Monthly Archives: May 2012

The quest for a HIV vaccine

Credit: UNAIDS

There is broad scientific consensus that getting to zero new HIV infections will require an HIV vaccine. Modelling shows that even a partially effective HIV vaccine can save many lives and dollars over time.

Although a vaccine to prevent HIV could be the tool to quicken the pace to reach the end of AIDS, the quest for an effective vaccine has until now proved elusive. The very nature and variety of the human immunodeficiency virus has meant that it has resisted most attempts to quell its spread and scientists and vaccinologists the world over are focusing efforts on finding solutions.

Exciting recent developments in HIV vaccine research are instilling hope around finding an effective vaccine. In 2009, results from a trial in Thailand—RV144—showed a 31.2% vaccine efficacy in preventing HIV infections. Although only modestly protective, the results instilled new hope that an HIV vaccine could be found and made available for populations around the world most in need of a vaccine.

The results represented a significant scientific advance, and were the first demonstration that a vaccine can prevent HIV infection in a general adult population. It was a discovery of great importance and has been followed by more encouraging data in the last couple of years.

Data presented in the past year has been presented on the protective immune responses that were stimulated by the Thai vaccine trial.  Trials are now planned to see if an RV144-like regimen will protect against a strain of HIV infection found in South Africa and against HIV acquisition by people at higher risk of exposure, specifically men who have sex with men.

UNAIDS and the US Centers for Disease Control worked closely with modelling teams to estimate the impact of the RV144 regimen in different countries and with different populations and found that 10% of infections could be prevented if the same 31% efficacy was found in people who receive the vaccine. This shows that a modestly effective HIV vaccine could add to the prevention toolbox of partially effective methods, hastening the decline of the HIV epidemic.

These and other advances in HIV vaccine development—including the design of new tools and technologies for vaccine delivery—have boosted optimism in the field about the prospects for the development of a safe and effective AIDS vaccine.

However, early data from the HIV Vaccines and Microbicides Resource Tracking Working Group is showing that a downturn in HIV vaccine funding that began in 2008 continued through 2011. The quest for effective HIV vaccines is a long-term investment in both the product (vaccines) and in the people who will develop, produce, market and support them. Investments in research and trials are essential and can bring benefits far beyond the AIDS field.

The need for a vaccine to prevent HIV is clear.  There are in excess of 34 million people living with HIV, and every day more than 7000 people are becoming newly infected with the virus. Although a vaccine may not provide the magic bullet to end the AIDS epidemic, it would provide an additional tool to add to the robust package of HIV prevention options which are now available.

UNAIDS will continue to work with multiple partners––scientific communities, national and international AIDS research agencies, the pharmaceutical industry, private foundations, member states, and affected communities––to push the HIV vaccine agenda forward and ensure that the quest for a safe and effective HIV vaccine continues.

Original Article via UNAids

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A History of HIV & AIDS – 1992

As we prepare to enter our 25th year, we are reflecting on the global HIV events from the last three decades.  HIV has swept across the globe touching communities on every continent.  Here’s an introduction to some of the key moments in the early global history of HIV.  Catch up on the story using the ‘Recent Posts’ link to the right.

We focus today on 1992 when the World Health Organisation (WHO) set as a priority target for prevention as the year 2000, it was envisioned that the whole population at risk from HIV and AIDS in Africa and Asia should live in communities where condoms were both readily available and affordable.

However despite a global target set by the WHO, in the UK, the Department of Health made it an offence to sell, advertise or supply HIV antibody testing kits to the public.  This at a time when a major UK newspaper ran a series of articles challenging the orthodox view that HIV alone causes AIDS. (Read: Poppers and Propaganda)

The first combination drug therapies for HIV are introduced.  Such “cocktails” are more effective than AZT alone and slow down the development of drug resistance.  It’s the first in a series of steps that would revolutionise HIV medicine forever.

American actor Anthony Perkins, known for his role as Norman Bates in the Psycho movies, dies from AIDS.

Australian singer Peter Allen dies from complications due to AIDS on June 18, 1992.

Popular science fiction writer Isaac Asimov dies on April 6. It was only this year, that his widow  revealed that his death was due to AIDS-related complications. The writer was infected during a blood transfusion in 1983.

At the Royal Free Hospital in London, an out-patients’ centre for HIV and AIDS is opened by Ian McKellen, and is named the Ian Charleson Day Centre after actor Ian Charleson.

Experts predicted that within five years there might be more people affected by AIDS in India than in any other country.

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LASS History Project

It’s been an exciting time for LASS recently, Archbishop Desmond Tutu recently became our international patron and as we countdown to our 25th anniversary, we are reflecting on the global HIV events from the last three decades by providing a historical overview of HIV and AIDS in world.

LASS has received funding from the Heritage Lottery Fund to develop a history project to mark our  25th anniversary year.  The project will create an archive, publication and mobile exhibition materials to capture the stories and experiences of people involved in LASS’s work over the past 25 years.

In doing so, we hope to raise awareness of the changing issues in responding to HIV and to challenge persistent myths and stereotypes. The work will take place over the next nine months, with the publication launched for World AIDS Day 2012.

The LASS History Project will record the changing experiences of people affected by HIV over the years, while highlighting the extent to which HIV continues to disproportionately affect the most marginalised. It will document and celebrate the way people in Leicester came together to respond to the new virus and will capture changes in attitudes, demography and health outcomes over the past 25 years. It will highlight the distinctive characteristics of LASS, which include our location in the ethnically and culturally diverse city of Leicester and changes in our client group over the years.

While we will show that HIV remains a significant local issue – with Leicester experiencing the 6th highest rising rate of infection in the country – we will also celebrate the improved life expectancy of people with HIV, and show how LASS has evolved to meet changing needs and demands on our services.

There are three main aspects to the project, all of which will offer volunteers opportunities to become involved.  Working with the Record Office for Leicestershire, Leicester and Rutland, we will organise and digitise LASS’s records, documents and photographs – currently held in various filing cabinets – to create a coherent archive lodged with Leicestershire Record Office and available online.

We will produce a publication documenting the history of LASS. This will be based on interviews with those involved with LASS, including service users and their families/partners, staff and volunteers, health professionals and partner organisations – one interview for each of the 25 years – to provide a 360 degrees perspective.

These interviews will be placed in the context of local, national and global developments. Drawing on the archive and publication, we will create a set of mobile exhibition materials for use at different venues in Leicester, Leicestershire and Rutland. Throughout the project we will work with other organisations to ensure that the project and its outputs involves and reaches a wide range of people, including targeted specific groups such as young people, LGBT people and African communities.

The project will offer volunteers a range of different opportunities to take part, including helping create the archive, research, carrying out and transcribing or summarising the interviews, and promoting and publicising the project. Volunteers will receive training – for instance in archive work, oral history interviews or media skills – and, depending on their roles, will develop a range of skills including documentation and research, interviewing and sound recording, media and presentation skills, and use of a range of Microsoft packages such as Word and Excel.

If you would like to volunteer for the project, please email tom@lass.org.uk for more details

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Will we ever have an HIV vaccine?

For around 30 years we have lived under the spectre of HIV. In the early 1980s, the mysterious appearance of symptoms that would later be known as AIDS led to unprecedented efforts to unmask the cause. On 23 April 1984, Margaret Heckler, the US Secretary of Health and Human Services, told the world that scientists had identified the virus that was the probable cause of AIDS. She was correct. She also said that a vaccine would be “ready for testing in approximately two years.” She was wrong.

Images by Wellcome Images/Flickr.

Despite 28 years of research, there is still no vaccine that provides effective protection against HIV, and in that time around 25 million people have died of HIV-related causes. To understand why creating a vaccine is so hard, you need to understand HIV. This is no ordinary virus. Scientists who study it speak of it with a mix of weary frustration and awed reverence.

The virus is the most diverse we know of. It mutates so rapidly that people might carry millions of different versions of it, just months after becoming infected. HIV’s constantly changing form makes it unlike any viral foe we have tried to thwart with a vaccine. “Almost every vaccine that’s been developed protects against a small number of strains,” says Gary Nabel, Director of the Vaccine Research Center at the US National Institute of Allergy and Infectious Diseases (NIAID).

Vaccines train the immune system to recognise part of a virus, creating a long-term armada of antibodies that seek and destroy the invader, should it ever show its face. For HIV, the most obvious target is gp120, the surface protein that it uses to attach itself to human cells. But gp120 also constantly changes shape, making it difficult to recognise. It also comes in clusters of three that are shielded by bulky sugar molecules, hiding it from the immune system.

On top of that, HIV targets immune cells, the very agents that are meant to kill it. And it can hide for years by shoving its DNA into that of its host, creating a long-term reservoir of potential infection.

So, creating an HIV vaccine is like trying to fire a gun at millions of shielded, moving targets. Oh, and they can eat your bullets.

Uphill struggle

So far, nature has provided little reassurance that a vaccine against HIV is even possible. For virtually every other microbe, there are people who naturally recover from their infections. “Nature itself provides the proof-of-concept experiment. It has told you that the body can inherently do this,” says Anthony Fauci, an immunologist who heads NIAID. But when it comes to HIV, “we have the astounding reality that, with more than 30 million people living with the virus, there is not a single documented case of someone mounting an immune response to completely eliminate the virus from their body.” Some people have the right genetic qualities to keep the virus in check, but no one clears it.

Given these challenges, it should be no surprise that vaccine research has been, to quote one researcher, a “Sisyphean onslaught of disappointments“. Only three potential candidates have made it through clinical trials. Vaxgen’s AIDSVAX vaccine, consisting of two fragments of the gp120, failed to provide any protection. Merck’s v520 vaccine, consisting of a harmless cold virus carrying three HIV genes, fared even worse. It was meant to marshall immune cells called T-cells to kill off infected cells. It failed. Worse still, the trial had to be stopped early because vaccinated people seemed to be more susceptible to infections, for reasons we still do not fully understand.

The only sliver of success came in 2009. A Thai trial of more than 16,000 people – the largest one yet – had been testing a combination of two vaccines: a bird virus containing three HIV genes, which was meant to prime the immune system, and a tweaked version of the AIDSVAX vaccine to act as a booster. Since both vaccines had failed individually, critics argued that the trial was a waste of time and money. But to many people’s surprise, the combination reduced the risk of infection by 31% – a statistically significant effect, though too low for a useable vaccine. (For comparison, the measles and polio vaccines are around 95% effective).

Some scientists were sceptical about the results, noting that the protection was short-lived and confined to people at low risk of infection. Others saw a ray of hope after years of frustration, a sign that a vaccine is in principle possible. Either way, the trial was confusing, especially since the vaccines did not reduce the levels of virus in infected people. Scientists are still trying to work out why the vaccine had any effect at all.

Renewed hope

But despite the muted results from existing trials, scientists in the field are unfazed. The reason, according to Wayne Koff from the International AIDS Vaccine Initiative, is that since the Thai results were announced, “the field that has begun to undergo a renaissance.”

It turns out that many HIV patients carry secret weapons – “broadly neutralising antibodies” – that can attack a wide range of HIV viruses. For these patients, it is too late. Their infections are already in full swing and the virus can mutate around their defences. But the discovery proved that HIV’s vaunted diversity is not the roadblock for vaccines that many scientists feared. If we taught the immune system to make these antibodies early, we could destroy the virus before it gained a foothold.

It is possible to isolate the right antibodies because we now know the shape of HIV’s surface proteins, down to the atomic level. Nabel used this knowledge to identify parts that stay the same while the rest of the virus shifts and mutates. These non-mutating regions are likely to be vital areas that cannot change without causing problems. He searched patients’ blood to find antibodies that target these conserved regions, and cells that make those antibodies. In 2010, he found three: two of which could neutralise 90% of HIV viruses. Other scientists, such as Dennis Burton of the Scripps Research Institute, have made similar discoveries using similar methods.

Nabel’s vision is a cocktail of these super-antibodies that target different parts of the virus, cutting off its evolutionary escape routes. He hopes to start clinical trials of his first-generation antibodies by early 2013, and he says is close to producing a second-generation of even heavier hitters that he thinks are two to three years away from early trials.

Vaccine researchers are also working on ways of stimulating our T-cells to kill infected cells at an early stage. This was the strategy behind Merck’s failed v520 vaccine, but scientists have since found better ways of smuggling viral genes into cells, and targeting them at the tissues most likely to be infected first. Both approaches would be complementary: “I think we would need a combination of broadly neutralising antibodies and a broad and robust T-cell response,” says Koff.

Compelling need

There is no telling when, or indeed if, these strategies will yield results, but what is certain is that the need for a vaccine will not diminish. There are many ways of preventing HIV infection, including condoms, microbe-killing gels, and the use of treatments as soon as people get infected. “We’d be going in the right direction with the tools we already have,” says Fauci. “But if we added a vaccine to the toolkit, even if it wasn’t 90% effective, you could have a major additive effect. There really is a compelling need for one.”

It may seem frustrating that decades of research have yielded nothing that satisfies this compelling need. But everything in the pipeline has depended on a steadily accumulating knowledge of the virus over those years. And as much as we know about the virus, and our immune response to it, there is still a great deal to learn. Also consider this. It took 47 years to create a vaccine for polio after the microbe behind it was identified. The measles vaccine took 42 years. The hepatitis B vaccine was a positive sprint at 16 years. “Twenty-eight years isn’t an inordinate amount of time,” says Fauci.

via: http://io9.com/5910946/will-we-ever-have-an-hiv-vaccine

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Young Lesbian, Gay, Bisexual and Transgender People face discrimination and negativity

Rainbow flag. Symbol of gay pride.

Rainbow flag. Symbol of gay pride. (Photo credit: Wikipedia)

A new poll commissioned by METRO suggests that despite huge strides towards equality in recent times, young lesbian, gay, bisexual and transgender (LGBT) people are still not able to be completely open about their sexuality and identity without fear of negative reactions and 65% of the population have witnessed or are aware of discrimination and abuse of LGBT people.

The same poll also shows that whilst awareness of discrimination against LGBT people is high, 72% of the population support the need for more and improved services for young LGBT people.

The poll of over 1,000 people of all ages across Great Britain conducted by Populus finds that:

  • 76% of people believe that young LGBT people experience negative reactions when they are open about their identity at school
  • The same proportion (76%) believe that young LGBT people experience negative reactions in the street when they are open about their identity and worryingly this figure rises to 84% of 18-24 year olds
  • 66% believe that young LGBT people experience negative reactions when they are open about their identity at work
  • Nearly 60% believe that young LGBT people experience negative reactions from their parents when they are open about their identity

These findings are perhaps not surprising when set alongside other findings from the poll about discrimination and abuse of LGBT people with one in 10 people being aware of or having witnessed physical abuse of LGBT people and a third having witnessed or been aware of verbal abuse of LGBT people – rising to half of all 18-24 year olds.  The poll also confirms that the use of the term ‘gay’ in the negative is widespread.

The findings come as a national survey of 15,000 young lesbian, gay, bisexual, transgender and questioning (LGBTQ) 16-25 year olds is launched . The National Youth Chances survey is seeking the views of young LGBTQ people across England and will use the data to identify their needs and to make recommendations for change. National Youth Chances is the biggest ever social research and influencing project of its kind, aiming to find out direct from young people about their experiences of education, employment, health, community and relationships.   Youth Chances is also engaging service providers, service commissioners, policymakers to make a commitment to make improvements for LGBTQ young people.

Dr Greg Ussher, Deputy CEO of Metro said:

Metro’s expertise in working with young LGBTQ people over nearly 30 years was the catalyst for National Youth Chances. There have been major steps forward in LGBT  equality and in understanding the needs of young people, but as the findings of this poll show we still have a long way to go to eliminating discrimination and ensuring that sexuality and gender identity are not barriers to young people’s happiness and wellbeing.  The findings are perhaps not so surprising when we consider the questioning of equality in current debates about equal marriage, which must be bewildering for most young people. Youth Chances offers us an opportunity to turn things around and make a real difference.

Dan Baker, Youth Chances Project Manager said:

These findings really demonstrate the importance of National Youth Chances and the need for us to understand directly from young people themselves about the challenges they face. It saddens me that when young people need the most support and understanding, they still face discrimination and fear because of who they are.  I want to encourage as many young people as possible to take part in the Youth Chances online survey so that their experiences can be counted.  There is clear support in the general population for more and better support for young LGBT people and I am committed to ensuring that Youth Chances results in recommendations for change and a real difference to young people’s lives

Via: Metro Centre On-line 

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NICE recommends IVF for older women, and for people with HIV


Since the original recommendations on fertility were published in 2004 there have been many advances in both treatments and in the understanding of different techniques.

– DR GILL LENG, NICE’S DEPUTY CHIEF EXECUTIVE

Childless women aged between 40 and 42 will be able to receive IVF on theNHS for the first time under proposals by the treatment regulator to help more people become parents.

Experts welcomed the National Institute for Health and Clinical Excellence‘s (NICE) planned new policy, which follows the emergence of evidence that IVF can benefit women of that age.

Since 2004 women aged 23 to 39 in England and Wales with an identified cause of infertility, or who have been infertile for at least three years, should have been offered up to three cycles of IVF.

But a squeeze on NHS spending and controversial restrictions mean many have been denied treatment.

Click to read ITV news, with video featuring ITV Daybreak’s Michelle Morrison on the proposed changes to who can get IVF on the NHS.

Under draft revised guidelines issued by NICE on Tuesday, eligibility for IVF – though only one cycle – will be extended to include women aged 40-42 who are deemed to suffer from “absolute infertility” and have no chance of conceiving by other means.

The regulator conceded, however, its stipulation that such women must not have previously undergone IVF was likely to mean that “quite small” numbers would actually benefit.

“Only a small minority of women aged 40-42 may benefit from the chance to have one cycle of IVF at that age,” said Susan Seenan, deputy director of patient group Infertility Network UK .

“It is good to see that the upper age limit for women has been raised as the evidence shows that we can have success with older women, though that should not take away from the clear message that age is still a major factor in fertility and that the longer one waits the greater the likelihood of problems”, said Professor Chris Barratt of Dundee University‘s school of medicine.

NICE also wants to cut the time women aged up to 39 should have been trying to conceive from three to two years. Seenan said that would reduce the frustration felt by childless couples and enable them to access IVF more quickly and thus increase their chances of starting a family.

The new proposals will also rule that only a single embryo should be transferred where possible.

It will also recommend for the first time that doctors can advise HIV-positive male patients that they can have unprotected sex with their female partner in order to conceive as long as the man meets certain criteria, such as being up to date with his antiretroviral medication, and agrees that they only do so when she is ovulating.

Catherine Murphy, head of policy at the Terrence Higgins Trust, welcomed the proposed change. “HIV medications have improved enormously in the last decade, making mother to baby transmission of HIV preventable and ensuring people can live long and healthy lives. It also means that natural conception is now a possibility for HIV positive men and HIV negative women in the right circumstances.

“An HIV diagnosis should no longer be a barrier to parenthood and we are very encouraged that NICE have recognised this in their consultation”, she added.

Original Article via The Guardian

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A History of HIV & AIDS – 1991

As we prepare to enter our 25th year, we are reflecting on the global HIV events from the last three decades.  HIV has swept across the globe touching communities on every continent.  Here’s an introduction to some of the key moments in the early global history of HIV.  Catch up on the story using the ‘Recent Posts’ link to the right.

A decade after the first cases of Aids are reported in the US (1991), an estimated 10 million people are infected with HIV worldwide.

The Red Ribbon has become the international symbol of AIDS awareness and support, not only for those living with HIV, but for their families, friends and people who are fighting for equality and non-discrimination.

The Red Ribbon Project was created by the New York-based Visual AIDS Artists Caucus in 1991, the individuals on the project wished to remain anonymous but wished instead to credit the Visual AIDS Artists Caucus as a whole in the creation of the Red Ribbon Project.  They also wanted to ensure the image was copyright free, so that no individual or organization would profit from the use of the red ribbon as it’s ethos is for it to be used as a consciousness raising symbol, not as a commercial or trademark tool.

The artists who formed the Visual AIDS Artists Caucus wished to create a visual symbol to demonstrate compassion for people living with AIDS and their careers.  Inspired by the yellow ribbons honouring American soldiers serving in the Gulf war, the colour red was chosen for its, “connection to blood and the idea of passion — not only anger, but love, like a valentine.”

First worn publicly by Jeremy Irons at the 1991 Tony Awards the ribbon soon became renowned as an international symbol of AIDS awareness, becoming a politically correct fashion accessory on the lapels of celebrities.

Read: Why A Red Ribbon Means AIDS (BBC)

At the Freddie Mercury Tribute Concert held at Wembley Stadium, London on Easter Sunday 1992, more than 100,000 red ribbons were distributed among the audience, with performers such as George Michael wearing one.  The Red Ribbon continues to be a powerful force in the fight to increase public awareness of HIV/AIDS and in the lobbying efforts to increase funding for AIDS services and research and LASS encourage you to wear yours every day!

To symbolize the United States’ commitment to combat the world AIDS epidemic, President George W. Bush’s administration began displaying a 28-foot AIDS Ribbon on the White House’s iconic North Portico on World AIDS Day 2007.  The display, now an annual tradition, quickly garnered attention, as it was the first banner, sign or symbol to prominently hang from the White House since Abraham Lincoln lived in the building.

HIV storyline in EastEnders

The largest peak in requests for HIV testing in the UK was observed in January 1991 when the character Mark Fowler, (of EastEnders), was diagnosed with HIV.  Mark was an original regular character in the BBC series starting February 1985.   Contracting HIV forced him to grow up fast and accept his responsibilities. He frequently found it difficult to accept the restrictions of the illness, which finally claimed his life in April 2004.

Mark initially kept his secret hidden from everyone.  However, as he and his friend, diane grow closer, he finally decides to tell her the truth about his HIV status in January 1991. He believes that he had come into contact with the virus through his girlfriend.  Eventually, Mark’s relationship with Diane never becomes serious, not for her at least.  She is a useful confidante however, and manages to persuade Mark to go for counselling at the Terrence Higgins Trust. (A real service you can access today, click this link for more information)!  Mark initially turns on his male counsellor, relaying all his bitterness at being a potential “AIDS victim”, but eventually feels the benefits of discussing his status.

During the summer, a study was published showing that HIV was transmitted much more easily through breast milk than had previously been thought but despite admitting that the news was discouraging , The World Health Organisation also said that women in developing countries should continue to breastfeed, as the threat to infant health from contaminated water was even greater than the threat from AIDS.

Freddie Mercury

Although the media was full of speculations about the state of Freddie Mercury’s health for a long time, he admitted to having the disease on 23rd November 1991.  Within 24 hours after this announcement, he had fallen into a coma and passed away.  He died of pneumonia in consequence of his HIV infection. He did not live to see the Olympic Games in 1992, which he composed the official anthem ‘Barcelona’ with opera singer Montserrat Caballé.

As one of the highest-profile victims of AIDS, Freddie Mercury’s death drew greater media awareness of the virus and started the fight to remove the stigma, discrimination and prejudice from a disease which could affect anyone.  A fight which, unfortunately continues today in 2012.

Magic Johnson

Magic Johnson, then an American professional basketball player who played point guard for the Los Angeles Lakers publicly announces that he is HIV-positive.

After a physical before the 1991–92 NBA season, Johnson discovered that he had tested positive for HIV.  In a press conference held in November, 1991 he made a public announcement that he would retire immediately and stated that his wife Cookie and their unborn child did not have HIV, and that he would dedicate his life to “battle this deadly disease”. – Magic continues to advocate HIV awareness today.

By the end of 1991, around 450,000 AIDS cases had been reported but it was estimated that 10 million individuals had been infected with HIV.

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