CHICAGO
(Reuters) - Nearly one in five gay and bisexual men in 21 major News (Updated
September 26, 2010)
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Sep 25 2010
By Frederik Joelving
NEW YORK (Reuters Health)
- Perhaps it wasn't sex workers and fast-growing cities that launched HIV onto
its deadly global rampage, but well-meaning doctors using dirty needles in the
first half of the 20th century.
While it's hard to know
for sure today, more than 90 years after the virus emerged, two new studies hint
that campaigns to eradicate tropical diseases in
"This is sort of an
example of good intentions gone wrong," said Dr. Thomas Strickland, an
expert in infectious diseases at
"They were saving
lives. They just didn't know that they were also setting up the pandemic of
HIV."
The virus jumped from
chimps to humans -- morphing from simian immunodeficiency virus, or SIV, to
human immunodeficiency virus -- in central
Most likely, scientists
speculate, a hunter got infected through a bite or a scratch as he prowled for
bush meat and butchered it west of the
What is still a matter of
debate is how a blood-borne disease infecting one or a few individuals in a
remote area could ever spread to the more than 33 million people who were
infected by 2008, and kill two million of them.
To try to answer that
question, Dr. Jacques Pepin, of the Universite de Sherbrooke in
For one of two studies
published this month, Pepin's team knocked on doors in dozens of villages in the
They asked a bunch of
questions of more than 900 villagers, including whether or not they'd been
treated for sleeping sickness -- at the time a grueling, hard-to-forget series
of injections, Pepin said.
The researchers also took
blood samples. Because the villagers who first caught HIV would be long dead
today, Pepin decided to use the less-deadly hepatitis C virus as well as another
blood-borne virus (human T cell lymphotropic virus 1, or HTLV-1) as models for
how HIV could have been inadvertently transmitted by the French colonial doctors
treating sleeping sickness.
What they found was
striking: if a person had been treated for the sleeping disease before 1951, the
chances that he or she had been infected with hepatitis C tripled. And HTLV-1
showed a similar pattern.
"What happened is
that for a long time, the needles and syringes used to administer the
intravenous drugs were not single-use," Pepin told Reuters Health.
"There were a lot of patients and not a lot of needles, so the
sterilization of needles was not very efficient."
"If HIV was present
in one of these patients 50 years ago, we can assume that they probably
transmitted HIV," he said. "It is exactly like intravenous drug users
who share needles."
According to Pepin, that
would also explain why the number of people 65 years and older who'd been
treated for sleeping sickness was six times lower than would be expected from
historical data: the missing seniors could have died of AIDS, the immune system
breakdown caused by HIV.
"Everybody now is
getting infected from having sex," said Strickland, who wrote an editorial
about the new findings, published in the journal Clinical Infectious Diseases.
"But that is not
very good transmission. You can have heterosexual sex ten or fifteen times
without getting infected. But if you get injected with a contaminated needle,
the risk is much higher."
Pepin's other study shows
that in Cameroon, a neighboring state that also used to be under French rule,
massive outbreaks of hepatitis C in the first half of the 19th century were
related to malaria treatment with the drug quinine.
More than half the
hundreds of graying heads he rounded up had traces of an earlier hepatitis C
infection in their blood.
"The most important
mode of infection was the intravenous treatment of malaria," said Pepin.
"If we put all of this together, it shows that there was a lot of
transmission of different viruses through different interventions for tropical
diseases."
"Probably HIV was
transmitted as well," he argues.
But nobody is left to
bear witness of what really happened, and not all scientists believe Pepin's
explanation.
"It is a wonderful
study on the hepatitis C virus," said Michael Worobey, a biologist at the
His version of what
happened follows the traditional line of argument among scientists: as colonial
powers began building cities and railroads, they transformed former woodlands
into densely populated towns rife with prostitution -- perfect hotbeds for
blood-borne diseases.
Eventually an infected
villager made his way to the city, setting off the HIV epidemic like a spark
falling on a dry savanna.
"I think a train is
a much better way to get a virus to a city than a needle," Worobey told
Reuters Health.
He said the idea that
doctors kicked off the HIV pandemic has been around for years. And while the new
experiments are probably the first to test it, he added, they don't settle the
question.
To Pepin, the two
explanations aren't mutually exclusive. Dirty needles "played a substantial
role that was probably as important as prostitution," he said.
Although single-use
needles are now commonplace in most of the world, and unprotected sex is the
major reason people get HIV, Pepin said some wisdom might still be gleaned from
what he found.
"Hopefully it will
make doctors a bit more prudent about novel medical interventions," he
said.
Sep 23 2010
CHICAGO
(Reuters) - Nearly one in five gay and bisexual men in 21 major
Young men, and especially
young black men, are least likely to know if they are infected with HIV,
according to the U.S. Centers for Disease Control and Prevention.
"For young men who
have sex with men - including young men of color who are least likely to know
they may be infected - the future is truly on the line," Dr. Jonathan
Mermin, director of CDC's Division of HIV/AIDS Prevention, said in a statement.
"It is critical that
we reach these young men early in their lives with HIV prevention and testing
services and continue to make these vital services available as they become
older."
The study tested 8,153
men who have sex with men in 21 cities taking part in the 2008 National HIV
Behavioral Surveillance System, which looked at the prevalence of the human
immunodeficiency virus and awareness of HIV status among this group of men. HIV
is the virus that causes AIDS.
They found that 28
percent of black men who have sex with men were infected with the HIV virus,
compared with 18 percent of Hispanic men and 16 percent of white men.
The incidence of HIV in
this group of men is strongly affected by education and income, the authors
said, noting that the lower a person's socioeconomic status, they more likely he
was to have HIV, CDC researchers reported in the CDC's weekly report on death
and disease.
Age was also a factor in
whether men know they are infected with HIV. Among those aged 18 to 29 who had
HIV, 63 percent did not know it, compared with 37 percent for men aged 30 and
older.
That is especially
dangerous because the CDC estimates that most new sexually transmitted
infections are passed along by people who do not know they are infected.
Mermin said the findings
show HIV is still a serious problem in
The CDC recommends that
gay and bisexual men of all ages get an HIV test each year, and men at highest
risk -- those who have multiple sex partners or use drugs during sex -- get
tested every three to six months.
"We need to increase
access to HIV testing so that more MSM (men who have sex with men) know their
status, and we all must bring new energy, new approaches, and new champions to
the fight against HIV among men who have sex with men," Dr. Kevin Fenton,
director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention, said in a statement.
(Editing by David Storey)
Carol Campbell
24 September 2010 | EN
More funds needed to get
this into the hands of women
Caprisa
[
The microbicide gel,
containing the antiretroviral agent tenofovir, passed phase III clinical trials
in June, and the success was announced at the XVIII International AIDS
Conference in
But efforts last month to
drum up funding for two final trials have so far produced promises of only US$58
million, much less than the US$100 million that the researchers want.
Salim Abdool Karim, a
scientist at the Centre for the Aids Programme of Research in South Africa (CAPRISA)
who led a study of the gel with his wife, Quarraisha Abdool Karim, said the
money is needed to pay for support studies and product licensing.
The CAPRISA 004 trial,
which found that tenofovir gel was at least 39 per cent effective in preventing
HIV infection when it was applied before and after sex, was conducted in
So far, the South African
Department of Science and Technology has offered US$13.5 million, USAID in
The funders made their
offers at an August meeting in
"I was very
disappointed after the meeting," said Karim. "I expected to walk out
with all the money we needed to take this project to the next level."
He is now meeting other
potential funders in the
"If we still do not
have enough we will ask
The UK Department for
International Development (DFID), once a major supporter of microbicide
research, has declined to fund the work, said Karim.
"That was very
disappointing as I had expected it would be interested in a project like
this," he added.
A DFID spokesperson said
the department partially funds the MRC, which is spending money on the trials.
Further, all DFID programmes are under review and it cannot presently make new
funding decisions.
Meanwhile, the European
and Developing Countries Clinical Trials Partnership (EDCTP) said it would first
have to consult member states. The Gates Foundation also attended the August
meeting but has not offered any funding so far, said Karim. The foundation did
not respond to SciDev.Net inquiries.