Toward a cure for AIDS: Scientists set research agenda

Reuters – 22 hrs ago CHICAGO (Reuters) - A team of global scientists has devised a strategy to find a cure for AIDS, an effort inspired by the remarkable story of a single U.S. patient named Timothy Ray Brown who was cured from the disease.

Brown's treatment in Berlin involved the destruction of his immune system and a stem cell transplant from a donor with a rare genetic mutation that resists HIV infection. The procedure is too costly and too difficult to replicate on a large scale.

But in the years since his successful treatment in 2007, Brown's story has become a rallying point for scientists who believe the time is now right to seek a cure for AIDS.

Since the AIDS epidemic started 31 years ago, scientists have made great strides in treating the disease. AIDS-related deaths worldwide fell to 1.7 million last year from some 1.8 million in 2010, according to the latest report from United Nations AIDS program (UNAIDS).

Cocktails of powerful HIV drugs can keep the infection at bay for years, but the virus is wily, weaving itself into the DNA of special immune system cells, where it can lie dormant and out of reach of medications. That makes it necessary for HIV patients to take drugs over a lifetime.

As a result of better access to treatment, more patients with HIV are living near-normal lives, but the numbers of patients needing drugs is rising, increasing the future costs of AIDS treatment.

"Treatment is for life, and we know that it is important today and that it can slow the spread of the virus," said Michel Sidibé, executive director of UNAIDS.

But he said treatment should not be an end in itself.

"If we continue to believe it is the endgame, then we will have a challenge to get to 'zero,'" Sidibé said, referring to the goal of ending the epidemic.

"It's a first step," said Francoise Barre Sinoussi, who won a Nobel prize for her part in identifying human immunodeficiency virus. She is co-chair of the International Working Group Towards an HIV Cure, which released its proposed steps toward a cure on Thursday.

Sinoussi said the next step will be determining the cost-effectiveness of the strategy. That work will begin in conjunction with the International Aids Society's 2012 conference, which runs from July 22-27 in Washington.

GETTING RID OF THE VIRUS

Dr. Steven Deeks of the University of California San Francisco division of HIV/AIDS, who is co-chair of the working group, said health professionals see a growing need to "switch from blocking the virus to getting rid of the virus."

Instead of trying to copy the treatment received by Brown, researchers will seek a similar response in a way that is less costly and easier to replicate.

Among the first tasks, according to Deeks, will be to continue basic research in the lab to understand why the virus persists in the body and where it hides out.

Scientists will also need to understand immune system function in HIV-infected patients and determine whether inflammation is playing a role in protecting the virus.

Other teams will need to determine why some patients develop antibodies to the virus, allowing them to control the infection, and whether this can be applied to the search for a cure.

Deeks said doctors need better tests to measure levels of the virus. Researchers will need to develop drugs that flush out the virus from its hiding places in the body, making it more vulnerable to treatment, as well as powerful medications to bolster the immune system's own ability to fight off infection.

Rowena Johnston, of the Foundation for AIDS Research, which is helping fund development of a cure, said the global strategy will help consolidate research efforts.

"Now that we know what the questions are, we can focus our efforts in the right direction," she said at a briefing announcing the new push.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, a part of the National Institutes of Health, said his agency supports the work but that it is far too early to handicap its success.

"We still have so much discovery to do with regard to a cure that there's no guarantee when or if it will happen. We're sort of where we were over a decade ago with a vaccine," he said.

Back then, scientists were far less certain about vaccine prospects after repeated trial failures, but sentiment changed in 2009 with the first report in Thailand of a modestly successful HIV vaccine trial.

"Now I can say, I'm confident that we'll get a vaccine, I just can't tell you when. With a cure, we're still at the very nascent phase of discovery," Fauci said.

(Additional reporting by Susan Heavey and Salimah Ebrihim in Washington; Editing by Michele Gershberg and Cynthia Osterman)

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Time to overhaul AIDS strategies for gays - study

"A staff member holds a packet containing a free condom in the HIV department of Taipei City Hospital in Taipei. Three decades of safe-sex messages to gays have failed to stem the spread of HIV among a population at greater risk of the AIDS virus than heterosexuals, experts warned in The Lancet on Friday. (AFP Photo/Sam Yeh)" title

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Ahead of AIDS Conference, New Reasons for Hope

HealthDay – 15 hrs ago THURSDAY, July 19 (HealthDay News) -- The first glimmer of hope for a cure for HIV came in 1996 with the advent of powerful drug cocktails known as highly active antiretroviral therapy (HAART). But the feeling was short-lived.

While HAART has drastically reduced deaths due to AIDS and other HIV-related diseases, it is no cure -- if patients stop taking the medications (because of side effects or other reasons), the virus bounces right back, as a 2010 study of patients in Latin America and the Caribbean showed.

Yet, there is now a renewed sense of promise that, even if it still years away, researchers have a better understanding of targets that could lead to a cure, said Rowena Johnston, vice president and director of research at the Foundation for AIDS Research. "We are seeing something that is probably a lot like that time in the 1990s," she said.

In 2012, new causes for optimism include approval of a new drug, Truvada, that can help prevent the spread of HIV, safer and more effective drugs to treat those who are infected and better efforts to diagnose HIV/AIDS in people who don't realize they have it.

These and other achievements will be a focus at the biennial International AIDS Conference, held this year in Washington, D.C. The meeting, which begins Sunday, has not been held in the United States in 22 years. Its return stems from the Obama administration's decision in 2009 to end the ban on HIV-positive people entering the country, Johnston said.

Hints at a cure

Another "large part of the basis for the new optimism" comes from the experience of one patient back in 2008, Johnston said. That was Timothy Brown, also known as "the Berlin patient," who was pronounced cured of HIV by his doctors.

The cure involved a special kind of blood transplant that Brown received for his leukemia from a donor that happened to have rare, mutant cells that did not allow HIV to take hold. This procedure is "absolutely not practical" for the general population, Johnston said, but it has launched research looking at ways to mimic the effect, by using gene therapy to make a patient's cells resistant to HIV.

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In Washington, free HIV-AIDS testing while you wait

"Faced with the highest HIV-AIDS rates in the United States, community health activists in the nation's capital have come up with a novel way for people to save their own lives while killing time. (AFP Photo/Jim Watson)" title

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Nobel laureate, discoverer of HIV, sees 'hope' for cure

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WHO endorses use of HIV medicines for prevention

Reuters – 2 hrs 27 mins ago NEW YORK (Reuters) - The World Health Organization has endorsed using HIV medicines among people who do not have the infection but are at high risk of getting it, and suggested that poor and wealthy countries alike set up pilot projects to better understand the benefits.

The United Nations agency made its suggestion on Friday, four days after U.S. regulators approved use of Gilead Sciences Inc's Truvada for people who are not infected but may engage in sexual activity with HIV-positive partners. The concept is known as pre-exposure prophylaxis (PrEP).

Truvada, which combines the anti-HIV drugs tenofovir and emtricitabine in one pill, is widely used to treat people already infected with the virus that causes AIDS. The medicine, which costs almost $14,000 a year in the United States, is the first treatment also approved for prevention.

"WHO is encouraging countries wishing to introduce PrEP to first establish small projects to help public health workers to better understand and realize its potential benefits," the agency said in a statement. It said appropriate HIV medicines should be given to those at high risk of infection.

"These could include men or transgender women who have sex with men," the group said.

WHO spokeswoman Sarah Russell said the agency could not recommend specific drugs for prevention, but she said, "It needs to be a drug like Truvada that has been developed for prevention purposes."

Russell said WHO expects Gilead to make Truvada available at a deeply discounted price in some poor countries.

"We believe Gilead will bring the price down to about $100 per year per person" in those countries, she said in an interview.

Gilead officials could not immediately be reached for comment.

WHO noted that an international study called Partners PrEP has shown that HIV medicines are highly effective at preventing the illness in men and women whose partners are infected.

That study, conducted in Kenya and Uganda and funded by the Bill & Melinda Gates Foundation, involved taking a daily tablet containing tenofovir or tenofovir in combination with emtricitabine.

The U.N. agency said it would evaluate the outcomes of the small projects, along with evolving scientific evidence, before issuing its own detailed guidelines next year on the use of HIV treatments for prevention.

WHO said it was important that people taking HIV drugs for prevention are HIV-negative because otherwise drug resistant forms of HIV could evolve. The agency said they should also continue using condoms and faithfully take their medicines on a daily basis.

(Reporting By Ransdell Pierson; Editing by Toni Reinhold)

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Biology Leaves Gay Men Highly Vulnerable to HIV: Study

HealthDay – 1 hr 23 mins ago FRIDAY, July 20 (HealthDay News) -- New research pinpoints a major reason why gay and bisexual men remain so vulnerable to the AIDS epidemic: When it comes to the transmission of HIV, a man who has unprotected anal intercourse is at especially high risk.

In fact, if that kind of intercourse was only as risky as vaginal intercourse, researchers report, HIV cases among gay and bisexual men would shrink dramatically. It would go down even more, they added, if their rates of casual sex declined.

The reality, however, is much different. "Everywhere we looked, HIV is expanding both in high- and low-income countries among men who have sex with men," said study author Dr. Chris Beyrer, director of the Johns Hopkins Fogarty AIDS International Training and Research Program.

The experts were quick to note that, worldwide, it is heterosexual men and women who are by far the majority of those who are infected with HIV. Still, more than 30 years into the AIDS epidemic, gay and bisexual men remain especially vulnerable to infection despite a heavy emphasis on condoms and HIV testing; these men make up the bulk of HIV cases in the United States and other Western countries.

According to UNAIDS, HIV is more common among gay and bisexual men than adults in general in all areas of the world, even Africa. In North America, an estimated 15 percent of gay and bisexual men are infected with HIV; the rate is the highest, 25 percent, in the Caribbean.

Previous research has shown that being on the receiving end of anal intercourse is equally risky whether you're a man or a woman. The risk was estimated at 1.4 percent per sex act with an infected person -- about 18 times more risky than male-to-female vaginal intercourse.

The study authors estimate that if receptive anal intercourse were only as risky as vaginal intercourse, HIV cases would fall by 80 percent to 98 percent among gay and bisexual men over five years. They also estimate that cases would fall by 29 percent to 51 percent if more gay and bisexual men had sex in long-term relationships instead of casual encounters.

The findings appear in the July 20 issue of The Lancet, along with several other studies that examine the prevalence of HIV -- the virus that causes AIDS -- in gay and bisexual men and offer suggestions about prevention.

Two studies examined the higher risk of HIV infection among black men.

One study found that black gay and bisexual men outside Africa are much more likely to be HIV-positive than the general population and other blacks. The other found that black gay and bisexual men in the United States were more likely to be infected with HIV than other gay and bisexual men, but less likely to have a history of substance abuse. If infected, they were also less likely to have started to take life-extending drugs that fight HIV.

There were other differences: black men were less likely to have access to medical care and more likely to have sex with other black men.

What to do? Another study suggests the greater use of prevention approaches -- such as condoms, more medical treatment for those who are already infected and use of medication that prevent infection -- could shrink new HIV cases among gay and bisexual men by one-fourth over the next decade. "But it's not simple as choosing the best ones. There are existing technologies, but we need to put them together" and expand them, said Dr. Patrick S. Sullivan, an associate professor at Emory University's Rollins School of Public Health.

It's also important, he said, to change societies that stigmatize homosexuality and turn it into a criminal offense.

More information

For more about AIDS, try the U.S. National Library of Medicine.

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HPV Might Raise Risk of Form of Skin Cancer

HealthDay – 1 hr 23 mins ago FRIDAY, July 20 (HealthDay News) -- Infection with cutaneous human papillomavirus (HPV) is linked to a type of skin cancer known as squamous cell carcinoma, according to a new study.

Risk factors for squamous cell carcinoma include exposure to the sun's harmful ultraviolet radiation, older age, light skin and a suppressed immune system. The international group of researchers found that having antibodies to certain types of cutaneous HPV may be an additional risk factor for this common form of skin cancer.

"Squamous cell carcinoma of the skin is the second most frequently occurring cancer among Caucasians in the United States, and the numbers of cases continue to rise," study author Dana Rollison, vice president and chief health information officer at Moffitt Cancer Center, in Tampa, Fla., said in a Moffitt news release.

Cutaneous (skin) HPV infection is different from the HPV infection associated with cervical cancer, the release pointed out.

The study investigated the links between cutaneous HPV antibodies in the blood and HPV infection in skin tumors.

The researchers tested 159 tissue samples with squamous cell carcinoma for the presence of cutaneous HPV infection. They found the skin cancer was significantly associated with antibodies to three different types of cutaneous HPV.

Additional links were found between antibodies to two other types of cutaneous HPV when compared to blood samples from people without skin cancer, according to the researchers.

Some experts argue that infection with a certain form of cutaneous HPV interferes with the repair of DNA in sun-damaged skin and could predispose people to squamous cell cancer, the release noted.

"We hope that this study, aimed at identifying the role of cutaneous HPV infection in

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Neanderthals May Have Self-Medicated

Scientific American – 1 hr 28 mins ago Click here to listen to this podcast

You might picture Neanderthals as cavemen gnawing on bones around a campfire. Which wouldn't be inaccurate. But Neanderthals may have also dined on roasted vegetables and known a bit about medicinal plants too. So says a study in the journal Naturwissenschaften (The Science of Nature).

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Alarming Whooping Cough Rates May Hit a Record High

she said, adding that the country may see record high pertussis rates this year. Nine deaths from whooping cough have been reported this year so far among roughly 18,000 cases that have reported to the CDC.

Schuchat said a number of factors are driving the increase. The disease is cyclical, she noted, with peaks and valleys that happen about every three to five years. Immunity to the vaccine could diminish over time. A rise in diagnoses and reporting of cases may influence the data as well.

Schuchat stopped short of blaming vaccine delayers and abstainers for the increase in cases. She said she’s aware of pockets around the country with large numbers of unvaccinated people, but added,

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Autumn Birthday Ups Odds of Living to 100: Study

HealthDay – 1 hr 23 mins ago THURSDAY, July 19 (HealthDay News) -- You may think of your birthday as only being important to your age and the possible presence of candles, cards and cake, but a new study suggests a link between your month of birth and longevity.

Researchers found that those who were born between September and November from the years 1880 to 1895 were more likely to reach the 100-year mark than their siblings who were born in March. The study does not prove a cause-and-effect link, just an association.

The meaning of the findings is unclear, and a researcher who studies lifespan called them mostly irrelevant to modern times.

But, Leonid Gavrilov, from the Center on Aging at the University of Chicago, who wrote the study with his wife, Natalia Gavrilova, said the findings point to the importance of the environment in which a child is conceived and later grows.

"We believe that avoiding any potential sources of damage to developing fetus and child may have significant effects on health in later life and longevity," Gavrilov said. "Childhood living conditions may have long-lasting consequences for health in later life and longevity."

The researchers looked at 1,574 centenarians -- people who reached the age of 100 -- in the United States. They found that those people born between September and November had about a 40 percent higher chance of living to 100 than those born in March.

Of course, the chances that people born in 1889-1895 would even reach the century mark was very low to begin with. Of those born in 1900 who were still alive at 50, just a third of 1 percent of men made it to 100, and just shy of 2 percent of women accomplished the feat, Gavrilov said.

Why might month of birth -- or month of conception -- affect how long someone lives? One possibility is that seasonal diseases played a role, Gavrilov said.

S. Jay Olshansky, a professor of public health at the University of Illinois at Chicago who's familiar with the findings, said the study is not newsworthy. "The results are probably valid, but largely irrelevant in our modern world since they apply to birth months from more than a century ago."

Regardless of the month someone was born or conceived, the odds are slim that you'll live to be 100. "This prospect has been rising through the 20th century, but not dramatically," Olshansky said.

At best, he said, "this research might offer a partial and extremely small explanation for a small fraction of why some people conceived and born more than a century ago lived for 100 years."

What does all this mean for your chances of living to 100 if you were born around the fall or -- perhaps less luckily -- in March? Good question -- and one that won't be answered until people around your age start hitting the century mark.

The study appeared in the Journal of Aging Research.

More information

For more about healthy aging, try the U.S. National Library of Medicine.

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Health Tip: Is My Blood Glucose Too Low?

HealthDay – 1 hr 23 mins ago (HealthDay News) -- Hypoglycemia (low blood sugar) is a common complication of diabetes, and can occur even in people whose diabetes is well-managed.

Although the condition isn't always preventable, the American Diabetes Association says diabetics and their loved ones should recognize the warning signs. The ADA offers this list of potential symptoms:

Feeling dizzy or shaking.Sweating and having pale skin.Developing a headache.Feeling hungry.Showing sudden changes in behavior.Moving clumsily.Having a seizure.Feeling confused or having difficulty paying attention.Feeling a "tingling" sensation around the mouth.

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