A selection of news stories which have appeared since March 26th 2004 at http://www.aidsmap.com.
First case of potential PI cross-resistance reported after lopinavir failure
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2675
Doctors in South Africa have reported the first case of Kaletra (lopinavir/ritonavir) failure in a protease inhibitor-naïve individual to be associated with a pattern of protease resistance mutations that confer cross-resistance to other protease inhibitors, despite apparently excellent adherence. The case is reported in a letter featured in the latest issue of the journal AIDS.
Protease inhibitors associated with plaques in the carotid arteries
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2676
HIV-positive individuals treated with a protease inhibitor are significantly more likely to develop lesions in their carotid arteries than HIV-positive patients treated with non-nucleoside analogues (NNRTIs), who are naïve to HAART (or who are taking dual nucleoside analogue treatment), according to a study published in the April 30th edition of AIDS.
Dementia, and neuropathy common in Ugandan HIV-positive patients
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2681
Dementia and sensory neuropathy are common among untreated HIV-positive individuals in sub-Saharan Africa, according to research presented this week at the American Academy of Neurology 56th Annual Meeting in San Francisco. Half of all HIV-positive patients presenting at an infectious disease clinic in Uganda had sensory neuropathy.
Russia's hard line on drug use making HIV prevention difficult
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2679
Russia's worsening HIV crisis is being exacerbated by government policy, police harassment, and prejudice, according to a report released today by Human Rights Watch.
Untreated HIV infection progresses to AIDS quicker in Thailand
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2680
The progression from HIV infection to AIDS and death from AIDS is more rapid in untreated young men infected with HIV-1 subtype E living in Thailand than in HIV-positive individuals with HIV-1 subtype B infection living in the United States and Europe, according to researchers from the Johns Hopkins Bloomberg School of Public Health, the Armed Forces Research Institute of Medical Sciences and Chiang Mai University in Thailand.
International standards on fixed dose combinations for HIV published
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2678
Representatives of drug regulatory authorities from southern Africa, Canada, Switzerland, Ghana, Tanzania, India, Indonesia, USA and Thailand have reached agreement on standards for approval of fixed dose antiretroviral combinations following a two day meeting in Gaborone, Botswana on March 29th and 30th.
Khayelitsha ARV programme publishes detailed results
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2674
Researchers from South Africa have published the first detailed journal report of clinical outcomes from the pioneering antiretroviral treatment programme delivered through primary care clinics in the Western Cape township of Khayelitsha. The findings appear in the April 9th edition of the journal AIDS.
No evidence that breastfeeding makes maternal HIV worse
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2670
Breastfeeding is not detrimental to the health of HIV-positive mothers, according to a study published in the April 30th edition of AIDS.
HAART alone not enough to stop spread of HIV in South Africa
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2667
Less than 10% of HIV-positive individuals in South Africa will be eligible to receive antiretroviral therapy if World Health Organisation guidelines which mandate the use of anti-HIV therapy in patients with a CD4 cell count below 200 cells/mm3 are followed, according to a French-funded study published in the May 1st edition of the Journal of Acquired Immune Deficiency Syndromes.
Low weight males have higher trough levels of lopinavir
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2669
Trough levels of the protease inhibitor Kaletra (lopinaivr boosted by ritonavir) are significantly higher in men with low body weight, according to a poster presentation at the Tenth Anniversary Conference of the British HIV Association (BHIVA) in Cardiff last week. The investigators, from Liverpool University Therapeutic Drug Monitoring Service, have called for further research to establish the clinical significance of their findings.
Migrants not responsible for spread of TB in UK
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2664
Migrants are not responsible for the increasing incidence of tuberculosis (TB) in the UK, according to research presented to the April meeting of the Society of General Microbiology. This finding stands in stark contrast to sensationalist media reporting which has blamed a recent increase in the incidence of TB in the UK on asylum seekers, particularly those infected with HIV.
Tenofovir no more likely to cause kidney problems in London patients than other antiretrovirals
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2668
Patients taking the nucleotide analogue, tenofovir, are no more likely to experience kidney problems than individuals taking other antiretrovirals, according to a poster presentation to the Tenth Anniversary Conference of the British HIV Association (BHIVA), in Cardiff last week.
Vitamin A supplementation does not lower shedding of HSV in HIV-positive women
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2666
Vitamin A supplementation does not reduce the genital shedding of herpes simplex virus-2 (HSV-2) in HIV-positive women, according to the results of a randomised placebo controlled trial published in the April 15th edition of the Journal of Infectious Diseases. The investigators also found genital shedding of HSV was strongly associated with the secretion of HIV in the genitals and recommend that aciclovir therapy should be provided as a way of preventing the transmission of both HSV and HIV.
Researchers claim definitive evidence that HIV-AIDS is not from oral polio vaccine
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2665
HIV-AIDS did not come from oral polio vaccine contaminated with chimpanzee virus, according to findings from an expedition designed to test the hypothesis by one of its key sympathisers. The findings are published online in the April 22nd edition of Nature.
Appeal for free ARV treatment for survivors of the Rwandan genocide
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2661
Advocates for survivors of genocide in Rwanda today called for antiretroviral treatment to be made available free to women who were infected with HIV during the systematic rape of tens of thousands in 1994. The Survivors Fund has launched an online petition calling on the British government to do more to pressurise pharmaceutical companies to make antiretroviral treatment affordable in Rwanda. International donors are also being urged to do more to help Rwandan women.
2NN study full results: nevirapine inferior to efavirenz?
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2659
Final results of a major international comparative study of nevirapine or efavirenz-based triple antiretroviral therapy suggest that nevirapine-based HAART may have proved inferior to efavirenz-based therapy over 48 weeks of follow-up, contrary to initial headline findings presented at the Tenth Conference on Retroviruses and Opportunistic Infections in Boston in 2003. The full results are published in the April 17th edition of The Lancet.
Reduction in number of sexual partners key to halting spread of HIV, says BMJ article
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2656
HIV prevention work is neglecting to inform individuals about the role partner reduction can play in stemming the spread of HIV, according to an article in the April 10th edition of the British Medical Journal. The authors, who represent international development agencies, the US government, and US universities, argue that the importance of partner reduction to slowing the spread of HIV is not being recognised amidst ideologically driven discussions which focus on either abstinence or condom use as the best way to prevent HIV. The authors' position is supported by an editorial in the same edition of the BMJ, and is applauded for highlighting the "simple truth" that partner reduction is of key importance to HIV prevention.
Clinton, World Bank, Global Fund, UNICEF strike deal to expand access to cheap ARVs and tests
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2652
A consortium of international agencies and the Clinton Foundation have developed a joint plan to purchase and distribute generic anti-HIV drugs and key HIV diagnostic tests to poorer countries hard-hit by HIV.
Yellow fever vaccine safe and effective in HIV-positive individuals with CD4 count above 200
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2645
The yellow fever vaccine is effective and safe in HIV-positive individuals with a CD4 cell count above 200 cells/mm3, according to a retrospective French study published in the March 25th edition of AIDS.
Four year follow-up shows Kaletra to be safe, effective, durable
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2651
Lopinavir/ritonavir (KaletraTM) has a potent and durable anti-HIV effect when used in combination with d4T and 3TC, and a good side-effect profile, according to a long-term safety study published in the March 25th edition of AIDS. The study investigators conclude that these results support the use of Kaletra in first-line HAART regimens.
HIV-positive women less likely to become pregnant and more likely to miscarry even if asymptomatic
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2648
HIV-positive women are less likely to get pregnant and more likely to have a miscarriage, according to a study conducted in Uganda and published in the March 26th edition of AIDS.
HIV-specific immune responses key to speed of disease progression
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2641
HIV-specific immune responses act to slow HIV disease progression, according to articles published in recent editions of the Journals of Infectious Diseases, Journal of Immunology, and The Lancet. The studies could have important implications for future HIV vaccine research.
Microbicides 2004 marks new wave of HIV prevention trials
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2642
The Microbicides 2004 meeting, which took place this week at London's Hilton Metropole hotel, drew 800 participants from 53 countries for four days of intensive discussion.
Microbicides pose new challenges for design of research studies
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2643
As reported here on aidsmap, the big news at the Microbicides 2004 Conference in London was the imminent start of five large efficacy trials of six different candidate microbicides. These could produce significant results by 2007, if the trials are successful in retaining the vast majority of volunteers (no mean feat given the degree of commitment these long studies imply for women who participate).
ARV-based HIV microbicides advanced by ground-breaking partnership
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2637
The International Partnership for Microbicides (IPM) has made a far-reaching agreement with Tibotec Pharmaceuticals, a Belgian subsidiary of Johnson & Johnson, to develop an antiretroviral drug as a microbicide to prevent HIV. The agreement was warmly welcomed by UK International Development Secretary Hilary Benn, speaking on Monday at the Microbicides 2004 conference in London.
HIV infection changes the genes that affect development of tuberculosis
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2634
The human leukocyte antigen (HLA) genes affect the development of tuberculosis (TB) differently in people with and without HIV-1 infection, according to research published in the March 15th edition of the Journal of Infectious Diseases.
Rectal HIV microbicides still a distant prospect
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2635
A seminar held last Sunday in London ahead of the Microbicides 2004 meeting reviewed progress towards rectal microbicides, products to prevent HIV transmission through anal sex. The meeting was organised by the University of California, Los Angeles AIDS Institute, with participants from Europe, North America and South Africa, some of whose findings were also presented at the main meeting.
Resistant HIV strains persist after at least five years on suppressive HAART
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2627
Drug-resistant strains of HIV can remain archived in the reservoir of latently infected cells for five years or more after a successfully suppressive HAART regime, according to research published in the April 15th issue of the Journal of Acquired Immune Deficiency Syndrome. This confirms previous findings that drug-resistant strains prior to suppressive HAART can re-emerge when HAART is stopped, and has important clinical implications, particularly for highly treatment-experienced people on salvage therapy.