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Third Annual U.S. Latino AIDS Awareness Day Addresses Stigma, Secrecy Surrounding HIV in Community
Reducing the stigma surrounding HIV and encouraging people in the U.S. Latino community to be tested for HIV are major themes of the third annual National Latino AIDS Awareness Day, scheduled for Saturday, Oct. 15. The theme of the day is "Love Yourself. Protect Yourself. Get Tested for HIV." An estimated 176,000 Latinos in the U.S. are HIV positive, and HIV/AIDS is a leading cause of death among both Latinos and Latinas, according to the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
10/14/05

NIH Launches Phase II Trial of HIV Vaccine for Three Strains of Virus
The U.S. National Institutes of Health (NIH) announced it has launched a Phase II clinical trial of an HIV vaccine that combines strains of the virus found in all regions of the world. Most other experimental vaccines have used strains of HIV from only one or two regions, making many judge the NIH trial as the "first attempt at a truly global AIDS vaccine," according to the Wall Street Journal. "This is the first Phase II study of a vaccine candidate that is broadly relevant to the global AIDS pandemic," Gary Nabel, director of the Dale and Betty Bumpers Vaccine Research Center of NIH, said.
10/12/05

Advanced HIV Disease Can Reduce Brain Tissue in Certain Regions Even With Treatment
Advanced HIV disease can continue to damage some types of brain tissue even when patients are receiving highly active antiretroviral therapy, according to a study published on Tuesday in the Proceedings of the National Academy of Sciences. Paul Thompson, a researcher at the David Geffen School of Medicine at the University of California-Los Angeles and colleagues from the University of Pittsburgh used a 3-D magnetic resonance imaging technique on the brains of 26 people diagnosed with AIDS and 14 HIV-negative people. The researchers found that the AIDS patients had 10% to 15% thinner brain tissue in regions that control movement, language and feeling. The tissue loss shown in the brain imaging of the AIDS patients correlated with motor and cognitive defects that the patients showed in multiple brain function tests. In addition, the extent of the tissue loss seemed to be related to patients' CD4+ T-cell counts.
10/12/05

New Device Offers Friendly Medication Reminder to HIV Patients
Johns Hopkins University Division of Infectious Disease researchers found that a pocket-sized device helps ensure that HIV-infected patients with slightly impaired memory comply with their treatment regimens. The portable Disease Management Assistance System, nicknamed "Jerry" by users, gives electronic-voice reminders, flashes a light and informs patients of the exact dosages and medications to take at a given time. Fifty-eight patients completed a four-month study. Half were given Jerry and attended adherence-counseling sessions. The other half received only counseling. The investigators recruited patients with either normal memory or mild memory impairment. Both groups had better adherence with Jerry, but the memory-impaired participants showed greater improvement. The study, "A Programmable Prompting Device Improves Adherence to Highly Active Antiretroviral Therapy," was published in the Sept. 15th issue of Clinical Infectious Diseases.
10/12/05

Abbott Agrees to Cut Kaletra's Price for Distribution in Brazil
Brazil has reached an agreement with Abbott Laboratories that will lower the price of the company's antiretroviral drug Kaletra per pill from $1.17 to 63 cents and protect the drug's patent, the Brazilian Ministry of Health said. Under the terms of the agreement, Brazilian manufacturers will not produce a generic version of the drug domestically and Abbott will lower the price of Kaletra, which will save the government $339 million over six years.
10/12/05

National Latino AIDS Awareness Day, Oct. 15, 2005
This Saturday, Oct. 15, marks the third annual National Latino AIDS Awareness Day in the United States. The HIV epidemic impacts us in so many ways that it's easy to lose sight of the huge range of Americans who are affected by the virus -- which is exactly why commemorations like National Latino AIDS Awareness Day are so important. Although only 14% of the U.S. population (and growing) is Hispanic, some 19% of all HIV-infected Americans are Hispanic, and HIV stigma within the Latino community remains high. As Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, says in this agency press release, all of us -- Latinos and non-Latinos alike -- must combine our efforts to fight not only HIV, but the fear, hatred and discrimination that continually worsen the epidemic.
10/12/05

HIV JournalView: Persistent, Low-Level Viremia May Breed Resistance
From the newly published September/October issue of The Body Pro's HIV JournalView: Patients with persistent, low-level viremia while on therapy remain a quandary for HIV clinicians: Should their largely effective (and presumably tolerable) HAART regimen be continued, risking resistance? Or should their treatment be switched, potentially exposing the patients to new adverse effects? In a study published in the Sept. 1 issue of JAIDS, University of North Carolina researchers suggest that the answer depends on the patient. Patients with a viral load between 1,000 and 10,000 copies/mL or who were taking an NNRTI-based regimen were found to be at increased risk for developing resistance if current therapy was continued. However, patients with a steady viral load of 1,000 copies/mL or less -- or those who were not on an NNRTI-based regimen -- could continue their current therapy with much less risk of virologic rebound, the researchers found.
10/12/05

HIV JournalView: Study Ties Insulin Resistance to NRTIs, Not PIs
From the newly published September/October issue of The Body Pro's HIV JournalView: Although the development of insulin resistance has long been associated with protease inhibitor (PI) use, it may actually be NRTIs that are to blame, according to a new analysis of data from the all-male Multicenter AIDS Cohort Study published in the Sept. 2 issue of AIDS. In a class-by-class comparison of the effect of HIV treatment experience on insulin resistance and hyperinsulinemia, NRTIs were the only class found to be significantly and independently associated with insulin resistance. Of the individual agents being taken by participants, only stavudine (d4T, Zerit) and lamivudine (3TC, Epivir) were associated with insulin resistance and high insulin levels. Indinavir (Crixivan) was associated with elevated insulin levels, but not insulin resistance. No link to insulin abnormalities was found for zidovudine (AZT, Retrovir) or didanosine (ddI, Videx).
10/12/05

HIV JournalView: Obesity Common Among HIV-Infected Patients in Philadelphia
From the newly published September/October issue of The Body Pro's HIV JournalView: A new report from the University of Pennsylvania cautions that the major body shape issue confronting HIV-infected patients -- particularly African Americans -- is not wasting, or even the focal fat changes associated with antiretroviral use, but rather garden-variety obesity. The report, published in the Aug. 15 issue of JAIDS, found that nearly 28% of women and 11% of men were obese, a known risk factor for cardiovascular disease. Although these rates were generally lower than among the general Philadelphia population, they are still disconcerting for clinicians, and point to the growing importance of weight management in the context of HIV care. The researchers noted that independent risk factors for obesity or being overweight included having a CD4+ cell count of 200 cells/mm³ or greater, not smoking cigarettes and, for women specifically, being African American. HIV therapy in general, and protease inhibitor-based therapy in particular, was not associated with being overweight or obese; a patient's viral load also appeared to have no impact.
10/12/05

HIV JournalView: Valproic Acid and "The Cure" -- Setting the Record Straight
From the newly published September/October issue of The Body Pro's HIV JournalView: News media leaped on the August publication of a study on valproic acid as a new form of HIV treatment, particularly given the closing sentence of the study's abstract: "This finding, though not definitive, suggests that new approaches will allow the cure of HIV in the future." Though not necessarily inaccurate, the statement led many to become overly excited about an experimental treatment that has, thus far, only been investigated in a proof-of-concept study published in the Aug. 13-19 issue of Lancet. The highly preliminary findings of that 4-patient study only serve to support further research into the role of valproic acid, which is known to inhibit HDAC1, a protein that represses HIV gene expression and production of virion. In theory, the blocking of this factor may lead to an outgrowth of HIV from resting cells without triggering the downsides of such activation -- e.g., the upregulation of cell surface markers and the cell-to-cell spread of HIV.
10/12/05

How Many HIV-Infected Patients Lived in the Areas Hit by Hurricane Katrina? (PDF)
The answer: approximately 21,000, all of whom may still be experiencing difficulty gaining access to the medical care they need. This fact sheet includes data on the number of HIV-infected patients who were living with HIV in hurricane-affected counties in Alabama, Louisiana and Mississippi, and provides information on the number of people who were served by each state's AIDS Drug Assistance Program.

More than a month after Katrina struck the Gulf Coast, we still know relatively little about the scope of the challenges that HIV-infected evacuees may be facing. What we do know, though, has been compiled in this collection of articles -- which includes a valuable list of resources for healthcare providers and AIDS organizations that may need to treat HIV-infected evacuees, or for those who are seeking to provide assistance to organizations in hurricane-affected areas.
10/12/05

Didanosine + Ribavirin May Cause Mitochondrial Toxicity
The coadministration of didanosine (ddI, Videx) and ribavirin in HIV/hepatitis C-coinfected patients significantly increases the risk for developing symptomatic mitochondrial toxicity, warn French researchers in a study published in the Sept. 1 issue of JAIDS. Mitochondrial toxicity (usually manifested as symptomatic hyperlactatemia or pancreatitis) was found to be 46 times more likely among coinfected patients receiving ribavirin and didanosine-containing HIV therapy. No other NRTI appeared to trigger the same adverse effect.
10/12/05

Too Much of a Good Thing: Overdosing on Dietary Supplements
Although vitamins and other dietary supplements are generally safe for HIV-infected patients, they can potentially cause a significant amount of harm, underscoring the importance of tracking not only a patient's supplement intake, but of the DOSES of those supplements as well. A recent report from London describes the case of an HIV-infected man who developed hepatitis after taking a wide range of supplements at higher-than-recommended doses.
10/12/05

A Portrait of Sex Education in U.S. States
Where does your state stand on abstinence-only programs? Every U.S. state has its own set of rules when it comes to sexual education for its youth. This in-depth resource provides a state-by-state breakdown of essential information, including: a review of current sex-education law, a list of programs that support (and oppose) comprehensive sex education, and key statistics on the sexual behavior of youths. The resource is maintained by the Sexuality Information and Education Council of the United States, an organization that supports comprehensive sex education.
10/12/05

New Calif. Law Prohibits Denial of Transplant Surgery Based on HIV Status
California Gov. Arnold Schwarzenegger signed into law a measure prohibiting health insurance companies from denying organ transplant coverage for HIV patients solely on the basis of their serostatus. The law, sponsored by Assemblymember Paul Koretz (D-West Hollywood), is the first of its kind in the nation to target such denials, which are often issued by most health insurers.
10/11/05

North American Teens More Approving of Premarital Sex Than in 1940s
According to a new survey released by San Diego State University, young women in the United States and Canada on average have first intercourse at age 15, have more oral sex and are less prudish than previous generations. The survey found that between 1943 and 1999, the percentage of sexually active young women increased from 13% to 47%. The approval of premarital sex rose from 12% to 73% among young women and from 40% to 79% among young men.
10/7/05

Merck Cervical Cancer Vaccine Highly Successful in 2-Year Trial
Merck & Co. has announced that its experimental human papillomavirus (HPV) vaccine, Gardasil, completely prevented early-stage cervical cancer and precancerous cervical lesions caused by the 2 most common forms of HPV. A 2-year study found that Gardasil was 100% effective in preventing precancerous lesions and early-stage cancers associated with HPV types 16 and 18 among participants who remained free of HPV infection until they received their final vaccine dose. In contrast, the placebo group had 21 cases of lesions and early-stage cancers associated with HPV types 16 and 18.
10/6/05

U.S. Releases Updated HIV Treatment Guidelines
The U.S. health department has released updated guidelines on the use of antiretrovirals to treat HIV-infected adults and adolescents. Among the most notable additions are cautionary notes on specific HAART regimens: Regimens consisting of didanosine (ddI, Videx) + tenofovir (Viread) + an NNRTI are not recommended in treatment-naive patients, due to reports of early virologic failure and rapidly emergent resistance. In addition, regimens containing ritonavir (Norvir)-boosted tipranavir (Aptivus) are not recommended in treatment-naive patients, based on a lack of clinical trial data and concerns about potential drug-drug interactions. Additional changes to the guidelines include updated guidance regarding the management of treatment-experienced patients, information about the use of tipranavir and data on the use of once-daily lopinavir/ritonavir (Kaletra).
10/6/05

Updated U.S. Occupational Exposure PEP Guidelines Released (PDF)
The U.S. Public Health Service released updated guidelines for healthcare workers on the management of occupational exposures to HIV. The updated occupational guidelines, published in the Sept. 30 issue of the Morbidity and Mortality Weekly Report, feature an expanded list of antiretrovirals that can be used for post-exposure prophylaxis (PEP) and include guidance on selecting an optimal PEP regimen, avoiding drug-drug interactions and seeking consultation, counseling and follow-up care.
10/6/05

FDA Approves Pediatric Dosing for Ritonavir
The U.S. Food and Drug Administration (FDA) has approved ritonavir (Norvir) for patients between the ages of 1 month and 2 years. The recommended pediatric dose for ritonavir, which should be administered orally as part of combination therapy, is 350 to 400 mg twice daily. However, clinicians are advised to commence ritonavir therapy with a dose of 250 mg and then increase it by 50 mg every 2 to 3 days.
10/6/05

Share Your Story: Signup Form for the Ryan White ACTION Campaign
Do you have a story to tell about how the Ryan White CARE Act has helped your clinic address the needs of HIV-infected patients? A partnership of major professional organizations, including the American Academy of HIV Medicine and the HIV Medicine Association, has launched a campaign to push for improvements to the act, which expired on Sept. 30 and has still not been reauthorized. The campaign is looking for healthcare professionals -- and their patients -- who are willing to share their personal perspectives on the pivotal role that the Ryan White CARE Act plays in U.S. HIV care. Fill out this form to learn more.
10/6/05

IAPAC, ANAC Announce Partnership on Medical Education, Developing World Efforts
The International Association of Physicians in AIDS Care (IAPAC) and the Association of Nurses in AIDS Care (ANAC) have announced a partnership to jointly provide medical education materials and other support for HIV physicians and nurses throughout the world. In a release, the organizations stated that the partnership would cover activities such as the development of co-branded medical education materials and the support of efforts to pair U.S. HIV physicians, nurses and other healthcare professionals with counterparts in various regions of the developing world, particularly in Africa.
10/6/05

Chicago Study Links Meth Use to Higher HIV, STD Rates Among MSM
Men who have sex with men (MSM) and who use crystal methamphetamine are much more likely to have HIV than MSM who do not use meth, according to a recent report from the Chicago Department of Public Health. The report, based on a survey of 1,147 Chicago MSM, found that 11% reported using meth at least once in the previous year. Of those, 22% were HIV infected, compared to 8% of non-users. In addition, rates of the sexually transmitted diseases (STDs) syphilis and gonorrhea among meth users were 3 times those found among non-users.
10/4/05

New British Life Insurance Guidelines Forbid Questioning Male Applicants About Sexuality
British life insurance agents cannot ask male applicants questions about their sexual practices in order to determine HIV risk, according to new guidelines from the Association of British Insurers (ABI) that went into effect on Oct. 1. About 400 companies are members of ABI and, between them, provide 94% of domestic insurance services sold in the United Kingdom.
10/4/05

Whitman-Walker Clinic Closes Maryland Facility
The Washington, D.C.-based Whitman-Walker Clinic (WWC) on Sept. 30 shut down its Takoma Park, Md., facility because of budget constraints. The clinic in May approved $2.5 million in cuts and announced it would permanently end services in the Northern Virginia and Maryland suburbs. However, the Virginia Department of Health, the city of Alexandria, Va., and Fairfax and Arlington counties in Virginia have pledged to provide as much as $590,000 to WWC to keep its Northern Virginia clinic operating until the end of 2006.
10/4/05

Small Study Says HIV Now Replicating at a Slower Rate
The rate at which HIV replicates might be slowing, suggesting that its viral fitness may have decreased since the 1980s, according to a small study published in the Sept. 29 issue of AIDS. Some experts warn, however, that the findings do not suggest that HIV has become less contagious or deadly. "The bottom line is that HIV is still dangerous," Carl Dieffenbach, head of the basic science program in the Division of AIDS at the National Institute of Allergy and Infectious Diseases, said, adding, "If it is attenuating, it is not doing it enough to make a difference in outcomes."
10/3/05

Risk of HIV Infection Increases Significantly During Pregnancy
Sexually active women who are pregnant or lactating are at a higher risk for HIV infection than sexually active women who aren't pregnant or lactating, according to a new study conducted in Uganda and led by Ronald Gray of the Johns Hopkins Bloomberg School of Public Health. The researchers suggest that hormonal changes -- not changes in sexual behavior -- are the likely cause of the increased risk, making targeted HIV prevention and education efforts among pregnant women even more imperative than previously thought. This large, prospective study was published in the Oct. 1 issue of Lancet.
10/3/05