God, AIDS, Africa & HOPE

Reflections / Gedanken

South Africas progress in the fields of HIV and AIDS

Numbers tested
before June 2010: 2 million tests annually  February 2011 11.9 million since June 2010  target:  further expansion at village level from June 2011 

Health centres accredited to provide ART
before June 2010: 490  February 2011: 2205 target: All 4000 health outlets by Dec 2011

People receiving HAART
before June 2010: 923000  February 2011: 1.4 mill  target: 3 mill by 2015

Nurses accredited to prescribe ART
before June 2010: 250 February 2011: 2000  target: 4000 by Dec 2011
Source: NAM

 

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

POZ Magazine: Cure Watch…

In December 2010, a man was declared cured of HIV. While his example won’t be widely repeated, it could lead to more useful strategies for a cure.
Timothy Ray Brown is “the Berlin patient.” He needed a stem-cell transplant to fight recurrent leukemia. His doctor, Gero Huetter, MD, knew that a small percent of people of northern European ancestry have a genetic variant called double CCR5 delta-32 deletion that seems to protect them from HIV. The virus attaches to CCR5 receptors on CD4 immune cells in order to enter and infect the cells (another attachment protein, CXCR4, is less commonly used). People genetically prevented from producing CCR5 receptors don’t contract HIV despite exposure.
For Brown’s transplant, Huetter found a match who had the genetic variant. After two transplants, Brown found that his HIV receded along with his cancer. Now, nearly four years after the second transplant, he remains free of HIV—without meds.
This cure is not widely useful, and not only because of its expense. Stem cell transplants rank among the most dangerous of medical procedures. Also called bone marrow transplants, they involve wiping out the immune system with high-dose radiation and chemotherapy before infusing stem cells from a donor. The body then grows a new immune system matching the donor’s. During chemo and radiation and before the new immunity takes hold, the recipient is vulnerable to infections and at serious risk of organ damage and other life-threatening conditions. There is also significant danger that the recipient’s body will reject the transplant.
Yet Brown’s case opens vistas for HIV eradication. While meds (entry inhibitors) blocking CCR5 attachment are in the HIV-treatment arsenal, they do not erase the virus and must be taken continuously. Brown’s experience shows that if CCR5 receptors can be genetically altered, the virus might be wiped out, making a lifetime of HIV meds unnecessary.
Researchers are working on exactly that, using technology called “zinc finger DNA-binding protein nuclease” to modify CD4 cells to match those of people with the double CCR5 delta-32 deletion. Several current studies ask whether infusing such cells—without the life-threatening transplant—will allow the Berlin cure to go global.

POZ magazine original article

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

POZ Magazine: HIV Drug Development Stalls

Companies that develop HIV drugs are at a standstill in bringing new medicines to market, Bloomberg reports. Of the 31 HIV meds on the market, only six were approved after 2004; Intelence was the last drug approved—and that was three years ago. The newest antiretrovirals are much safer and more effective, have fewer side effects and must be taken less frequently. As a result, the bar for bringing new drugs to market has gotten higher and fewer drugs are in the pipeline. This also means that HIV-positive people who develop drug resistance have fewer treatment options.

Source:  Poz Magazine

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

POZ Magazine: World AIDS Day: 1 Million Now on HIV Meds in South Africa

One million people are now on antiretroviral (ARV) treatment in South Africa, according to an announcement December 1 by South African Deputy President Kgalema Motlanthe, which was reported by Agence France-Presse.
South Africa has one of the highest rates of HIV infection in the world. The United Nations estimates that out of a population of 50 million, 5.6 million are living with HIV. The country went through nearly a decade of inaction on the epidemic—largely a result of then President Thabo Mbeki’s skepticism about the link between HIV and AIDS. This changed toward the end of the past decade, with the implementation of one of the largest ARV distribution programs in the world.
Deputy President Motlanthe and Health Minister Aaron Motsoaledi kicked off their World AIDS Day observation by visiting the homes of households affected by the epidemic in a rural South African village. “What we are observing here is the devastation of HIV/AIDS. All four houses we visited here were headed by grandmothers who are looking after orphans,” said Motsoaledi, adding: “What is left for us is to see how we pick up the pieces.”  Picking up the pieces is something that the country has been quick to do in recent years. The country now has the highest rate of people with HIV on ARV therapy on the African continent, and in the past year it hit this new milestone.
“More than 200,000 new patients have been initiated on ARVs since April this year, bringing a total number to 1 million,” Motlanthe told a public gathering to mark World AIDS Day in the eastern province of Mpumalanga.

Source:  http://www.poz.com/rssredir/articles/hiv_southafrica_antiretroviral_761_19491.shtml

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

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, , ,

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