This issue of HATIP included only news headlines.

Could valproic acid eradicate HIV from the body?

http://www.aidsmap.com/en/news/7E9AE4D0-FA87-432E-837F-7A350A8F4E94.asp?hp=1

A small proof-of-concept study has shown that the drug valproic acid (Depakote) may be able to reduce the pool of dormant HIV-infected cells in the body. According to the authors of the study, which was published in the 13th August edition of The Lancet, this may eventually point the way towards a cure for HIV infection.

Large study proves that HAART reduces rates of AIDS and death

http://www.aidsmap.com/en/news/AF7E5131-64CA-4EB0-82AD-E1134D3A5594.asp?hp=1

Use of highly active antiretroviral therapy (HAART) in HIV-positive patients reduces the risk of developing AIDS or death by 86% compared with no treatment, according to a large analysis of data from the Swiss HIV Cohort Study. The results were published in the 30th July edition of The Lancet.

Hepatitis A vaccination effective and safe in HIV-positive children

http://www.aidsmap.com/en/news/A1FE36D3-47A6-4EB0-997D-E6A89FAD24A5.asp?hp=1

HIV-positive children who do not have severe immunosuppression or HIV-related symptoms respond well to vaccination against hepatitis A virus, according to a Brazilian study published in the August 15th edition of Clinicial Infectious Diseases. The investigators also found that vaccination against hepatitis A does not adversely affect viral load.

Gilead reports problems putting tenofovir, FTC and efavirenz into one pill

http://www.aidsmap.com/en/news/0A2FF989-61AA-48B8-A0B2-274BC4B2FA22.asp?hp=1

Efforts to combine tenofovir, emtricitabine (FTC) and efavirenz in one pill are still failing to produce a product that is bioequivalent to dosing the three drugs separately, Gilead Sciences announced yesterday.

Superinfection with drug-resistant HIV: case reported

http://www.aidsmap.com/en/news/18934733-FD9F-467E-A995-63FEE627B21E.asp?hp=1

A case of superinfection with a drug-resistant strain of HIV is reported in the August 12th edition of AIDS. The case involves a 31-year-old gay man in San Diego, California, who was initially diagnosed with a drug sensitive strain of sub-type B HIV but was subsequently discovered to have been superinfected with a strain of sub-type B resistant to two classes of antiretroviral drugs. Superinfection resulted in a significant increase in the individual’s viral load and a fall in his CD4 cell count.

TB drug resistance on rise in Botswana as HIV epidemic grows

http://www.aidsmap.com/en/news/CD8F7F52-4AF2-4ED6-9BFC-632F7199C83F.asp?hp=1

Resistance to tuberculosis (TB) drugs in newly diagnosed TB patients grew threefold in Botswana between 1995 and 2002, jeopardising the country’s achievements in TB control, according to a study published in the July 30th edition of The Lancet.

IAS: $7 viral load test equivalent to more expensive high tech viral load tests, Malawi study shows

http://www.aidsmap.com/en/news/700F85D5-89A8-4063-B38B-BCCFE5AB8900.asp?hp=1

A test for HIV levels in the blood that can spot treatment failure using similar technology to HIV antibody testing yields results that are almost as accurate as the viral load tests now in use in the developed world, but at a fraction of the cost, researchers from Malawi and the University of North Carolina reported last month at the Third International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro, Brazil.

IAS: Activists and investigators debate future of trials of drug that may prevent HIV

http://www.aidsmap.com/en/news/3BAF85DA-3C18-49F1-A8A1-49F37C94F8D7.asp?hp=1

Salvaging an HIV prevention approach that has been jeopardised by poorly run studies and adverse publicity was one of the hot topics at last month’s Third International AIDS Society Conference in Rio de Janeiro. Three studies using tenofovir (Viread) as pre-exposure prophylaxis (treatment to prevent infection, PREP in short) have been halted in Cambodia, Nigeria and Cameroon, and there are continued concerns around a fourth study in Thailand.

IAS: DART trial shows AZT/3TC/tenofovir effective in majority after one year

http://www.aidsmap.com/en/news/5DE0173C-C055-4FCC-A6B4-C6AC6B5169C4.asp?hp=1

A triple-nucleoside regimen of AZT, 3TC and tenofovir proved effective at controlling viral load in more than half of the participants in the African DART trial over 48 weeks of follow-up, according to findings presented last month at the Third International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro, Brazil.

IAS: Rifampin TB treatment does not reduce response to NNRTIs, South Africans report

http://www.aidsmap.com/en/news/02647FB0-F753-47AD-B799-A8002D3105EC.asp?hp=1

Using rifampin-based therapy alongside a triple antiretroviral regimen that contains drugs from the NNRTI class (either nevirapine or efavirenz) does not result in a poorer response to treatment or greater toxicity, South African researchers reported last week at the Third International AIDS Society Conference on HIV Treatment and Pathogenesis in Rio de Janeiro, Brazil.

IAS: Studies in Uganda show generic fixed-dose combinations safe and effective in children with HIV

http://www.aidsmap.com/en/news/5D207B8F-D795-4786-B55B-0C9A71FEBA9B.asp?hp=1

The use of fixed dose combination antiretroviral therapy (ART) formulations in HIV-infected children is feasible and effective and the use of Triomune (fixed-dose d4T/3TC and nevirapine) led to a significant increase in CD4 cell counts and a decrease in viral load during the initial 48 weeks of therapy, Dr Linda Barlow-Mosha of the Makerere University (Kampala, Uganda)/Johns Hopkins University Research Collaboration (MU-JHU) told last week’s Third International AIDS Society Conference on HIV Treatment and Pathogenesis in Rio de Janeiro, Brazil. She presented the results of an open label study in which children were treated with adult tablets (quartered or halved depending on the child’s weight) of Triomune or syrup formulations of antiretrovirals.

IAS: WHO clinical staging excluding many without symptoms from HIV treatment, despite need

http://www.aidsmap.com/en/news/0B192145-F496-457A-8AA5-1858ED2A0863.asp?hp=1

In resource-poor settings where there is little or no access to laboratory facilities to do CD4 cell counts, the HIV/AIDS clinical staging system, devised by the World Health Organization (WHO), is often used to determine a patient’s need for antiretroviral therapy (ART); however, a recent study from South Africa has found that using WHO clinical staging alone could miss a lot of patients with CD4 cell counts below 200 cells/mm3.

IAS: High risk of death for South Africans in first six months of ART, isoniazid may reduce risk

http://www.aidsmap.com/en/news/8B7AFADB-0327-49C6-BFFF-16C29D44B6FD.asp?hp=1

South African miners receiving antiretroviral therapy (ART) are just as likely to die during the first six months of treatment as their untreated counterparts, researchers from the London School of Hygiene and Tropical Medicine reported last week at the Third International AIDS Society Conference on HIV Treatment and Pathogenesis in Rio de Janeiro, Brazil. The reduction in death and illness associated with ART only begins to kick in after six months of treatment, the researchers said.

IAS: 3TC infant prophylaxis during breast-feeding reduces HIV infection rate at six months

http://www.aidsmap.com/en/news/BEB006E6-A7B9-4B30-B28E-2A0261F95A5F.asp?hp=1

Daily dosing with 3TC (lamivudine, Epivir) for infants of HIV-positive mothers reduces the risk that a baby will acquire HIV infection from its mother through breast-feeding, according to the results of a joint Tanzanian/Swedish study presented last week at the Third International AIDS Society Conference on HIV Treatment and Pathogenesis in Rio de Janeiro, Brazil.

IAS: Columbia University is coordinating treatment scale at multiple sites in several sub-Saharan African countries

http://www.aidsmap.com/en/news/FED2073B-900E-4722-AB1E-20FF315A3497.asp?hp=1

Columbia University is coordinating treatment scale at multiple sites in several sub-Saharan African countries.

IAS: Study in Côte d’Ivoire describes factors associated with survival in older children with HIV: not all respond to treatment

http://www.aidsmap.com/en/news/2D23D101-D9C2-4346-8BE7-7FB06576333D.asp?hp=1

Being of very low weight for their age, having a history of tuberculosis and having a viral load above 100,000 copies/ml predict poor survival in older African children with HIV, according to a study conducted in the Côte d’Ivoire and presented to the Third International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro. And even though antiretroviral treatment (ART) can dramatically improve the health of many children who go onto treatment, "it is not always enough," said Dr Philippe Msellati of the Institut de Recherche pour le Développement (IRD)/Université Montpellier, France, especially if treatment isn’t started soon enough.

IAS: Kidney disease may be highly prevalent amongst HIV-infected in Africa

http://www.aidsmap.com/en/news/EA0A3CB2-FE5A-474A-B09A-7CFB467965CC.asp?hp=1

Renal (kidney) disease may be highly prevalent amongst treatment-naive HIV-positive individuals in Africa, according to two posters presented at the Third International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro, affecting between 25% and 50% of HIV-positive individuals attending HIV clinics in Kenya and Uganda. The level of renal insufficiency identified suggests the need for extensive education on antiretroviral dosage adjustments necessary for patients with renal insufficiency, and the need for assessment of creatinine clearance whenever symptoms suggestive of kidney disease are present in people receiving antiretroviral treatment in Africa.

UK international HIV funding increased

http://www.aidsmap.com/en/news/9D11B4D3-AF51-4638-A990-D567A833B589.asp?hp=1

The United Kingdom is to increase its contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria, international development secretary, Hilary Benn MP, has announced.

IAS: Two studies suggest that it may be possible to screen for acute primary HIV infections in sub-Saharan Africa

http://www.aidsmap.com/en/news/5C1DBA68-9129-413C-A639-A7E45946DBE9.asp?hp=1

Two studies presented on Monday at the Third IAS Conference on HIV Pathogenesis and Treatment in Rio de Janeiro, Brazil reported that a significant number of acute HIV infections, which are undetectable using standard HIV antibody-based tests, can be recognized using other screening methods - even in resource-limited settings in sub-Saharan Africa.

IAS: Remaining on 3TC despite resistance leads to better immunological and clinical outcomes

http://www.aidsmap.com/en/news/D79429DD-CAE4-458D-B182-22672ABB2BEA.asp?hp=1

Treatment-experienced patients with the M184V resistance mutation who are virologically failing a highly active antiretroviral therapy (HAART) regimen that contains 3TC (lamivudine, Epivir) are significantly less likely to experience a fall in CD4 cells or develop symptoms of HIV disease progression if they continue to take 3TC monotherapy rather than take a complete treatment break, according to the final results of an Italian study presented as a late breaker to the Third International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro.

IAS: Have we prematurely discarded triple NRTI regimens?

http://www.aidsmap.com/en/news/35E77428-3072-4294-A02B-8290CEC5430A.asp?hp=1

A lively debate on the use of triple nucleoside reverse transcriptase regimens (NRTIs) ended the first day of the Third International AIDS Society Conference on HIV pathogenesis and treatment in Rio de Janeiro. The debate, chaired by the UK's Professor Brian Gazzard, focused squarely on whether the public health approach to antiretroviral therapy in resource-limited nations - which have large groups of populations that are not well-served by the current World Health Organisation (WHO) guidelines suggesting that first-line regimens are NNRTI-based (e.g. those co-infected with TB, women of childbearing age, those with HIV-2) - may lead to them receiving second-class anti-HIV therapy compared with well-resourced nations if WHO were to recommend triple NRTIs in their revised guidelines, due out this later this week.

IAS: Circumcision prevents three out of four female-to-male HIV infections

http://www.aidsmap.com/en/news/BA448CC3-7935-43E6-947C-987D69B82D54.asp?hp=1

The first ever randomized controlled trial (RCT) of male circumcision as an HIV prevention measure has produced such strong evidence of a protective effect that the trial has been halted early and all participants have been offered circumcision, the Third International IAS Conference on HIV Pathogenesis and Treatment in Rio de Janeiro heard on July 26th.

IAS: UN HIV envoy delivers call to action to Rio conference

http://www.aidsmap.com/en/news/8A5C8057-7FAC-452A-B3C7-1294E8874368.asp?hp=1

"What we desperately need in the response to AIDS today are voices of advocacy: tough unrelenting, informed. The issues are so intense, the situation is so precarious for millions of people, the virus cuts such a swath of pain and desolation, that your voices, as well as your science, must be summoned and heard," Stephen Lewis, UN Secretary-General’s Special Envoy for HIV/AIDS in Africa, told those attending the opening plenary of the Third IAS Conference on HIV Pathogenesis and Treatment on Sunday.

IAS: AZT-related anaemia is rare, but may be less prevalent with fixed-dose combinations, meta-analysis shows

http://www.aidsmap.com/en/news/8D480CE7-8E2B-4F01-9487-913431A85B86.asp?hp=1

An analysis of 54 clinical trials including over 12,000 patients has concluded that severe anaemia is a rare side-effect of AZT (zidovudine) treatment, but that the risk is enhanced by a high viral load or low haemoglobin level before starting therapy. These findings were presented today at the Third International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro.

IAS: Routine HIV testing acceptable to most pregnant women in Zimbabwe

http://www.aidsmap.com/en/news/62A74D5A-D2BB-4A32-A687-8A0F8488CC21.asp?hp=1

Routine HIV testing in antenatal services would be acceptable to the majority of women in Zimbabwe, according to a study presented to the Third International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro on July 26th. However, the investigators, from Zimbabwe and France, also found that a significant number of women would opt-out of voluntary HIV testing, mainly because they did not wish to know their HIV status or feared testing for HIV without their partner’s consent.

IAS: The New York Patient - source found but mysteries remain

http://www.aidsmap.com/en/news/88F21CB1-B77D-4F0B-9D4D-F8D683337A76.asp?hp=1

The source of infection for the New York gay man whose multi-drug-resistant and apparently virulent stain of HIV caused a public health alert earlier this year has apparently been found.

IAS: Atazanavir safe and effective during pregnancy

http://www.aidsmap.com/en/news/802E84C0-87E6-4CA2-82B5-E59761967DEA.asp?hp=1

Highly active antiretroviral therapy (HAART) regimens including the protease inhibitor atazanavir (Reyataz), appear to be safe and effective during pregnancy, according to a small US study presented as a poster to the Third International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro, Brazil.

IAS: Single dose nevirapine for mother doesn't lead to worse CD4 response to HAART

http://www.aidsmap.com/en/news/D15A2763-C672-42C2-BE78-34CF7AD207F6.asp?hp=1

Women who took a single dose of the non-nucleoside analogue (NNRTI), nevirapine (Viramune) to prevent mother-to-baby transmission of HIV have an immunological response to HAART comparable to women who did not use nevirapine in this way, according to a study presented to the Third International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro on July 25th.

IDUs acquire resistance at same rate as non-IDUs

http://www.aidsmap.com/en/news/FC700635-67D9-40F8-AD61-8769D1320935.asp?hp=1

A large Canadian study comparing rates of resistance in antiretroviral-naïve individuals with and without a history of injecting drug use (IDU) has concluded that there are no major significant differences between rates of resistance of the two groups during the first two-and-a-half years of highly active antiretroviral therapy (HAART). However, the IDU rate of non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance was slightly elevated, although this was of borderline significance. The study is published in the July 22nd issue of the journal, AIDS.

Microchip could bring CD4 cell counting to poorest countries

http://www.aidsmap.com/en/news/92FD8582-2581-4719-B3C6-DB0AA17AB564.asp?hp=1

A new CD4 cell counting machine that uses cheap technology developed for digital cameras is just as accurate as conventional laboratory techniques and could make CD4 cell counting feasible in many resource-limited settings within a few years, according to a study published in the July edition of Public Library of Science (PLoS) Medicine.

North Indians have naturally lower CD4 cell counts: implications for treatment decisions

http://www.aidsmap.com/en/news/EF471324-C469-442E-ABBA-62F104C64624.asp?hp=1

North Indians have lower CD4 cell counts than individuals from the west. Consequently, the use of US Centers for Disease Control (CDC) categories of HIV disease severity to guide treatment decisions could lead to patients from northern India starting anti-HIV therapy or prophylaxis unnecessarily early, according to a paper published in the July edition of the Journal of Infection.

ART reduces TB incidence, but some risk persists

http://www.aidsmap.com/en/news/A1DE1ECB-8FBA-4AB1-A69C-DE9681A0500B.asp?hp=1

While antiretroviral therapy (ART) substantially reduces the incidence of tuberculosis (TB) and restores immunity to TB mycobacteria (mTB), a recent review of epidemiological, clinical and laboratory data in the July 22nd issue of AIDS suggests that the immune restoration from ART is incomplete and that most people with HIV will continue to have a heightened risk of TB that will persist with long-term treatment. The study’s authors believe these findings could have significant implications for TB control programmes.