chief at the U.S. Centers for Disease Control and
Prevention. But he warned they may not apply to people exposed to HIV through
male-female sex, drug use or other ways. Studies in those groups are under way.
Because Truvada is
already on the market, the CDC is rushing to develop guidelines for doctors who
want to use it to prevent HIV, and urged people to wait until those are ready.
As a practical matter,
price could limit use. The pills cost $5,000 to $14,000 a year in the
Whether insurers or
government health programs should pay for them is one of the tough issues to be
sorted out, said Dr. Anthony Fauci, director of the National Institute of
Allergy and Infectious Diseases.
"This is an exciting
finding," but it "is only one study in one specific study
population," so its impact on others is unknown, Fauci said.
His institute sponsored
the study with the Bill & Melinda Gates Foundation. The findings were
published online by the New England Journal of Medicine.
It is the third AIDS
prevention victory in about a year. In September 2009, scientists announced that
a vaccine they are now trying to improve protected 1 in 3 people from getting
HIV in a study in
Gay and bisexual men
account for nearly half of the more than 1 million Americans living with HIV.
Worldwide, more than 7,000 new infections occur each day. Only 5 to 10 percent
of global cases involve sex between men.
"The condom is still
the first line of defense," because it also prevents other sexually spread
diseases and unwanted pregnancies, said the study leader, Dr. Robert M. Grant of
the Gladstone Institutes, a private foundation affiliated with the
AIDS drugs already are
used to prevent infection in health care workers accidentally exposed to HIV,
and in babies born to infected mothers. Taking these drugs before exposure to
the virus may keep it from taking hold, just as taking malaria pills in advance
can prevent that disease when someone is bitten by an infected mosquito.
The strategy showed great
promise in monkey studies using tenofovir (brand name Viread) and emtricitabine,
or FTC (Emtriva), sold in combination as Truvada by California-based Gilead
Sciences Inc.
The company donated
Truvada for the study, which involved about 2,500 men at high risk of HIV
infection in
More than 40 percent of
participants had taken money for sex at least once. At the start of the study,
they had 18 partners on average; that dropped to around six by the end.
The men were given either
Truvada or dummy pills. All had monthly visits to get HIV testing, more pills
and counseling. Every six months, they were tested for other sexually spread
diseases and treated as needed.
After a median follow-up
of just over a year, there were 64 HIV infections among the 1,248 men on dummy
pills, and only 36 among the 1,251 on Truvada.
Among men who took their
pills at least half the time, the risk of infection fell by 50 percent. For
those who took pills on 90 percent or more days, risk fell 73 percent. Tests of
drug levels in the blood confirmed that more consistent pill-taking gave better
protection, and in one subgroup, the reduction in risk was 92 percent.
The treatment was safe.
Side effects were similar in both groups except for nausea in the Truvada
patients. Weight loss also was more common in the drug group, but it occurred in
very few. Further study is needed on possible long-term risks.
All participants will get
a chance to take Truvada in an 18-month extension of the study to see if men
will take the pill more consistently if they know it helps, and whether that
provides better protection. About 20,000 people are enrolled in other studies
testing Truvada or its component drugs around the world.
The government will
review all ongoing prevention studies, such as those of vaccines or anti-AIDS
gels, and consider whether people getting dummy medicines should now get Truvada
since it has been shown effective in gay men.
Some people have
speculated that could expose
"The potential for
having an intervention like this that has never been broadly available before
raises new questions. It is something we would have to discuss internally and
externally," Jaffe said.
Until the CDC's detailed
advice on Truvada is available, the agency said gay and bisexual men should use
condoms consistently and correctly, get tested and treated for HIV and other
sexually transmitted diseases, get counseling and reduce their number of sexual
partners.
(AFP) – 1 day ago
The survey, by the
government-funded Medical Research Council and non-profit organisation Gender
Links, found that 37.4 percent of men in the north-central
It follows up on a
national survey carried out last year that found that more than one in four
South African men admitted to having raped a woman or girl.
"The previous level
was so high that we didn't expect it to be even higher," Rachel Jewkes, a
researcher at the Medical Research Council, told AFP.
Researchers surveyed 487
men and 511 women in
The study group was 90
percent black and 10 percent white, reflecting the province's demographics,
authors said.
Over half the women
surveyed said they had experienced some form of violence -- emotional, economic,
physical or sexual -- in their lifetimes, and 78.3 percent of men admitted to
perpetrating some form of violence against women.
The MRC study found that
only one in 25 rapes had been reported to the police.
In the 2009 study, one in
five confessed rapists tested positive for HIV.
Copyright © 2010 AFP.
All rights reserved.
(AFP) – 2 days ago
There were 1,305
confirmed new HIV infections in first 10 months of the year, compared with 835
for the whole of 2009, the health ministry said.
Sex between men accounted
for nearly 80 percent of all cases this year, and more than half of those
infected were aged between 20 and 29.
"From 2007 there has
been a shift in the predominant trend of sexual transmission from heterosexual
contact to males having sex with males," a health ministry report said.
The human
immunodeficiency virus (HIV) attacks the human body's immune system, rendering
it defenceless against infections and leading to AIDS.
Teresita Marie Bagasao,
country coordinator of the UNAIDS programme, said that among all countries in
Asia, only the Philippines and Bangladesh were now reporting increases in cases,
with others stable or decreasing.
The United Nations also
reported Tuesday that the number of new cases of HIV/AIDS around the world had
dropped by about one-fifth over the past decade.
"They (Philippine
authorities) need to actually address the factors which lead to
infections," Bagasao told AFP.
"Providing treatment
can only be sustainable if there is a very strong and comprehensive programme of
preventing further infections."
She said the government
needs to educate those at high risk, and provide them with condoms.
Apart from sexual
contact, 11 percent of all new Philippine HIV cases were transmitted through
needle-sharing by injecting drug users, and one percent were transmitted by a
mother to her baby.
Copyright © 2010 AFP.
All rights reserved.