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Blood test may help find hidden virus
Study supports effectiveness of rejected drug
Prison AIDS rate six times national average
Richman to leave commissioner post
Kenya to mandate marriage HIV testing
The Times of London said doctors expected the new discovery to lead to therapies that totally controlled the virus and completely halted its progression to AIDS.
The test could pinpoint the waste products of the virus's replication, the newspaper said.
These consisted of small loops or 'circles' of viral DNA that could be found in white blood cells.
"The 'circle test' will mean better treatment for patients with HIV and should help us to identify new therapies which will lead to total control of this virus within the body," said Dr. Sunil Shaunak of London's Hammersmith Hospital.
Most current AIDS medications are not believed to be effective in seeking out and destroying the virus as it hides in various places in the body, according to researchers. This means that while treatment may temporarily reduce the amount of virus, it continues to replicate in places the treatments do not reach.
"The complex and toxic medications HIV patients receive at present can now be monitored more effectively and should lead to more informed decisions about the best therapy for each one.
"The challenge now lies in understanding the nature of the reservoir in which the virus continues to grow despite anti-retroviral drugs." (ABC News)
The findings, published in the journal Nature Medicine, showed most women in the study initially were infected by multiple variants of HIV while all of the men initially were infected by a single variant of HIV.
Previous studies in the United States and Europe on how HIV was transmitted focused mainly on men and led many to believe that only one variant of the virus was transmitted at the time of infection.
The new study appeared to confirm that to be the case in men, but not in women.
Once infected by single or multiple variants of HIV, the virus replicates itself into even more genetic variants, making it difficult to develop a vaccine.
The ongoing study, led by the Fred Hutchinson Cancer Research Center of Seattle, was one of many aimed at better understanding HIV in the belief that the best way to find a vaccine is to understand how the virus works.
"It may be that a vaccine might work better in men than in women," said Dr. Julie Overbaugh, who led the research.
The study tracked the sexual activity of heterosexual men and women in Kenya over more than four years, monitoring them for the presence of HIV at intervals of about three months.
Of the 32 women infected, 20 were found to have been infected with multiple variants of HIV. Further tests revealed each of the women was infected by a single partner, indicating they had contracted a variety of strains of HIV from one man, not several.
Of the 10 men in the study who were infected, all were infected with a single variant of HIV.
Overbaugh admitted that like many medical studies, this one "raises more questions than it answers," adding that researchers must now consider "what the consequences are for women that are infected with a more complex virus."
Other questions she said must now be addressed are whether HIV infects women in a different way than men, if HIV infects different cell types in women and whether the virus replicates differently in women.
Studies comparing how the virus behaves in men and women are becoming increasingly important as the number of women infected had risen.
About 33 million people worldwide are infected with HIV while 16 million who have been infected have died. This year about 5.6 million people globally contracted HIV while about 2.6 million died of AIDS.
In Africa, where the problem is the most severe, the number of women living with the virus has exceeded the number of men. About 12.2 million African women are infected with HIV while 10.1 million African men have the virus. (Reuters)
Adefovir, manufactured by Gilead Sciences of Foster City, was the first drug to get a cold shoulder from AIDS activists, who complained that the side effects were too great.
That helped persuade a Food and Drug Administration advisory panel last month to recommend against approving it, leading the company to drop further efforts to get it to market.
But a study led by UC-San Francisco researcher James Kahn, done in part at San Francisco General Hospital, found that the medicine was helpful to a group of patients whose other drug therapies were not doing a good job keeping in check the amount of HIV, or human immunodeficiency virus, circulating in their bloodstream.
The research studied the effects on 442 patients at 33 medical centers nationwide.
Adefovir, an anti-retroviral drug known as a nucleotide analog, cut the amount of virus detected by 60 percent, making it only a modest performer among other drugs used to trip the virus that causes the acquired immune deficiency syndrome.
Among patients who had already become resistant to other nucleotide analogs, the average response was a 70 percent drop in the virus.
But Kahn said what surprised researchers was how long-lasting the effects were. Patients were still getting results nearly a year after beginning the therapy, well past the time when many other drugs begin to lose their effectiveness.
"It clearly has anti-viral activity that is durable and sustainable, with pretty easy adherence," Kahn said. He said he was disappointed that the FDA advisory panel had chosen not to recommend it for approval.
Jeff Getty, an AIDS activist in San Francisco, said many people thought that the anti-viral properties of the drug were relatively weak when weighed against its harsh effects on the kidneys, which began to malfunction in many patients. The study found that those effects were reversible when the therapy was stopped.
Furthermore, Gilead has another drug, tenofovir, which shows much greater promise, Getty said.
There were fears that people taking adefovir might then become resistant to tenofovir, which is similar.
"We don't need more drugs that barely work and that are very toxic," Getty said. "We have enough of those already."
Still, Getty said he did not oppose the FDA approval of adefovir, even though some AIDS activists did. When it came to hearings, Getty said there was a "deafening silence" from AIDS groups, never before seen when an anti-HIV drug was being considered for approval.
On Dec. 3, Gilead announced it would no longer pursue adefovir as an AIDS therapy and instead put efforts into drugs such as tenofovir, which is currently being tested on patients.
The company said it would continue to pursue approval of adefovir as a treatment for hepatitis B, at much lower doses than were used to treat HIV patients. (San Francisco Examiner)
In addition, from 1994 to 1996, the prevalence of AIDS among prison inmates in the US was 199 per 100,000, six times the national rate of 31 per 100,000, the government scientists say.
Female inmates had especially high rates of AIDS, 287 per 100,000, or 23 times the national rate for women. High rates of AIDS were also evident among incarcerated Hispanics and blacks, with 313 and 253 cases per 100,000, respectively, compared with 100 per 100,000 among incarcerated whites. By geographic region, the south and the northeast had the highest rates of incarcerated AIDS patients during the study period, Drs. Hazel Dean-Gaitor and Patricia Fleming report in the December 3rd issue of the journal AIDS.
These figures, Dean-Gaitor and Fleming emphasize, represent a "conservative estimate of the incarcerated population with AIDS." The study represents "one step in understanding the scope of HIV within prisons better and is long overdue," according to a journal editorial by Dr. Timothy Flanigan and colleagues from Brown University in Providence, Rhode Island.
"The next step," they say, "is to facilitate a coordinated, effective, and compassionate response" to HIV care among incarcerated persons. "Many individuals who are incarcerated have been 'invisible' to the medical system," they point out. "In order to reach these individuals, incarceration must be seen as an opportunity to initiate comprehensive medical care that can then continue in the community after release."
In the new position, Richman will be responsible directly to the Mayor as Director of Social Services, and will oversee the Health Department, the Dept. of Human Services (which provides services for abused and neglected children, as well as juvenile justice programs), the Recreation Dept., and smaller city agencies, such as the Philadelphia Anti-Graffiti network.
Street has also appointed Alba Martinez, currently executive director of Congreso de Latinos Unidos, as commissioner of the Dept. of Human Services. Martinez, who has been Congreso's director for about seven years, was an early AIDS activist in the city's Latino community, and produced "AIDS in the Barrio," one of the first videos on the epidemic among Latinos in the US in 1988.
Martinez is the first openly gay person who has ever been appointed to a commissioner post in Philadelphia city government, although others have served as commissioners who have not been public about the sexual preferences. Her appointment by Street, who was actively opposed in the recent election by the organized white gay community, is seen as particularly ironic given the charge that Street is homophobic, a claim that grows out of his opposition to domestic partnership legislation last year.
Richman has been Health Commissioner since 1993.
Several prominent figures in the local AIDS service community are rumored to be seeking consideration for the health commissioner post, including Patricia Bass, co-director of the AIDS Activities Coordinating Office, and Ivan Lugo, MD, who runs the city's dental services and who provided care at Temple University's dental infectious disease clinic for many years.
The East African Standard quoted Wako as saying that such a law will help prevent the spread of HIV.
However, Wako said those wishing to get married will be free to decide whether to go ahead with their marriage plans after testing HIV positive.
"People planning to get married will soon have to produce a HIV test certificate, but they will decide to marry or not," Wako said.
AIDS has been rampant in the east African country since 1984 when the first case was detected. The infection rate shot up from three percent in 1990 to 14 percent in 1999. (Comtex)