Entries in HIV/AIDS (7)


WHO Recommends Earlier HIV Treatment

Bananastock/Thinkstock(GENEVA, Switzerland) -- The World Health Organization announced on Sunday that it is recommending earlier treatment for people who are HIV-positive.

According to WHO, if people in the developing world who are HIV-positive are given lifesaving drugs earlier it could potentially avert an additional 3 million deaths and prevent 3.5 million more new HIV infections by 2025.

A single pill combining three drugs would be given to those people much earlier, when their immune systems are still strong. Evidence shows that earlier treatment keeps patients healthier and lower the amount of virus in the blood, which in turn reduces the risk of spreading the virus to someone else.

“These guidelines represent another leap ahead in a trend of ever-higher goals and ever-greater achievements,” says WHO Director-General Dr. Margaret Chan. “With nearly 10 million people now on antiretroviral therapy, we see that such prospects – unthinkable just a few years ago – can now fuel the momentum needed to push the HIV epidemic into irreversible decline.”

Implementation would add 10 per cent to the overall bill for treatment of HIV/AIDS in the developing world, but WHO is convinced the idea is cost effective in the long run.

Copyright 2013 ABC News Radio


Genetically Modified Cells Could Prevent Death from HIV/AIDS, Study Finds

(NEW YORK) -- Using genetic modification to treat HIV could create cells that are resistant to the two major types of the virus, preventing it from evolving into AIDS, according to a new study.

Researchers at the Stanford University School of Medicine and the University of Texas at Austin used a method known as targeted trait stacking to paste a series of HIV-resistant genes into T cells — immune cells targeted by the AIDS virus — blocking infection at multiple stages and providing protection against R5-tropic and X4-tropic, the two separate forms of HIV. Any truly useful treatment for HIV would have to protect against both of these forms.

“We inactivated the CCR5 gene, and then introduced 3 additional genes,” Dr. Matthew Porteus, an associate professor of pediatrics at Stanford and lead investigator in the study, told ABC News. “When cells had all four of these traits, we found that after 25 days the cells were completely resistant to both types of HIV.”

One of the major obstacles to treating HIV is the high mutation rate of the virus. Patients must use a cocktail mix of drugs, known as Highly Active AntiRetroviral Therapy (HAART), in order to fight the virus at different stages.

“HIV is a great shape shifter,” said Sara Sawyer, an assistant professor of molecular genetics and microbiology at the University of Texas at Austin and co-author of the study.  “It can come up with new solutions, so a single drug does not work very well. That’s why HIV patients are given multiple drugs at once.”

Ideally, researchers hope to discover a cocktail of genes, not just drugs.  They informally call it genetic-HAART, and it would bolster a patient’s immune system with HIV-resistant T cells. While other non-resistant cells were being killed by the virus, these supplemented T cells would remain, strengthening the patient’s immune system and serving as an alternative to traditional HIV treatments.

“This method would give people a protected reservoir of T cells that would thwart off immune system collapse, and the secondary infections that give rise to AIDS,” said Sawyer.

The next steps in refining this particular approach to combating HIV/AIDS include finding the right cocktail of genes, and inserting them into T cells from AIDS patients. These modified T cells could then be used in animals to determine whether or not they remain resistant over time. These steps are required by the Food and Drug Administration before it can approve clinical trials, which could take 3-5 years.

“To develop novel therapies you have to be an optimist,” said Porteus. “The findings in this study are a proof of concept; we’ve proven this could work.”

The study was funded by the Foundation for AIDS Research and will be published in the Jan. 29 issue of the journal Molecular Therapy.

Copyright 2013 ABC News Radio


Going Gray With HIV, a Complicated Affair

File photo. Jupiterimages/Thinkstock(NEW YORK) -- No one would argue that living a long time after receiving an HIV diagnosis is a good thing.

"I feel fabulous," says Carlton Smith, who was diagnosed with HIV 25 years ago. He is on the cusp of 50, "but I don't look like it," he is quick to say.

But what lies ahead for people like Carlton, diagnosed with HIV decades ago? They are living far beyond what anyone predicted when the HIV epidemic hit the United States in the 1980s.

By the year 2015, more than 50 percent of Americans living with HIV will be older than 50. As the availability of anti-iretroviral medications continues to expand, the rest of the world will not be far behind. But researchers are only beginning to understand how HIV and its treatment affects those living with HIV as they age.

Not that HIV hasn't always been a complicated disease for patients and their doctors to manage.

"Before aging was an issue, [HIV] care was complicated by multi-drug regimens [as well as] co-infections" and "major socioeconomic issues, including stigma, addiction, incarceration, homelessness and undernutrition," said Dr. Amy Justice, a professor of medicine and public health at Yale University. "Now we add to that mix chronic, noninfectious disease," she said at this week's International AIDS Conference.

According to a study released Thursday, among people over age 45, those with HIV are more likely to have more chronic diseases, such as high blood pressure, diabetes and cancer.

"Longer duration of being HIV-infected or exposed to [anti-retroviral therapy] were also associated with a higher prevalence of these chronic diseases," said Dr. Judith Schouten of the Academic Medical Center in Amsterdam and lead author of the study. Further, these diseases tended to occur five years earlier among patients with HIV than among those without HIV.

Take Carlton, for example. He also has diabetes. He takes four pills every day for HIV, and several more for diabetes. He takes his HIV pills in the morning in his diabetes pills in the evening. He has a doctor for his HIV, and another for his diabetes. This is working well for him, and he rarely forgets his pills.

But what happens if he develops other diseases requiring medication, such as high blood pressure, which runs in his family? Will he need another doctor? More pills?

As doctors look toward the treatment of a population aging with HIV, "we need to think about the limits of the silos of care we have created," says Justice, and focus instead on treating the whole patient, not just their different diseases.

But the interaction between chronic HIV and aging is only part of the issue. Older people also comprise 10 percent of new HIV infection in the U.S. And while many people might believe that older people aren't at risk for contracting HIV through sex, Ron Swanda, a 66-year-old longtime Washington, D.C., resident, has a simple message for the country: "Seniors are sexual."

He's right. More than 80 percent of men and more than 60 percent of women over 50 report having had sex in the last year in the U.S.

And older people have unique risks -- both behavioral and biological -- for acquiring new HIV infection. Men over age 50 are six times less likely to use condoms than their younger counterparts. And older women have thinner vaginal walls, which likely increases the risk of HIV transmission, according to Justice.

"I'm not saying that every grandma needs to be tested," said Swanda, who is a prominent activist for seniors and has been HIV-positive for more than 30 years. "But I want the country to do more to educate seniors about HIV and to test those at highest risk."

Copyright 2012 ABC News Radio


Two More Patients HIV-Free After Bone Marrow Transplants

Bananastock/Thinkstock(BOSTON) -- Researchers at Brigham and Women’s Hospital in Boston have discovered that, following bone marrow transplants, two men no longer have detectable HIV in their blood cells.

The finding is significant because it suggests that by giving these patients transplants while they were on anti-retroviral therapy, they may have been cured of the AIDS-causing virus.

“We expected HIV to vanish from the patients’ plasma, but it is surprising that we can’t find any traces of HIV in their cells,” said Dr. Timothy Henrich, one of the researchers studying the two men. “It suggests that under the cover of anti-retroviral therapy, the cells that repopulated the patient’s immune system appear to be protected from becoming re-infected with HIV.”

The findings were presented Thursday at the AIDS 2012 conference in Washington, D.C. The story shares similarities with that of Timothy Ray Brown, also known as “the Berlin patient,” but there are important differences. While the cells used in Brown’s transplant procedure were specifically chosen from a donor who had a genetic mutation that resisted HIV, these patients received transplants with normal cells. Also, the two patients whose cases were presented at the meeting are still taking anti-retroviral medications normally used to treat HIV-positive patients, while Brown is no longer taking these medications.

Further study will need to be done to prove that the two patients are truly cured.

“Studies over time including biopsies of lymphatic tissue would be required,” said Dr. Michael Saag, an infectious disease expert from University of Alabama at Birmingham. He said only time will tell if these patients remain HIV-free.

While it appears from these cases, as well as that of the Berlin patient, that altering a patient’s immune system may lead to a “cure” for HIV, bone marrow transplants are currently too costly and dangerous for all HIV patients to be able to undergo them.

Separately, scientists are trying to use gene therapy to alter patients’ immune systems to free them of HIV.  Most of the research in this field is very preliminary, but scientists at the Fred Hutchinson Cancer Research Center are trying to perform stem cell transplants with cells that have been genetically modified to be resistant to HIV, much like the cells that the Berlin patient received.

“We have not yet transplanted any patient as part of our study,” said Dr. Hans-Peter Kiem of the Clinical Research Division at Fred Hutchinson Cancer Research Center and an attending transplant physician at Seattle Cancer Care Alliance. But Kiem and his research team have recently been awarded a research grant to further investigate stem cell transplantation as treatment as a means to find a cure for HIV.

Copyright 2012 ABC News Radio


HIV/AIDS Infection Rates on Rise in US as Rare Conference Opens

Chris Maddaloni/CQ Roll Call(WASHINGTON) -- As 25,000 global experts descend on Washington, D.C., this week for the first International AIDS Conference in the United States in 22 years, they face some sobering statistics: 3 percent of all residents in the nation's capital are infected with the HIV virus.

And with 7 percent of all black males HIV-positive, the city has a higher infection rate than African countries like Ethiopia, Nigeria and Rwanda.

The world might be winning the war on AIDS -- 2.7 million had HIV in 2010, down from 3.2 million a decade earlier -- according to UNAIDS, but the United States, alongside Eastern Europe, has seen a surge of new infections.

Nearly 1.2 million Americans are now living with HIV/AIDS, an all-time high, with nearly 50,000 new infections every year, according to the Centers for Disease Control and Prevention.

Even with last week's FDA approval of the preventive drug Truvada and antiretrovirus therapies that have virtually eliminated the transmission rate from mother-to-child, a large U.S. population has not reaped the good news.

African-Americans, who represent 14 percent of the U.S. population, account for the largest group, or 44 percent of all new HIV infections and deaths in 2009, according to the Foundation for AIDS Research.

"There is still no cure for AIDS and the fact that we have reduced transmission rates has generated a lot of excitement," said Gail Wyatt, associate director of the UCLA AIDS Institute.

"Our challenges have to do with disparities we have always seen between those who can afford health care and those who are not in the health care system," she said. "We are talking about affordable care and who gets treatment and which populations are disenfranchised and have not gotten care and have no insurance. The same issue has not gone away with the availability of new treatments."  

Copyright 2012 ABC News Radio


Panel Urges Expanded Use of Antiretrovirals for HIV

Alex Wong/Getty Images(WASHINGTON) -- An international panel of experts recommended Sunday that antiretroviral therapy start earlier for patients infected with the human immunodeficiency virus (HIV).

The new recommendations, released at the 19th International AIDS Conference in Washington, D.C., illustrate a new era in the treatment of HIV, one in which physicians are not only concerned about AIDS’ defining illnesses, but also the damage that the virus can cause when it is not controlled.

Traditionally, patients do not start therapy until levels of a specific kind of immune cell in the body – the CD4 cells – drop below 500. But multiple studies in the past two years suggest that therapy is beneficial to patients at any CD4 count.

The nonprofit group International Antiviral Society-USA pointed out new evidence that suggests that the untreated virus can lead to other conditions, such as kidney disease and cardiovascular disease.

“We are no longer only focused on traditional AIDS-defining infections,” said Dr. Melanie Thompson, principal investigator of the AIDS Research Consortium of Atlanta and a member of the Antiviral Society.  “We know that HIV is doing damage to the body all the time.”

The panelists stated that the new antiretroviral medications are friendlier and have fewer side effects, which has played a role in their decision to suggest starting these medications earlier. Previous guidelines were influenced by earlier antiretroviral drugs, which had many more side effects and complications.  The recommendations, although global, are aimed in particular toward countries that have the resources to provide treatment to everyone who needs it.

The new recommendations, if adopted, will lead to many of patients not previously on therapy taking medications, which some warn might lead to increased resistance to existing antiretroviral therapies.

The U.S. Food and Drug Administration last week approved the use of Truvada, a combination of two antiretroviral drugs, for pre-exposure prophylaxis (PrEP); in other words, in people who are not yet infected but who are at high risk of contracting the virus.

Copyright 2012 ABC News Radio


Is Chagas the New AIDS? Experts Disagree

Comstock/Thinkstock(NEW YORK) -- Chagas disease, a parasitic infection spread to humans by insects, is not the new HIV/AIDS of the Americas, according to infectious disease experts who called the comparison “unrealistic” and “unfortunate.”

Responding to an editorial posted Monday in PLoS Neglected Tropical Diseases and the media attention that followed, Rick Tarleton, president of the Chagas Disease Foundation, said the diseases have little in common beyond disproportionately affecting poor people.

“I think it’s an unfortunate comparison,” said Tarleton, a distinguished research professor at the University of Georgia studying Chagas disease. “There are stigmas attached to HIV/AIDS that themselves are inappropriate, but it would be even more inappropriate to apply them to something like Chagas disease.”

About 300,000 people in the U.S. have Chagas disease, an infection transmitted to humans by blood-sucking insects. But almost all of them became infected before coming to the U.S. from Mexico, Central America and South America, according to the U.S. Centers for Disease Control and Prevention.

“It’s difficult to say whether the type of attention this is generating is going to be good or bad for people with the disease,” said Tarleton, describing how many people with Chagas disease face obstacles in getting care. “I don’t think the comparison to HIV/AIDS is a realistic one, and I don’t expect it to serve the situation terribly well.”

But Dr. Peter Hotez, dean of Baylor College of Medicine’s National School of Tropical Medicine, said he penned the provocative editorial to rally resources for people with Chagas disease.

“I wanted to call attention to the disease; make people aware of it,” said Hotez, adding he had no intention to diminish the impact of HIV/AIDS. “I believe that Chagas disease is every bit as important as the AIDS problem, but no one’s ever heard of the disease.”

When asked whether drawing a connection to HIV would stigmatize people with Chagas disease, Hotez replied “I don’t think it can get any worse for them.”

“They already lack access to medical care and many governments are ignoring the problem,” he said. “They’re already treated as outcasts.”

The insects that transmit Chagas disease, nicknamed “kissing bugs” for their tendency to bite people’s lips, infest low-income housing in countries where the disease is endemic. They bite at night, allowing parasites from their feces to infect the itchy wound. Insecticide can kill them, but few can afford it.

“For most of the people affected, it’s not an avoidable infection,” said Tarleton. “It is totally preventable, but largely unavoidable in certain regions.”

But unlike HIV, Chagas disease is largely asymptomatic. Only 30 percent of those who get it develop serious health problems such as heart failure.

“An HIV infection without treatment is essentially a death sentence, but most people with Chagas disease live with the infection for many decades and some people live a perfectly long life without any treatment,” said Tarleton.

And unlike HIV, Chagas disease can be treated in three months.

“In Chagas disease, there are treatments that cure the infection,” said Tarleton.  Current HIV treatments are life-long. “The downside is there is toxicity associated with those drugs in a substantial number of people, and it’s difficult to determine how effective the drugs are. They can cure the infection, but they don’t always cure the infection.”

Those drugs also come at a cost upward of $11,000, according to the editorial, making them out of reach for most.

Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn., and president of the National Foundation for Infectious Diseases, agreed there’s much to be done to improve care for people with Chagas disease.

“This might be called a forgotten disease of forgotten people -- impoverished people in the developing world. And there have not been major efforts to find better drugs to combat this illness,” he said.

And while the comparison between Chagas and HIV may be alarmist, Schaffner said he hopes it will help rally resources.

“I was surprised, frankly, at the whole tone of the editorial,” he said. “But I hope it shifts the view from forgotten problems of forgotten people to newly recognized and appreciated problems of people who need help.”

Copyright 2012 ABC News Radio

ABC News Radio