God, AIDS, Africa & HOPE

Reflections / Gedanken

The vaccine confusion

AstraZeneca vaccine stopped – so the headlines around the world when South Africa decided to re-think the use of the vaccine it bought for a higher price without checking the expiry date – and one could think this is a typical story – or another example of the incompetence of South Africa’s national government. That may be the case, but I guess, in this time and situation government bashing should not be first priority but to look a bit deeper into this headline creating event.

The first batch of vaccines in South Africa was designated to be used for the health worker at the forefront of the fight against the pandemic; and obviously the aim is to protect those doctors, nurses and health workers against the virus. It was known that the AstraZeneca vaccine was not a 100% protection, but a small and not peer-to-peer reviewed study, which in itself poses more questions than answers was cited as the reason to stop the vaccination drive before it started.
And here the first critical thought has to be mentioned:
This discussion is way above the heads of the general population. The South African government, in its drive to be as transparent as possible, decided to bring into the public a level of medical research discourse which created more confusion than it helped to motivate people to make an informed decision on wanting to be vaccinated. It also laid bare the underlying belief of many, that a vaccine is either the miracle cure or not helping at all.
In reality, we are far from understanding the virus and the potential of vaccinations in this case. Questions about how long the vaccine will work, what possible boosters are needed, how mutations will change the course of strategy and whether vaccinated people can still be infected or pass on the virus are questions in transition of answers. Combinations of vaccines would be another question which warrants an answer.

The advent of highly expert driven expert discussions in the public and political domain is creating more havoc and uncertainty then intended by those allowing for it. And looking through publications and mini studies and opinion pieces one can’t stop thinking that some so-called or self-identified experts have their own popularity as priority number one on their agenda. Also here social media are at parts more a curse than a blessing, when it comes to relay information which are factual correct and done in a way which enlighten ordinary people.

The additional problem in South Africa is that even those, who vote for the governing party not necessarily trust anybody in government, knowing what they know via the Zondo Commission. Too much lies, too much deception, to many people in charge just looking for their own advantage and having their own hidden agendas.

As it stands at the moment, no decision is taken what happens to the amount of expensive vaccines waiting in the cold storerooms of South Africa. It would be a pity if they would be given back or expire- as they still prevent severe illness and death for those being vaccinated with them.

Generally speaking we have to learn to appreciate what medical advances can do – and to understand that all are building blocks to prevent the pandemic from raging on – none is currently the golden bullet which stops the virus in the track. And there is something else to learn: that health experts should only cover parts of the political decision-making process in pandemic times for complex societies. There is more to balance and if one part is dominant, it will derail the process of taking with them the people governed.

Filed under: Africa, Politics and Society, Reflection, Society and living environment, South Africa, Uncategorized, , , , , , , ,

Signs of hope – remission without long-term treatment

At the recent conference of the International Aids Society in Paris it was a topic hotly discussed by academics, researchers and representatives of NGO’s:

A 9-year-old South African child diagnosed with HIV when he was 1 month old has been in HIV remission for 8½ years — without regular treatment. This is the first reported case of a child controlling their HIV infection without drugs in Africa and the third known case globally. The related research was conducted among others by Prof Dr Mark Cotton, board member of our HOPE Cape Town Association.

Soon after diagnosis, the child was placed on antiretroviral treatment, or ART, for 40 weeks, at which point treatment was stopped and the child’s health was monitored. Blood tests in late 2015 revealed the child is in HIV remission, meaning levels of the virus in the blood are undetectable using standard tests. Subsequent testing of samples dating back to the child’s infancy confirm remission was achieved soon after treatment was stopped. Treatment was paused as part of a larger research trial investigating the potential for early ART to decrease infant mortality and cut the need for lifelong treatment among newborns infected with HIV. “This is really very rare,” said Dr. Avy Violari, head of pediatric clinical trials at the Perinatal HIV Research Unit at the University of Witwatersrand in South Africa. Violari is the child’s doctor and presented the findings at the 9th International AIDS Society Conference on HIV Science in Paris

The child, not identified, was part of a study known as the Children with HIV Early Anti-retroviral Therapy, or CHER, trial, conducted in the years 2005 to 2011. More than 370 infants infected with HIV were randomly assigned to immediately receive ART for either 40 weeks or 96 weeks. A third group received no immediate treatment, but instead was looked after according to standard guidelines at the time. The CHER trial set out to investigate whether mortality rates could be reduced, but also whether earlier treatment could keep children healthy enough to enable them to come off treatment for certain periods. “We were hoping to make it a slower-progressing disease,” said Violari.

The study found mortality decreased by 76% and HIV disease progression reduced by 75% among the infants who received treatment immediately, for 40 or 96 weeks. The group receiving standard treatment saw an increase in mortality based on interim results, so that arm of the trial was stopped early. But virus levels in the 9-year-old case remained and remain undetectable. “The child is the only child showing remission,” said Violari. “We cannot see virus in the blood … we can see fragments of the virus in the cells,” she said, adding that these fragments appear not to be able to replicate, for now.

The South African child is the third reported case of long-term HIV remission in a child after early, limited treatment with antiretroviral drugs.

The first case was a Mississippi baby, a girl born in 2010, who received ART just 30 hours after birth until she was 18 months old, at which point HIV remission was achieved. The baby sustained remission for 27 months, until 2015, when she rebounded and the virus was found in her blood, crushing hopes that this approach could be the route to a “functional cure” for HIV. Next came the 2015 case of a French teenager, now 20, whose mother was HIV positive. The French child was given antiretroviral treatment soon after birth, stopped treatment at age 6 and has maintained undetectable levels of the virus in her blood since.

“We are delighted and excited by what happened with this child … we need to extrapolate from this to the benefit of other children on antiretroviral drugs,” said Prof Mark Cotton, Professor of Pediatrics at Stellenbosch University in South Africa, who co-led the study. “Africa is still the epicenter of the epidemic and more babies are acquiring HIV than anywhere else.”

Cotton hopes his team presenting these results will boost morale, both among cure researchers and those managing treatment programs for children across the continent.

More links:

Hope for future HIV cure revived
It is really very rare
Without drugs

Filed under: Africa, HIV and AIDS, HIV Treatment, HOPE Cape Town Association, HOPE Cape Town Association & Trust, Medical and Research, South Africa, , , , , , , , , , , , , , , ,

We demand a cure

The HIV activist Larry Kramer from the US gave an impassioned speech calling for a cure for the virus at a Gay Men’s Health Crisis gala (23.3.2015). The 79-year-old activist said that he no longer has “any doubt that our government is content, via sins of omission or commission, to allow the extermination of my homosexual population to continue unabated,” pointing blame at the U.S. president, Congress, the National Institutes of Health, and the head of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, for their inaction.

Even if this might be a bit of an overreaction, one can understand the frustration of being 34 years into the pandemic and a cure or a therapeutic vaccine seems to be far away. Knowing how much money has been gone to war and the destruction of people every year it is understandable that the plight and suffering of so many million people worldwide must cause an ongoing outcry. More so as it was the USA President Ronald Reagan who clearly missed the boat of stopping this pandemic in the early times because of his religious convictions not allowing to pay attention to the drama of gay people dying. He never acknowledged it contrary to the late Nelson Mandela, who also was silent during his tenure as president of the country. But he acknowledged at least afterwards that shying away from this topic because of his traditional upbringing was a big mistake affecting millions of South Africans.
It is true: We have achieved a lot – and for the first time a global initiative, the Global AIDS Fund, was able to coordinate the war against the pandemic on a global scale. But as time passes and medications are keeping the virus at least in the so-called developed countries at bay it seems the momentum is lost and there are only half-hearted efforts to stem the pandemic further. It seems that Ebola is now more frightening than HIV even if the numbers don’t match up at all.
I am convinced that if we don’t pay attention, HIV will come back to hunt the global village and when you have a close look at the development of multi-resistant TB it is only a question of time when this little bug called HI virus will go the same route. The human race tends to never learn that nature and creation on that level also strives for survival – and looking around and seeing all those infectious diseases and STIs we thought we have conquered and cornered: TB, polio, syphilis, Ebola… – there is still a long way to go and to underestimate a virus or bacteria has cost us dearly and will continue to do so.

Larry Kramer ended up his speech with: “We must aspire to a cure once and for all. Let’s demand a cure and a society that values people with HIV enough to pay for it. Only if we aspire to more can we demand more. Only if we demand more will we get more … The power to change history is still within our grasp. We cannot wait another 34 years. This evil still being waged against us must cease. The battle cry now must be one word: CURE. CURE. CURE.”

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

From lesbian sex and HVI transmission to the banning of the Red Cross in Catholic Schools- interesting read in between

Going to the high volumes of articles and journals in the field of HIV and AIDS I thought the following could be interesting for you:

Lesbian sex is thought to be the most safe one, but there is a fresh report from Houston in Texas confirming a rare female to female transmission of HIV. It is further reported that this transmission took place between two women in a monogamous relationship. All details of the story are published in “Morbidity and Mortality Weekly Report” – published 14.03.2014. To read a summary please click here

From the Mississippi Baby to the California Baby – we meanwhile know about the benefits of early treatment and the possibility of HIV eradication if treated within the first hours of infection.  Read more on this topic from the 21st Conference on Retroviruses and Opportunistic Infections here

From the CROI Conference as well there are new about safer sex without condom. Ever since the HPTN Study 052, it was concluded that having an undetectable HIV viral load strongly reduces the risk of HIV transmission. But how safe is condom-less sex if one’s viral load is undetectable? Read about the ongoing PARTNER study here

Hepatitis C – a short while ago a disaster for every person being HIV  has become a center of attention after treatment and cure evolved in a speedy way. The first medications have been retired shortly after introduction to make place for more effective treatment. Read about this exciting and important development here

HIV controllers were always an interesting study group. It was thought that those people could control HIV and were protected from getting sick. New research shows that the situation is more complicated and that such people have higher level of chronic inflammation. An interview with Jonathan Li, MD researching in this field might be giving interesting clues about the benefits and treats for those being naturally controlling HIV and you can read it here

Manila on the Philippines shows quite a rise on HIV infections and obviously the city responsible are trying to reign in with prevention messages and the free distribution of condoms. The dominant Roman-Catholic Church  condemns in the person of Auxiliary Bishop Broderick Pabillo this contribution and he calls to follow the example of Africa – where in his opinion only abstinence and fidelity has brought the numbers down. Read more about this interesting point of  view here

The Catholic Church in Belize has banned the Belize Red Cross amongst other organizations from all 200 Catholic Schools in the country. To read the response of the Red Cross click here

Filed under: Catholic Church, General, HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, Politics and Society, Reflection, Religion and Ethics, Society and living environment, Uncategorized, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Cure Is On The Way

There is indeed hope on the horizon and it is good to express this hope for the millions infected and affected.  And yes, we should not be overenthusiastic but there is light at the end of the tunnel. And light gives life..

 

lynneaispositivelybeautiful

http://www.nytimes.com/2011/11/29/health/new-hope-of-a-cure-for-hiv.html?pagewanted=all&_r=0

http://www.nytimes.com/2013/03/04/health/for-first-time-baby-cured-of-hiv-doctors-say.html?pagewanted=all

http://www.thebodypro.com/content/71343/12-year-old-boy-receives-cord-blood-transplant-in-.html?ap=1100

It started with Timothy Brown AKA The Berlin Patient AKA The first Person to be cured of HIV. He found out he was HIV positive in 1995. His life was saved by the medication that made living with HIV a reality. In 2006 he received a new threat to his life, leukemia. he under went chemo therapy just the same as many cancer patients but the leukemia came back. the next step was a bone marrow transplant.

Many years ago there was a documentary on people who were resistant to HIV. It was late one night and I couldn’t sleep so I flipped through the channels and stopped on one with a graphic showing how HIV entered a cd4 cell. I remember them following a man who described how he began to lose all his friends due to complications of AIDS and he noticed that many of…

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

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