Pre-Chewed Baby Food Said to Transmit H.I.V.

Researchers have identified another way that babies can be infected with H.I.V. — through food pre-chewed by an infected parent or caretaker.

Although thousands of babies have been infected in the United States over the last 15 years, pre-chewed food has been documented as the cause of just three cases, federal epidemiologists said here Wednesday.

But such transmission may not be so rare, Dr. Kenneth L. Dominguez’s team from the Centers for Disease Control and Prevention said at the 15th Conference on Retroviruses and Opportunistic Infections.

Pre-chewing food apparently occurs among many groups in this country and elsewhere. So transmission of H.I.V., the AIDS virus, to infants may be an unrecognized problem in developing countries where dental care is lacking, commercially prepared baby foods and blenders are not available and parents and caretakers may need to soften foods, Dr. Dominguez said in an interview.

His team said there were several reasons for reporting the three cases, dating from 1993, for the first time. One was to make health care providers and caregivers of infected children aware of the potential risk of pre-chewing. Another was to ask doctors and family members to report suspected cases to health officials to quantify the threat.

Human immunodeficiency virus is present in saliva, but usually in amounts too low to cause transmission. So, presumably, blood, which has larger amounts of the virus, is also needed for transmission.

Infected chewers with inflammations or open mouth sores can pass the virus to infants through cuts or other common teething conditions, Dr. Dominguez said.

Although the three cases were among African-Americans born in the United States, pre-chewing is prevalent among many ethnic and racial groups, according to a recent national survey of infant feeding by the C.D.C., Dr. Dominguez said.

Specific findings from the survey have not been released.

“It’s likely that some cultural influences are involved, and I am sure that people are doing what their grandmothers and aunties did in practices carried through generations,” Dr. Dominguez said.

Epidemiologists from the centers, working with researchers at St. Jude Children’s Research Hospital in Memphis and the University of Miami, intensively investigated all three cases, ruling out other causes of transmission like breast feeding, sexual abuse and needle sticks.

The first two cases involved boys from Miami infected in the mid-’90s. One boy’s infection was detected when he was 39 months old, shortly before his death, after previously testing negative for the virus twice. The mother, who was infected, reported pre-chewing food for the boy.

The second boy’s mother was uninfected but lived with an infected aunt who pre-chewed his food. He survives. In the third case, a girl from Memphis was found to be infected in 2004 at 9 months old after testing negative for the virus three times. Her mother was infected and pre-chewed food for her daughter.

Genetic studies showed that the viruses isolated from the first and third cases matched those of the mother. The second case’s caregiver died before blood samples could be obtained. H.I.V. isolated from the caregiver’s infected male sexual partner did not match that from the boy.

Researchers will try to determine whether other dangerous microbes like hepatitis B virus and Helicobacter pylori might be transmitted through pre-chewed food.

Source: www.nytimes.com

Study Finds Possible Targets for H.I.V. Drugs

Using a new type of genetic screen, researchers at Harvard Medical School have identified 273 proteins that the AIDS virus needs to survive in human cells, opening up new potential targets for drugs.

Their work, published online on Thursday by Science magazine, used RNA interference to screen thousands of protein-making genes; previously, scientists had identified only 36 human proteins that the virus uses to break into cells, hijack their machinery and start reproducing.

“This is just terrific work,” said Dr. Robert C. Gallo, director of the Institute of Human Virology at the University of Maryland and a co-discoverer of the virus. “I think it’s destined to be one of the top papers in this field for the decade.”

Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and the government’s top AIDS expert, called the Harvard team’s work “elegant science,” but added a caution.

“It remains to be seen if any of these proteins they identified are useful clinically,” Dr. Fauci said. “This is hypothesis-generating, not hypothesis-solving. It creates a lot of work — someone has to go down each of these pathways.”

The lead author on the paper, Dr. Stephen J. Elledge, is a geneticist, and this is his first work on the human immunodeficiency virus, which causes AIDS. His previous work has been on cancer, Dr. Elledge said, trying to figure out how cells sense when their chromosomes are broken, and this paper was a collaborative effort.

“I can’t even grow H.I.V. in my lab,” Dr. Elledge said, so he had to use virus grown by Dr. Judy Lieberman, director of the medical school’s AIDS division and one of the co-authors.

Dr. Elledge’s team used a library of tens of thousands of different short interfering RNAs, bits of genetic code — each of which, when introduced into a cell, knocks out the cell’s ability to make a single protein.

Next, about 21,000 samples of cells, each crippled in its ability to produce one protein, were placed in separate wells on laboratory plates and dosed with the virus.

If the virus could not reproduce normally in a given well, it suggested that the missing protein was one of those it needed.

Of the 273 human proteins identified, only 36 had been previously found by other methods.

The virus, which is itself only a short string of genetic material inside a protective capsule, can make only 15 proteins, so it has to adopt human proteins to its own use.

The advantage of targeting human proteins is that the virus would presumably not be able to mutate to avoid drugs that block them, Dr. Elledge said. Right now, virus strains evolve resistance to antiretroviral drugs, which attack the 15 proteins made by the virus itself, like reverse transcriptase and protease. The mutations force AIDS patients to switch drug regimens — not always successfully.

The disadvantage is that blocking human proteins can, obviously, be fatal to humans. But, as Dr. Gallo pointed out, cancer therapy works that way — doctors try to block proteins that feed fast-growing tumor cells without killing too many other fast-growing cells, like those in the bone marrow.

Right now, Dr. Elledge said, only one drug that targets one of the known human proteins, a receptor called CCR5, has been developed, and it has just won approval.

The new screening technology, known as siRNA, is now used in many laboratories, so this work could theoretically have been done elsewhere, or by using older, more laborious methods.

Dr. Elledge said he benefited from working at Harvard, which could afford the expensive robotics and imaging technology needed.

“And I had lots of collaborators and very dedicated people,” he said.

To confirm that the newly identified proteins were important to the life cycle of the virus — which Dr. Elledge described as “opaque” — the team ran further tests on three of them.

Many of the proteins identified by the screen are already known to be important to cells in the immune system, which is the port of entry for H.I.V.

Dr. Abraham L. Brass, a co-author, said the screening method undoubtedly missed other proteins the virus needs, “but the majority of the ones we found are highly likely to play a role in H.I.V. propagation.”

Source: www.nytimes.com

Study: 1 in 10 men had overlapping sex partners, raising HIV risk

www.wavy.com

A University of North Carolina study shows that one in every ten men observed in a 1-year period had overlapping sexual partnerships, which could be a contributing factor in the spread of HIV.

The UNC researchers also found that the prevalence of concurrent sexual partnerships was higher among black and Hispanic men than in other groups. Those men also are likely to have had sex with other men, and to have female sexual partners who also have concurrent sexual partnerships.

The findings were based on data collected from 4,928 men during a 2002 survey conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention.

The study is published in the December 2007 issue of the American Journal of Public Health.

Photo by ABC News

Europe gives final approval to Pfizer HIV drug

economictimes.indiatimes.com

LONDON: Pfizer Inc, the world's largest drugmaker, said on Monday the European Commission had approved its AIDS drug Celsentri, the first in a new class of oral HIV medicines.

The drug, which is known generically as maraviroc and as Selzentry in the US, is the first designed to keep the HIV virus that causes AIDS from entering healthy immune cells. Older AIDS medicines attack the virus itself.

It works by blocking the CCR5 co-receptor that serves as a main doorway for the HIV virus into immune cells.

The green light from the European authorities had been expected after a panel of EU experts recommended the product in July. The medicine was also cleared by the US Food and Drug Administration last month.

Celsentri is approved for use in patients who have tried other medicines and for whom a diagnostic test has confirmed their HIV strain is linked to the CCR5 receptor.

New York-based Pfizer is counting on new medicines such as Celsentri to help drive profits as several blockbusters lose patent protection and its top-selling Lipitor cholesterol treatment faces strong competition.

Industry analysts have projected annual Celsentri sales of about $500 million by 2011.

Pfizer's Celsentri(R) Approved in the European Union, Providing a Novel Treatment Option for Treatment-Experienced HIV Patients

Pregnancy for HIV-Positive Women Safer in Early Stages of Virus

www.kaisernetwork.org

HIV-positive women who want to become pregnant should be informed that pregnancy is safer during the early clinical stages of the virus, when CD4+ T cell counts are higher, according to a study published recently in Tropical Medicine & International Health, Uganda's Monitor reports.

Lieve Van der Paal of Uganda's Medical Research Council and colleagues from the Uganda Virus Research Institute examined the medical records of 139 HIV-positive women of reproductive age residing in southwestern Uganda who were in a clinical group established in 1990. The researchers examined the effect of pregnancy on HIV progression and survival among HIV-positive women before the introduction of antiretroviral drugs.

The study found that women who became pregnant had higher CD4 counts when they enrolled in the study and that they had a slower decline of CD4 cells than those who did not become pregnant. The study also found that CD4 counts declined faster after pregnancy. The researchers concluded that the "initial comparative immunological advantage possessed by fertile women before they become pregnant is subsequently lost as a result of their pregnancy." The researchers suggested that women taking antiretrovirals who have low CD4 counts wait until their CD4 counts have increased before becoming pregnant.

According to the study, HIV-positive women who want to become pregnant should be warned about the potential negative effect a pregnancy could have on their immune system's ability to fight HIV and should be offered contraception. Pregnant women living with HIV who are eligible for antiretroviral therapy "should be offered such treatment as a priority group since they are at high risk for fast progression" of HIV and because the antiretrovirals will help prevent mother-to-child HIV transmission, the study said. The study also found that since the introduction of a program aimed at preventing mother-to-child transmission, less than 5% of HIV-positive mothers in southwest Uganda do not breast-feed (Kirunda, Monitor, 9/17).

Study Warns Hiv+ Women On Births

HIV Drug Enters Phase III Trials

www.dogflu.ca

It is being reported that 2 phase III clinical trials are set to begin using Schering-Plough's HIV drug Vicriviroc, which is given to patients who have stopped responding to other treatments

It is being reported that an HIV drug manufactured by Schering-Plough is entering in to a phase 3 clinical trial.

Two phase 3 clinical trials are underway for vicriviroc, which is taken once daily and is used to treat HIV patients whose virus has stopped responding to other drug therapies.

Each of the clinical trials is featuring 375 participants. Both trials follow a 48 week study in which vicriviroc showed "potent and sustained viral suppression" in patients not responding to other treatments.

There are some noted safety issues with the drug, as cases of cancer have been reported in study participants.

"As a next-generation HIV entry inhibitor, vicriviroc has the potential to benefit a broad range of patients by offering a potent, sustained viral response and a single once-daily dose in combination with optimized background therapy," said Robert J. Spiegel, M.D., chief medical officer and senior vice president, Schering-Plough Research Institute. "There is an urgent need for new antiretroviral agents with novel mechanisms of action and we look forward to the further clinical evaluation of vicriviroc in these large global studies."

Schering-Plough HIV drug begins late-stage trials

Peru Blood Banks Closed After Four People Were Infected With HIV

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240 blood banks in Peru have been closed by officials after at least four people were infected with HIV from blood transfusions in a public hospital. Carlos Vallejos, Health Minister has said the blood banks will be inspected by a commission that will include officials from the World Health Organisation.

A Health Ministry investigation has found that Judith Rivera, a 44-year-old mother of four, was infected with the virus after receiving blood transfusions during an operation for a tumor in April at a state hospital in Callao.

Carlos Vallejos has confirmed three other cases, including that of an 11-month-old infant, all at the same hospital. A 17 year old boy also claims to have been infected after receiving a transfusion at the hospital. This claim has yet to be confirmed by the ministry.

Jose Cruz is an adviser on blood and laboratory safety for the Washington-based Panamerican Health Organisation. He has called the state of Peru’s blood banks “worrying”.

He also said that Peru, along with Bolivia, Colombia and Mexico are on the organisation’s list of countries that fail to perform preliminary disease screening on all blood collected in blood banks.

It has been estimated that out of Peru’s 27 million inhabitants a shocking 93,000 are HIV positive.

HIV/AIDS cases on rise in China

China reported 18,543 new cases of HIV carriers and 4,314 cases of full-blown AIDS in the first half of this year.

Two thousand and thirty-nine peopled died of the disease in the first six months of the year, said Han Mengjie, assistant to the director of the office with AIDS Control Work Committee of the State Council.

By late July, the accumulated number of AIDS/HIV patients in China totaled 214,300, of which people with full-blown symptoms of the disease numbered 56,758, and 18,246 had died of the killer disease, Han said at a recent symposium sponsored by the United Nations Children's Fund (UNICEF), the office with AIDS Control Work Committee of the State Council, the Ministry of Civil Affairs, and Henan Provincial Government in Zhengzhou, capital of central China's Henan Province.

Han cited drug abuse as the major form of newly reported HIV infections across the country, and warned that the virus was seemingly spreading from high-risk groups to the general public because of other factors such as unsafe sex and migration of those people already infected with the virus.

AIDS Showing No Signs Of Slowing Down In China

China reports leap in new HIV/AIDS cases

AIDS drug maybe effective in cancer

timesofindia.indiatimes.com

A type of drug commonly used to treat HIV can slow the growth of cancer cells, researchers have found. The discovery raises hopes that drugs developed to fight one killer disease could help tackle another.

The HIV drug nelfinavir is now going through its first trial in patients with a range of cancers, in light of the new evidence.

Cancer scientists think that by 'repositioning' drugs already approved as HIV therapies, they could help to save lives by reducing the 15-year wait and estimated $1 billion for getting a cancer drug from lab to clinic.

Phillip Dennis and his co-workers at the US National Cancer Institute in Bethesda, Maryland, began testing HIV drugs on cancer cells after noticing that the toxic effects the virus has on cells are similar to the changes seen in cancerous cells.

The quest for new ways to treat cancer has previously led to painkillers and morning-sickness treatments being enlisted to fight the disease.

Dennis' team tried adding six approved HIV drugs to a wide variety of cancer cell types grown in the lab. Three of the drugs significantly slowed the growth of the tumour cells and increased cell death, the researchers report in the journal Clinical Cancer Research. The most effective of the three, nelfinavir, which impedes the activity of protein-degrading enzymes in the cell, also blocked tumour growth in mice injected with cancer cells. UK, who has previously found that a different HIV drug, lopinavir, has potential for stopping cervical cancer.

"Cancers have many parallels to viral infection," he says.

Hampson suggests that viruses such as HIV defend themselves against the immune system by switching on the host cell's garbage disposal unit—called the proteasome—so that protective immune proteins are destroyed before they can fight the virus.

Cancer-causing mutations can also activate the proteasome, so drugs that block protein breakdown, such as nelfinavir, could theoretically halt both diseases.

Nelfinavir is now in preliminary clinical trials, which should reveal the dose that can be tolerated by patients with cancer, and how it affects solid tumours in the body.

The idea of moving drugs between branches of medicine is gaining ground —HIV drugs are being tested against the SARS virus, and the anti-malarial drug chloroquine is being explored as a potential cancer therapy.

Dennis says that "the concept of screening all drugs for anti-cancer properties has potential", and he hopes
that a plan to test every drug approved by the US Food and Drug Administration (USFDA) on tumour cells will go ahead.

New HIV Test

http://www.wptv.com/

BACKGROUND: More than 1 million people living in the United States are living with HIV/AIDS. Each year, more than 40,000 people will be diagnosed with it. The Centers for Disease Control reports 74 percent will be men. African Americans, who make up just 12 percent of the population, account for almost half of the HIV/AIDS cases. HIV is transmitted by a person who is HIV–infected and can be transmitted by blood, semen, vaginal secretions and breast milk. The most common ways HIV is transmitted is unprotected sex, unprotected oral sex, sharing needles and infection during pregnancy, childbirth and breastfeeding.

WHAT WORKS? More than 20 drugs are currently available for treating HIV. Because HIV genes mutate so easily and the virus reproduces so rapidly, most people who are infected have many different forms of the virus in their bodies. In some cases, mutated strains take on new properties that make them more resistant to the drugs used in antiretroviral therapy -- the primary means of treatment for HIV infection. During antiretroviral therapy that does not fully suppress the virus, a strain that develops drug resistance will grow more quickly than strains lacking such resistance, and the resistant strain will replicate to become the most prominent virus in the person's body.

A NEW TEST: Researchers at Duke University Medical Center have developed a highly sensitive test for identifying which drug-resistant strains of HIV are harbored in a patient's bloodstream. The test may provide physicians with a tool to guide patient treatment by predicting if a patient is likely to become resistant to a particular HIV drug, said one of its developers, Feng Gao, M.D., associate professor of medicine. Drug resistance is one of the most common reasons why therapy for HIV, the virus that causes AIDS, fails.

WHY IT’S DIFFERENT: The Duke test examines the genes of HIV strains for mutations at certain positions that are known to be linked to drug resistance. The researchers analyze blood samples from three different groups of HIV patients: those who had never received antiretroviral treatment, those who had received treatment but were not currently being treated and those who were receiving treatment, but the treatment was not completely successful. After processing the blood samples and isolating the genetic material in each of them, the researchers added tiny fluorescent tags designed to stick to HIV genes in particular ways. Tags designed to stick to mutated gene locations known to produce drug resistance were labeled to appear green, while tags designed to stick to the same gene locations but where the genes had not mutated were labeled to appear red. The researchers used a sophisticated computer program to count the number of molecules with green or red fluorescent tags in each sample. The test proved sensitive enough to detect a single mutated virus out of 10,000 nonmutated viruses in the patient samples.

NOT JUST HIV: The test may have a broader medical application as well. It has the potential to detect mutations that confer drug resistance in hepatitis B, hepatitis C and tuberculosis.

New HIV Drug Receives Positive Response From FDA Advisory Panel

http://www.allheadlinenews.com/

Nidhi Sharma - AHN News Writer

Washington D.C. (AHN) - The Food and Drug Administration said Friday that a new experimental HIV-fighting drug from Merck and Co. appears to outweigh the "current identified" risks.

The federal announcement of Isentress comes ahead of a panel meeting next Wednesday that will recommend whether the drug should be approved.

Merck's studies of Isentress show the drug is safe and effective to treat HIV patients who have developed a resistance to other medications. If approved, the drug, known generically as raltegravir, would be the first in a new class of HIV medicines called integrase inhibitors that block the virus from infecting cells and reproducing.

According to announcement on FDA's website, the common side effects of the drug include a rash and elevated levels of creatine in the blood. No deaths in the clinical trial data could be linked to the drug, they wrote.

Currently, HIV patients are treated with two or three types of drugs. However, over time, most HIV viruses mutate and stop responding to the drugs, creating the need for new types of drugs.

According to the Centers for Disease Control, nearly 1 million people in the U.S. are HIV positive. The decision n drug's approval is expected mid-October.

If approved, Isentress is expected to compete with Pfizer's Selzentry, another new HIV drug that the FDA approved last month for drug-resistant HIV patients.

Zimbabwean Teachers To Instruct Life Skills To Avoid HIV Infection

http://www.voanews.com/

By Carole Gombakomba

The United Nations Children’s Fund, or UNICEF, is training 1,500 Zimbabwean teachers in new and practical methods to stop the spread of HIV/AIDS.

The week-long training exercise ending Friday stands to benefit more than 500,000 children. The teachers, from training colleges in Harare, Bulawayo, Mutare, Masvingo and Mutoko, will be teaching primary and secondary school children living skills to avoid HIV infection as well as fending off sexual molestation or exploitation.

Zimbabwe's Ministry of Education is rolling out the US$500,000 program.

UNICEF says the decline in Zimbabwe's HIV prevalence rate in recent years can be attributed to behavior changes including a later start of sexual activity for young girls in particular, faithfulness in sexual relations, and increased use of condoms.

Sex now primary cause of China HIV spread

Older adults don't give up on sex

Sex now primary cause of China HIV spread

Source: www.reuters.com

Unsafe sex has overtaken intravenous drug use as the primary cause of new HIV infections in China, suggesting that AIDS is spreading from high-risk groups to the general public, state media reported on Monday.

Of the 70,000 new HIV infections recorded in 2005, nearly half contracted the virus through sexual contact, the China Daily reported, citing a report released jointly by the Ministry of Health and the China Centre for Disease Control and Prevention.

"It's the first time since 1989, when the first HIV infection was detected, for sex to top the transmission list nationwide," the newspaper quoted Gao Qi, of the China HIV/AIDS Information Network, as saying.

China has an estimated 650,000 people living with HIV or AIDS, and while the government has become increasingly open about the problem, efforts to fight the spread of the virus are still hampered by conservative attitudes about sex and suspicion of grassroots activists and non-governmental organizations.

Surveys show that one in 10 sexually active men in China have been involved with prostitution at least once, and the government was taking measures to initiate condom use programs and AIDS education among sex workers, the newspaper said.

It is also focusing prevention efforts on gay men, who made up 7.3 percent of the new infections through sex.

A separate survey conducted by China's Centre for Disease Control and Prevention found that although teenagers in China were having sex at an earlier age, 40 percent did not use protection the first time and they had little AIDS education.

"They know little about HIV/AIDS, let alone preventative measures," the China Daily quoted An Jiaao, of the centre's National Institute for Health Education, as saying.

HIV/AIDS became a major problem for China in the 1990s when hundreds of thousands of poor farmers, mostly in the central province of Henan, became infected through botched blood-selling schemes.