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Entries in HIV (59)

Sunday
Mar312013

Oklahoma Dentist's Patients Struggle to Cope with HIV, Hepatitis Scare

iStockphoto/Thinkstock(TULSA, Oka.) -- Among the 7,000 patients who may have been exposed to HIV and Hepatitis in an Oklahoma dentist's office are children, as their nervous parents wait to get them tested and grapple with how to explain the public health nightmare.

Deann Zavala took her four children to Dr. Wayne Scott Harrington, an oral surgeon who practices in Tulsa and Owasso. She said her youngest daughter had a tooth extracted.

"How do you look at her and be like, 'You could have AIDS?'" she told ABC News Radio.

The state dental board is offering free testing to Harrington's patients after a 17-count complaint revealed his allegedly poor sterilization practices could have put them at risk for contracting HIV, hepatitis C, and hepatitis B.

Patients received a letter from the Tulsa Health Department on Friday informing them of an inquiry into Harrington's practice and advising them to get screened.

Zavala, who said she trusted Harrington to care for her four children, was left shaken.

"If you can't trust a doctor and a dentist and ... the people that are supposed to do right by you ... who can you trust?" she said.

The dentist's alleged practices came to light after a patient who had no known risk factors other than receiving dental treatment in Harrington's office, tested positive for both HIV and hepatitis C.

After hearing about the infected patient on March 15, the Oklahoma Board of Dentistry conducted a surprise investigation of the dentist's practice on March 18, allegedly finding numerous sterilization and cross-contamination issues.

Harrington, who has been practicing for more than 30 years, may face criminal charges. The dentist voluntarily surrendered his state dental license and other permits, and a formal hearing before the dentistry board is scheduled for April 19.

Copyright 2013 ABC News Radio

Sunday
Mar172013

Study Found Adults 'Functionally Cured' of HIV Before Mississippi Baby

ABC News Radio(NEW YORK) -- On the heels of the supposed first "functional cure" for HIV in a baby born in Mississippi, French researchers reported Friday that they had studied 14 adult patients who had experienced a similar remission from the virus. The patients in the French study had been off HIV medications for up to 10 years.

The French researchers followed patients who underwent treatment with antiretroviral drugs soon after they'd become infected with HIV. After taking the medications for several years, they stopped taking the antiretrovirals. That was "fashionable at the time," said Christine Rouzioux, a professor at Necker Hospital and University of Paris Descartes. They are all now in what Rouzioux calls "HIV remission," because the virus has not worsened and they have not shown symptoms for years.

"I know that the U.S. term is 'functional cure,'" Rouzioux told ABCNews.com. "In France, we speak about 'remission.' … The patient controls the virus, but they still have the virus."

The study, which was published Friday in the journal PLOS Pathogens, may show that the baby was not the first documented case of someone "functionally cured" of HIV as researchers announced earlier this month.

Rouzioux and Public Library of Science representatives told ABCNews.com that they did not rush their study into publication when the case of the Mississippi baby was announced.

Dr. Deborah Persaud, who works at Johns Hopkins Children's Center and studied the Mississippi baby, said there were similarities between the 14 French patients and the baby, but that the baby had even lower HIV levels than the French patients.

While Rouzioux and Asier Sáez-Cirión, a senior HIV researcher at the Pasteur Institute in Paris, reported about 100 copies of HIV DNA or RNA per 1 million cells in their patients, Persaud said she found less than five copies of HIV DNA or RNA per 1 million cells in the Mississippi baby.

"I'm not sure anybody knows what that means," said Dr. Mark Kline, a pediatric HIV and AIDS specialist at Baylor College of Medicine in Houston. "I don't know that someone with five is necessarily going to be better off in the long term than someone with 100."

Kline said he, too, has had patients who were technically HIV-positive but have had no need for antiretroviral medication. He has also heard of patients who started antiretroviral therapy and were able to stop without experiencing worsening symptoms.

"This phenomenon that they're describing has been appreciated and known," Kline said. "I think there's a good rationale for saying if you can identify these people and do treatment earlier, you can decrease the viral burden and decrease the reservoirs of infected cells in the body and probably alter the long-term course."

It can take anywhere from a few weeks to a few years after infection for a person to show symptoms of HIV. As such, early treatment isn't always an option, according to Kline.

Rouzioux's patients all experienced symptoms very early, which is why they were able to get swift antiretroviral treatment, she said. Rouzioux and her colleagues followed their patients for about 11 years, she said.

Although these types of patients have been written about before, Kline said this particular study was important because it identified which patients had a genetic predisposition that allowed them to naturally keep HIV at bay and which patients did not, and therefore went into remission because of treatment.

Rouzioux's colleague, Sáez-Cirión, said about 0.5 percent of all HIV-positive patients were able to control the virus without medication because of a genetic predisposition, but the 14 people in the study did not have this advantage.

The researchers concluded that HIV-positive patients who undergo early treatment for at least one year have a 15 percent chance of going into HIV remission for at least two years after stopping treatment.

"The probability was 10 to 15 percent, which is amazing when compared with the probability of natural (non-drug-induced) control," Sáez-Cirión said.

Still, it's not wise for HIV-positive patients to stop taking medications because they can develop resistance to them, Kline said.

"Those are bridges you can burn that you can never rebuild," he said. "If you just stop treatment or take treatment intermittently, it's very likely that you'll develop a resistance to one or more medications. Once a resistance is present in an individual, it's there to stay. There may be no going back to those particular medications."

Copyright 2013 ABC News Radio

Saturday
Mar162013

Bee Venom May Provide Protection Against HIV

iStockphoto/Thinkstock(NEW YORK) -- A toxin contained in bee venom may have the ability to prevent HIV infection when packaged properly.

Researchers at Washington University in Saint Louis, tested a specific delivery system of the toxin, called melittin, in lab dishes and found that "super-tiny blobs" of the bee venom component can attach to and destroy the HIV virus, according to Science News.

The nanoparticles of melittin selectively attached to the HIV virus and poked holes in its protein coat. The result, according to the study, was sharply diminished amounts of the virus.

The researchers also tested the toxin on cells from vaginal walls, due to the frequency of HIV entering the body through the vagina. The treatment being studied did not have any negative impact on the human cells because of protective structures attached to their outsides. According to Science News, the structures prevent the nanoparticles from attaching to healthy human cells.

The study, published in Antiviral Therapy, has a long way to go before a functional drug can be developed, but is exciting nonetheless. According to Science News, the nanoparticles must still be proven able to be produced in a uniform manner and would require adhesive properties to prevent the toxin from entering the bloodstream.

Nonetheless, Antony Gomes from the University of Calcutta in India told Science News, "There are very few reports available on venom-based treatment against viruses. This type of research has the potential to proceed further for product development.”

Copyright 2013 ABC News Radio

Monday
Mar042013

Was Mississippi Baby Cured of HIV?

Photodisc/Thinkstock(ATLANTA) -- A Mississippi baby born with HIV more than two years ago appears to be the first documented case of a child being cured of the virus, according to doctors and scientists.

The unidentified child has now been "functionally cured" and has been off medication for about a year with no signs of the HIV infection.  If the child remains healthy, it would mark only the second time in the world's history that a person has been cured of HIV, which is the virus that causes AIDS.

The landmark case was announced on Sunday at the 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta.

Dr. Deborah Persaud of Johns Hopkins University in Baltimore was one of the lead researchers and author of the report, which was released by The Foundation for AIDS Research (amfAR).

The infant was diagnosed with HIV at birth to a mother who did not receive prenatal care or HIV treatment, Dr. Rowena Johnston, director of amfAR, told ABC News.

The infant was transferred to the University of Mississippi Medical Center and started on antiretroviral treatment about 30 hours after birth.  Doctors took the apparently unusual step of prescribing three aggressive drugs (AZT, 3TC, nevirapine) at once after the baby was born.

Johnston pointed to the early intervention of the three medications as the difference-maker.

"If one had to make an educational guess, the difference was receiving the treatment dose very soon after birth, earlier than standard of care in the U.S.," Johnston said.

Initial HIV viral load tests were high and then expectedly decreased in the first month.  Viral loads were detectable three times and became undetectable by one month of age.

The baby was on treatment and in care until 12 to 15 months of age, at which point the baby was lost to follow-up after doctors lost contact with the mother and the baby stopped receiving any medication.  The baby returned for care at 23 months of age.

Surprisingly, viral loads were still undetectable, despite being off treatment for almost a year.

Johnston said the results were all the more shocking because doctors do not usually recommend stopping treatment at any time in children with HIV from birth.

The results surprised Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi, who was treating the child.

"My first thought was to panic.  I thought, 'Oh my goodness, I have been treating a child who is not actually infected,'" she said.

A battery of "highly sensitive" tests confirmed the absence of HIV, according to a news release.

Dr. Anthony Fauci, with the National Institutes of Health, cautions that more studies are needed before calling the results a breakthrough.

"You have to be careful because this is just a single case and although the data looked pretty convincing that you got to be careful that this may not be broadly applicable to other situations," Fauci told ABC News Radio.

The only other documented case of an HIV cure to date remains that of Timothy Brown, the so-called "Berlin patient."

Brown's story -- arguably one of the most followed in the realm of HIV research -- began in 1995 when he was diagnosed with HIV while attending school in Berlin.  For the next 11 years, doctors treated him with anti-retroviral therapy, to which he responded positively.

His oncologist, Dr. Gero Hutter of the Charite Hospital in Berlin, opted to give Brown a stem-cell transplant to treat his leukemia.  But rather than choosing a matched donor, he used the stem cells of a donor he found who had what is known as a CCR5 mutation, a mutation that makes cells immune to HIV.

After the transplant, Brown was able to stop HIV treatment without experiencing a return of his HIV disease.  The Mississippi case will likely spark new directions of research for adults, too.

"This could prevent a lifetime of treatment," Johnston said.  "We want people to understand just how game-changing this may be."

Fauci of the National Institutes of Health says the results could have a global impact if they can be replicated.

"About a thousand babies a day are born HIV infected throughout the world," he said.

Copyright 2013 ABC News Radio

Tuesday
Dec182012

Home Testing for HIV: Reading the Lines in Do-It-Yourself Test

OraSure Technologies, Inc./Getty Images(NEW YORK) -- Do-it-yourself home testing for HIV, the virus that causes AIDS, has arrived.

The OraQuick In-Home HIV Test, the only one approved for over-the-counter use by the Food and Drug Administration that captures testing and results in one sitting, hit drug-store shelves two months ago.  An earlier HIV home test, called Home Access, required a user to prick a finger with a spring-loaded lancet, collect a drop of blood on a test card, mail it to a lab and call in a week for the results.

Aimed at those who might have avoided getting tested in the past either out of fear, stigma, worries over confidentiality or inconvenience, the new home test has been hailed as a breakthrough.

"It's hard not to be fully enthusiastic about the test," said Dr. Myron Cohen, director of the Institute for Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill.  "Everything we do to increase testing has to have some degree of benefit.  By identifying and treating people early, we preserve normal life span and excellent health and reduce contagion."

But the new home test, which sells for about $40 and can also be bought online, has generated its share of hand-wringing, too.

"We generally like this thing," said Dan Tietz, executive director of the research and advocacy group AIDS Community Research Initiative of America, or ACRIA.  "It decreases some of the barriers to testing.  It kind of puts HIV in front of people, but there's a bunch of cautions."

For one, there's what Tietz called the "freaking out by themselves problem."  For the first time, there's no live counselor present -- not even a voice over the phone -- to deliver the results, offer support and make referrals.

In lieu of an in-person counselor, OraSure Technologies, which makes the OraQuick test that the FDA approved in July -- has set up a toll-free 24/7 customer support center with bilingual reps (English-Spanish).  They're not certified counselors but have been trained to answer questions about HIV/AIDS, explain how the test works and what the results mean.  

They can also hook up callers to counseling and care, using the Centers for Disease Control and Prevention's National Prevention Information Network and the HIV Medicine Association, and can also transfer callers directly to a health care professional or agency, said Ron Ticho, senior vice president for corporate communications at OraSure.

"Our representatives go through more than 160 hours of training," Ticho said.

Test kits come with instructions, warnings and precautions.  Home-testers can find the same test information on OraSure's website, along with the same referral databases the call center uses.  But handing concerns about HIV over to a toll-free number has raised questions.

Much is made of the fact that without a counselor present, even with warnings on the box and inserts and brochures written for a seventh- to eighth-grade reading level, home-testers might not understand that, as with all HIV tests, regardless of the testing method, a positive result is preliminary and needs to be confirmed by a more specific test given at an HIV test site.

This is especially worrying with the home test because although the OraQuick test is the same rapid test that medical professionals have used at testing sites since 2004, it loses some of its accuracy in the hands of consumers.  The percentage of results that will be accurately positive drops from 99.3 at a testing site to 92.9 when do-it yourselvers test themselves at home.  This means that about one person in 12 could get a false negative.

Another stumbling block is the "window period" -- the time it takes, usually 12 weeks, for the body to develop the antibodies the test detects after exposure to HIV, giving some people a "false sense of safety" that they're HIV negative when they are in fact HIV positive and at their most contagious.

OraSure emphasizes that its HIV home test is simply an additional option to the testing already available -- which often comes free -- at public health clinics, community service organizations and doctors' offices.

"We know that there's a lot of individuals who should be getting tested but aren't, and this is another opportunity for them to do so," OraSure's Ticho said.  "Is it the right option for everyone?  Probably not."

Copyright 2012 ABC News Radio

Monday
Dec102012

Doctors Find Success Using Retooled HIV to Fight Leukemia

Christine Chardo Photography for The Tiny Sparrow Foundation(PHILADELPHIA) -- In April, Emma Brooke Whitehead’s leukemia seemed unbeatable.

Emma, a 6-year-old from Phillipsburg, Pa., had been fighting the disease for nearly two years and doctors at Children’s Hospital of Philadelphia said there were no standard treatments left.  So they took a gamble on a new, potentially groundbreaking treatment -- using HIV.

They removed millions of Emma’s disease-fighting white blood cells and used genetically altered HIV -- a virus that easily gets into human immune systems -- to turn Emma’s cells into a kind of immunological “directed missile,” specifically programmed to destroy the leukemia cells.  The cells were then returned to Emma’s body.

“All of the things that make the HIV virus able to cause disease have been removed from this particular virus whose only purpose is to put a gene into a cell,” said Dr. Stephan Grupp, a pediatric oncologist at CHOP who uses HIV to infiltrate the immune system. “There is no danger of infection and there is no longer the HIV virus.”

Kari Whitehead, Emma’s mother, said that initially after the treatment Emma became very ill -- she had a fever as high as 105 degrees -- and doctors warned the family that she might not make it through the night.

Grupp then gave the second grader a rheumatoid arthritis drug “off label.”  In arthritis, the drug was meant to block a specific part of the body’s immune reaction, part caused by white blood cells called T cells. In Emma’s case, it blocked the side effect of the cancer treatment. In just 12 hours, she stabilized.

“She was the first child in the world they tried it on and they told us they didn’t know what to expect,” Whitehead told ABC News. “They do feel now that the arthritis drug that they used will keep the kids in the future from getting any where close to that [sick].”

Grupp says that Emma, now eight months past her treatment, is in complete remission.

“She has no leukemia in her body for any test that we can do -- even the most sensitive tests,” he said. “We need to see that the remission goes on for a couple of years before we think about whether she is cured or not. It is too soon to say.”

He said that the treatment is being tried experimentally at two hospitals and was intended for childhood leukemia that has returned and no longer responds to chemotherapy. He said doctors hoped the T cell treatment would eventually replace bone marrow transplants.

“This treatment was really her [Emma's] only chance,” Grupp said. “She has been treated with extended chemotherapy and she wasn’t getting any better. … For me, it’s incredible.”

Whitehead said Emma, now 7, looked and felt “amazing” and had reunited with her dog Lucy.

“There is a big difference,” she said. “She has a ton of energy. She’s back with her class. She was even able to play a little bit of soccer. So she’s doing wonderful right now.”

Copyright 2012 ABC News Radio

Tuesday
Nov202012

Get Tested for HIV, Task Force Recommends

ABC News(WASHINGTON) -- In an effort to curb HIV transmission and get treatment to those already infected, the U.S. Preventive Services Task Force has recommended that every American between the ages of 15 and 65 be tested for HIV.

Experts hope that the new recommendations will encourage more Americans to get tested and, if necessary, get treated.

"HIV screening is an important way to help people who have HIV, and also to prevent transmission," said Dr. Doug Owens, a leader of the task force and professor of medicine at Stanford University and the Veterans Affairs Palo Alto Health Care System. 

Owens said that HIV treatment "decreases the amount of circulating virus," making it less likely for it to spread from person to person.

Roughly 1.2 million Americans are currently living with HIV -- a number that has been increasing steadily over the past five years, according to the U.S. Centers for Disease Control and Prevention.  There continue to be about 48,000 new cases per year in the United States, but new treatments are allowing people to live long lives after they're diagnosed.

"Hopefully, more people with HIV will be identified and treated earlier," said Dr. Roger Chou of the Pacific Northwest Evidence Based Practice Center, whose study on the evidence supporting the new recommendation was published Tuesday in the Annals of Internal Medicine.

HIV-positive patients who start treatment while their immune systems are relatively intact live longer and are less likely to spread the virus to other people.  But 20 percent of patients are unaware they have the virus, said Dr. Carlos Del Rio, co-director of the Emory Center for AIDS research in Atlanta.

"This news about screening is very exciting," Del Rio said.

Previous task force recommendations on HIV testing, published in 2005, called for adults to get tested only if they'd had unprotected sex with multiple partners or used intravenous drugs -- in other words, were at high risk.  But up to a quarter of patients who test positive for HIV report no risk factors, according to the new Preventive Services Task Force statement.

"People are terrible at knowing their own risk," said Del Rio, adding that people may be unaware of the HIV status of their sexual partners.  "And doctors are terrible at asking them about risk.  It can be difficult to discuss sex and drugs with our patients."

The task force recommendations are used by Medicare and other insurance companies to determine what laboratory tests should be covered.  Other important task force recommendations included screening for breast and colon cancer, as well as high cholesterol.

"I don't have to ask my patients if they eat hamburgers before ordering a cholesterol test," said Del Rio.  "Now I can do a routine HIV test when patients come to clinic."

In order for the U.S. Preventive Services Task Force to make a testing recommendation, the test has to be accurate, treatment for the disease must be available and the benefits of the treatment outweigh the harms.

"HIV testing is one of the most accurate tests that we have for any condition," said Chou.

Coupled with the fact that the benefits of HIV treatment are now known to outweigh the risks, screening now makes sense, according to the experts on the task force.

Copyright 2012 ABC News Radio

Monday
Nov192012

HIV Testing for Everyone? Experts Say Yes 

ABC News Radio(WASHINGTON) -- About 1.2 million people in the U.S. are HIV-positive. And about one in five of them doesn't know it.

In an effort to broaden the front in the war on AIDS, experts now says almost everyone should be tested for the AIDS virus -- probably including you.
 
Those who don't know they are infected are believed to transmit about 20,000 new cases of AIDS each year.
 
The U.S. Preventive Services task force now recommends that all people ages 15 to 65 get tested for AIDS. Those younger or older who have increased risk factors should also be screened, according to the task force's new recommendations.
 
Risk factors include:

  • unprotected sex with multiple partners
  • any partner with HIV
  • any injection drug use, and
  • exchanging sex for money

The task force also says that all pregnant women should be tested for the HIV virus.
 
Earlier diagnosis means earlier treatment, and that means sharp reductions in the spread of AIDS and in AIDS-related deaths.
 
Copyright 2012 ABC News Radio

Thursday
Jul262012

Why Baby Boomers Need Hepatitis C, HIV Testing

iStockphoto/Thinkstock(WASHINGTON) -- Researchers took aim at baby boomers on Wednesday, urging this group of Americans to get tested for hepatitis C and HIV -- or possibly face liver failure.

Scientists at the AIDS 2012 conference in Washington, D.C., revealed data showing that those infected with HIV and hepatitis C are at very high risk for liver failure.  But hepatitis C infection is often a silent illness, as it can often go undetected since some patients experience little to no symptoms.

Health officials believe hundreds of thousands of new hepatitis C infections occurred annually between the 1970s and 1980s, most of them in the younger adults of the era -- the generation born from 1945 through 1965, known as the baby boomers.  The hepatitis C virus was not identified until 1989.

The new data follows recommendations issued by the U.S. Centers for Disease Control and Prevention in May urging that all baby boomers should be tested for hepatitis C.

As more effective treatments for hepatitis C have become available, it is important to identify patients with the virus so that complications such as liver failure and liver cancer can be prevented.  New medications on the market promise shorter treatment periods and fewer side effects for patients.

Dr. Victor Lo Re, an infectious disease researcher at the University of Pennsylvania, presented data that revealed even HIV patients who are treated for HIV with anti-retrovirals are at higher risk than other patients for liver failure.

“Everyone who is at risk should be tested for both hepatitis C and HIV,” he said.

Testing of baby boomers for hepatitis C could lead to 800,000 more boomers getting treatment and could possibly save more than 120,000 lives.

Copyright 2012 ABC News Radio

Wednesday
Jul252012

AIDS Conference Turns Focus to the Future

Alex Wong/Getty Images(WASHINGTON) -- After stirring up enthusiasm and hope that the end of the AIDS epidemic may finally be possible, scientists, policymakers and others at the International AIDS Conference on Tuesday turned their focus to the challenges -- and potential solutions -- that lie ahead in the fight against HIV.

There remain more than 50,000 new HIV infections each year in the United States, and new data from the HIV Prevention Trials Network presented this week showed that the rate of HIV among black gay men under age 30 is nearly 6 percent -- a rate as high as that in Sub-Saharan countries in Africa most affected by the virus.

"In the U.S., the burden of HIV is not shared equally by population or region," said assistant Health and Human Services (HHS) secretary Dr. Howard Koh.

Addressing HIV-related health disparities is one of three overarching goals of the the U.S. National HIV/AIDS Strategy, along with reducing new infections and increasing access to HIV care.  Such a strategic national approach is critical in addressing the HIV epidemic, Koh said.

Launched in 2010, the strategy outlines a list of specific goals, including decreasing the number of yearly HIV infections by 25 percent by the year 2015.

"We are making important progress," Koh said.  For example, he noted, among the more than 8,000 publicly funded community health centers in the United States there has been a 13 percent increase in people tested for HIV in the past year.

He also cited a national campaign to decrease HIV-related stigma, as well as nearly $80 million in new grants to expand HIV care announced by HHS Secretary Kathleen Sebelius earlier this week.  New data, however, is not yet available to assess the impact of these initial steps.

As policymakers grappled with how best to stem the spread of HIV, scientists considered the progress in a search for an HIV cure.

"The field is quickly advancing," said AIDS researcher Dr. Javier Martinez-Picado, senior investigator at the IrsiC-aixa AIDS Research Institute in Spain.  Yet, Martinez-Picado said he foresees several more years of laboratory research to advance basic science knowledge before considering clinical trials.

But as the world waits for science to progress in research labs, doctors need to use the tools available now in the most efficient way possible, said Dr. Nelly Mugo of the University of Nairobi and Kenyatta Hospital in Kenya.

Mugo stressed that with the advent of a new set of proven prevention strategies -- antiretroviral therapy early in the course of disease, pre-exposure prophylaxis and voluntary male circumcision -- it is critical to tailor packages of HIV interventions to specific populations.

"The interventions and the things that work for men who have sex with men in Cambodia may be very different for heterosexual individuals in Africa," she said, adding that the world needs to "be ready to get rid of those policies and approaches that do not work," in order to "focus resources and efforts on what is proven and impactful."

Copyright 2012 ABC News Radio







ABC News Radio