The page cannot be foundThe page you are looking for might have been removed, had its name changed, or is temporarily unavailable.Please try the following:
HTTP Error 404 - File or directory not found. |
Saturday, March 9, 2013
HIV 'Cure': Is It Real? Is It Safe?
Thursday, March 7, 2013
U.S. doctor's "gutsy" move led to baby's cure from HIV
JACKSON, Mississippi/CHICAGO, Illinois (Reuters) - The doctor who cured an HIV infected baby for the first time is happier talking to children than to adults and is finding all the attention since the news came out a little overwhelming.
Dr. Hannah Gay and colleagues Dr. Katherine Luzuriaga of the University of Massachusetts and Dr. Deborah Persaud of Johns Hopkins University in Baltimore reported on the child's case at a medical meeting in Atlanta on Sunday.
'The breakthrough has been exciting and I'm very hopeful that that's going to lead to future research that will give us some answers,' said Gay, a Mississippi pediatrician and soft-spoken mother of four adult children.
But the attention is difficult for a woman 'much more comfortable talking to children than adults,' said her husband, Paul Gay. 'She didn't anticipate this kind of explosion of attention.'
Dr. Gay, a 59-year-old native of Jackson, Mississippi, likes to spend time designing needle points, singing in her church choir and reading theology or medical literature when she's not working 12-hour days treating patients, in a state with the nation's highest poverty rate.
'She is the most unlikely person in the world to be getting this kind of international attention, really,' said Jay Richardson, her former pastor at the Highland Colony Baptist Church. 'You don't ever hear her talking about herself or trying to promote herself in any way. She's a quiet, humble person. Extremely intelligent. Very committed to her faith. Very involved in her church. Very committed to teaching children the bible.'
Except for six years working in Ethiopia as a missionary, Dr. Gay has spent the bulk of her academic and professional career at the University of Mississippi, where she received her undergraduate and medical degrees and met her husband of 37 years. She has worked the better part of her career at the university's medical center serving the state's youngest victims of HIV.
During that time, Dr. Gay has published several articles about ways to keep mothers from passing HIV infection to their babies and participated in the federally sponsored Pediatric AIDS Clinical Trials Group, which studied the use of the aggressive treatment of children who are at high risk of infection.
Her daughter Ruth Gay Thomas says as an AIDS specialist her mother has had to fight the battles of her patients, overcoming access to healthcare and the stigma that comes along with being infected with HIV in the United States.
'She practices compassion and huge, unimaginable amounts of patience with her patients and their families,' Thomas said. 'She really has to embody a whole lot more than just the smart doctor that knows the right medications to give.'
To treat her own rheumatoid arthritis, Dr. Gay takes medicine that affects her immune system. 'She has that in common with her patients, but it's been a problem because with her compromised immune system, she can't have as much of a hands-on touching of her patients that was always so satisfying for her,' her husband said.
When a rural hospital in Mississippi delivered a premature baby girl in July 2010 from a mother who had just tested positive for HIV during labor, it was only natural that they would turn to Dr. Gay. The child's mother had not received any prenatal care, nor had she gotten any treatment for her HIV infection, putting the baby at high risk of becoming infected.
Dr. Gay chose to start the baby on the full treatment regimen of three potent drugs when she was just 30 hours old, even before the child's infection was confirmed.
It was a bold move. Most babies exposed to HIV in the womb or during labor would have been given a six-week course of one or two drugs intended to reduce the risk of acquiring infection until tests could confirm she was infected.
'The doctor made a judgment call that the risks for this baby were so high that they were going to assume the baby was infected,' said Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases, a part of the National Institutes of Health or NIH.
Some critics have questioned Dr. Gay's decision, which may have exposed the child to the risk of toxic medications without confirmation of her infection.
'This was a gutsy call that turned out to be correct,' said Fauci, adding that if it had turned out that the baby was not infected, they could have withdrawn the drugs. 'They made the right guess.'
Dr. Gay continued to treat the child until January 2012, when she was 18 months old and her mother stopped bringing the child in for appointments. Gay's team tracked her down in the fall of 2012, but the mother had not given her child any HIV medication since January.
Before restarting treatment, Gay did several tests, fully expecting that the virus had come roaring back. But none of the tests detected the virus. That's when she brought in colleagues Luzuriaga of the University of Massachusetts and Persaud of Johns Hopkins University in Baltimore, who did a series of ultrasensitive tests. They were only able to find trace amounts of genetic material from the virus, but nothing capable of rekindling the infection.
The child, now 30 months old, remains off medication and continues to fare well. 'We can't find any virus to treat at this point,' Dr. Gay said.
She said it is not clear what the child's story will mean in the wider scheme of HIV research, but she hopes it may lead to a cure for other babies infected at birth.
'I guess the message that I want to get across to the public very strongly is, we don't know yet if we can create the same outcome in other babies.' she said. 'It's far too early to draw too many conclusions. There's not a cure in sight this week.'
Dr. Gay said she is glad that this is happening in Mississippi and hopes it boosts the state's reputation.
'But it's a whole lot bigger than this one child, the University Medical Center or the state,' she said. 'It may take a long time, but I hope it will point us in the right direction to come up with a cure we can consistently apply to other babies worldwide.'
Colleagues at the medical center are planning a celebration for Dr. Gay to 'let her know how proud we are,' said Amy Smith, a nurse practitioner who works with the doctor. 'She's the type that wouldn't want a big fuss made about her, but we're going to do it anyway.'
(Reporting by Julie Steenhuysen and Emily Le Coz; Editing by Jilian Mincer and Claudia Parsons)
Dr. Hannah Gay and colleagues Dr. Katherine Luzuriaga of the University of Massachusetts and Dr. Deborah Persaud of Johns Hopkins University in Baltimore reported on the child's case at a medical meeting in Atlanta on Sunday.
'The breakthrough has been exciting and I'm very hopeful that that's going to lead to future research that will give us some answers,' said Gay, a Mississippi pediatrician and soft-spoken mother of four adult children.
But the attention is difficult for a woman 'much more comfortable talking to children than adults,' said her husband, Paul Gay. 'She didn't anticipate this kind of explosion of attention.'
Dr. Gay, a 59-year-old native of Jackson, Mississippi, likes to spend time designing needle points, singing in her church choir and reading theology or medical literature when she's not working 12-hour days treating patients, in a state with the nation's highest poverty rate.
'She is the most unlikely person in the world to be getting this kind of international attention, really,' said Jay Richardson, her former pastor at the Highland Colony Baptist Church. 'You don't ever hear her talking about herself or trying to promote herself in any way. She's a quiet, humble person. Extremely intelligent. Very committed to her faith. Very involved in her church. Very committed to teaching children the bible.'
Except for six years working in Ethiopia as a missionary, Dr. Gay has spent the bulk of her academic and professional career at the University of Mississippi, where she received her undergraduate and medical degrees and met her husband of 37 years. She has worked the better part of her career at the university's medical center serving the state's youngest victims of HIV.
During that time, Dr. Gay has published several articles about ways to keep mothers from passing HIV infection to their babies and participated in the federally sponsored Pediatric AIDS Clinical Trials Group, which studied the use of the aggressive treatment of children who are at high risk of infection.
Her daughter Ruth Gay Thomas says as an AIDS specialist her mother has had to fight the battles of her patients, overcoming access to healthcare and the stigma that comes along with being infected with HIV in the United States.
'She practices compassion and huge, unimaginable amounts of patience with her patients and their families,' Thomas said. 'She really has to embody a whole lot more than just the smart doctor that knows the right medications to give.'
To treat her own rheumatoid arthritis, Dr. Gay takes medicine that affects her immune system. 'She has that in common with her patients, but it's been a problem because with her compromised immune system, she can't have as much of a hands-on touching of her patients that was always so satisfying for her,' her husband said.
When a rural hospital in Mississippi delivered a premature baby girl in July 2010 from a mother who had just tested positive for HIV during labor, it was only natural that they would turn to Dr. Gay. The child's mother had not received any prenatal care, nor had she gotten any treatment for her HIV infection, putting the baby at high risk of becoming infected.
Dr. Gay chose to start the baby on the full treatment regimen of three potent drugs when she was just 30 hours old, even before the child's infection was confirmed.
It was a bold move. Most babies exposed to HIV in the womb or during labor would have been given a six-week course of one or two drugs intended to reduce the risk of acquiring infection until tests could confirm she was infected.
'The doctor made a judgment call that the risks for this baby were so high that they were going to assume the baby was infected,' said Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases, a part of the National Institutes of Health or NIH.
Some critics have questioned Dr. Gay's decision, which may have exposed the child to the risk of toxic medications without confirmation of her infection.
'This was a gutsy call that turned out to be correct,' said Fauci, adding that if it had turned out that the baby was not infected, they could have withdrawn the drugs. 'They made the right guess.'
Dr. Gay continued to treat the child until January 2012, when she was 18 months old and her mother stopped bringing the child in for appointments. Gay's team tracked her down in the fall of 2012, but the mother had not given her child any HIV medication since January.
Before restarting treatment, Gay did several tests, fully expecting that the virus had come roaring back. But none of the tests detected the virus. That's when she brought in colleagues Luzuriaga of the University of Massachusetts and Persaud of Johns Hopkins University in Baltimore, who did a series of ultrasensitive tests. They were only able to find trace amounts of genetic material from the virus, but nothing capable of rekindling the infection.
The child, now 30 months old, remains off medication and continues to fare well. 'We can't find any virus to treat at this point,' Dr. Gay said.
She said it is not clear what the child's story will mean in the wider scheme of HIV research, but she hopes it may lead to a cure for other babies infected at birth.
'I guess the message that I want to get across to the public very strongly is, we don't know yet if we can create the same outcome in other babies.' she said. 'It's far too early to draw too many conclusions. There's not a cure in sight this week.'
Dr. Gay said she is glad that this is happening in Mississippi and hopes it boosts the state's reputation.
'But it's a whole lot bigger than this one child, the University Medical Center or the state,' she said. 'It may take a long time, but I hope it will point us in the right direction to come up with a cure we can consistently apply to other babies worldwide.'
Colleagues at the medical center are planning a celebration for Dr. Gay to 'let her know how proud we are,' said Amy Smith, a nurse practitioner who works with the doctor. 'She's the type that wouldn't want a big fuss made about her, but we're going to do it anyway.'
(Reporting by Julie Steenhuysen and Emily Le Coz; Editing by Jilian Mincer and Claudia Parsons)
Wednesday, March 6, 2013
U.S. doctor's 'gutsy' move led to baby's cure from HIV
JACKSON, Mississippi/CHICAGO, Illinois (Reuters) - The doctor who cured an HIV infected baby for the first time is happier talking to children than to adults and is finding all the attention since the news came out a little overwhelming.
Dr. Hannah Gay and colleagues Dr. Katherine Luzuriaga of the University of Massachusetts and Dr. Deborah Persaud of Johns Hopkins University in Baltimore reported on the child's case at a medical meeting in Atlanta on Sunday.
'The breakthrough has been exciting and I'm very hopeful that that's going to lead to future research that will give us some answers,' said Gay, a Mississippi pediatrician and soft-spoken mother of four adult children.
But the attention is difficult for a woman 'much more comfortable talking to children than adults,' said her husband, Paul Gay. 'She didn't anticipate this kind of explosion of attention.'
Dr. Gay, a 59-year-old native of Jackson, Mississippi, likes to spend time designing needle points, singing in her church choir and reading theology or medical literature when she's not working 12-hour days treating patients, in a state with the nation's highest poverty rate.
'She is the most unlikely person in the world to be getting this kind of international attention, really,' said Jay Richardson, her former pastor at the Highland Colony Baptist Church. 'You don't ever hear her talking about herself or trying to promote herself in any way. She's a quiet, humble person. Extremely intelligent. Very committed to her faith. Very involved in her church. Very committed to teaching children the bible.'
Except for six years working in Ethiopia as a missionary, Dr. Gay has spent the bulk of her academic and professional career at the University of Mississippi, where she received her undergraduate and medical degrees and met her husband of 37 years. She has worked the better part of her career at the university's medical center serving the state's youngest victims of HIV.
During that time, Dr. Gay has published several articles about ways to keep mothers from passing HIV infection to their babies and participated in the federally sponsored Pediatric AIDS Clinical Trials Group, which studied the use of the aggressive treatment of children who are at high risk of infection.
Her daughter Ruth Gay Thomas says as an AIDS specialist her mother has had to fight the battles of her patients, overcoming access to healthcare and the stigma that comes along with being infected with HIV in the United States.
'She practices compassion and huge, unimaginable amounts of patience with her patients and their families,' Thomas said. 'She really has to embody a whole lot more than just the smart doctor that knows the right medications to give.'
To treat her own rheumatoid arthritis, Dr. Gay takes medicine that affects her immune system. 'She has that in common with her patients, but it's been a problem because with her compromised immune system, she can't have as much of a hands-on touching of her patients that was always so satisfying for her,' her husband said.
When a rural hospital in Mississippi delivered a premature baby girl in July 2010 from a mother who had just tested positive for HIV during labor, it was only natural that they would turn to Dr. Gay. The child's mother had not received any prenatal care, nor had she gotten any treatment for her HIV infection, putting the baby at high risk of becoming infected.
Dr. Gay chose to start the baby on the full treatment regimen of three potent drugs when she was just 30 hours old, even before the child's infection was confirmed.
It was a bold move. Most babies exposed to HIV in the womb or during labor would have been given a six-week course of one or two drugs intended to reduce the risk of acquiring infection until tests could confirm she was infected.
'The doctor made a judgment call that the risks for this baby were so high that they were going to assume the baby was infected,' said Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases, a part of the National Institutes of Health or NIH.
Some critics have questioned Dr. Gay's decision, which may have exposed the child to the risk of toxic medications without confirmation of her infection.
'This was a gutsy call that turned out to be correct,' said Fauci, adding that if it had turned out that the baby was not infected, they could have withdrawn the drugs. 'They made the right guess.'
Dr. Gay continued to treat the child until January 2012, when she was 18 months old and her mother stopped bringing the child in for appointments. Gay's team tracked her down in the fall of 2012, but the mother had not given her child any HIV medication since January.
Before restarting treatment, Gay did several tests, fully expecting that the virus had come roaring back. But none of the tests detected the virus. That's when she brought in colleagues Luzuriaga of the University of Massachusetts and Persaud of Johns Hopkins University in Baltimore, who did a series of ultrasensitive tests. They were only able to find trace amounts of genetic material from the virus, but nothing capable of rekindling the infection.
The child, now 30 months old, remains off medication and continues to fare well. 'We can't find any virus to treat at this point,' Dr. Gay said.
She said it is not clear what the child's story will mean in the wider scheme of HIV research, but she hopes it may lead to a cure for other babies infected at birth.
'I guess the message that I want to get across to the public very strongly is, we don't know yet if we can create the same outcome in other babies.' she said. 'It's far too early to draw too many conclusions. There's not a cure in sight this week.'
Dr. Gay said she is glad that this is happening in Mississippi and hopes it boosts the state's reputation.
'But it's a whole lot bigger than this one child, the University Medical Center or the state,' she said. 'It may take a long time, but I hope it will point us in the right direction to come up with a cure we can consistently apply to other babies worldwide.'
Colleagues at the medical center are planning a celebration for Dr. Gay to 'let her know how proud we are,' said Amy Smith, a nurse practitioner who works with the doctor. 'She's the type that wouldn't want a big fuss made about her, but we're going to do it anyway.'
(Reporting by Julie Steenhuysen and Emily Le Coz; Editing by Jilian Mincer and Claudia Parsons)
Dr. Hannah Gay and colleagues Dr. Katherine Luzuriaga of the University of Massachusetts and Dr. Deborah Persaud of Johns Hopkins University in Baltimore reported on the child's case at a medical meeting in Atlanta on Sunday.
'The breakthrough has been exciting and I'm very hopeful that that's going to lead to future research that will give us some answers,' said Gay, a Mississippi pediatrician and soft-spoken mother of four adult children.
But the attention is difficult for a woman 'much more comfortable talking to children than adults,' said her husband, Paul Gay. 'She didn't anticipate this kind of explosion of attention.'
Dr. Gay, a 59-year-old native of Jackson, Mississippi, likes to spend time designing needle points, singing in her church choir and reading theology or medical literature when she's not working 12-hour days treating patients, in a state with the nation's highest poverty rate.
'She is the most unlikely person in the world to be getting this kind of international attention, really,' said Jay Richardson, her former pastor at the Highland Colony Baptist Church. 'You don't ever hear her talking about herself or trying to promote herself in any way. She's a quiet, humble person. Extremely intelligent. Very committed to her faith. Very involved in her church. Very committed to teaching children the bible.'
Except for six years working in Ethiopia as a missionary, Dr. Gay has spent the bulk of her academic and professional career at the University of Mississippi, where she received her undergraduate and medical degrees and met her husband of 37 years. She has worked the better part of her career at the university's medical center serving the state's youngest victims of HIV.
During that time, Dr. Gay has published several articles about ways to keep mothers from passing HIV infection to their babies and participated in the federally sponsored Pediatric AIDS Clinical Trials Group, which studied the use of the aggressive treatment of children who are at high risk of infection.
Her daughter Ruth Gay Thomas says as an AIDS specialist her mother has had to fight the battles of her patients, overcoming access to healthcare and the stigma that comes along with being infected with HIV in the United States.
'She practices compassion and huge, unimaginable amounts of patience with her patients and their families,' Thomas said. 'She really has to embody a whole lot more than just the smart doctor that knows the right medications to give.'
To treat her own rheumatoid arthritis, Dr. Gay takes medicine that affects her immune system. 'She has that in common with her patients, but it's been a problem because with her compromised immune system, she can't have as much of a hands-on touching of her patients that was always so satisfying for her,' her husband said.
When a rural hospital in Mississippi delivered a premature baby girl in July 2010 from a mother who had just tested positive for HIV during labor, it was only natural that they would turn to Dr. Gay. The child's mother had not received any prenatal care, nor had she gotten any treatment for her HIV infection, putting the baby at high risk of becoming infected.
Dr. Gay chose to start the baby on the full treatment regimen of three potent drugs when she was just 30 hours old, even before the child's infection was confirmed.
It was a bold move. Most babies exposed to HIV in the womb or during labor would have been given a six-week course of one or two drugs intended to reduce the risk of acquiring infection until tests could confirm she was infected.
'The doctor made a judgment call that the risks for this baby were so high that they were going to assume the baby was infected,' said Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases, a part of the National Institutes of Health or NIH.
Some critics have questioned Dr. Gay's decision, which may have exposed the child to the risk of toxic medications without confirmation of her infection.
'This was a gutsy call that turned out to be correct,' said Fauci, adding that if it had turned out that the baby was not infected, they could have withdrawn the drugs. 'They made the right guess.'
Dr. Gay continued to treat the child until January 2012, when she was 18 months old and her mother stopped bringing the child in for appointments. Gay's team tracked her down in the fall of 2012, but the mother had not given her child any HIV medication since January.
Before restarting treatment, Gay did several tests, fully expecting that the virus had come roaring back. But none of the tests detected the virus. That's when she brought in colleagues Luzuriaga of the University of Massachusetts and Persaud of Johns Hopkins University in Baltimore, who did a series of ultrasensitive tests. They were only able to find trace amounts of genetic material from the virus, but nothing capable of rekindling the infection.
The child, now 30 months old, remains off medication and continues to fare well. 'We can't find any virus to treat at this point,' Dr. Gay said.
She said it is not clear what the child's story will mean in the wider scheme of HIV research, but she hopes it may lead to a cure for other babies infected at birth.
'I guess the message that I want to get across to the public very strongly is, we don't know yet if we can create the same outcome in other babies.' she said. 'It's far too early to draw too many conclusions. There's not a cure in sight this week.'
Dr. Gay said she is glad that this is happening in Mississippi and hopes it boosts the state's reputation.
'But it's a whole lot bigger than this one child, the University Medical Center or the state,' she said. 'It may take a long time, but I hope it will point us in the right direction to come up with a cure we can consistently apply to other babies worldwide.'
Colleagues at the medical center are planning a celebration for Dr. Gay to 'let her know how proud we are,' said Amy Smith, a nurse practitioner who works with the doctor. 'She's the type that wouldn't want a big fuss made about her, but we're going to do it anyway.'
(Reporting by Julie Steenhuysen and Emily Le Coz; Editing by Jilian Mincer and Claudia Parsons)
Tuesday, March 5, 2013
HIV linked to higher chance of heart attack
NEW YORK (Reuters Health) - People with HIV are almost 50 percent more likely to have a heart attack than those who aren't infected with the virus - even after taking into account their other health risks, according to a new study.
Researchers aren't sure what explains the higher heart attack rate in HIV-positive people, but they speculate it's a combination of the effects of HIV itself and the antiretroviral drugs used to treat it.
'It's a complicated picture,' said Dr. Matthew Freiberg, who led the new study at the University of Pittsburgh School of Medicine in Pennsylvania. 'We're still trying to understand the mechanisms.'
Just over 1.1 million people in the U.S. have HIV, according to the Centers for Disease Control and Prevention. Another 50,000 are infected each year.
Because treatment now allows HIV-infected people to live longer, researchers have started turning their attention to the other health problems those people face later in life, such as heart disease.
The new study included more than 82,000 U.S. veterans, almost all men. About one-third of them were infected with the human immunodeficiency virus.
During an average of almost six years, 871 of the study participants had a heart attack, of which 176 were fatal.
The researchers found that veterans with HIV were consistently more likely to suffer a heart attack than HIV-negative veterans in their 40s, 50s and 60s.
After Freiberg and his colleagues took into account participants' other heart risks - including high blood pressure, diabetes and drug and alcohol use - those with HIV were still 48 percent more likely to have a heart attack during the study period.
The findings suggest antiretroviral drugs accounted for at least part of the extra risk among people with HIV. But past studies have shown the virus itself also contributes to heart problems, according to Freiberg.
'It may be that HIV as it's in your body, like other infections, may be promoting an inflammatory response that is leading to these increased risks of heart attack,' he told Reuters Health - but so far, that's just a theory.
Having hepatitis C or kidney disease was also tied to a higher chance of heart attack among veterans, the research team reported Monday in JAMA Internal Medicine.
Dr. Patrick Mallon, from the University College Dublin School of Medicine and Medical Science in Ireland, said past research showed a link between HIV and cardiovascular disease.
But it's been unclear whether other differences between groups of people with and without HIV - such as smoking rates and cholesterol levels, for example - could be driving the extra risk.
The new report helps clear that up by comparing two very similar groups of people where HIV status is one of the only differences, he noted.
'There have been a lot of signals for a very long time in HIV, and we're now starting to see people constructing studies properly that really give us some very clear answers,' Mallon, who wrote a commentary accompanying the new study, told Reuters Health.
HIV has also been linked to disturbances in fat use and storage in the body.
Mallon and Freiberg agreed that people with HIV should make sure they have their blood pressure and cholesterol checked regularly and do whatever else they can to prevent heart disease - such as quitting smoking.
'There is a lot that the individual can do to mitigate their risk along the lines of lifestyle interventions,' Mallon said. 'At a personal level, that would be step number one.'
SOURCE: http://bit.ly/15vcqlf JAMA Internal Medicine, online March 4, 2013.
Researchers aren't sure what explains the higher heart attack rate in HIV-positive people, but they speculate it's a combination of the effects of HIV itself and the antiretroviral drugs used to treat it.
'It's a complicated picture,' said Dr. Matthew Freiberg, who led the new study at the University of Pittsburgh School of Medicine in Pennsylvania. 'We're still trying to understand the mechanisms.'
Just over 1.1 million people in the U.S. have HIV, according to the Centers for Disease Control and Prevention. Another 50,000 are infected each year.
Because treatment now allows HIV-infected people to live longer, researchers have started turning their attention to the other health problems those people face later in life, such as heart disease.
The new study included more than 82,000 U.S. veterans, almost all men. About one-third of them were infected with the human immunodeficiency virus.
During an average of almost six years, 871 of the study participants had a heart attack, of which 176 were fatal.
The researchers found that veterans with HIV were consistently more likely to suffer a heart attack than HIV-negative veterans in their 40s, 50s and 60s.
After Freiberg and his colleagues took into account participants' other heart risks - including high blood pressure, diabetes and drug and alcohol use - those with HIV were still 48 percent more likely to have a heart attack during the study period.
The findings suggest antiretroviral drugs accounted for at least part of the extra risk among people with HIV. But past studies have shown the virus itself also contributes to heart problems, according to Freiberg.
'It may be that HIV as it's in your body, like other infections, may be promoting an inflammatory response that is leading to these increased risks of heart attack,' he told Reuters Health - but so far, that's just a theory.
Having hepatitis C or kidney disease was also tied to a higher chance of heart attack among veterans, the research team reported Monday in JAMA Internal Medicine.
Dr. Patrick Mallon, from the University College Dublin School of Medicine and Medical Science in Ireland, said past research showed a link between HIV and cardiovascular disease.
But it's been unclear whether other differences between groups of people with and without HIV - such as smoking rates and cholesterol levels, for example - could be driving the extra risk.
The new report helps clear that up by comparing two very similar groups of people where HIV status is one of the only differences, he noted.
'There have been a lot of signals for a very long time in HIV, and we're now starting to see people constructing studies properly that really give us some very clear answers,' Mallon, who wrote a commentary accompanying the new study, told Reuters Health.
HIV has also been linked to disturbances in fat use and storage in the body.
Mallon and Freiberg agreed that people with HIV should make sure they have their blood pressure and cholesterol checked regularly and do whatever else they can to prevent heart disease - such as quitting smoking.
'There is a lot that the individual can do to mitigate their risk along the lines of lifestyle interventions,' Mallon said. 'At a personal level, that would be step number one.'
SOURCE: http://bit.ly/15vcqlf JAMA Internal Medicine, online March 4, 2013.
Monday, March 4, 2013
Anti-AIDS pill, vaginal gel unsuitable for Africa: study
JOHANNESBURG (Reuters) - Trying to prevent HIV infection through vaginal gels or daily tablets has proven ineffective in the southern African region ravaged by the disease because people did not use the medicines properly, a study released on Monday said.
A ground-breaking study issued in 2010 indicated a vaginal gel containing an HIV drug can sharply reduce infections in women who use it before and after sex.
However, a test of the gel and two types of anti-HIV pills among more than 5,000 women in South Africa, Zimbabwe and Uganda showed that, based on blood tests, more than 70 percent did not use the medication as instructed.
'We are obviously disappointed in the results. We were very hopeful that these products, which we know have been effective in other studies and clearly have a lot of promise, would work,' Jeanne Marrazzo, a researcher on the project for the University of Washington, told reporters in a teleconference.
'Women did not use consistently any of the products. Adherence was very low,' said Marrazzo, part of the project known as the Vaginal and Oral Interventions to Control the Epidemic (VOICE).
HIV/AIDS experts said the results showed how important a factor human behavior is when devising ways to prevent HIV.
'HIV prevention is never just biomedical - behavior is key. What we've learned from VOICE and other trials is that adherence to the prescribed dose - the behavioral component - is the variable that determines effectiveness,' said Mitchell Warren, director of the HIV prevention advocacy group AVAC.
East and southern Africa are the areas most heavily affected by the HIV epidemic. Out of the total number of people worldwide in 2009 living with HIV, 34 percent were in 10 countries of southern Africa, according to the U.N. Programme on HIV/AIDS.
Experts have been searching for years for inexpensive, safe and simple medications to decrease the risk of transmission among a population that is largely destitute and with little access to quality health care.
The study also found the group most likely to contract HIV - unmarried women under 25 - was also the most likely not to use any of the medicines. The results were presented at a Conference on Retroviruses and Opportunistic Infections in Atlanta.
The three-year study that started in September 2009 tested a daily tablet called Truvada, which was approved for HIV prevention in July 2012 by the U.S. Food and Drug Administration after it was shown to significantly reduce the risk of HIV infection when used as a preventative measure.
The gel with a drug called tenofovir, which a previous study showed reduced HIV infections in women by 39 percent over two and a half years, and an oral tenofovir tablet were also tested.
Researchers have been trying for years to formulate a microbicide - a gel, cream, ring or tablet inserted into the vagina or rectum before sex to prevent transmission of the human immunodeficiency virus (HIV) that causes AIDS.
'We need to rethink the design of these intervention trials ... in healthy people because it is difficult for anybody to take a pill or anything every day, particularly when you are healthy and do not feel that you need a drug,' said Marrazzo.
Truvada is made by Gilead Sciences, which also developed tenofovir. In 2006, Gilead assigned a royalty-free license for tenofovir gel to CONRAD.
Jonathan Mermin, an HIV/AIDS prevention expert at the U.S. Centers for Disease Control and Prevention (CDC) said these trial results underscored the complexities of getting healthy people to use preventative measures against HIV.
'Clinicians and public health professionals will have to further assess and better understand how to promote and support the high levels of adherence necessary,' he said.
(Additional reporting by Kate Kelland in London; Editing by Louise Ireland and Michael Roddy)
A ground-breaking study issued in 2010 indicated a vaginal gel containing an HIV drug can sharply reduce infections in women who use it before and after sex.
However, a test of the gel and two types of anti-HIV pills among more than 5,000 women in South Africa, Zimbabwe and Uganda showed that, based on blood tests, more than 70 percent did not use the medication as instructed.
'We are obviously disappointed in the results. We were very hopeful that these products, which we know have been effective in other studies and clearly have a lot of promise, would work,' Jeanne Marrazzo, a researcher on the project for the University of Washington, told reporters in a teleconference.
'Women did not use consistently any of the products. Adherence was very low,' said Marrazzo, part of the project known as the Vaginal and Oral Interventions to Control the Epidemic (VOICE).
HIV/AIDS experts said the results showed how important a factor human behavior is when devising ways to prevent HIV.
'HIV prevention is never just biomedical - behavior is key. What we've learned from VOICE and other trials is that adherence to the prescribed dose - the behavioral component - is the variable that determines effectiveness,' said Mitchell Warren, director of the HIV prevention advocacy group AVAC.
East and southern Africa are the areas most heavily affected by the HIV epidemic. Out of the total number of people worldwide in 2009 living with HIV, 34 percent were in 10 countries of southern Africa, according to the U.N. Programme on HIV/AIDS.
Experts have been searching for years for inexpensive, safe and simple medications to decrease the risk of transmission among a population that is largely destitute and with little access to quality health care.
The study also found the group most likely to contract HIV - unmarried women under 25 - was also the most likely not to use any of the medicines. The results were presented at a Conference on Retroviruses and Opportunistic Infections in Atlanta.
The three-year study that started in September 2009 tested a daily tablet called Truvada, which was approved for HIV prevention in July 2012 by the U.S. Food and Drug Administration after it was shown to significantly reduce the risk of HIV infection when used as a preventative measure.
The gel with a drug called tenofovir, which a previous study showed reduced HIV infections in women by 39 percent over two and a half years, and an oral tenofovir tablet were also tested.
Researchers have been trying for years to formulate a microbicide - a gel, cream, ring or tablet inserted into the vagina or rectum before sex to prevent transmission of the human immunodeficiency virus (HIV) that causes AIDS.
'We need to rethink the design of these intervention trials ... in healthy people because it is difficult for anybody to take a pill or anything every day, particularly when you are healthy and do not feel that you need a drug,' said Marrazzo.
Truvada is made by Gilead Sciences, which also developed tenofovir. In 2006, Gilead assigned a royalty-free license for tenofovir gel to CONRAD.
Jonathan Mermin, an HIV/AIDS prevention expert at the U.S. Centers for Disease Control and Prevention (CDC) said these trial results underscored the complexities of getting healthy people to use preventative measures against HIV.
'Clinicians and public health professionals will have to further assess and better understand how to promote and support the high levels of adherence necessary,' he said.
(Additional reporting by Kate Kelland in London; Editing by Louise Ireland and Michael Roddy)
U.S. baby's cure from HIV raises hope, new questions
CHICAGO (Reuters) - The remarkable case of a baby being cured of HIV infection in the United States using readily available drugs has raised new hope for eradicating the infection in infants worldwide, but scientists say it will take a lot more research and much more sensitive diagnostics before this hope becomes a reality.
In a medical first for an infant, the Mississippi toddler was born in July 2010 infected with HIV, treated within 30 hours of delivery with aggressive HIV therapy, which continued for 18 months. She is now considered cured of her infection, a team of researchers led by Dr. Deborah Persaud, a virologist at Johns Hopkins University in Baltimore, said in a news conference at the Conference on Retroviruses and Opportunistic Infections in Atlanta on Sunday.
'From a clinical perspective, this means that if you can get an infected baby on to antiretroviral drugs immediately after delivery, it's going to be possible to prevent or reverse the infection - essentially cure the baby,' said Dr. Steven Deeks, an HIV/AIDS researcher at the University of California at San Francisco who is attending the conference, where the case was presented to researchers on Monday.
Deeks and others hailed the findings as a great advance in the search for a cure in babies born infected with HIV. But the researchers said they also suggest the need for better ways to diagnose HIV infection, a process that typically takes up to six weeks.
'This could have a profound effect on how we approach babies born to HIV-infected moms,' Deeks said.
Treatment of HIV-infected mothers before delivery is the best way to prevent HIV infection of infants, experts say, but even in resource-rich countries such as the United States, 100 to 200 babies are born each year infected with HIV, the virus that causes AIDS, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.
Worldwide, especially in developing countries, as many as 1,000 babies are born infected each day. For these children, the findings could have a major impact on the 'terrible burden of HIV infection throughout the world,' Fauci said.
Michel Sidibé, executive director of the Joint United Nations Programme on HIV/AIDS, known as UNAIDS, said the news 'gives us great hope that a cure for HIV in children is possible,' but it also underscores the need for research and innovation, 'especially in the area of early diagnostics.'
Fauci said the child's case was an important 'proof of concept,' but he cautioned that it was only one case and it needs to be further validated.
'The real question is will this be broadly applicable to other infants?' he said.
Fauci said there is a risk that without better diagnostics, children who were never infected in the first place could be exposed to toxic drugs with very early treatment.
In the case of the Mississippi girl, Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi Medical Center in Jackson, made the call to treat the child with HIV drugs even before her infection was confirmed because she believed the child was at such great risk of infection. Had she been wrong, the therapy would have been stopped.
'Since the mother had really been at such high risk of transmitting to the baby, they decided to treat on square one,' said Fauci, as opposed to giving the child a lower, preventative dose of drugs until test results confirm an infection.
'The approach of treating really, really early needs to be pursued,' he said. 'When we get better diagnostics where we can tell within the first day or so whether the baby is infected, an approach like this looks like it might be a reasonable thing to pursue with the appropriate clinical trials.'
Fauci said it is not time to change treatment protocols for infants who are born infected. 'It's a single case. We've got to be careful about that.'
(Reporting by Julie Steenhuysen; Editing by Jilian Mincer and Douglas Royalty)
In a medical first for an infant, the Mississippi toddler was born in July 2010 infected with HIV, treated within 30 hours of delivery with aggressive HIV therapy, which continued for 18 months. She is now considered cured of her infection, a team of researchers led by Dr. Deborah Persaud, a virologist at Johns Hopkins University in Baltimore, said in a news conference at the Conference on Retroviruses and Opportunistic Infections in Atlanta on Sunday.
'From a clinical perspective, this means that if you can get an infected baby on to antiretroviral drugs immediately after delivery, it's going to be possible to prevent or reverse the infection - essentially cure the baby,' said Dr. Steven Deeks, an HIV/AIDS researcher at the University of California at San Francisco who is attending the conference, where the case was presented to researchers on Monday.
Deeks and others hailed the findings as a great advance in the search for a cure in babies born infected with HIV. But the researchers said they also suggest the need for better ways to diagnose HIV infection, a process that typically takes up to six weeks.
'This could have a profound effect on how we approach babies born to HIV-infected moms,' Deeks said.
Treatment of HIV-infected mothers before delivery is the best way to prevent HIV infection of infants, experts say, but even in resource-rich countries such as the United States, 100 to 200 babies are born each year infected with HIV, the virus that causes AIDS, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.
Worldwide, especially in developing countries, as many as 1,000 babies are born infected each day. For these children, the findings could have a major impact on the 'terrible burden of HIV infection throughout the world,' Fauci said.
Michel Sidibé, executive director of the Joint United Nations Programme on HIV/AIDS, known as UNAIDS, said the news 'gives us great hope that a cure for HIV in children is possible,' but it also underscores the need for research and innovation, 'especially in the area of early diagnostics.'
Fauci said the child's case was an important 'proof of concept,' but he cautioned that it was only one case and it needs to be further validated.
'The real question is will this be broadly applicable to other infants?' he said.
Fauci said there is a risk that without better diagnostics, children who were never infected in the first place could be exposed to toxic drugs with very early treatment.
In the case of the Mississippi girl, Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi Medical Center in Jackson, made the call to treat the child with HIV drugs even before her infection was confirmed because she believed the child was at such great risk of infection. Had she been wrong, the therapy would have been stopped.
'Since the mother had really been at such high risk of transmitting to the baby, they decided to treat on square one,' said Fauci, as opposed to giving the child a lower, preventative dose of drugs until test results confirm an infection.
'The approach of treating really, really early needs to be pursued,' he said. 'When we get better diagnostics where we can tell within the first day or so whether the baby is infected, an approach like this looks like it might be a reasonable thing to pursue with the appropriate clinical trials.'
Fauci said it is not time to change treatment protocols for infants who are born infected. 'It's a single case. We've got to be careful about that.'
(Reporting by Julie Steenhuysen; Editing by Jilian Mincer and Douglas Royalty)
India board rules against Bayer in cancer drug patent case
CHENNAI (Reuters) - An Indian patent appeals board upheld on Monday a decision to allow a domestic company to sell a generic version of Bayer AG's cancer drug Nexavar, in a blow for global drugmakers' efforts to hold on to monopolies on high-price medicines.
The ruling paves the way for the issue of more so-called compulsory licenses as governments, particularly in emerging markets such as China and Thailand, battle to bring down healthcare costs and provide access to affordable drugs to treat diseases such as cancer, HIV-AIDS and hepatitis.
Bayer, Germany's largest drugmaker, said it would continue to fight to overturn the decision, which it said weakened the international patent system and endangered pharmaceutical research.
Under a global Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement, countries can issue compulsory licenses on certain drugs that are deemed unaffordable to a large section of their populations.
India's $13 billion drug market is seen by drugmakers as a huge opportunity, but there are concerns about the level of protection for intellectual property in the country -- where generic medicines account for more than 90 percent of drug sales -- after a series of judicial setbacks for 'big pharma'.
COMPULSORY LICENCE CHALLENGED
Last year, the Indian patents office allowed Natco Pharma to sell generic Nexavar at 8,800 rupees ($160) for a month's dose -- a fraction of Bayer's price of 280,000 rupees.
Bayer challenged this decision to grant Natco a compulsory license at the Intellectual Property Appellate Board (IPAB) in the southern city of Chennai.
On Monday the board dismissed the petition, although it did order Natco Pharma to pay a royalty of 7 percent on sales of generic Nexavar to Bayer, an increase from the 6 percent royalty that had earlier been set.
Also, the board fined Natco Pharma 50,000 rupees for presenting incorrect facts during the legal proceedings. The amount would be donated to a cancer treatment hospital, the board ordered.
Announcing the decision, Justice Prabha Sridevan said the kidney and liver cancer drug should be available at an affordable price to everybody.
Bayer said in a statement it 'strongly disagreed' with the conclusions of the board, adding that it would seek to challenge it at the High Court in Mumbai.
'The challenges faced by the Indian healthcare system have little or nothing to do with patents on pharmaceutical products as all products on India's essential drug list are not patented,' the company said.
Natco Pharma Company Secretary M. Adinarayana told reporters the board had delivered a 'reasoned, detailed' decision that could be 'sustained in any court of law'.
LEGAL SETBACKS
In a separate case, Bayer has accused another Indian drugmaker, Cipla, of infringing its patent on Nexavar. Cipla had launched its generic version of Nexavar before Natco won the compulsory license.
Cipla undercut Natco's price in May last year and now sells the drug at 6,840 rupees for a month's dose.
Among other setbacks for Western drug companies, India has revoked patents granted to Pfizer Inc's cancer drug Sutent, Roche Holding AG's hepatitis C drug Pegasys and Merck & Co's asthma treatment aerosol suspension formulation.
Another case involving drug patents is currently in front of the Supreme Court, with Novartis battling against an earlier decision refusing it a patent on cancer drug Glivec.
New Delhi has also taken other measures, such as controlling the prices of generic medicines and providing free medicines at government-run hospitals that cater to the country's poor.
Last week a government panel recommended a formula to curb prices of patented drugs to make them affordable for the world's second-most populous country.
($1 = 54.90 rupees)
(Additional reporting and writing by Kaustubh Kulkarni in MUMBAI; Editing by Alex Richardson)
The ruling paves the way for the issue of more so-called compulsory licenses as governments, particularly in emerging markets such as China and Thailand, battle to bring down healthcare costs and provide access to affordable drugs to treat diseases such as cancer, HIV-AIDS and hepatitis.
Bayer, Germany's largest drugmaker, said it would continue to fight to overturn the decision, which it said weakened the international patent system and endangered pharmaceutical research.
Under a global Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement, countries can issue compulsory licenses on certain drugs that are deemed unaffordable to a large section of their populations.
India's $13 billion drug market is seen by drugmakers as a huge opportunity, but there are concerns about the level of protection for intellectual property in the country -- where generic medicines account for more than 90 percent of drug sales -- after a series of judicial setbacks for 'big pharma'.
COMPULSORY LICENCE CHALLENGED
Last year, the Indian patents office allowed Natco Pharma to sell generic Nexavar at 8,800 rupees ($160) for a month's dose -- a fraction of Bayer's price of 280,000 rupees.
Bayer challenged this decision to grant Natco a compulsory license at the Intellectual Property Appellate Board (IPAB) in the southern city of Chennai.
On Monday the board dismissed the petition, although it did order Natco Pharma to pay a royalty of 7 percent on sales of generic Nexavar to Bayer, an increase from the 6 percent royalty that had earlier been set.
Also, the board fined Natco Pharma 50,000 rupees for presenting incorrect facts during the legal proceedings. The amount would be donated to a cancer treatment hospital, the board ordered.
Announcing the decision, Justice Prabha Sridevan said the kidney and liver cancer drug should be available at an affordable price to everybody.
Bayer said in a statement it 'strongly disagreed' with the conclusions of the board, adding that it would seek to challenge it at the High Court in Mumbai.
'The challenges faced by the Indian healthcare system have little or nothing to do with patents on pharmaceutical products as all products on India's essential drug list are not patented,' the company said.
Natco Pharma Company Secretary M. Adinarayana told reporters the board had delivered a 'reasoned, detailed' decision that could be 'sustained in any court of law'.
LEGAL SETBACKS
In a separate case, Bayer has accused another Indian drugmaker, Cipla, of infringing its patent on Nexavar. Cipla had launched its generic version of Nexavar before Natco won the compulsory license.
Cipla undercut Natco's price in May last year and now sells the drug at 6,840 rupees for a month's dose.
Among other setbacks for Western drug companies, India has revoked patents granted to Pfizer Inc's cancer drug Sutent, Roche Holding AG's hepatitis C drug Pegasys and Merck & Co's asthma treatment aerosol suspension formulation.
Another case involving drug patents is currently in front of the Supreme Court, with Novartis battling against an earlier decision refusing it a patent on cancer drug Glivec.
New Delhi has also taken other measures, such as controlling the prices of generic medicines and providing free medicines at government-run hospitals that cater to the country's poor.
Last week a government panel recommended a formula to curb prices of patented drugs to make them affordable for the world's second-most populous country.
($1 = 54.90 rupees)
(Additional reporting and writing by Kaustubh Kulkarni in MUMBAI; Editing by Alex Richardson)
Subscribe to:
Posts (Atom)