News (Updated June
19, 2011)
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By Genevra Pittman
Jun 17, 2011
(Reuters Health) - The
rate of new HIV cases in gay and bisexual men may have dropped in California in
the mid-2000's, suggests a new study published 30 years after the discovery of
the virus that causes AIDS.
Still, the rates of new,
positive HIV tests in recent years were highest in men age 18 to 24, a finding
that suggests younger men may be more likely to engage in risky behaviors such
as unprotected sex, researchers say.
"We now have pretty
clear evidence that the fact that people have lower viral loads and more and
more are on treatment means that there's less transmission" of HIV, said
Pamina Gorbach, an epidemiologist who studies risk behavior and HIV at the
University of California, Los Angeles.
While this research is not
the first to hint at a shrinking rate of new HIV cases in gay and bisexual
California
men, "it'll be interesting to see if the pattern is the same in terms of a
continuing downward trend," Gorbach, who was not involved in the new study,
told Reuters Health.
The Centers for Disease
Control and Prevention estimates that more than 1 million people in the
United States
have HIV.
Led by Dr. Qiang Xia, then
at Research Triangle Institute International, in
Research Triangle Park
,
North Carolina
, the researchers calculated rates of new HIV-positive diagnoses at counseling
and testing sites run by the California Department of Public Health.
Their study included all
gay and bisexual men who had at least one test at those sites between 1997 and
2007 after a prior negative HIV test. Xia, now at the New York City Department
of Health and Mental Hygiene, and her co-authors organized the data to account
for the effect of HIV testing campaigns in California on the number of men being
tested, and to adjust for the fact that some men were tested multiple times
during those years.
They included data from as
many as 18,000 men per year.
Rates of new annual
diagnoses of HIV increased from 2 percent of men in 1997 to 2.4 percent in 2003.
Then, the rate fell back to 1.9 percent in 2006 according to the data, presented
in the American Journal of Epidemiology.
In particular, rates of
new annual diagnoses in African American men dropped from 4.8 percent to 2.3
percent over the course of the study period.
Despite that trend, Xia
and colleagues wrote that it was "concerning" that in the later years
of the study, men age 18 to 24 had the highest rate of new HIV diagnoses - 2.9
percent in 2006.
Young people, as well as
minorities, "are the groups that are hardest to reach," Gorbach said.
"But as we expand our program and use new methods of prevention and new
approaches, I think we'll do a better job with these groups."
The authors point out that
because they only looked at one group of testing sites, their data may not show
the actual rates of new HIV cases in the whole state. But the trends, they say,
may reflect how the frequency of the virus is changing among gay and bisexual
men in
California
.
Susan Scheer, who studies
HIV at the San Francisco Department of Public Health, said that the downward
trend is probably the result of more people knowing their HIV status and being
less likely to pass on the virus if they do have it.
"The time between
tests is decreasing," Scheer, who was also not part of the new research,
told Reuters Health. "That's really been a big push, especially in recent
years -- to get more people tested more often. I think that's probably a big
part of it, (and) we do see really high rates of treatment among people who are
positive."
"When all those
things come together, (people with HIV) are less likely to transmit
infection," she added.
Gorbach said that in
California
, the HIV epidemic is "very concentrated" among gay and bisexual men,
and that it may take a little longer to see a drop in new HIV diagnoses among
other groups.
She also thinks the trend
will eventually be visible on a nationwide scale, as more people with the virus
are taking antiretroviral drugs and have less of the active virus in their
blood.
However, Gorbach said one
thing that hasn't changed much is that many people are still engaging in risky
behavior that increases their chance of getting HIV. And Scheer added that many
Americans still aren't getting tested for the virus, which is why about a
quarter of people across the country who are infected don't know it, she said.
Still, Gorbach said,
"I think it's a great time to be optimistic about prevention."
SOURCE: bit.ly/kmmAsp
American Journal of Epidemiology, online May 17, 2011.
Claire Keeton
14 June, 2011
The Big Read: South African scientists are launching an important HIV clinical
trial to confirm the efficacy of a gel that reduces the risk of women getting
HIV.
This is the first South
African-led consortium to conduct HIV research at seven centres, said the
executive director of the Wits Reproductive Health and HIV Institute, Professor
Helen Rees.
Until now, multi-site
trials were led by international scientists collaborating with local peers.
"The planning for the
Facts study is well under way and we hope to be in the field by August,"
said Rees.
The past year has seen a
revolution in HIV-prevention research sparked by three exciting results - one
being the gel.
A Tenofovir vaginal gel
proved 39% effective at protecting young women from HIV and halved the risk of
Herpes HSV-2, according to the Caprisa 004 study in
KwaZulu-Natal
.
Facts aims to confirm
these results.
Until now, the most
effective prevention options have been condom use, prevention of mother to child
HIV transmission, or PMTCT, medical male circumcision and HIV counselling and
testing.
South Africa
has made dramatic gains since 2008 in:
Reducing the number of
six-week-old infants infected with HIV from 8% to 3.5% nationally, through
its PMTCT programme;
Expanding medical male
circumcision, with 140000 men nationally being circumcised; and
Expanding access to
condoms, with plans to distribute 1billion male condoms and 6million
female condoms this year.
About 12million South
Africans were tested for HIV since April last year.
Department of Health
deputy director-general Dr Yogan Pillay said: "We are doing a lot . [but]
our results are very mixed. We need to do more targeted prevention."
The old slogan for
prevention "ABC - abstain, be faithful and condomise" - is inadequate
for
South Africa
's HIV epidemic.
For example, married women
may get HIV from unfaithful husbands who refuse to wear condoms with them.
Professor Salim Abdool
Karim, director of the Centre for Aids Programme Research in
South Africa
, said: "The tools we have are mismatched for the epidemic. We need
women-controlled methods."
Recent studies show
HIV-negative women and men can be protected from the virus by antiretroviral
drugs. This approach is known as Prep, or pre-exposure prophylaxis. Prep options
show potential and will shape the HIV/Aids national strategic plan for South
Africa 2012/16.
Rees said: "We need
to act on these results, but we also need to build in checks and balances so
that the wheels of the fragile healthcare system do not come off.
"The prevention of
mother to child HIV transmission is one [established] example of Prep that has
been massively effective.
"PMTCT was
implemented based on research and successfully integrated into a national
programme that has saved hundreds of thousands of children's lives and improved
their quality of life."
Rees chaired a discussion
at the fifth South African Aids Conference in
Durban
last week on the "promise and perils" of providing the new forms of
Prep in
South Africa
.
The most promising Prep
tools in the pipeline are:
The Tenofovir vaginal gel,
also known as a microbicide;
Truvada tablets combining
two antiretrovirals. These prevented infection in 42% of men having sex
with men at high risk of infection (iPrex results released last November);
and
Early initiation of triple
antiretroviral drugs by people with HIV. This protected their partners 96%
of the time from HIV (HPTN 052 trial results released last month).
Conference delegates
debated the next steps on these discoveries.
Young women in their teens
and early 20s are at highest risk of HIV.
Men having sex with men,
or MSM, who identify themselves as "high risk" would also benefit from
an innovative prevention tools.
Rees said: "In
South Africa
they are reluctant to come forward to health services, except to a few special
clinics and pilot sites.
"We need to set up
MSM clinics attached to the public sector and train people in MSM sexual health
issues. We could try to introduce Truvada in this setting and the men would have
to be carefully monitored for uptake, adherence and drug resistance.
"More
generally, in the new national strategic plan we need to cater for high-risk
groups who do not access mainstream health services, like MSM and sex
workers."
Doctors are strongly
advocating starting ARV treatment early to avoid infecting sexual partners.
They insist that it will
benefit both individual and public health, for example, by reducing TB
infections.
Right to Care clinical
director Dr Francesca Conradie said: "In terms of interventions, this is
hot right now. We should start putting people on treatment when their CD4 count
(a measure of their immunity) is up."
Friday, 17th June 2011
According to a
US
study, premature infants are less healthy, have a higher risk of
heart-health-related problems and a greater chance of struggling socially in
adulthood.
The rates of
mother-to-child HIV transmission have dropped in
South Africa
, according to a recent national survey.
According to the poll by the South African Medical Research Council, the rate in
the country is now 3.5 per cent, reports PlusNews.
Researchers said by 2015, they hope there will be no more vertical HIV
transmission in the African nation.
Around 40 per cent of children born to HIV-positive mothers could contract the
virus before or during birth, if they do not have access to antiretrovirals
provided through public services for the prevention of mother-to-child
transmission.
The survey results were released at the SA AIDS 2011 Conference, and they show a
reduction of around five per cent in the transmission rates shown in previous
surveys.
Recently,
Zimbabwe
announced pregnant women in the African country will be given free blood
transfusions during delivery in a bid to prevent maternal and infant mortality,
particularly among women who have HIV/AIDS.
Posted by Paul Robertson
Pratibha Minhas
06/16/2011
A molecule drawn out from
a marine microorganism could possibly be the next biggest progression in the
treatment of two fatal illnesses including tuberculosis (TB) and human
immunodeficiency virus (HIV).
This declaration has been
made by scientists on Wednesday.
Providing novel hope to
those suffering from HIV and TB, a group of researchers from the Tuberculosis
Research Centre (TRC), IIT-Madras and Periyar University drawn out the molecule,
Transitmycin, from the marine micro-organism, 'Streptomyces sp', which was
detached from a soil model amassed from the coral reef off the coast of
Rameshwaram.
Scientists stated that the
brominated and pigmented antibiotic has been discovered to be active against
both the diseases.
Principal investigator and
head of the department of bacteriology at the TRC, Dr. Vanaja Kumar said, "Transitmycin
inhibited drug sensitive, multidrug resistant (MDR) and XDR Mycobacterium
tuberculosis strains as well as bacterial pathogens."
It was also discovered to
be active against latent bacilli.
Exciting them more, the
compound was detected to slow down two most widely prevalent clades of HIV-1,
the subtypes B & C.
Medical specialists stated
that the latter subtype was most prevalent in
India
and portions of the African continent, reportedly accountable for the worst
outbreaks and around half of all contagions.
Notably, this compound is
said to be effectual against both Mycobacterium and HIV, a distinctive trait
that permits the cure of patients who have been infected with both these
pathogens unlike the subsisting medications, which cannot be taken at the same
time as they counteract, the researchers said.
Preclinical study,
comprising animal researches, are to be adopted before examining this compound
in human clinical trials, they said, adding that it would be ready in a period
of ten years if the plan fell in place.
SAN MARINO
,
Calif.
, June 14, 2011 /PRNewswire/ -- Viral Genetics, Inc. (Pinksheets: VRAL)
continues to make the transition to a clinical-stage company. The Company's two
lead pharmaceutical programs -- APi1177 for HIV/AIDS, and various Metabolic
Disruption (MDT) compounds for drug-resistant cancers -- are being advanced
towards clinical development under sponsor- or investigator-initiated
Investigational New Drug (IND) pathways. An
IND
application is the submission that a company provides to the FDA requesting
permission to conduct clinical trials on humans. Each program is continuing as
detailed below.
HIV/AIDS -- APi1177 Pre-IND
The Company recently
communicated with the United States Food and Drug Administration (FDA) through
submission of a pre-IND package for APi1177. As a result of this dialogue, the
Company is focused on a three-step plan leading towards filing a full
IND
and clinical trials in the
US
.
Step one of the plan is
securing a manufacturer to supply APi1177 in sufficient quantity and meeting
established quality standards throughout the remainder of the development and
clinical trial process. Up until this point the Company's manufacturer has
produced "research grade" drug which has been sufficient for early
preclinical studies conducted to date, but all drug used going forward must be
produced in compliance with Good Laboratory Practice (GLP) and Good
Manufacturing Practice (GMP) standards. A suitable manufacturer has been
identified and they are now working with the Company's research-grade
manufacturer to reproduce the product used in earlier-stage studies.
Upon completion of this,
step two of the development plan is to move forward with a limited number of
relatively-brief laboratory studies designed to establish any "in
vitro" antiviral efficacy for APi1177 as well as to highlight any potential
issues relating to interaction with existing HIV antiviral drugs. While
"efficacy" results may be achieved in certain assays during this stage
-- that is, reducing the amount of HIV virus (viral load) or blocking
reproduction of the virus -- this batch of in vitro studies is primarily geared
towards meeting FDA guidelines that have been designed specifically for the
anti-retroviral drugs commonly used to treat HIV/AIDS.
Step three of the
IND
plan is to complete standard animal safety, pharmacology, and toxicology
studies designed to highlight any safety or toxicity issues. The Company has
identified a potential laboratory partner to complete these animal studies. The
Company's strategy is to submit the IND after completion of step one or two, but
prior to step three, on the basis that step three would be completed as a
condition to moving ahead in humans. Conditional on availability of funding, the
Company believes it will be able to submit an
IND
application for APi1177 in 3-6 months.
MDT Cancer Study -- Scott
and
White
Hospital
The clinical trial
protocol for this study, which is being funded by a grant of $1.5 million to the
hospital, is now being prepared for review by the Institutional Review Board (IRB)
of Scott and
White
Hospital
located in
Temple
,
Texas
and affiliated with
Texas
A&M
University
Health
Sciences
Center
. The review is the final step prior to submission of the Investigator IND
(I-IND) to the FDA. IRB review is primarily focused on establishing, monitoring
and reviewing the treatment of research subjects in experiments, ensuring
certain ethical standards are maintained.
The enrollment and
treatment phase of the study can commence following IRB and FDA approval of the
protocol. While the Company had earlier indicated that patient enrollment and
treatment was expected to start in the spring, the final protocol for the
clinical trial was delayed due to the addition of new types of cancers to be
studied as well as difficulty in obtaining a non-MDT compound being used in one
arm of the study for one type of cancer. The amended protocol is now being
finalized by the investigators, and may be modified again in the future although
we do not anticipate any significant additional delays.
While the central aim of
the study is to determine efficacy of our MDT compounds in certain patients in
certain cancers, and we are involved in reviewing the study's design, the study
itself is being conducted and controlled by the hospital investigators. IRB
review is expected to be completed between June and July 2011 and the Company
expects the I-IND to be submitted shortly thereafter.
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