Posts Tagged ‘Safety

27
Jan
10

Herpes Medication Does Not Reduce Risk of HIV Transmission, Study Finds

ScienceDaily (Jan. 25, 2010) — A five-year international multi-center clinical trial has found that acyclovir, a drug widely used as a safe and effective treatment taken twice daily to suppress herpes simplex virus-2 (HSV-2), which is the most common cause of genital herpes, does not reduce the risk of HIV transmission when taken by people infected with both HIV and HSV-2.

The results of the study are published in the New England Journal of Medicine.

Up to 90% of people with HIV infection also have HSV-2 infection. Most people who are infected with HSV-2 do not know they have the virus because symptoms can be mild or absent. HSV-2 infection can cause recurrent sores and breaks in the skin of the genital region, which can be mild and often go unnoticed. HSV-2 infection also attracts immune cells called CD4 T-cells to the genital region, which HIV uses to establish or pass infection.

Multiple studies have shown that frequent genital herpes recurrences increase the amount of HIV in the blood and genital tract. The HIV virus is also shed from genital herpes ulcers and persons with such ulcers transmit HIV to others more efficiently. Five preliminary studies showed that it is possible to decrease the amount of HIV in the blood and genital tract through treatment to suppress HSV-2, but these studies did not measure whether this translated into a reduction in HIV transmission. Researchers had hoped that acyclovir’s ability to suppress the herpes virus, which causes symptomatic genital sores and breaks in the skin but also frequently is active without symptoms, could reduce the likelihood of sexual transmission of HIV from a person with HIV and HSV-2. The study is the first to determine whether twice daily use of acyclovir by individuals who are infected with both HSV-2 and HIV reduced the transmission of HIV to their sexual partners. The authors conclude that daily acyclovir therapy did not reduce the risk of transmission of HIV, in spite of the fact that acyclovir reduced plasma HIV RNA by a ¼ log and the occurrence of genital ulcers due to HSV-2 by 73%.

Led by the University of Washington in Seattle and funded by the Bill & Melinda Gates Foundation, the Partners in Prevention HSV/HIV Transmission Study was conducted among 3,408 African HIV serodiscordant couples, in which one partner had HIV and the other did not. In all the couples, the partner who had HIV also had HSV-2 infection. The study took place at 14 sites in seven countries in eastern and southern Africa (Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda and Zambia). In sub-Saharan Africa, the majority of new HIV infections occur among heterosexual HIV discordant couples, many of whom are in stable partnerships and unaware that one partner has HIV and the other does not. Genital herpes is thought to be a factor in a substantial proportion of new HIV infections in Africa.

The study began recruitment in Nov. 2004 and ended follow-up of participants in Oct. 2008. Results were first announced in May 2009 and were presented at the International AIDS Society (IAS) meeting in Cape Town, South Africa, on July 22, 2009.

In the primary analysis of HIV transmissions determined by laboratory testing to have occurred within the couple and not acquired from an outside partner, there were 41 infections in the acyclovir arm and 43 in the placebo arm — not a significant difference. Of the partners who were infected with HIV, 68 % were women. Acyclovir suppressive treatment did show significant reductions in the frequency of genital ulcers (by 73%) and the average amount of HIV in the blood (by 0.25 log10 copies/milliliter, a reduction of 40%), compared to the placebo arm.

“As is often the case with large efficacy trials, you learn to expect surprises,” said Dr. Connie Celum, the leader of the study and a UW professor of Global Health and Medicine in the Division of Allergy and Infectious Diseases. “We found that, in spite of a significant reduction in plasma HIV levels and genital ulcer disease with acyclovir suppressive therapy, there was no reduction in HIV transmission. This was a disappointing finding, but a critical outcome of this study is the understanding that interventions must achieve a bigger reduction in HIV levels in order to reduce HIV transmission, especially among persons with high HIV levels. This will be important in informing future interventions to reduce HIV infectiousness.”

Celum said the study is a direct assessment of the impact of herpes suppression on HIV transmission and is the most direct way to see if it’s possible to make a person less infectious and less likely to transmit HIV to their partner. Although the primary outcome of reducing HIV transmission was not observed, Celum said the study achieved many significant mile¬stones that will help to inform HIV prevention research in a number of ways. Among these were HIV testing of approximately 55,000 couples of unknown HIV serostatus, screening of more than 6,500 HIV serodiscordant couples, and enroll¬ment of 3,408 couples in which the HIV- infected partner was dually infected with HSV-2 and not eligible for antiretroviral therapy, based on national guidelines. Adherence to twice daily acyclovir was high, with 88% of doses dispensed (the drug was not dispensed during pregnancy or if visits were missed), and 96% of dispensed doses taken, as measured by pill counts. Retention of study participants at 24 months of follow-up was 92% for HIV infected partners and 84% for HIV uninfected partners.

The Partners in Prevention HSV/HIV Transmission Study is the first clinical trial to directly test whether suppressing HSV-2 infection in HIV-infected persons could reduce rates of HIV transmission and HIV disease progression. The study was randomized, placebo-controlled and double-blinded, meaning that both participants and the care providers did not know which treatment the participants were receiving. Both the placebo and treatment groups received standard HIV prevention services, which included being supplied with condoms, treated for other sexually transmitted infections, and provided care for HIV infection. All participants received extensive counseling, both individually and as a couple, throughout the study period, on how to reduce the risk of HIV infection.

“This was an ambitious study, and I applaud our collaborators at the University of Washington, the investigators and study teams in Africa, the study participants, and the communities where the study was done, for their dedication over the past five years,” Celum said. “We will continue to learn from this study about risk factors for HIV transmission, which will bear fruit for both the HIV prevention and the vaccine fields for years to come.”

27
Jan
10

7% of Sub-Saharan’s old people living with HIV

SENIOR Citizens Association of Zambia National Co-ordinator Rosemary Sishimba has said seven per cent of the older people in Sub-Saharan African countries are living with HIV/AIDS pandemic.

Officiating at media breakfast organised by Helpage International on Wednesday, Sishimba said it was sad that the media had not prioritised coverage of the elderly in society.

“Little is known about the vital role of older persons in social development, in the context of the HIVand AIDS pandemic a disease that has ravaged African countries socially and economically,” Sishimba said.

She said the evidence suggests that the older persons had taken the burdensome role of caring for the children as a result of HIV and AIDS in sustaining families,usually with scanty resources.

“We carried out regional consultative meetings on HIVand AIDS for the older people in eight African countries and we found out that in Kenya 72,550 older people were living with the pandemic,” she said. “As at now we have not yet established the per centage rate for Zambia as we are still carrying out the survey,” Sishimba said.

She said it was important for the government and cooperating partners to ensure that the older people in society were sensitised on the social norms of condom use.

“The problem that the older people are facing right now is that they think HIV and AIDS is a disease that can only be contracted by the young in society,” she said. “The existing preventive education message targets younger people, leaving out or programme that would be relevant to older people,”

Sishimba said the media should play an active role in reporting and sensitizing the aged in society about the pandemic.

“The Non-Governmental Organizations (NGO) need to collaborate with media to sensitize the public and government about the need and circumstances of older people in general and older care givers. It is however very unfortunate that the media houses hardly have interest in reporting on issues concerning the older people in society,” Sishimba said.

She said if the Sub-Saharan countries were to win the fight against HIV and AIDS more concerted efforts was an important aspect.

23
Dec
09

Don’t hang HIV carriers; educate them

Wednesday, 23 December 2009 08:18 By Ariel Rubin

Hardly a day goes by in Uganda without a case of defilement making the rounds in newspapers and media outlets. From the lurid tales spewed out daily by the Red Pepper tabloid to disheartening articles in the Daily Monitor and New Vision of allegations of police defiling rape victims and young women killing attempted rapists, these stories are garnering more and more attention. But why? No other country seems to be as focused on defilers as Uganda. Indeed, one of the major justifications for the controversial “Anti-Homosexuality Bill 2009” is that the proposed law is a necessary measure to counteract the increasing amount of sexual abuse being perpetrated by homosexuals throughout the country.

According to a recent report by the African Network for Prevention against Child Abuse and Neglect (ANPPCAN) Uganda Chapter, 16 children were sexually abused daily in the first six months of this year in Uganda. A total of 9,480 child-abuse related cases were reported to various sources and of these, around 2,600 were defilement. According to Anselm Wandega, the national coordinator for research, information and advocacy at ANPPCAN, the number of child abuse cases in Uganda is “unacceptably high.” He blamed the high incidences of defilement on breakdown in the family system. 

This “breakdown of the family” and the fear it has engendered in Ugandans is one of the major pillars of Bahati and company’s arguments for further marginalising and criminalising Uganda’s gay community. This sentiment was echoed by Topher Mugumya, then-programme coordinator for research, information and advocacy at the ANPPCAN Uganda Chapter, who noted in 2007 that the widespread myth that having sex with a young child can “cleanse” one of HIV had led to a spike in child rape by HIV-positive men. This blanket statement, without any substantial qualification, is all that supporters of the anti-gay bill need to further stoke the fire. A quick glance at comments on Andrew Mwenda’s November 10th op-ed piece in this magazine shows just how many visceral, fear-driven reactions there are.

Instead of a nuanced and intelligent debate about the legality and ethicality of such a bill, the discourse revolves around a sinister cabal of homosexuals fiendishly preying upon innocent school children. Perversely, this renders the two terms synonymous, thus permitting proponents of the Anti-Homosexuality Bill to stifle opposition by calling any supporter a homosexual and thus invariably a defiler of small children. Even though the Penal Code Act already includes provisions which criminalise rape and defilement, Pastor Martin Ssempa can still vehemently argue that, “For too long we have had a problem that boys are raped and sodomised in school settings. Now when we deal with aggravated homosexuality, we are trying to provide equal protection before the law.”

 Unfortunately much of the debate over the Anti-Homosexuality Bill 2009 and the serious problem Uganda faces regarding child abuse seem to have become confused, allowing those like Ssempa to articulate that this deeply unfair bill is one that promotes equality. Indeed, ANPPCAN’s numbers pose a serious problem to Ugandan society but the spurious and offensive notion of a massive homosexual recruitment and rape drive is not the reason why. The difference between pedophilia and homosexuality must be elucidated so that the real reasons behind this bill can be understood and the appropriate responses to child abuse can be generated.

Ultimately, it would be prudent to investigate just how many cases of child rape by HIV-positive men are occurring as this is the kind of claim which can (and given the popular support for the bill, clearly has) stoke serious and often spurious biases against one small segment of the population. It is worth noting that according to one World Vision survey, 60% of girls reported sexual abuse while the number for boys was only 13%, indicating that heterosexual defilement is still a significantly bigger issue than same-sex abuse. As Dr Sylvia Tamale noted in a recent speech at Makerere University, “Over 50% of child sexual abuse reports involve children below 10 years of age, and the perpetrators are heterosexual men who are known to the victim.”  However, no one is tabling an “Anti-Heterosexuality Bill” in Parliament. 

There is no doubt that sexual abuse of minors poses a serious problem but it must not be conflated with the practice of consensual homosexual relations between two adults. The two issues have to be separated and dealt with accordingly. Instead of spending so much time and money advocating the execution of those with HIV/AIDS, the government would be wise to start educating.

21
Dec
09

Group: HIV/AIDS among Top 10 crises of the year

By MICHAEL ASTOR (AP)

 NEW YORK — Dwindling funding for HIV/AIDS threatens to leave an estimated 10 million infected people without treatment in the developing world, making it one of 2009’s Top 10 humanitarian crises, according to Doctors Without Borders.

 

Other crises that made the list released by the medical humanitarian group Monday were: governments blocking access to lifesaving assistance in Sri Lanka, Pakistan and Sudan; a lack of respect for civilian safety and aid efforts in Yemen, Afghanistan, Pakistan, Democratic Republic of Congo and Somalia; and inadequate international funds to fight neglected diseases and malnutrition.

 

The executive director of Doctors Without Borders’ U.S. section, Sophie Delaunay, said the group wanted to alert policy makers not to let down their guards in the fight against HIV/AIDS, which continues to be a crisis despite the advent of life-sustaining treatment.

 

“When there are concerning signs of a retreat for access to treatment, it’s important to state that HIV/AIDS is an emergency,” Delaunay said.

 

Her international humanitarian organization, also known as MSF for its French name, Medecins Sans Frontieres, began issuing its annual list in 1998 after a devastating famine in southern Sudan went largely unnoticed by the U.S. media.

 

The list, which does not rank the crises by order of importance, seeks to foster greater awareness of crises that may not receive adequate attention in the press.

 

Since pledging to support universal AIDS treatment coverage by 2010 at the G8 Summit in Scotland in 2005, many countries, including the United States, have announced plans to reduce or limit funding, Delaunay said.

 

“In some countries doctors are turning patients away, advised to wait until other patients die,” she warned. “What’s going to happen is that patients are going to show up at the door of our clinics and there is a high possibility of us getting overwhelmed.”

 

In Sri Lanka, battles between the government and Tamil Tiger rebels left tens of thousands of civilians trapped with only limited medical care this spring after aid groups were banned from the conflict zone.

 

In Somalia, where 42 relief workers have been killed since 2008, the ongoing civil war forced 200,000 people to flee the capital, Mogadishu, in the first months of 2009.

 

In Yemen, shelling during fierce fighting between government forces and rebels forced MSF to close the only hospital serving an entire district.

 

And in the Democratic Republic of Congo, civilians gathered with their children at an MSF vaccination site in the Kivu province were attacked by government forces — a move the group says severely undermined the trust necessary to carry out independent medical humanitarian work.

 

In Pakistan’s Swat valley, MSF was forced to suspend operations due to violence that saw its hospitals struck by mortar fire and two of the group’s workers killed.

 

The group also flagged the international community’s continued neglect of diseases such as Chagas, leishmaniasis, sleeping sickness and the Buruli ulcer that mostly affect the poor in developing nations.

 

Malnutrition, which causes the deaths of between 3.5 million to 5 million children a year, also was called a crisis. The group said that while the international community spends $350 million each year to fight malnutrition, an estimated $11.5 billion was needed.

 

“Our teams on the ground are witnessing the very tangible human consequences of these crises directly, either in war zones or in the AIDS and nutrition clinics in which they work,” MSF International Council President Dr. Christophe Fournier said in a statement. “We’re therefore compelled and obligated to speak out.”

 

MSF provides emergency medical assistance to populations in danger in 70 countries.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05
Oct
09

Study Finds That Certain Cancers Are More Common In HIV-Infected Individuals

From AIDSBeacon.com:

A recent study published in the Journal of Acquired Immune Deficiency Syndromes (JAIDS) found that the incidence of non-AIDS defining malignancies, such as anal and lung cancer, is increased for HIV-infected individuals.

“Non-AIDS defining illnesses” includes all forms of cancers except skin, lymphoma, cervical carcinoma, Kaposi’s sarcoma and some ill-defined cancers. These are considered AIDS defining and are known to be of higher prevalence in HIV-positive individuals.

In this study, it was found that HIV-infected patients also have a higher risk of developing certain non-AIDS defining illnesses.

The study was conducted on 33,420 HIV-infected and 66,840 HIV-uninfected patients for a period between 1997 and 2004. The incidence rate of cancerous malignancies was measured. Factors such as age, gender, and race were taken into account.

The results showed that HIV-infected individuals were 60 percent more likely to have anal, lung, Hodgkin’s lymphoma, melanoma, prostate, and liver cancer than non HIV-infected individuals.

One theory for the possible cause of this trend is that antiretroviral therapy that HIV-positive individuals undergo might increase their risk of developing those particular cancers. Another possibility is that HIV-infected individuals are more prone to traditional risk factors due to lifestyle or other situations.

Another theory is that HIV itself increases an individual’s chance of developing cancer inherently.

One weakness of the study is the lack of female participants; males represented about 98 percent of the study’s population.

This study has led to plans for further research on immune function in patients with or without cancer.

For more information, please see the original study in JAIDS (abstract) and the press release from Southwestern Medical Center.

05
Oct
09

Condoms are not reliable in fight against HIV, says African cardinal

They are at it again! Condoms are not 100% effective in preventing HIV but can reduce your risk greatly, if used properly and consistantly. 

From CatholicNews.com:

By Carol Glatz
Catholic News Service

VATICAN CITY (CNS) — Condoms are not always effective in preventing the spread of HIV/AIDS in Africa, said Cardinal Peter Turkson of Cape Coast, Ghana.

Abstinence, fidelity in marriage and universal access to antiretroviral drugs are the strategies the church continues to promote in the fight against AIDS, he said.

The cardinal, who will turn 61 Oct. 11, made the comments during a Vatican press conference Oct. 5, presenting some of the issues to be discussed during the second special Synod of Bishops for Africa.

Cardinal Turkson was asked about the AIDS epidemic in Africa and what position the synod will take, specifically concerning the use of condoms in HIV prevention.

He said when “people propose the use of condoms it becomes effective only in families where they are going to be faithful.”

However, condoms give “people a false sense of security, which rather facilitates the spread of HIV/AIDS,” he said.

Condoms cannot be relied upon to provide 100-percent protection against HIV transmission because “there are condoms which arrive in Ghana, which in the heat and whatever burst during sex,” he said.

Because there is always a chance condoms might break during sexual intimacy, he is reluctant to recommend condom use even to married couples in which one partner is affected with HIV, he said.

The priorities for African bishops at the synod will remain “abstinence and loyalty and fidelity” within marriage, he said.

During pastoral counseling, he said he presents the issues and discusses them with the person seeking advice, which “allows the person to decide, to (make) his own decision.”

He said he does not “undervalue the possibility that somebody who has AIDS recognizes his own Christian commitment (and) would simply just decide to refrain from sex,” even if he or she were in a faithful marriage, in order to prevent the spread of HIV.

“Some would in such a situation have advised the use of condoms by a partner who has HIV so that it doesn’t spread, but again, in our part of the world, even the use of condoms is sometimes risky,” he said.

“If we have proper, top quality condoms, then one can probably with certainty speak about” the effectiveness of an infected partner using condoms, “but that is also not the case” in Ghana, he said.

Cardinal Turkson said he would rather see the resources spent on manufacturing and providing prophylactics to Africa be earmarked for subsidizing antiretroviral drugs for the people there.

“Let us use those resources to support the production of antiretroviral drugs so (they) would be more available to people,” he said. “That’s probably the big favor that we can do for the people suffering from HIV/AIDS.”

05
Oct
09

Ozzy Osbourne ‘was told he could be HIV positive by doctors’

Anyone who puts themself at right can contract HIV!!!  Ozzy Osbourne talks about his experience with an HIV test.

From Telegraph.co.uk:

The former Black Sabbath singer said he was “devastated” to be told the news.

“I went to the doctor and had an [HIV] test and he told me it was positive,” he said, in an interview in this month’s Glamour magazine. “That was one of the worst days of my life.”

He was asked to do another test to confirm the diagnosis, which came back negative.

The doctor put the first, false diagnosis down to the heavy drinking and drug-taking lifestyle he used to enjoy tampering with his immune system.

“When I used to f—ing get loaded I would get myself into all kinds of situations,” said Osbourne, whose womanising was legendary before he settled into family life with wife Sharon.

“It turned out that because I was drinking and using drugs so much, my immune system had dropped so that it was a borderline result. When I went back to be tested again it was negative.”

Ozzy may have been the relative that his daughter Kelly was referring to when she broke down at an Aids charity benefit in London two years ago.

“This charity is really important to me because one of my family is HIV positive,” she said at the time. “And I’m so proud of him.”

The revelation is one of a series about Ozzy’s life that have emerged in recent weeks as he promotes his autobiography, I Am Ozzy.

Among others is the news that he still enjoys conjugal trysts with wife Sharon but struggles to bring the liaisons to a satisfactory conclusion.




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