God, AIDS, Africa & HOPE

Reflections / Gedanken

07/08/2010 • 3:38 pm Comments Off on POZ: HIV Stem Cell Therapy in Mice Is Successful

POZ: HIV Stem Cell Therapy in Mice Is Successful

Source: http://www.poz.com/rssredir/articles/hiv_zincfinger_sangamo_761_18693.shtml

Researchers are reporting that a new method for altering the genes of immune cells to make them resistant to HIV infection was a success in mice. The study was published online on July 2 in the journal Nature Biotechnology.
The new type of therapy, which treats stem cells with engineered zinc-finger nucleases, is designed to help the body grow new CD4 cells that don’t carry one of the key coreceptors—CCR5—that HIV requires to enter and infect a cell. In this experiment, Nathalia Holt, PhD, from the Keck School of Medicine at the University of Southern California at Los Angeles, and her colleagues compared two groups of mice that are bred to have a human immune system. The first group was given untreated stem cells. The second group received a batch of zinc-finger-treated cells.
Holt’s team found that the treated stem cells multiplied rapidly in the mice and were highly resistant to HIV infection. By comparison, the untreated cells did not spawn HIV-resistant cells, and the mice who receive the untreated cells experienced HIV-related CD4 cell losses, indicative of disease progression.
Sangamo BioSciences is developing this therapy, and small exploratory studies of zinc-finger therapy are already taking place in humans.

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

07/03/2010 • 10:33 am Comments Off on Vienna Declaration Seeks Changes to “War on Drugs”

Vienna Declaration Seeks Changes to “War on Drugs”

Please read and sign the Vienna Declaration on: http://www.viennadeclaration.com/the-declaration.html

———————————–

The Vienna Declaration

The criminalisation of illicit drug users is fuelling the HIV epidemic and has resulted in
overwhelmingly negative health and social consequences. A full policy reorientation is needed.

In response to the health and social harms of illegal drugs, a large international drug prohibition regime has been developed under the umbrella of the United Nations.1 Decades of research provide a comprehensive assessment of the impacts of the global “War on Drugs” and, as thousands of individuals gather in Vienna at the XVIII International AIDS Conference, the international scientific community calls for an acknowledgement of the limits and harms of drug prohibition, and for drug policy reform to remove barriers to effective HIV prevention, treatment and care.

The evidence that law enforcement has failed to prevent the availability of illegal drugs, in communities where there is demand, is now unambiguous.2, 3Over the last several decades, national and international drug surveillance systems have demonstrated a general pattern of falling drug prices and increasing drug purity—despite massive investments in drug law enforcement.3,4

Furthermore, there is no evidence that increasing the ferocity of law enforcement meaningfully reduces the prevalence of drug use.5 The data also clearly demonstrate that the number of countries in which people inject illegal drugs is growing, with women and children becoming increasingly affected.6 Outside of sub-Saharan Africa, injection drug use accounts for approximately one in three new cases of HIV.7, 8 In some areas where HIV is spreading most rapidly, such as Eastern Europe and Central Asia, HIV prevalence can be as high as 70% among people who inject drugs, and in some areas more than 80% of all HIV cases are among this group.8

In the context of overwhelming evidence that drug law enforcement has failed to achieve its stated objectives, it is important that its harmful consequences be acknowledged and addressed. These consequences include but are not limited to:

  • HIV epidemics fuelled by the criminalisation of people who use illicit drugs and by prohibitions on the provision of sterile needles and opioid substitution treatment.9, 10
  • HIV outbreaks among incarcerated and institutionalised drug users as a result of punitive laws and policies and a lack of HIV prevention services in these settings.11-13
  • The undermining of public health systems when law enforcement drives drug users away from prevention and care services and into environments where the risk of infectious disease transmission (e.g., HIV, hepatitis C & B, and tuberculosis) and other harms is increased.14-16
  • A crisis in criminal justice systems as a result of record incarceration rates in a number of nations.17, 18 This has negatively affected the social functioning of entire communities. While racial disparities in incarceration rates for drug offences are evident in countries all over the world, the impact has been particularly severe in the US, where approximately one in nine African-American males in the age group 20 to 34 is incarcerated on any given day, primarily as a result of drug law enforcement.19
  • Stigma towards people who use illicit drugs, which reinforces the political popularity of criminalising drug users and undermines HIV prevention and other health promotion efforts.20, 21
  • Severe human rights violations, including torture, forced labour, inhuman and degrading treatment, and execution of drug offenders in a number of countries.22, 23
  • A massive illicit market worth an estimated annual value of US$320 billion.4 These profits remain entirely outside the control of government. They fuel crime, violence and corruption in countless urban communities and have destabilised entire countries, such as Colombia, Mexico and Afghanistan.4
  • Billions of tax dollars wasted on a “War on Drugs” approach to drug control that does not achieve its stated objectives and, instead, directly or indirectly contributes to the above harms.24

Unfortunately, evidence of the failure of drug prohibition to achieve its stated goals, as well as the severe negative consequences of these policies, is often denied by those with vested interests in maintaining the status quo.25This has created confusion among the public and has cost countless lives. Governments and international organisations have ethical and legal obligations to respond to this crisis and must seek to enact alternative evidence-based strategies that can effectively reduce the harms of drugs without creating harms of their own. We, the undersigned, call on governments and international organisations, including the United Nations, to:

  • Undertake a transparent review of the effectiveness of current drug policies.
  • Implement and evaluate a science-based public health approach to address the individual and community harms stemming from illicit drug use.
  • Decriminalise drug users, scale up evidence-based drug dependence treatment options and abolish ineffective compulsory drug treatment centres that violate the Universal Declaration of Human Rights.26
  • Unequivocally endorse and scale up funding for the implementation of the comprehensive package of HIV interventions spelled out in the WHO, UNODC and UNAIDS Target Setting Guide.27
  • Meaningfully involve members of the affected community in developing, monitoring and implementing services and policies that affect their lives.

We further call upon the UN Secretary-General, Ban Ki-moon, to urgently implement measures to ensure that the United Nations system—including the International Narcotics Control Board—speaks with one voice to support the decriminalisation of drug users and the implementation of evidence-based approaches to drug control.28

Basing drug policies on scientific evidence will not eliminate drug use or the problems stemming from drug injecting. However, reorienting drug policies towards evidence-based approaches that respect, protect and fulfil human rights has the potential to reduce harms deriving from current policies and would allow for the redirection of the vast financial resources towards where they are needed most: implementing and evaluating evidence-based prevention, regulatory, treatment and harm reduction interventions.

EFERENCES
1. William B McAllister. Drug diplomacy in the twentieth century: an international history. Routledge, New York, 2000.
2. Reuter P. Ten years after the United Nations General Assembly Special Session (UNGASS): assessing drug problems, policies and reform proposals. Addiction 2009;104:510-7.
3. United States Office of National Drug Control Policy. The Price and Purity of Illicit Drugs: 1981 through the Second Quarter of 2003. Executive Office of the President; Washington, DC, 2004.
4. World Drug Report 2005. Vienna: United Nations Office on Drugs and Crime; 2005.
5. Degenhardt L, Chiu W-T, Sampson N, et al. Toward a global view of alcohol, tobacco, cannabis, and cocaine use: Findings from the WHO World Mental Health Surveys. PLOS Medicine 2008;5:1053-67.
6. Mathers BM, Degenhardt L, Phillips B, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: A systematic review. Lancet 2008;372:1733-45.
7. Wolfe D, Malinowska-Sempruch K. Illicit drug policies and the global HIV epidemic: Effects of UN and national government approaches. New York: Open Society Institute; 2004.
8. 2008 Report on the global AIDS epidemic. The Joint United Nations Programme on HIV/AIDS; Geneva, 2008.
9. Lurie P, Drucker E. An opportunity lost: HIV infections associated with lack of a national needle-exchange programme in the USA. Lancet 1997;349:604.
10. Rhodes T, Lowndes C, Judd A, et al. Explosive spread and high prevalence of HIV infection among injecting drug users in Togliatti City, Russia. AIDS 2002;16:F25.
11. Taylor A, Goldberg D, Emslie J, et al. Outbreak of HIV infection in a Scottish prison. British Medical Journal 1995;310:289.
12. Sarang A, Rhodes T, Platt L, et al. Drug injecting and syringe use in the HIV risk environment of Russian penitentiary institutions: qualitative study. Addiction 2006;101:1787.
13. Jurgens R, Ball A, Verster A. Interventions to reduce HIV transmission related to injecting drug use in prison. Lancet Infectious Disease 2009;9:57-66.
14. Davis C, Burris S, Metzger D, Becher J, Lynch K. Effects of an intensive street-level police intervention on syringe exchange program utilization: Philadelphia, Pennsylvania. American Journal of Public Health 2005;95:233.
15. Bluthenthal RN, Kral AH, Lorvick J, Watters JK. Impact of law enforcement on syringe exchange programs: A look at Oakland and San Francisco. Medical Anthropology 1997;18:61.
16. Rhodes T, Mikhailova L, Sarang A, et al. Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliatti City, Russian Federation: a qualitative study of micro risk environment. Social Science & Medicine 2003;57:39.
17. Fellner J, Vinck P. Targeting blacks: Drug law enforcement and race in the United States. New York: Human Rights Watch; 2008.
18. Drucker E. Population impact under New York’s Rockefeller drug laws: An analysis of life years lost. Journal of Urban Health 2002;79:434-44.
19. Warren J, Gelb A, Horowitz J, Riordan J. One in 100: Behind bars in America 2008. The Pew Center on the States Washington, DC: The Pew Charitable Trusts 2008.
20. Rhodes T, Singer M, Bourgois P, Friedman SR, Strathdee SA. The social structural production of HIV risk among injecting drug users. Social Science & Medicine 2005;61:1026.
21. Ahern J, Stuber J, Galea S. Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence 2007;88:188.
22. Elliott R, Csete J, Palepu A, Kerr T. Reason and rights in global drug control policy. Canadian Medical Association Journal 2005;172:655-6.
23. Edwards G, Babor T, Darke S, et al. Drug trafficking: time to abolish the death penalty. Addiction 2009;104:3.
24. The National Centre on Addiction and Substance Abuse at Columbia University (2001).  Shoveling up: The impact of substance abuse on State budgets.
25. Wood E, Montaner JS, Kerr T. Illicit drug addiction, infectious disease spread, and the need for an evidence-based response. Lancet Infectious Diseases 2008;8:142-3.
26. Klag S, O’Callaghan F, Creed P. The use of legal coercion in the treatment of substance abusers: An overview and critical analysis of thirty years of research. Substance Use & Misuse 2005;40:1777.
27. WHO, UNODC, UNAIDS 2009. Technical Guide for countries to set targets for universal access to HIV prevention, treatment and care for injection drug users.
28. Wood E, Kerr T. Could a United Nations organisation lead to a worsening of drug-related harms? Drug and Alcohol Review 2010;29:99-100.

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

06/19/2010 • 2:44 pm 3

POZ Magazine: AIDS Draws “Red Card” at World Cup

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has launched its “red card” campaign with the support of international soccer stars “to ensure an HIV-free generation by the 2014 FIFA World Cup” in Brazil, according to a UNAIDS statement. The goal is to eliminate the transmission of HIV from mother to child. The campaign title refers to the red card a soccer referee gives a player to eject him or her from a game.

The UNAIDS statement:

New global initiative at the FIFA World Cup shines spotlight on the elimination of mother-to-child transmission of HIV

JOHANNESBURG, 12 June 2010—A new campaign is using the power and outreach of football to unite the world around a common cause—preventing the transmission of HIV from mother to child. Launched today in South Africa by the UNAIDS Executive Director, Michel Sidibé, international musician Akon, UNAIDS Goodwill Ambassador and producer of the World Cup opening ceremony, Lebo M, UNAIDS National Goodwill Ambassador, Jimmie Earl Perry, and Kirsten Nematandani, President of the South African Football Association. The campaign aims to ensure an HIV-free generation by the 2014 FIFA World Cup to be held in Rio de Janeiro, Brazil.

Each year, an estimated 430 000 babies are born with HIV globally, the large majority in Africa. Over the course of a 90-minute football match, nearly 80 babies will become newly infected with HIV. In many parts of Africa, AIDS-related illness is the leading cause of death among infants and young children.

Through the campaign—backed by international football stars and UNAIDS Goodwill Ambassadors Michael Ballack of Germany and Emmanuel Adebayor of Togo—captains of 32 World Cup qualifying teams have been invited to sign the appeal: “From Soweto to Rio de Janeiro, give AIDS the red card and prevent babies from becoming infected with HIV.” Nineteen captains have already signed on, including host country South Africa and defending champion Italy.

“By the next football World Cup we can virtually eliminate HIV transmission to babies,” said UNAIDS Executive Director Michel Sidibé who attended the campaign launch in South Africa. “Let us give AIDS the red card permanently.”

The lives of mothers and their babies can be saved through a combination of HIV testing and counselling, access to effective antiretroviral prophylaxis and treatment, safer delivery practices, family planning, and counselling and support for optimal infant feeding practices.

An estimated 33.4 million people are living with HIV worldwide. Since 2001, there has been a 17% reduction in new HIV infections globally. However, for every two people who access antiretroviral treatment, five more become newly infected with HIV.

Contact:

UNAIDS New York | Richard Leonard | +1 646 666 8003 | LeonardR@unaids.org
UNAIDS South Africa | Sheba Okwenje | +127 11 517 1634 | okwenjeb@unaids.org

Source: http://www.poz.com/rssredir/articles/unaids_red_card_1_18571.shtml

http://www.unaids.org/en/KnowledgeCentre/Resources/PressCentre/PressReleases/2010/20100601redcard.asp

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

06/13/2010 • 3:16 pm Comments Off on POZ magazine: Anal Warts Should Be Tested for Cancerous Cells

POZ magazine: Anal Warts Should Be Tested for Cancerous Cells

Anal warts in men who have sex with men (MSM) often contain cancerous and precancerous cells, an “unsettling” finding of a study reported in the July 1 issue of Clinical Infectious Diseases. The authors indicate that simply treating anal warts isn’t enough among MSM—they should be surgically removed and tested for high-grade cells that can potentially cause serious disease. Anal warts are typically caused by two non-cancerous strains of the same virus: human papillomavirus (HPV) types 6 and 11. Because of the perceived low risk of serious disease, many people with anal warts avoid treatment or opt for less invasive ablation procedures, such as cryotherapy (freezing the warts) or laser removal. The new findings, reported by Hans Schlecht, MD, of Drexel University College of Medicine in Philadelphia and his colleagues, suggest that surgical removal may be necessary in order to test for pre-cancerous and cancerous clusters within the warts. These high-grade patches of cells are often caused by two cancerous HPV strains, types 16 and 18. The study conducted by Schlecht’s group was designed to look for hidden, or “occult,” pre-cancerous or cancerous cells in anal warts surgically removed from 320 MSM. Fifty percent of the men enrolled in the study were living with HIV. About 34 percent of the men had anal warts containing pre-cancerous cells. In fact, 3 percent of the men were found to have anal cancer. The high-grade cells were more likely to be documented in the warts taken from the HIV-positive men—47 percent compared with 26 percent of the HIV-negative men in the study. What’s more, seven of the eight men in the study diagnosed with anal cancer were coinfected with HIV. Unfortunately, neither a high CD4 cell count nor an undetectable viral load appeared protective against pre-cancerous and cancerous lesions among the HIV-positive men in the study. CD4 cell counts averaged 431, and about 50 percent of the men had viral loads below the level of detection at the time the high-grade lesions were detected. “The present study demonstrates that, in a large urban population of MSM, condylomata [anal warts] requiring surgical excision frequently harbored occult high-grade anal intraepithelial neoplasia or anal squamous cell cancer,” the authors concluded. “These data emphasize the importance of obtaining tissue for histopathological examination in MSM presenting for treatment of anogenital condylomata. Prevention of recurrences and careful clinical follow-up of anal condylomata harboring high-grade anal intraepithelial neoplasia may be a method of anal cancer prevention in MSM, particularly in those with HIV infection.”

Source: http://www.poz.com/rssredir/articles/anal_warts_neoplasia_761_18534.shtml

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

06/12/2010 • 1:07 am Comments Off on POZ magazine: Fatigue Common in People With HIV, Often Linked to Psychological Factors

POZ magazine: Fatigue Common in People With HIV, Often Linked to Psychological Factors

Up to 88 percent of people with HIV experience fatigue, and psychological problems appear to be one of the most likely culprits, according to a study published online June 2 in AIDS. Fatigue has historically been a common problem among people living with HIV, with prevalence rates approaching 90 percent in some studies. Untreated fatigue can lead to unemployment and social isolation, and it can reduce people’s ability to effectively care for themselves. To examine fatigue in HIV disease in the modern treatment era, Eefje Jong, MD, of Slotervaart Hospital in Amsterdam, and her colleagues analyzed data from 42 studies published between January 1996 and August 2008. In addition to wanting to learn more about the prevalence of fatigue in more recent years, the researchers set out to understand the factors—including demographic, physiological, psychological and HIV-specific issues—associated with the condition. They also hoped to gain a better sense of the most effective treatment modalities for the condition. In previous studies, researchers have found that between 20 and 60 percent of people with chronic HIV infection, and up to 85 percent of people with an AIDS diagnosis, have suffered from fatigue at one time or another. In the studies reviewed for Jong and her colleagues’ analysis, fatigue prevalence rates ranged from 33 to 88 percent. The demographic factors most consistently predictive of fatigue were younger age and unemployment. The authors hypothesized that older people might report less fatigue because they had more effective coping strategies or more time to adjust to medication regimens. Studies that examined race, sex and income were not consistent, though lower income was associated with greater fatigue in at least one study. In terms of HIV-related issues, CD4 and viral load were not consistently linked with fatigue, though people with more HIV-related symptoms were more likely to have the condition. Studies on comorbid conditions—such as diabetes and hepatitis B or C—were mixed, with some studies finding a connection with fatigue and others showing no connection at all. Surprisingly, body weight and composition appeared to have no bearing on fatigue, nor did blood levels of proteins related to inflammation, such as interleukin-6 (IL-6) or tumor necrosis factor (TNF) alpha. Some studies showed that lower testosterone levels predicted fatigue, but others did not. Of all the factors considered, psychological disorders—particularly depression and anxiety—had the strongest and most consistent connection with fatigue. Sleep problems also predicted fatigue. Though the total hours a person slept didn’t have an impact, people who napped during the daytime were more likely to suffer with the problem. Finally, while a number of treatments for fatigue were explored in the studies, medication was not consistently helpful. Medications with the strongest evidence of fatigue treatment were testosterone and psychostimulants, including Adderall (dextroamphetamine) and Ritalin (methylphenidate hydrochloride). Non-medicinal interventions were more helpful, however, especially cognitive behavioral therapy. Graded exercise therapy (GET) is another possible option to fight fatigue. With GET, a person logs his or her daily activity and increases it to the point where the exercise begins to worsen symptoms. GET has been successful in HIV-negative people with chronic fatigue syndrome, but no good recent studies focused on HIV-positive people. Though exercise and fatigue studies have been conducted in people with HIV, the authors chose not to include any of them in their analysis, because none used a validated instrument for assessing fatigue either before or during the exercise intervention. “Currently the evidence for interventions with medication is not strong,” the authors said. “Behavioral interventions and GET seem more promising.” Because fatigue is so common, and so dramatically reduces a person’s quality of life, the authors urge care providers to assess their patients for the condition. The researchers state that “in case of fatigue, clinicians should not search only for physical mechanisms, but should question depression and anxiety in detail.” Finally, the authors are calling on researchers to develop an evidence-based approach to screening and treating fatigue in people with HIV.

Source: http://www.poz.com/rssredir/articles/hiv_fatigue_psychological_761_18540.shtml

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

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