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• TOP 10 HIV MEDICAL STORIES OF 2006: NEW CME/CE ACTIVITY
David Wohl, M.D., Reviews the Most Critical HIV Developments of 2006
It's one of the most insightful, entertaining, informative HIV research recaps you'll read this year: The Body PRO's David Wohl, M.D., presents an end-of-year review of the developments that made the biggest waves among HIV health care professionals in 2006. If you're looking for an easy-to-digest recap of the most critical news in HIV over the last calendar year, this is the article to read. Free CME/CE credit is available for U.S. physicians, nurses and pharmacists!  Click Here |
• PODCASTS AND EXPERT COVERAGE OF CROI 2007
The 14th Conference on Retroviruses and Opportunistic Infections (CROI 2007) is winding down in Los Angeles, but The Body PRO's wide-ranging coverage is just getting started! From expert summaries to podcast interviews, our team will go beyond the research to bring you insightful analysis of conference highlights. Here's just a taste of what you can already find within our CROI 2007 coverage:
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• HIV TREATMENT & COMPLICATIONS
Non-AIDS-Related Mortality Surpasses AIDS-Related Mortality as Cause of Death Among HIV-Infected Individuals
There is no doubt that HAART has profoundly altered the course of HIV infection, transforming it from a terminal illness into a chronic illness. To drive this point home, new research from Johns Hopkins University, published in the Feb. 1 issue of JAIDS, reveals that among HIV-infected individuals on HAART who have a CD4+ cell count above 200 cells/mm3, the risk of dying from a non-AIDS-related cause now exceeds the risk of dying from an AIDS-related cause. AIDS-related mortality dropped from a high of 40.9 deaths per 1,000 person-years in 1998 to a low of 20.2 deaths per 1,000 person-years in 2003, the research states. However, offsetting this decline is the finding that non-AIDS-related mortality increased from 10.7 deaths per 1,000 person-years in 1997 to a high of 22.7 deaths per 1,000 person-years in 2003. Injection-drug users with CD4+ cell counts above 200 cells/mm3 appear to be at highest risk of dying from non-AIDS-related causes, according to the study. Based on these findings, the investigators noted that "further efforts to reduce mortality in [the HIV-infected] population require attention to conditions that have not traditionally been considered to be HIV related." Click Here
HSV-2 Treatment Can Control HSV-2 and HIV Replication, Study Finds
Treatment with valacyclovir (Valtrex) 500 mg twice daily not only reduces the viral load of herpes simplex virus type 2 (HSV-2), but also reduces HIV viral load in women coinfected with HIV-1 and HSV-2, according to results from a randomized, double-blind, placebo-controlled trial. Sixty-eight women who received daily treatment with valacyclovir for three months demonstrated a mean reduction in genital HIV-1 RNA of 0.29 log10 copies/mL from baseline (P < .001), as well as a mean reduction in plasma HIV-1 RNA of 0.53 log10 copies/mL from baseline (P < .001). The suppressive effects of valacyclovir on plasma HIV-1 RNA increased with time (P < .001), suggesting that longer treatment may lead to greater reductions in HIV-1 replication. As expected, valacyclovir dramatically lowered genital HSV-2 shedding; the rate of genital shedding was 54.4% among individuals receiving placebo compared with a rate of 19.1% among those receiving valacyclovir (P < .001). "The strong and significant reduction in plasma and genital HIV-1 RNA levels associated with valacyclovir treatment suggests that sustained forms of HSV-2 control (either antiviral therapy or effective vaccination) may reduce HIV-1 transmission, assuming that a reduction in genital and plasma HIV-1 RNA levels is a proxy for decreased transmissibility," the investigators stated in their Feb. 22 New England Journal of Medicine article. Click Here |
• HIV TRANSMISSION
Male Circumcision Reduces Men's HIV Infection Risk by 65%, Not 50%, Data Re-Evaluation Says
Circumcision may provide even better protection against HIV infection than previously thought. Re-evaluation of the data from two headline-grabbing, U.S.-funded clinical trials in Kenya and Uganda reveals that male circumcision could reduce a man's risk of HIV infection through heterosexual sex by 65%, according to researchers. In December 2006, the two trials were stopped early and the nearly 8,000 participants were all offered circumcisions when it became apparent that the procedure reduced participants' risk of HIV infection by what, at the time, was deemed to be approximately 50%. Click Here
Abstinence-Only Sex Ed Lacks Scientific Support, Study Says
More than $1 billion in U.S. government funding has gone into state-run, abstinence-only programs in the past 10 years, although there is little scientific evidence to support those programs. Nonetheless, between 1995 and 2002, U.S. teens in sex-ed classes were more likely to be taught how to say no to sex than they were to be taught about birth control methods, according to a recent study from the Guttmacher Institute. Researchers found that abstinence was promoted "in the absence of any substantial scientific evidence supporting the effectiveness of the approach." The primary reason? States rely heavily on federal abstinence funding, which restricts information about birth control. Only three states -- California, Maine and Pennsylvania -- decline the federal funding, which frees them (albeit expensively) to go their own way on sex education. Click Here
To read the Guttmacher Institute's full report, "Changes in Formal Sex Education: 1995-2002," click here.
Gates Foundation, Canadian Government Announce Joint HIV Vaccine Initiative
The Bill & Melinda Gates Foundation and the Canadian government have announced a $139 million initiative to establish an HIV vaccine research institute. At a press conference last week, Canadian Prime Minister Stephen Harper -- who was conspicuously absent from the XVI International AIDS Conference in Toronto last August -- stood with Bill Gates to introduce the plan. The Canadian government will provide about $111 million over five years, and the Gates Foundation will provide $28 million. The initiative aims to develop a working HIV vaccine within 10 years and will build the first research facility in the world with the production capacity to manufacture experimental vaccines for clinical trials. Click Here
Clinical Trial to Determine Whether New Type of Diaphragm Can Be Used For HIV Prevention
Researchers at the Women's Global Health Imperative program at the University of California-San Francisco's Medical Center are conducting a large-scale clinical trial among 4,500 women in Zimbabwe and South Africa to test the effectiveness of diaphragms in HIV prevention. The study, which is largely being funded by the Bill & Melinda Gates Foundation, will focus on a diaphragm called SILCS, which is being development by PATH, a Seattle-based nonprofit organization. Unlike Ortho All-Flex, the most widely used diaphragm, SILCS is "one-size fits most," which would mean that women would not be required to undergo a pelvic exam in order to receive one. If it passes muster, SILCS would be on track to receive U.S. Food and Drug Administration approval by 2010. Click Here
Inmates in Chicago Encouraged To Get Tested for HIV
Rev. Jesse Jackson made an appearance at Chicago's Cook County Jail last weekend to encourage inmates to get tested and learn their HIV status: "You can help us attack a killer disease before a killer disease kills us all," he proclaimed. Jackson took an HIV test and then watched as dozens of inmates lined up to take their own oral swab, rapid-result HIV test. Current Illinois state law requires that inmates be offered HIV testing upon intake and prior to release at state prisons. Other states -- and even the U.S. federal government -- have begun considering measures that would mandate HIV testing for all inmates. Click Here
Vancouver Needle-Exchange Program Doesn't Increase Drug Users' HIV Risk, Study Finds
In contrast to a prior report, injection drug users (IDUs) who frequent needle-exchange programs are not at increased risk of HIV infection, according to a study published in the February issue of the American Journal of Medicine, Reuters Health reports. An earlier study conducted in Vancouver found that IDUs who frequently used a needle-exchange program had a higher incidence of HIV infection compared with individuals who used the program only occasionally, prompting many to oppose such programs. Another analysis conducted in Vancouver by Evan Wood of the British Columbia Centre for Excellence in HIV/AIDS and colleagues found that individuals who reported frequently exchanging needles did indeed have a higher HIV incidence rate compared with individuals who did not report this behavior (18.1% vs. 10.7%; P < .001). However, many frequenters of the needle-exchange program were daily heroin or cocaine users or had other high-risk characteristics, such as living in unsteady housing or earning money through commercial sex work. These factors explain the higher HIV incidence among more frequent users of needle-exchange programs found in the earlier study, according to the researchers, not the needle-exchange program itself. Click Here |
• HIV IN THE NEWS
Advocacy Group Sues Federal Agencies Over Medical Marijuana Statements
U.S. government agencies are lying about medical marijuana -- at least, that's what the advocacy group Americans for Safe Access (ASA) said in a lawsuit it filed against the U.S. Department of Health and Human Services (DHHS) and the U.S. Food and Drug Administration (FDA). According to the group, the DHHS and the FDA have publicly released "false and misleading statements" denying the benefits of medical marijuana. ASA cited several studies that found marijuana benefits HIV-infected patients suffering from peripheral neuropathy, AIDS wasting, muscle spasticity and chronic pain. The lawsuit was filed following a study published in the Feb. 13 issue of the journal Neurology, in which the use of medical marijuana was found to reduce peripheral neuropathy pain by as much as 34% over five days. Click Here |
• HIV OUTSIDE THE UNITED STATES
Forget the Formula: Babies More Likely to Survive If Breastfed, Study Finds
Babies born in developing countries stand a better chance of surviving if their HIV-infected mothers breastfeed them instead of feeding them formula, according to a study presented by Hoosen Coovadia at the 14th Conference on Retroviruses and Opportunistic Infections in Los Angeles on Monday. Given the lack of clean water and the prevalence of infectious agents in developing countries, the abundance of immune factors present in mothers' breast milk are critical for building infants' immune systems so that they can survive their younger years -- a benefit that far outweighs the risk of HIV transmission. Coovadia, a pediatrician at South Africa's University of KwaZulu-Natal, noted that advising HIV-infected mothers to breastfeed would result in 300,000 children acquiring the virus, but five times as many children -- 1.5 million -- would be saved from succumbing to other diseases. As such, Coovadia advocates breastfeeding in all regions with an infant mortality rate of 25% or higher. Click Here
Short Documentary on Chinese AIDS Orphans Wins Oscar
The Blood of Yingzhou District, a film about Chinese AIDS orphans, won the Oscar for best documentary short film at the 2007 Academy Awards. The film focuses on Anhui province, a neighboring province to Henan -- the center of China's HIV epidemic. An estimated 650,000 people are living with HIV in China, and as the disease moves further into the general population, the traditional Chinese obligation to care for extended family is colliding with the nation's fear of HIV -- leaving thousands of AIDS orphans caught in the middle. Chinese officials estimate there are currently 76,000 AIDS orphans in the country, a number that is expected to grow to 260,000 by 2010. "I think the award really raises awareness about AIDS in China and especially the plight of AIDS orphans," commented an activist close to the documentarians. "When we talk about AIDS orphans people really usually think of Africa, but in China this is still a very serious issue." Click Here
United Nations Rep Disputes "HIV Cure" Claim, Ordered to Leave Gambia
After questioning the Gambian president's claim that he can cure HIV with an herbal remedy, United Nations representative Fadzai Gwaradzimba has been asked to leave the country. Since January, President Yahya Jammeh has claimed that he can cure HIV with the application of a few herbal remedies, provided the patient is no longer taking antiretrovirals. The president has not yet been willing to put his "cure" to a scientific test. Gwaradzimba became an unwelcome guest in Gambia when she questioned whether there was any scientific proof of the efficacy of Jammeh's treatment, and expressed concern that President Jammeh's claim could encourage high-risk sexual behavior. Click Here
HPV Vaccine in Demand Among Gay Men in the United Kingdom
Dozens of gay men in London have requested and received the human papillomavirus (HPV) vaccine, Gardasil, produced by Merck & Co. Inc. Gardasil has been approved in the United States and United Kingdom to prevent four strains of HPV -- which together cause 70 percent of all cervical cancers and 90 percent of all cases of genital warts -- in girls and young women. However, HPV may also trigger anal and penile cancers, for which men who have sex with men are at risk. "We started offering vaccination to gay men in January and recently we've been giving about 10 a week," said Dr. Sean Cummings of the Freedomhealth clinic in London. The Terrence Higgins Trust, a leading UK HIV charity, said the case for large-scale vaccination in men would depend on the outcome of future clinical trials. Click Here
$6 Billion Needed to Avert Deadly Drug-Resistant Tuberculosis Pandemic, Expert Says
An estimated 27,000 cases of extensively drug-resistant tuberculosis (XDR-TB) crop up each year throughout China, India, Russia, South Africa and other locales. Because XDR-TB is resistant to many of the oral and injectable drugs used to control the illness, the number of new cases could reach catastrophic proportions if efforts are not quickly taken to control regional outbreaks. World Health Organization TB expert Paul Nunn told attendees of the 14th Conference on Retroviruses and Opportunistic Infections in Los Angeles that $600 million a year for the next 10 years will be needed to staunch a catastrophic global epidemic. This money is essential for recruiting and training staff in countries hit hardest by TB and HIV infection in order to build an infrastructure to better diagnose and control XDR-TB infection before it spreads. Click Here |
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