God, AIDS, Africa & HOPE

Reflections / Gedanken

11/24/2010 • 7:58 pm Comments Off on POZ Magazine: Protein Discovery Helps Explain the Body’s Failure to Kill HIV

POZ Magazine: Protein Discovery Helps Explain the Body’s Failure to Kill HIV

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Researchers at Rush University Medical Center in Chicago have discovered a protein produced by HIV that keeps infected cells from signaling the  immune system that they are harboring the virus and should be killed. These data, which suggest a new target for HIV  drugs, were published online October 18 in the journal Cell Host & Microbe and are discussed in a release available at EurekAlert.
Among the most powerful tools in the immune system’s toolbox for killing infected or defective cells are natural killer (NK) cells. They are unlike HIV-specific CD8 cells, which require a lot of stimulation by other parts of the immune system before they can go into action. NK don’t require virus-specific stimulation before they can recognize and kill infected cells. Yet, for reasons not fully understood, they don’t work the way they should against HIV.

Given the potency of NK cells, and their potential to run amok and kill healthy cells, they must first encounter three different types of proteins on the surface of a potentially infected cell. First, an infected cell needs to express a type of receptor called a major histocompatibiliy (MHC) receptor, which indicates that the cell belongs to the person. The NK cell must also encounter a stimulatory molecule and a costimulatory molecule on the target cell’s surface. If all three of these molecules are present and bind to the corresponding NK cell receptors, then the NK cell will release a chemical that degrades the infected cell.
During the past two decades, immunologists have investigated how NK cells interact with HIV-infected cells, but researchers have long been baffled by a key finding. While the kinds of cellular proteins that are supposed to flag the cell for destruction do get made during the HIV replication process and travel to the surface of the cell, NK cells still fail to recognize and kill them.
It turned out that yet another type of protein called Natural killer T-cell and B-cell Antigen (NTB-A) is also needed at the cell’s surface to alert NK cells that the cell is infected and needs to be destroyed. In the case of HIV, the NTB-A didn’t make it to the surface. Researchers, however, found that HIV did not directly suppress the NTB-A. So why didn’t it make it to the surface to alert the killer cells?
Ankur Shah, PhD, from Rush University, and his colleagues now think they know the answer. Shah’s team found that an accessory protein made by HIV, called Vpu, keeps NTB-A from reaching the cell’s surface. Shah’s team proved this by altering the Vpu protein made by HIV in cells in test tubes and then observing what happened when they added NK cells. The NK cells were 100 times as likely to recognize and kill cells infected with HIV that produced the defective Vpu protein than those infected with HIV that produced the normal Vpu protein.  “With this information, we now have a major new target for drug therapies

Source:   http://www.poz.com/rssredir/articles/hiv_vpu_nkcells_761_19447.shtml

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , ,

11/18/2010 • 5:44 am Comments Off on HIV prevalence is going nowhere in South Africa

HIV prevalence is going nowhere in South Africa

Results of the 20th antenatal surveillance survey, which were released this week, show that South Africa’s HIV epidemic is not gaining nor is it slowing down. But does this mean that the country’s efforts in combating HIV are paying off?
Every year over a period of one month, pregnant women between the ages of 15 – 49 attending selected public antenatal care clinics in the country’s 52 health districts take part in an anonymous HIV testing programme. This is for the annual antenatal HIV surveillance survey which helps the Health Department project the prevalence of the epidemic in the general population, so it can develop policy and plan interventions. The survey for 2009 involved 33 000 women and shows very little difference from the previous four years, during which prevalence has hovered around 29%.
“By 2009, we have got 29.4 percentage prevalence. From 2006, nothing is changing in terms of prevalence. Actually, it has flattened out”, said Health Minister Dr Aaron Motsoaledi, announcing the results at Birchwood hotel, near the Johannesburg International Airport.
“Why is it important?” , Motsoaledi asked. “By 1990, the prevalence was only 0.7% and it kept on going high and high until it reached a peak of 30 by 2003. From 2005 or so, it started getting flat. We don’t know for how long it will stay flat, but it’s like that. There’s no change in terms of the prevalence in the general population of antenatal women”, he said.
Although the epidemic seems to be stagnant, the survey shows a difference of HIV distribution among different age groups. At a high level of 21.7%, HIV prevalence among pregnant women between the ages of 15 – 24 is unchanged from the 2008 finding. However, infection is increasing among older women. HIV prevalence levels among the 15 – 24 year age group have to drop drastically in order to show that the country’s efforts are making a dent on HIV distribution. The level of prevalence in this age group is also a marker in the Millennium Development Goal specific to reducing HIV.
“Our MDG baseline is 21.7%. By 2015, this must go to 17.3%. This is the most important group to use to provide evidence when monitoring new HIV infections incidence. The 15 – 24 year olds is a very important group to us to tell us what’s happening. These are still very young (women) who are falling pregnant for the first time. These are new entrants and what is happening to them is a good reflection of showing the changes in terms of the prevalence”, the Health Minister said.
The only group where HIV prevalence is not stagnant is the 30 – 34 year age group. “It has increased to 41.5% in 2009. This age group, which is the hardest hit is moving from 39.6%, 40.4%”, he said. The World Health Organisation’s Dr Patrick Abok interprets the finding.  “We are seeing a lot of people now having access to treatment and care, which means that many people now are trying to know their status and be able to come early and have access to treatment and care. The other element is regarding the awareness… having people who know they are HIV-positive and knowing where to go and seek treatment, and in that way, it positively is affecting their lifestyle in terms of now trying to live longer. So, we are bound to see that number increasing simply because it means that the number of people who have access to treatment, very few of them will be dying. The longer they live that means the more people in that category, the more the prevalence”, said Dr Abok.
Deputy chair-person of the South African National AIDS Council (SANAC), Mark Heywood, described the results as being “fairly predictable”. Heywood said the report suggests that the country is not doing well to prevent new HIV infections. “We’re not getting on top of the HIV epidemic, at least, as far as prevention is concerned. It shows that there is still very high numbers of new HIV infections and it shows that we have a growing number of people living with HIV in this country because of the combination of new infections and people who are now living as a result of antiretroviral treatment. I wouldn’t say that it points to our failures, but it points to our short-comings and our inadequacies, and it tells the Department of Health and SANAC that they have to do more to get this thing right, and, actually, we’re not getting it right this moment in time”, Heywood said.
As usual, KwaZulu-Natal has the highest HIV prevalence, followed by Mpumalanga and the Free State. The lowest prevalence – below 20% – is in the Northern and Western Capes, while the North West, Gauteng, Limpopo and the Eastern Cape have a prevalence level of between 20 – 30%. Prevalence levels also vary within provinces, with certain districts ranking higher than others.
Source”
ihttp://www.health-e.org.za/news/article.php?uid=20033008

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, Politics and Society, , , , , , , ,

11/07/2010 • 10:52 am Comments Off on 07.11.2010 AIDS Gala Berlin – and where is the bishop?

07.11.2010 AIDS Gala Berlin – and where is the bishop?

Again, I am guest at the German AIDS Gala in Berlin, the 17th of its kind. And again the German Oper Berlin is booked out and masses of people are flocking to attend this prestigious event. Michaela from Dresden is accompanying me to this event and after being picked up by the Shuttle Service at the hotel, it is once again a funny feeling to take the red carpet, letting the journalists and photographers guess who the couple is.. 🙂 Being asked how I felt about the feature of myself and HOPE Cape Town in the Berliner Morgenzeitung I must admit that I even didn’t know about it – nobody told me. Quick I realise that HOPE Cape Town will feature prominently this eve as one of the projects sponsored by the German AIDS Foundation. Brief chats with Her Highness, the Begum Aga Khan, the National foreign Minister Guido Westerwelle and his husband and others from the Board of Trustees follow before the programme starts. And as now expected, the chairperson of the board of trustees of the German AIDS Gala in Berlin, the Begum Aga Khan tells the audience about her visit at HOPE Cape Town last year – a film shows her and me visiting the Ithemba Ward and I wish all our HOPE Community Health Workers, senior staff and management could hear the applause as she congratulates the projects and the priest for their work down there in the Western Cape. These are moments were I would love to beam myself away for the time being – sometimes it is interesting enough for me difficult to hear public praise. But it is also the feeling of encouragement present.

The programme contains great opera – I do enjoy it and when the Opera Children’s choir sings “Laudate Domino” I suddenly realise that there is no official representative of the church. And if feels suddenly so completely wrong: National ministers, certainly all important people of the local and national business world, politicians and artists are present – showing their committment towards the battle against a pandemic which changed the world – celebrating also partly a project, which originated and is still support by a German-speaking Catholic community and no representative of my church is present. And I suddenly realise that also in Dresden the last five years there was no-show of the local bishop or his representative. The sorrows and the joy of the people are the sorrows and the joy of us Christians – I ask myself whether it is not poor judgement to be not present visible as a church at major events where people from so different walks of life unify and come together in this important cause. I suddenly feel sad a moment, but then the joy of the choir carries me away from it.

Congratulations to the German AIDS Foundation and all its helper for this great eve – and I am grateful that within one week I am able to attend to major fundraising galas bringing hope and future again to South Africa. A big part of the proceeds of Berlin are also going to HOPE Cape Town and supporting our work. Deo gratias.

Filed under: HIV and AIDS, HOPE Cape Town Association & Trust, Medical and Research, Networking, Reflection, Society and living environment, , , , , , , , , , , , , , ,

10/24/2010 • 9:50 pm Comments Off on POZ Magazine: New Study Challenges Assumptions About HIV Treatment as Prevention

POZ Magazine: New Study Challenges Assumptions About HIV Treatment as Prevention

A new Chinese study conducted among heterosexual couples of mixed HIV status found that antiretroviral (ARV) therapy does not substantially reduce the risk of HIV transmission in a real-world setting. The study, published October 1 in the Journal of Acquired Immune Deficiency Syndromes, and reported by aidsmap, suggests that more data might be needed before rushing to roll out HIV treatment-as-prevention programs around the globe.
Treatment-as-prevention rests on a fairly well-established theory that when ARV therapy reduces an HIV-positive person’s viral load, he or she will be less likely to transmit the virus to sex partners. While this has been noted for nearly a decade, the strategy has received increasing attention in light of recent studies showing a reduction in HIV transmission in both San Francisco and Vancouver, two cities where an increasing number of HIV-positive people have received ARV therapy and the average community viral loads have dropped substantially.

To test this theory further, researchers looked at HIV transmission rates among 1,927 mostly monogamous couples in the Henan province of China, where one of the partners had HIV and the other did not. Many people in this province became infected from tainted equipment used for blood donations.
Surprisingly, the researchers found that there was no statistically meaningful difference in the rate of transmission in the couples whose HIV-positive partner was on ARV therapy (3 percent transmission) compared with couples where the HIV-partner was not on treatment (5 percent transmission).
The study’s authors acknowledge that poor adherence could have contributed to the failure to find that ARV therapy reduced transmission risk. Nevertheless, aidsmap reports that Myron Cohen, MD, from the University of North Carolina in Chapel Hill said in an accompanying editorial that the study results “demand a giant pause.”
“Will ART suppress transmission of HIV under ‘real life’ conditions?” he asks. “[I]t seems wise to try and answer this question before we fully deploy a ‘Test and Treat strategy,’ expecting to detect a benefit to the general population.”

Source:  http://www.poz.com/rssredir/articles/hiv_china_prevention_761_19254.shtml

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, , , ,

10/16/2010 • 3:14 pm Comments Off on POZ Magazine: Forecasting the Future of HIV

POZ Magazine: Forecasting the Future of HIV

As much as $722 billion might be needed to tackle HIV by 2031, if no cure or vaccine is found, according to new research published in The Lancet and reported by PlusNews. Study authors predict that in the next 20 years, annual HIV infections will be halved to about 1.2 million. However, new treatment guidelines will raise costs by 43 percent, and about one third of funding must be spent in Africa to stop the epidemic.  Researchers noted that the amount of money needed could drop to $400 billion if countries restructured their AIDS funding policies now.

To read the PlusNews story, click here.

Source: http://www.poz.com/rssredir/articles/Future_OF_HIV_1_19243.shtml

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, Politics and Society, , , , , ,

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