Meta-analysis highlights wide variation in success of developing world HIV treatment

http://www.aidsmap.com/en/news/D5BDFA9D-5222-450D-8575-1B79F33B79C5.asp?hp=1

A meta-analysis of studies of antiretroviral treatment in resource-limited settings shows large variations in the success of treatment. The findings are published in the July 15th edition of the journal Clinical Infectious Diseases.

Tenofovir may linger up to 3 weeks in body: discontinue with caution

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Sub-optimal levels of tenofovir (Viread) that could lead to drug resistance may linger in the body for at least three weeks after the drug is discontinued, according to a report in the May edition of Antimicrobial Agents and Chemotherapy. The findings, published by a French and Spanish research group, call into previous assumptions about the safety of discontinuing tenofovir treatment, say the researchers.

Traditional healers being integrated into HIV care and treatment in Kwazulu-Natal

http://www.aidsmap.com/en/news/E24CE61D-B50C-4FE1-BC21-20E8E4BEDD30.asp?hp=1

Efforts to improve the care and treatment of South Africans with HIV/AIDS are often hampered by misunderstandings and poor relations between Western healthcare workers, and the community-based African traditional healers (or sangomas) that many people first turn to when they have a medical complaint. However, a new project launched in the Nelson R. Mandela School of Medicine/University of KwaZulu-Natal (UKZN) in Durban is trying to build bridges and improve collaboration with traditional healers caring for people with HIV/AIDS.

PEPFAR-funded NGOs present progress at 2nd South African AIDS Conference

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A diverse group of non-governmental organizations (NGOs), funded by the United States President's Emergency Plan for AIDS Relief (PEPFAR), presented their first year’s progress at a satellite conference of the 2nd South African AIDS Conference in Durban. Funded projects focused on providing aid to orphans and vulnerable children, `faith-based` HIV prevention services, voluntary counselling and testing services, collaborations with traditional healers, operational research into the long-term success of PMTCT programmes, nurse-driven antiretroviral therapy, and antiretroviral treatment delivery in an antenatal clinic.

PEPFAR working closely with South African government to support HIV treatment and care

http://www.aidsmap.com/en/news/B414BAEA-07D5-4EFF-B67E-555669ECAF95.asp?hp=1

Before the official start of the 2nd South African AIDS Conference, representatives from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) held a satellite conference to review the challenges faced and progress made by the programme’s South African partners during the first year of the plan's implementation.

Rifampicin resistance linked to dosing schedule in HIV-positive TB patients

http://www.aidsmap.com/en/news/C251CD10-402E-48B4-A9D6-98610CFBEC33.asp?hp=1

Resistance to the anti-tuberculosis (TB) drug rifampicin (Rifadin / Rimactane) in HIV-positive patients is most likely to develop if the drug is taken intermittently during the first two months of treatment, according to a retrospective study published in the 1st July edition of Clinical Infectious Diseases. The study also showed that the risk of resistance was not affected by whether the patients took rifampicin or the similar drug rifabutin (Mycobutin).

Standard tests underestimate resistance in mothers who received nevirapine when giving birth

http://www.aidsmap.com/en/news/A3C49CD6-6951-4B70-B872-887600D5C1D3.asp?hp=1

Highly sensitive resistance tests that can detect very small populations of drug-resistant virus have shown that in women exposed to single-dose nevirapine (Viramune) at the time of delivery, nevirapine resistance is more common than thought, and may persist for up to two years, according to findings from two studies published in the July 1st edition of the Journal of Infectious Diseases.

BMJ editorial: assess cardiovascular risk and consider delaying HAART until CD4s reach 200 cells/mm3

http://www.aidsmap.com/en/news/29BEBA80-8FA8-4404-B4E9-34A2B21146AF.asp?hp=1

An editorial published in the June 11th issue of the British Medical Journal argues that HIV clinicians should take cardiovascular disease risk into account, in addition to the risk of HIV progression, before suggesting that treatment-naive individuals begin highly active antiretroviral therapy (HAART).

Modest reductions in new cases of TB seen in South African isoniazid trial

http://www.aidsmap.com/en/news/A82A1807-EF2A-4188-A2F2-FECE67524FDF.asp?hp=1

A study from South Africa has shown that giving isoniazid to HIV-infected adults attending a workplace HIV clinic reduced the incidence of tuberculosis (TB) by over a third. However, the investigators, writing in the 8th June edition of the Journal of the American Medical Association warn that levels of TB diagnoses remained high even after preventive isoniazid treatment and that additional interventions are needed to reduce disease and death most effectively.

HIV-1 subtype in West Africa less susceptible to unboosted PIs

http://www.aidsmap.com/en/news/C58D67B2-86F7-4086-9FC5-C3DBDD0F64C7.asp?hp=1

The prevalent HIV-1 subtype in West Africa is less susceptible to some protease inhibitors, according to a study published in the July 15th edition of Clinical Infectious Diseases (now on-line). The investigators from Japan, Ghana and France, found that ritonavir (Norvir) had the strongest inhibitory effect and nelfinavir (Viracept) the weakest effect of any protease inhibitor included in their analysis and "propose that the combination of ritonavir and protease inhibitors other than nelfinavir is still clinically applicable" for the treatment of the HIV subtype prevalent in West Africa.

Leading South African health and social advocate calls for an end to denialism at South African Conference on AIDS

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"The best way of honouring the memory of Nkosi Johnson and many other children who met premature deaths at the hands of HIV/AIDS is to end denialism now!", Dr Mamphela Ramphele told a cheering audience last night during the opening of the Second South African Conference on AIDS. She urged fellow South Africans to transcend their past and work together to ensure the human rights of people with AIDS.

South African AIDS Conference opens with call for unity

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"We must start working together," Professor Lynn Morris of South Africa’s National Institute for Communicable Disease told the participants of South Africa’s Second National AIDS Conference on the evening of June 6th in her welcoming address to the meeting. Professor Morris is also the chairperson for the conference being held this week (June 7-10) in Durban.

HIV-1 and HIV-2 coinfection: viral response to HAART differs

http://www.aidsmap.com/en/news/1EFDF0C5-5686-46FD-98EE-986CF81BC1CC.asp?hp=1

For patients coinfected with both HIV-1 and HIV-2, both viruses should be taken into account when selecting treatment regimes and measuring outcome, emphasise investigators writing in the July 15th edition of Clinical Infectious Diseases (now on-line). These cautions are included in a case report of an individual, coinfected with HIV-1 and HIV-2, who initially achieved good immunological and virological outcomes on commencing highly active antiretroviral therapy (HAART). However, the individual experienced an increase in HIV-2 viral load and fall in CD4 cell count after HAART was changed to a simpler regimen which kept HIV-1 undetectable.

Stevens-Johnson syndrome affects mother and son taking nevirapine

http://www.aidsmap.com/en/news/55E68DBB-4A17-4C8B-86CF-924C5D270735.asp?hp=1

Two cases of the rare side-effect of nevirapine, Stevens-Johnson syndrome, involving a mother and her son, are reported in the June 10th edition of AIDS. The investigators "are unaware of any previous familial clustering" of Stevens-Johnson syndrome associated with nevirapine treatment.

Risk of diabetes increased by being HIV-positive and on HAART

http://www.aidsmap.com/en/news/460E8178-0626-411B-AA43-3B588F458682.asp?hp=1

HIV-positive men who are taking highly active antiretroviral therapy (HAART) are more than four times more likely to develop diabetes than HIV-negative men, according to an analysis of data from the Multicenter AIDS Cohort Study (MACS). These findings were published in the 23rd May edition of the Archives of Internal Medicine.

Africa's HIV palliative care needs examination

http://www.aidsmap.com/en/news/F2A267D9-C935-45EB-9937-3BA270A97B2B.asp?hp=1

HIV palliative care in southern Africa is being provided by family members and local communities, who are "often inadequately trained in clinical skills and lack access to essential drugs," according to a review article published in the June 4th edition of The Lancet. The investigators also argue that palliative care will continue to be important in Africa even when antiretrovirals become available.

Zambia: provinces left behind in ARV rollout

http://www.aidsmap.com/en/news/5DA4446D-0148-4BD0-905C-68848C3C73BD.asp?hp=1

In the remote district of Zambezi, near the Zambian border with Angola, getting hold of anti-AIDS drugs is a major struggle for those living with the virus.

New research questions link between African food crisis and AIDS

http://www.aidsmap.com/en/news/ACA5DF7C-7CB3-4D7B-87E4-0B5B9219E9EE.asp?hp=1

The link between HIV/AIDS and hunger in rural communities has received a great deal of attention in Southern Africa, where HIV/AIDS seems to have added a new dimension to the region's four-year-long food crisis. But a new report has argued that although HIV/AIDS constitutes a humanitarian catastrophe, the impact of the epidemic was not a major cause of the region's food crisis during 2001 and 2004.

Pancreatitis risk studied in 20 US HIV drug trials

http://www.aidsmap.com/en/news/42191A1D-70AE-4526-A9FE-9138A6E0E2FA.asp?hp=1

Overall rates of pancreatitis were similar for patients taking single or dual nucleoside analogue (NRTI) regimens, according to a review of 20 United States clinical trials published in the June 1st edition of the Journal of Acquired Immune Deficiency Syndromes. However, as would now be expected, the combination of ddI/d4T was associated with the highest incidence of pancreatitis of any nucleoside analogue combination, with the HAART regimen of indinavir/ddI/d4T "associated with particularly high rates of pancreatitis, reminiscent of high-dose ddI-monotherapy trials."

Total lymphocyte count, anaemia, add to symptoms in pinpointing who needs treatment in Thailand

http://www.aidsmap.com/en/news/6793640B-E0B9-41DA-9E32-F1B3B7B9AC50.asp?hp=1

Current WHO advice on the detection of severe immunosuppression in the absence of sophisticated laboratory tests may result in a significant underestimate of the number of people who would benefit from immediate antiretroviral therapy, according to findings from a joint US/Thai study published in the June 1st edition of the Journal of Acquired Immune Deficiency Syndromes.

Tattooing associated with HIV risk in Chennai, India

http://www.aidsmap.com/en/news/9C786221-5D9F-496C-91C4-1A5659ACC5EA.asp?hp=1

Around 30% of the intravenous drug users (IVDUs) in Chennai, India, are infected with HIV, and around one out of six of these has passed the infection onto their regular sex partners, according to a cross-sectional study published in the May 1st edition of the Journal of Acquired Immune Deficiency Syndrome. Once HIV prevalence among a high-risk IVDU population becomes so high, the paper says "HIV epidemics can become self-perpetuating, with even modest levels of risk behaviour leading to substantial rates of infection. And yet very few of the participants in this study, including those who were infected, thought that they were at any risk of contracting HIV."

Lipodystrophy on first-line ARV regimens common in Indian patients

http://www.aidsmap.com/en/news/B15C0D05-95D8-42BF-ABEF-E51EF79E10BE.asp?hp=1

Lipodystrophy appears to be just as common in Indian patients receiving antiretroviral treatment as it is in the United States and Europe, according to a report from an HIV clinic in Pune, Western India, published in the June 1st edition of the Journal of Acquired Immune Deficiency Syndromes.