Monthly Archives: July 2011

Hepatitis C Is Transmitted by Unprotected Sex Between HIV-Infected Men: Ongoing Epidemic in New York City in HIV-Infected Men

Sexual transmission of hepatitis C virus (HCV) is considered rare. But a new study by researchers at Mount Sinai School of Medicine, working with the Centers for Disease Control and Prevention (CDC), provides substantial evidence that men with HIV who have sex with other men (MSM) are at increased risk for contracting HCV through sex.
The results of the study are published in the July 21 edition of the CDC’s Morbidity and Mortality Weekly Report.

HCV transmission primarily occurs through exposure to blood, and persons who inject drugs at greatest risk. But when Mount Sinai researchers observed a large increase in the number of new cases of HCV transmission among HIV-infected men who did not inject drugs, they took a closer look to examine the role of sexual transmission among these men.

The researchers identified 74 HIV-infected men between October 2005 and December 2010 who had documented new HCV infection and yet reported no other risk factor for HCV infection, including injection drug use. When they compared 22 of these men with a control group of 53 closely matched HIV-infected MSM who did not have HCV infection, they found that the men who had recently contracted HCV were 23 times more likely to have had unprotected anal sex with men. In addition, HCV genetic analysis suggested that HCV was transmitted within social networks of these men, consistent with the presence of a city-wide epidemic.

“While hepatitis C is rarely transmitted among stable heterosexual couples, this is clearly not the case among HIV-infected MSM in New York City,” said Dr. Daniel Fierer, Assistant Professor of Medicine and Infectious Diseases at Mount Sinai School of Medicine. “MSM, and to some extent their health care providers are generally not aware that having unprotected receptive sex can result in HCV infection. The good news is that the cure rate for new HCV infections is very high with early treatment, but without regular testing of the men at risk, these largely asymptomatic infections may be missed and this opportunity lost.”

“Our study suggests that HIV-infected MSM should take steps to protect themselves and others by using condoms. Also, health care providers should be screening these men for hepatitis C, and public education and outreach programs should include information about these risks,” Dr. Fierer concluded.

Via Science Daily

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HIV Patients Losing Out From Cuts To Specialist Social Workers

People with HIV are losing out on vital social care support due to cuts to specialist social worker roles and rising eligibility thresholds.

That was the warning from a report published yesterday by the National Aids Trust, based on a survey of 149 healthcare professionals involved in the care of HIV positive patients.

Over three-quarters of respondents said the social care received by their patients benefited them, with 74% citing social care’s valuable role in providing physical or personal care, 71% citing emotional support and 65% saying social care helped patients adhere to treatment.

Specialist social work support was the most valued intervention by healthcare staff, with 77% citing its benefits.

However, several respondents warned that such posts were being cut, creating problems of stigma for service users who did not feel comfortable approaching generic social work teams.

“The current move to a ‘generic’ approach to social work is very unhelpful for HIV-infected patients, who often have complex medical histories and complex needs – requiring someone with some appropriate HIV-related knowledge to address these,” said one respondent.

Almost half of respondents (45%) said their patients had trouble accessing social care support, due to high and rising eligibility thresholds, lack of capacity in teams or referral processes being too slow.

The report concluded:

“These findings suggest that HIV-specialist social care support should, wherever possible, be maintained (particularly in high prevalence areas). Innovative solutions should be considered such as a number of local authorities sharing some HIV specialist social care staff to whom complex cases can be referred and who can also act as trainers for generic social care providers.”

Funding for social care for people with HIV/AIDS has traditionally come through the aids support grant. This was rolled into councils’ overall formula grant this year, although the government made notional allocations to local authorities for this purpose.

“Local authorities should put arrangements in place to ensure these funds are spent as intended, whether through greater flexibility or eligibility thresholds, greater provision of lower-level one-to-one social care support or greater support for voluntary sector open-access tailored services.”

By Mithran Samuel from Community Care

If you would like to find out more about the AIDS Support Grant and HIV social care, including the history of the grant and the current situation, Andrew Pearmain, HIV Consultant Practitioner, has produced a comprehensive report entitled Feast to Famine: HIV Social Care and the AIDS Support Grant.

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HIV/AIDS Posters From Around The World [Exhibition]

There is a fascinating new exhibition at Leicester’s New Walk Museum, curated by Dr Sarah Graham from the School of English. It’s called ‘Spreading the Word: AIDS Posters from Around the World’ and draws on the Wellcome Collection’s massive archive.

This year marks two important anniversaries: it is 30 years since AIDS was identified as a new disease and 20 years since the red ribbon was adopted as a symbol of the fight against HIV and AIDS. Dr Graham is working on a research project called Vital Signs: Representing AIDS which explores the various ways in which HIV and AIDS have been represented in a range of media including fiction, poetry, drama, memoir, film and visual art. The exhibition is the first outcome from this project.

There are 24 posters in the exhibition from the UK, USA, Africa, India and Australia, mostly from the early 1990s. The range of messages they convey is broad: some express the dangers of the disease quite bluntly; some demonstrate protection measures; others make a plea for a supportive attitude towards HIV+ people.

Also evident is the range of organisations which have produced posters, from Government departments to charities such as ACT-UP and the Terrence Higgins Trust. And the approach ranges from deadly serious through informative to, well, Australian superhero Condoman.

Dr Graham originally contacted the Wellcome Trust at the end of 2009 about mounting an exhibition and the Trust has been very supportive of the project as part of their mission is to make materials from their massive collection accessible to the public. New Walk Museum has also been very helpful in providing public gallery space, ensuring that the exhibition is seen by as many visitors as possible.

Although some AIDS posters produced over the years have been quite graphic, Dr Graham has been careful in making her selection suitable for family viewing so visitors to the museum can be assured that they won’t see anything more ‘shocking’ than a condom or two men embracing.

The exhibition is free to visit and runs until Sunday 28 August 2011.

(Press release)

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Anti-HIV Drug Made by GM Plants Begins Trials In Humans

The antiviral was manufactured in GM tobacco with a view to using the same technique to slash the cost of other life-saving drugs in the developing world.

The antiviral drug synthesised by genetically modified plants is being tested on a small number of women in the UK to establish its safety, bringing closer the possibility of cheap modern medicines for the developing world.

The drug’s developers hope it can be used to prevent HIV infection, but the real breakthrough is that the research demonstrates it is possible for similar molecules – known as monoclonal antibodies – to be produced relatively cheaply in plants to the high standards needed for their use in humans.

The human trial has been approved by the UK licensing body, the Medicines and Healthcare products Regulatory Agency (MHRA), and is taking place in Guildford at the clinical research centre of the University of Surrey.

Pharma-Planta is a project launched seven years ago with the objective of using GM plants to slash the cost of drugs that are hard to produce. The scientists’ aim is to increase the availability of these modern medicines – which are often highly effective – in the poorest countries of the world.

Access to medicines in the developing world is extremely limited. The World Health Organization estimates that 23 million infants worldwide do not get adequate basic immunisation and 1.7 million children under five die from vaccine-preventable diseases.

“The driver was to produce these medicines economically and at a level that would satisfy global demand,” said Professor Julian Ma from St George’s University, London, who is the joint co-ordinator of the European Union-funded project.

Many medicines are synthesised at great expense in fermentation vats containing bacteria or mammalian cells. By contrast Pharma-Planta produced the anti-HIV monoclonal antibody in GM tobacco plants grown in soil in greenhouses in Germany. After 45 days, they were harvested, their leaves were shredded and “highly purified antibodies” were extracted.

The researchers say there is little risk of such GM plants spreading or contaminating other crops because they are contained and would not be grown on anything like an agricultural scale.

Ma said it was “a red letter day” when they received the go-ahead from the drugs regulator. “The approval from the MHRA for us to proceed with human trials is an acknowledgement that monoclonal antibodies can be made in plants to the same quality as those made using existing conventional production systems. That is something many people did not believe could be achieved,” he said.

Eleven healthy women have volunteered to take part in the trial and two of them have been given the antibody so far, with a third woman having been given a placebo. The trial is designed only to demonstrate the safety of the antibody, called P2G12, at different dosages. Much bigger trials in women at risk of contracting HIV would be necessary to test whether it could prevent infection.

If it does prove effective, the drug would probably have to be used in combination with other monoclonal antibodies to minimise the chance that the virus developed resistance, as it easily does to antivirals.

The process is between 10 and 100 times cheaper than conventional production systems, said Professor Rainer Fischer of the Fraunhofer Institute for Molecular Biology and Applied Ecology in Aachen, Germany, where the plants were grown.

The most useful monoclonal antibodies, such as the anti-cancer drug Herceptin, are still covered by patents owned by major pharmaceutical companies, but once these expire the new technique could offer a way to make cheap versions available in poor countries.

Original article written by Sarah Boseley for The Guardian

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The Ryan White Story (Continued)

During the course of his short young life Ryan White changed the face of HIV and AIDS as we knew it, forever. He is, to this day, an inspiration and hero for many people living with HIV/AIDS. This is his story, part 5 of 10.

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25,000 Babies Born With HIV/AIDS Annually

As the world celebrates good results of an HIV/Aids drug trial conducted in Kenya and Uganda, the country once a role model in the fight against HIV/Aids, has for the last 10 years not made any progress in reducing the incidence of the disease.

The announcement early this week in the US that the use of certain ARVs among discordant partners had cut infection by 73 per cent is dampened by reports that the number of new infections every year is exceeding the number the government can treat. At the same time, donor money for the fight against the pandemic is dwindling.

Fresh alarm
Though infections in Uganda, which once had the highest, incidence rate in the world, dropped from 30 per cent in the early 1990s to around 7 per cent to date, Centre for Disease Control (CDC-Uganda), a bilateral partner within the US mission to Uganda has raised fresh alarm over increasing HIV/Aids infections.

Dr Wuhib Tadesse, the director CDC-Uganda at a news conference in Entebbe last week, said Uganda was the only country where HIV incidence has remained unchanged for more than 10 years. “In Uganda, for every person started on antiretroviral therapy, there are three new HIV infections and this is unsustainable,” Dr Tadesse said.

Dr Tadesse said there are no clear-cut answers to explain this trend, but added concerted efforts will be needed to stop new infections. “We are investigating what has caused this stagnation in the fight against HIV/Aids in Uganda and we are very concerned,” Dr Tadesse said. “But complacence could be part of the problem. Young people nowadays no longer see people dying; they see people on ARVs but getting children. We need to re-examine our strategies in the fight against HIV/Aids. Leaders at all levels are spending a lot of time in workshops than in the communities to sensitive the people and this must stop.”

According to Dr Tadesse, in the past 10 years, Uganda appears to have turned a corner in the opposite direction as more people continue to get infected. CDC figures show that there are 1.2 million Ugandans with the virus. However, according to Dr Tadesse, only about half of those who are in need of the life-saving drugs under the new treatment guidelines were receiving them by the end of last year. He said unless government deals with new infections through effective prevention strategies, achieving the universal treatment coverage of 80 per cent will be difficult.

Much of Uganda’s HIV/Aids programmes are being funded through the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund.
Dr Tadesse said under PEPFAR, Uganda has received over $1.2 billion between 2004-2010. Globally, as of September 2010, PEPFAR supported ART for 3.2 million people, care and support to 11 million people, counseling and testing to 33 million and provided $5.1 billion to Global Fund initiative.

However, with more than 110,000 new infections occurring every year, more funds will be required to help Uganda regain its reputation in the fight against HIV/Aids. But health experts at CDC-Uganda are concerned that if these new infections continue the way they are, it will be hard for Uganda government to cope with the cost of offering treatment to all. The number of Ugandans on ARVs has risen from 10,000 a decade ago to 200,000. But figures from the Uganda Aids Commission indicate that an extra 300,000 Ugandans in need of ARVs do not have access to the drugs because they cannot afford them.

In his response to the crisis, Dr Kihumuro Apuuli, the director general of the UAC, has since warned that the rising number of new infections will cause a critical challenge in the future, suggesting that more focus should be put on prevention and that the government should stop over relying on donor monies in its battle against the HIV/Aids pandemic.

A senior official in the Ministry of Health who preferred anonymity in order to speak freely, said even those on ARVs receive treatment largely as a result of American generosity. “We are guilty,” she said, adding: “As government, we have not taken prevention seriously. We have concentrated so much on treatment and care yet more Ugandans are getting infected each year and the number of those who need ARVs is increasing. It is time we reviewed the old-fashioned prevention because it has flopped. The few people in Uganda are using the “ABC”- abstain, be faithful and use condoms strategy”.

By Yasiin Mugerwa of Daily Monitor

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SEEK concludes HIV-v vaccine Phase Ib/II trial

UK based biopharmaceutical firm SEEK has concluded a Phase Ib/II trial evaluating the safety, efficacy and tolerability of HIV-v vaccine.

The vaccine showed almost 90% difference in viral count in HIV-infected patients in comparison to placebo group, following a single vaccine injection.

SEEK claims its HIV-v vaccine targets only the conserved regions in the internal proteins of the HIV virus which remain constant across all HIV strains.

The company expects to investigate partnerships to undertake complete human trials during 2012-13.

SEEK CEO Gregory Stoloff said the next step will be to progress this to final human trials and determine the optimum dose and dosing regime to further enhance the vaccine’s efficacy.

SEEK chief scientific officer Wilson Caparros Wanderley said the results demonstrate that after a single immunizationthe HIV-v vaccine produces a response from both the antibody and T cell immune systems to the conserved regions only.

Original article written by Pharmaceutical Business Review

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