God, AIDS, Africa & HOPE

Reflections / Gedanken

08/28/2010 • 7:55 am Comments Off on POZ Magazine: New Strategy Could Eradicate Latent HIV-Infected Cells

POZ Magazine: New Strategy Could Eradicate Latent HIV-Infected Cells

Researchers report that they have taken the first step toward killing cells that are latently infected with HIV—cells that serve as a reservoir of persistent HIV reproduction and that current antiretroviral (ARV) drugs can’t reach. Their findings have been accepted by the open-access journal AIDS Research and Therapy.
Combination ARV therapy is incredibly potent. Numerous studies have shown that the therapies in widest use today can suppress all but the tiniest amount of HIV. However, the miniscule amount of HIV that remains—likely coming from reservoirs, such as resting CD4 cells, that aren’t always reached by ARV therapy—can completely reseed the body with virus as soon as a person stops taking his or her treatment.
Those resting cells have snippets of HIV DNA integrated into their own DNA, but they aren’t actively making new virus. Unfortunately, ARVs don’t affect cells that aren’t actively reproducing, and the amount of HIV DNA in the CD4s is so small that it doesn’t trigger the cell’s natural self-protection mechanism, which causes cells to self-destruct when their DNA gets altered too much.
Now, a group of Israeli researchers believes they have developed a method for getting to those latent cells and killing them. The group, led by Abraham Loyter, PhD, of Hebrew University in Jerusalem, is looking at ways to force the virus to integrate in multiple places in the cell’s DNA, triggering the cell’s chemical panic button and causing it to kill itself, a process called apoptosis.
Loyter and his colleagues developed two chemicals—dubbed INS and INrs peptides—that can prompt this process and combined them with an experimental protease inhibitor. The group then treated HIV-infected human immune cells for two weeks with the compounds, which they called the “mix.” Loyter’s group then allowed the remaining cells to grow out for an additional two weeks. HIV DNA levels were measured at three time points: before treatment with the mix, after two weeks of treatment, and then again two weeks after treatment was stopped.
Loyter’s team found that the “mix” worked as they’d hoped. After two weeks of treatment with the combination, no HIV DNA could be found, and this remained the case for an additional two weeks after the last dose of the treatment was added to the cells. The authors caution it is possible that some residual integrated HIV DNA was still present in the cells. Nevertheless, their results are encouraging.
“Stimulation of viral integration by the INS and INrs peptides, combined with the prevention of virion production by the protease inhibitor, not only resulted in blocking of HIV-1 infection but also in extermination of the infected cells by invoking apoptosis,” the authors concluded.
“Whilst this research is promising, a major caveat with these studies is that they are preliminary,” Loyter cautioned. “So far these experiments have only been shown to ‘cure’ HIV from small dishes of cultured cells in the authors’ laboratory, but the findings are an exciting development in the quest to eradicate this devastating global pandemic.”

Source: http://www.poz.com/rssredir/articles/hiv_mix_dna_761_18978.shtml

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

08/06/2010 • 10:50 pm Comments Off on POZ Magazine: Late HIV Diagnosis Is Substantially Higher in People Over 50

POZ Magazine: Late HIV Diagnosis Is Substantially Higher in People Over 50

Source: http://www.poz.com/rssredir/articles/hiv_age_older_761_18888.shtml

People age 50 and older are nearly 2.5 times more likely to be diagnosed late with HIV than younger adults, according to a study published in the August 24 issue of AIDS. What’s more, older people who are diagnosed late are 14 times more likely to die prematurely than people who are diagnosed promptly after infection.
Researchers are increasingly concerned about the HIV epidemic in older adults. For one thing, people are living much longer—and into old age—than in the early years of the epidemic. The Centers for Disease Control and Prevention estimates that by 2015 more than half of all adults living with HIV in the United States will be older than 50. Older adults are also becoming infected and getting diagnosed with HIV at increased rates.

A study published in the July 1 issue of the Journal of Acquired Immune Deficiency Syndromes indicated that older adults respond well to antiretroviral treatment, though CD4 responses to therapy were blunted in seniors diagnosed after the age of 50—likely because they were not tested earlier and entered care only after their CD4s were abnormally low.
Additional research has been needed to verify these observations, as most resources for testing and access to care are currently targeted toward younger adults.
To determine trends in HIV infection, diagnosis and mortality in older adults, Ruth Smith, a senior scientist at the Health Protection Agency Centre for Infections in London, and her colleagues conducted an analysis of epidemiological data on all adults 15 and older who were newly diagnosed or were accessing HIV-related care between 2000 and 2007 in England, Wales and Northern Ireland.

Adults 50 and older increased from 8.3 percent in 2000 to 9.7 percent in 2007, and the absolute number of older adults diagnosed with HIV more than doubled during the period from 2000 to 2007.
Smith and her colleagues found that late diagnosis was a serious problem overall, but particularly so for older people. While 48 percent of older adults had a CD4 count less than 200 at the time of diagnosis, this was true of only 33 percent of younger adults. Among men who have sex with men, the number of older men who were diagnosed late was nearly twice that of younger men: 40 percent compared with 21 percent. Older heterosexual women were about 50 percent more likely to present late as well.
Age also played a significant role in early mortality—older adults with a late HIV diagnosis were 2.4 times as likely to die within a year of diagnoses as younger adults. Smith’s team did not have sufficient data to ascertain the reasons for the increased risk in older adults. In addition, there was a decline between 2000 and 2007 in short-term mortality among younger adults diagnosed late with HIV disease, but no decline among older adults.

Another statistic makes painfully clear the need for greater early testing efforts in people older than 50. Older adults who were diagnosed with a CD4 cell count less than 200 were 14 times more likely to die within a year of diagnosis than those diagnosed promptly (14.4 percent versus 1 percent). While this study was conducted in Great Britain, similar data have been noted in the United States.
“These findings highlight the need for increased targeted prevention efforts and HIV testing strategies among older adults to ensure earlier testing and treatment and reduce transmission of HIV,” the authors concluded. “Adults aged 50 years and over account for a significant number of persons living with HIV in developed countries, and it is important that global and national surveillance outputs include older age groups.”

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

07/31/2010 • 7:43 pm Comments Off on POZ Magazine: Prevention Is Failing to Target MSM When They’re Young Enough

POZ Magazine: Prevention Is Failing to Target MSM When They’re Young Enough

If we are going to prevent HIV transmission in young men who have sex with men (MSM), we must find strategies to reach them when they are in their early teens. So say researchers who presented a study Monday, July 19, at the XVIII International AIDS Conference in Vienna.
HIV infection among young MSM is often a conundrum. Studies show that they understand what sexual acts place them at highest risk for HIV infection, but many engage in unprotected anal intercourse with other men of unknown HIV status. What is paradoxical and frustrating is that when prevention researchers ask the young men why they engaged in high-risk behaviors, they typically respond that they didn’t think that what they were doing would lead to becoming infected.
To better understand the context behind this kind of reasoning, D. Dennis Flores III, from Emory Healthcare in Atlanta and his colleagues conducted interviews with 10 young MSM from that city who had recently been diagnosed with HIV. Nine of the men were African American, and one was Latino. Their ages ranged from 18 to 24. The interviews with the young men covered four topic areas: risk behavior, HIV education, the Internet and healthy role models.
As has been found in previous studies, the majority of the young men had viewed themselves as either unlikely or very unlikely to contract HIV in their lifetimes, and half reported experiencing coercion and sexual abuse at the time of sexual initiation.
One 18-year-old participant, Nathaniel, described his own sexual initiation: “I had to be around 13… He worked at my school, he was around 30, a janitor. He was always nice to me for no reason. I mean, I kind of guessed it after a while. He would talk to me. One day I just left school with him. The most we ever did was oral; we didn’t do anything else. But after that, like, he tried talking to me more about leaving school. I really didn’t like him after that.”
Flores and his colleagues found that while all the young men had undergone sex education while in middle school or high school, none reported that these classes included information about gay sex. Moreover, only one of the young men reported having any gay role models while growing up. This meant that relevant sex education occurred on the Internet, which from a sexual risk perspective, can be quite perilous. When these young men went online, most of them saw graphic high-risk sexual encounters, and this behavior quickly became what they perceived as normal and desirable.
“[The Internet] sure has taught me a lot of tricks,” explained 24-year-old Adrien. “Things that I never thought were humanly possible. It gave me a reference. I guess it was kind of revolutionary for me ’cause I’d never seen two men, like, actually get enjoyment out of it. So it was like getting exposed to that was, like, wow, you know…different.”
One of the most important findings, said Flores, was that by the time the young men encountered prevention messages and programs targeted to young gay men, higher-risk sexual activity had already become the norm. For some, they contracted HIV before having ever encountered targeted prevention information.
Flores concluded his presentation by stressing that targeted education, focused on young MSM, should be occurring as early as elementary or middle school and that parents should be taught to be supportive and to teach their sons how to avoid sexual coercion. Moreover, Flores’s team recommends engaging young MSM who are out about their sexual orientation to serve as peer educators and role models for other young men. Lastly, Flores stressed the critical need to use new technologies online to reach young MSM with prevention methods before it is too late.

by David Evans

Source: http://www.poz.com/rssredir/articles/hiv_young_gay_761_18855.shtml

Filed under: HIV and AIDS, HIV Prevention, Medical and Research, Society and living environment, , , , , ,

07/22/2010 • 9:00 pm Comments Off on 22.07.2010 and more contemplations on the World AIDS Conference in Vienna

22.07.2010 and more contemplations on the World AIDS Conference in Vienna

Discussion this morning with several people about our experience with the World AIDS Conference this year. The quality of the presentations was one discussion point. It came to mind a presentation about research work with commercial sex workers in an African country. The well-funded research’s conclusion was that a. there must be more research and b. that commercial sex workers are in need of special interventions.
Well, I am sure I would come to this conclusions without any research study – lots of money saved for more deserving purposes. Follow up questions: Who is monitoring and evaluation the proposals and giving the go-ahead for such research? Or was the presentation itself the week point?  General question: Is there somehow not the self inventing and containing wheel of research out of research for the purpose of research and justifying the own existence in this field?

Some presentations I heard have not really changed over the years: the same countries, the same sort of overflowing Power Point presentations, squeezing as many words as possible on one slide – have there be no developments in these countries/fields/outreach programmes?

It was good to see and hear about the GUS countries and problems in Russian speaking countries – for contents, but also for the sole purpose to bring new faces and a new dynamic to the conference.

Once again the lack of the engagement of official churches which are doing a big part of the work in this field was noticable. Additional the prayer room /room of silence was – and I apologise already here if I step on someones toes – a disgrace in itself. I was shocked to see it.

But after all this criticism also positive aspects of the conference: One always learns something, the exchange with people around the world, the sideline sessions, one sometimes bumps into going through the Global Village – excellent presentations I have seen and heard there . The dedication of the people standing  next to their poster presentations to answer questions or standing for hours in their respective boot to engage with the visitors – they all have my respect.
Some presentations have been standing – and one can learn that even academics are indeed able to present a complicated issue in a way that at least a non medical person gets the picture, paired with some anecdotes to make you smile in between.
My experience of the registration process was great – recalling the long queues of Toronto….

I have been reminded once again how the pandemic has changed the world and how brave men and women, infected and affected fight it with affection and with so much empathy for those who have no voice in this world.

Encouraging research (one would always hope for more), optimism paired with realism – setting goals and going home with the dream and the will to work hard to achieve it. At the end the experience at such a big conference is always mixed, but: I was privileged to be here, I am grateful for all the experience and I already have an idea about 2012 in Washington.

Which means in conclusion: The conference has still a meaning for me, but we have to streamline and look out, the we watch out to use our financial resources meaningful and that “politics” do not interfere with the judgement of who is able to present and share experience and knowledge.

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

07/22/2010 • 12:53 am Comments Off on 21.07.2010 Thoughts about Vienna and the International AIDS Conference

21.07.2010 Thoughts about Vienna and the International AIDS Conference

In two days the International AIDS Conference is history again and I am sure once again we will not have reached the goal of the conference as it has been also the case for the previous conferences. Who does not remember the “Access for all” slogan -to be reached by 2010.. We have 2010 and even as we have made great progress.. we have a long way to go to reach the “Access for all – Treatment for all” goal.

Bill Clinton made it in his speech clear that in the times, where financial promises are emptied by the so-called circumstances that on the other hand too many people fly to too many conferences. I must admit that I am often also amazed how many people attending from one organisation and how many see such conferences as their chance to go on an oversea trip. I am not sure that the way, the conference is organised and the millions on sponsor money is spent to fly people from so many different backgrounds to one venue – the lady looking after a vegetable project and the highly skilled researcher – and when I see the first sitting in a talk given by the latter:  not sure it makes sense or has any meaning.
On the other hand, yes, it is an opportunity to network, seen and be seen and somehow I have the impression, lots of small NGO”s draw part of their pride to have a stall at the Global Village and some photographic memories. And this has its own rights, as many for the first time understand the scale of engagement worldwide.

So I don’t have plan B to suggest how to organise such a conference in a way which does not waste too much sponsor money – lack of resources let people die..  and we as activists cannot blame pharmaceutical companies and politicians if we don’t reflect on how we organise ourselves.

The main topic this time is human rights and HIV / AIDS. There is indeed a lot to do. And here are also the churches asked to contribute more, they see themselves in our days as advocates for human rights, but here it gets tricky: gender equality, homosexuality, sexual behaviour and culture are only some to the topics which make it difficult for some churches to engage in a more decisive way for the good of those, whose human rights are at stake.

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

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