Increased severity of Kaposi's sarcoma in HIV-1-infected Zimbabwean women
Zimbabwean women with HIV/AIDS who present with AIDS-related Kaposi sarcoma (AIDS-KS) are younger than male counterparts of similar AIDS-KS status and have a more severe course of KS, according to the findings of a cross-sectional study published in the March 1st edition of the Journal of Acquired Immune Deficiency Syndromes.
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Mozambique : treatment access unequal between regions
If you are an HIV-positive Mozambican in need of antiretroviral treatment (ART), life can resemble a lottery, in which your chances of accessing the life-prolonging medication depend on the region, or even the district, where you live.
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Toxicity of nevirapine-based ART differs in pregnant HIV-infected Mozambican and Thai women with higher CD4 counts
There may be differences in the rates of severe hepatotoxicity associated with nevirapine-containing highly active antiretroviral therapy (NVP-ART) in pregnant women with higher CD4 counts (above 250 cells/mm3) in Mozambican and Thai women, according to the findings of a prospective study published in the April 1st edition of the Journal of Acquired Immune Deficiency Syndromes and recent Thai findings reported by Thai and US researchers at the 2007 Conference on Retroviruses and Opportunistic Infections in Los Angeles, USA.
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Abbott announces Kaletra price cut for lower middle-income countries, makes new offer to Thailand
Abbott announced today that it will cut the price of Kaletra (lopinavir/ritonavir) in 40 lower middle-income countries to $1000 a year following discussions with World Health Organization Director-General Margaret Chan. It also made a new price offer to the Thai government, which has been planning a compulsory license in order to import generic lopinavir/ritonavir.
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Economic decline in Zimbabwe contributes to failure of community HIV prevention trial A complex community-based intervention implemented in Zimbabwe has failed to reduce the incidence of new HIV infections in the population. Researchers from the UK, Zimbabwe and South Africa studied the impact of an integrated community and clinic-based intervention programme, one strategy thought to have potential to promote behaviour change. However, despite “greater programme activity and knowledge in the intervention communities”, no significant difference in HIV incidence was found between the control and intervention communities, an effect in part blamed on the dire economic situation in the country.
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Genital herpes quadruples risk of HIV acquisition in high-risk women in Tanzania
Chronic or recent infection with the genital herpes virus (HSV-2) increases the risk of acquiring HIV more than four- and five-fold, respectively, according to research undertaken amongst high-risk women in Tanzania and published online ahead of print in the May 1st issue of the Journal of Infectious Diseases. Although other sexually transmitted infections – including Chlaymdia trachomatis and bacterial vaginosis – were also associated with an increased risk of HIV infection, the investigators estimate that approximately 63% of HIV incidence in the study was attributable to HSV-2 infection, whether or not it caused symptomatic genital ulcer disease (GUD).
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Parasitic infections and antiparasite treatment have no effect on HIV levels in HIV-positive adults in Malawi
Parasitic infections particularly helminths were more common in HIV-uninfected than HIV-infected adult outpatients, and neither helminth infections nor anti-parasitic treatment had an impact on HIV viral loads, Malawian and US researchers report in the May 1st edition of the Journal of Infectious Diseases.
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Depression increases the risk of disease progression and death in HIV-positive Tanzanian women
Depression plays an important role in clinical disease progression and death in HIV-1-infected women in Sub-Saharan Africa, according to the findings of a retrospective study published in the April edition of the Journal of Acquired Immune Deficiency Syndromes. The study found that depression is common among HIV-infected Tanzanian women and recommends screening for depression and providing psychosocial interventions as part of a comprehensive HIV care.
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Tibotec licenses darunavir to Aspen in Africa
Tibotec, a division of Johnson & Johnson, announced today that it has concluded a non-exclusive, royalty-free voluntary licensing agreement with South African company Aspen Pharmacare for its protease inhibitor darunavir (Prezista).
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Rural Indian HIV epidemic being neglected despite complex patterns, high prevalence
Although HIV infection in India was thought to be mainly concentrated in urban areas, a “rural epidemic” is beginning to be documented in the southern Indian state of Karnataka. In the Bagalkot district, HIV prevalence and associated factors were found to vary widely, even between villages, but with the highest prevalence found in rural areas. These results have important implications for prevention and care programmes to be implemented in the area, report Marissa Becker, from the University of Manitoba, Canada, and co-authors.
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d4T dose can be reduced without loss of effectiveness, meta-analysis reports
A systematic review of nine clinical trials of d4T (stavudine, Zerit) shows that a dose of 30mg twice daily has equivalent efficacy to the standard 40mg dose prescribed to adults weighing more than 60kg, with some evidence of fewer side-effects. The review is published this month in the journal Expert Opinions in Pharmacotherapy.
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Infant feeding guidelines should promote exclusive breastfeeding, South African research group says
Further evidence to support a recommendation for exclusive breastfeeding by HIV-positive mothers in resource-limited settings was published today by South African researchers in The Lancet. They say it is time to revise UNICEF and World Health Organization (WHO) guidelines on infant feeding in order to promote exclusive breastfeeding more aggressively.
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Meta-analysis confirms hepatitis C vertical transmission more likely with coinfected mothers
A new meta-analysis has confirmed that the mother-to-child transmission risk for hepatitis C virus (HCV) nearly doubles for mothers who are HCV/HIV coinfected. In coinfected mothers with detectable HCV viremia, the risk is nearly tripled. The results, published in the April 15th issue of Clinical Infectious Diseases, confirm those of a 2003 meta-analysis by another researcher.
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WHO & UNAIDS recommend circumcision as HIV prevention tool in Africa
The World Health Organization (WHO) and UNAIDS are to recommend that circumcision programmes should become part of HIV prevention programmes in countries seriously affected by HIV, following an expert consultation earlier this month.
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First-trimester antiretrovirals a 'possible' risk for genital abnormalities in male babies
According to an analysis of over fourteen years of data, antiretroviral therapy (ART) has not generally increased the rate of birth defects in children born to HIV-positive mothers (compared to mothers not taking ART). However, genital malformations called hypospadias were seen more frequently in male children born to women taking antiretrovirals during the first trimester. The review was published in the March 1st issue of the Journal of Acquired Immune Deficiency Syndromes.
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Interferon Gamma Release Assays (IGRAs) — a complicated and expensive way to answer a simple question?
Interferon Gamma Release Assays (sometimes ELISPOT tests) are blood tests that can determine whether a person has been exposed to tuberculosis (TB). The test, involves incubating blood samples with proteins unique to TB and then measuring whether T- cells in the blood secrete microbe-fighting gamma interferon —which should occur if someone has previously been exposed to TB.
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Blood and urine tests for TB: still great hope for antigen detection
“At the most peripheral level of the health system [the health post/primary care level], there is currently no [TB lab] test available,” said Dr Vinand Nantuyla of FIND. “FIND is evaluating a urinary antigen test and we expect that the demonstration phase will be completed by 2009, at which point the test will be available.”
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Sniffing out tuberculosis - TB breath tests under investigation
What if you could just breathe into a device and within minutes, a healthcare worker could tell whether you have tuberculosis (TB) — without even having to consult the lab? Although such a simple point-of-care breath test for TB doesn’t exist yet, several groups are working towards that goal, according Dr Ruth McKerney, of the London School of Hygiene and Tropical Medicine. She gave an overview of several of the approaches to “smelling TB” being investigated at the STOP TB Working Group on New Diagnostics/FIND meeting in Paris.
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Transformation of TB diagnostics on horizon: special report
Electronic noses that can “smell” tuberculosis (TB), a desktop machine that can read TB DNA and tell what drugs it is sensitive to within minutes, a DNA amplification-based test for TB that requires no sophisticated equipment at all, or a strip test as simple as a home-pregnancy kit that can detect the hard-to-diagnose forms of TB that affect children or people with HIV in a sample of urine — the TB diagnostics pipeline is burgeoning with new technologies which, if they work out in the field and can be produced at a price affordable to the developing world, could transform how TB is managed within the next decade if not in the next several years.
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TB diagnosis: Improving the yield with fluorescence microscopy
One key strategy for improving the effectiveness of smear microscopy is concerned with how to get the best sputum sample, and how to treat it to get it to reveal all its secrets. Some of these approaches could even increase the likelihood of getting a diagnosis of smear-positive TB in a person with HIV.
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TB diagnosis: For now, still desperately seeking better diagnostics
The audience’s response to all the talk about improving smear microscopy was mixed. Some felt that the combination of these approaches could achieve an impact similar to having a new more sensitive diagnostic test:
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TB diagnosis: Reducing the number of smears and clinic visits needed
Making the process of seeking smear microscopy more convenient for people, especially for the economically disadvantaged, is the focus of one of the strategies that FIND is now moving into large scale demonstration studies: one stop diagnosis.
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TB diagnosis special report: why smear microscopy needs to be improved
“It’s clear that in the presence of HIV, smear microscopy [the lab test for active TB] is severely compromised and that we need new tools. But in the meantime perhaps there are ways we can modify the smear approach or modify the sputum processing in order to get the best out of smear microscopy until these new tools come on the scene,” said Dr. Andy Ramsey from the Special Programme for Research and Training in Tropical Diseases (TDR) and the STOP TB Working Group on New Diagnostics, speaking at a symposium held by the Foundation for Innovative New Diagnostics (FIND)] at the 37th World Union Conference on Lung Health, held in November 2006 in Paris.
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Background on smear microscopy in TB diagnosis
In the 1870’s and 1880’s, the German researcher, Robert Koch developed the technique known as smear microscopy, which he used to identify the rod-shaped bacterium, Mycobacterium tuberculosis (as well as a number of bacteria that cause other diseases — he was quite a prolific researcher).
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Decentralisation of care could improve adherence to TB treatment, Ethiopian study shows
Poor treatment adherence in Ethiopian tuberculosis (TB) patients is much more likely if patients have too far to travel to reach a clinic, especially during the continuation phase of TB treatment as they begin to feel better, Ethiopian and Norwegian researchers report in the February edition of PLoS Medicine.
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Opening a window the best way of reducing TB spread in hospitals
Ventilating tuberculosis (TB) wards by opening windows is more likely to reduce the risk of infection than mechanical ventilation and should be practiced wherever the climate permits, say researchers from Imperial College, London, in the February edition of PLoS Medicine.