Australian researchers have unveiled a new immunotherapy technique to help prevent the progression from HIV infection to AIDS. Details of the simple,
cost-effective technique are published May 2nd in the open-access journal PLoS Pathogens.

There is an overwhelming need for effective immunotherapies for HIV, as current therapies are expensive, impractical, and often highly toxic. The
authors, led by Professor Stephen Kent, propose a technique named OPAL therapy-Overlapping Peptide-pulsed Autologous CeLls-a reinfusion of fresh
blood cells incubating with overlapping SIV peptides. The OPAL technique was successfully tested in animal trials for stimulation of immunity,
control of virus levels, and prevention of AIDS.

Vaccination diminished the levels of virus 10-fold lower than in controls, and was shown to be durable for over one year past initial vaccination.
Therefore, viral replication was shown to be prolonged and more manageable, resulting in fewer deaths from AIDS.

The study is the result of collaboration among researchers from the University of Melbourne, the National Serology Reference Laboratory, and the
University of New South Wales. The researchers plan to conduct future OPAL-therapy clinical trials in HIV-infected humans.

Control of Viremia and Prevention of AIDS following Immunotherapy of SIV Infected Macaques with Peptide-Pulsed Blood.
De Rose R, Fernandez CS, Smith MZ, Batten CJ, Alca?†ntara S, et al. (2008)
PLoS Pathog 4(5): e1000055. doi:10.1371/journal.ppat.1000055
Click here to view article online

About PLoS Pathogens

PLoS Pathogens publishes outstanding original articles that significantly advance the understanding of pathogens and how they
interact with their host organisms. All works published in PLoS Pathogens are open access. Everything is immediately available subject only to the
condition that the original authorship and source are properly attributed. Copyright is retained by the authors. The Public Library of Science uses
the Creative Commons Attribution License.

PLoS Pathogens

About the Public Library of Science

The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world’s scientific and medical
literature a freely available public resource.

Public Library of Science
Continue reading →

A pharmaceutical plant in Uganda this week will begin production of generic antiretroviral drugs following an order from the Ugandan government for drugs worth 17 billion Ugandan shillings, or about $10 million, the East African Business Week reports (Etyang, East African Business Week, 1/28).

Ugandan President Yoweri Museveni in October 2007 commissioned the 15-acre pharmaceutical plant, which will produce triple-therapy combination antiretroviral and first-line malaria treatments. Ugandan pharmaceutical importer Quality Chemical Industries and Indian pharmaceutical company Cipla will produce the drugs. The factory will manufacture the antiretroviral combination therapy Triomune, which contains lamivudine, stavudine and nevirapine. In addition, the factory will produce the first-line antimalarial combination treatment Lumartem, which contains artemisinin and lumefantrin (Kaiser Daily HIV/AIDS Report, 11/26/07).

According to the Business Week, Uganda’s Ministry of Health and other government agencies are covering the cost of the initial batch of drugs with 8 billion shillings, or about $4.7 million, and 9 billion shillings, or about $5.3 million, respectively, for the first quarter. The government is expected to spend 68 billion shillings, or about $40 million, during the first year of the project. Donor organizations also will cover a portion of the cost, Emmanuel Otaala, minister of state for primary health care, said. He added that the government has inserted an HIV/AIDS category into its budget to cover its portion of the cost and to fund other HIV/AIDS services.

Emmanuel Katongole, managing director of the plant, said the cost for a monthly supply of antiretrovirals produced at the plant will be about 30% less expensive than imported drugs currently available in the country, adding that the final cost will be $9 for a one month’s supply. Katongole said the plant initially will “focus on addressing the problems of scarcity and affordability of drugs” in an effort to expand antiretroviral access.

During the project’s first phase, the plant will produce two million antiretroviral and malaria drugs daily. The plant initially will provide antiretrovirals only to the Ugandan government but will then begin supplying drugs to the private sector and other African countries. The plant is expected to begin exporting drugs to Rwanda and Tanzania by the end of 2008, Katongole said.

According to the Business Week, about 100,000 Ugandans currently have access to no-cost antiretroviral treatment, but about 238,000 people in the country are expected to need the drugs by 2012. In 2005, about 42% of people in need of antiretrovirals had access to them, according to statistics (East African Business Week, 1/28).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

The U.S. embassy in Vietnam on Tuesday announced that President’s Emergency Plan for AIDS Relief will allocate $1.4 million to three HIV/AIDS initiatives in Vietnam, the Thanh Nien News reports.

For one of the initiatives, PEPFAR will provide support and distribute grants to the Center for Community Health Promotion, CARE International in Vietnam, the Health and Environment Services Development and Investment, and the Italian nongovernmental organizations CESVI. The NGO will provide support for HIV-positive people, orphans and vulnerable children through September 2009 in the Quang Ninh province, Nghe An province and Hai Phong, according to Thanh Nien News (Tuong, Thanh Nien News, 7/2).

For the second program, PEPFAR will assist the Ministry of Education and Training in providing reproductive health and HIV/AIDS education to secondary school students (Vietnam News Brief Service, 7/2). Save the Children will implement the education programs in Ho Chi Minh City and Quang Nihn and Quang Tri provinces through September 2010.

The third initiative aims to improve services for women living with HIV/AIDS in Ho Chi Minh City and Hai Phong City. The Center for Community Health and Development, the Center for International Health and Development at Boston University and the Development Center for Promotion of Quality of Life will administer the program through September 2009.

Thanh Nien News reports that PEPFAR is providing $88 million to Vietnam for HIV/AIDS programs in 200 (Thanh Nien News, 7/2).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

Today, the Mississippi State Department of Health (MSDH) reports one new human case of West Nile virus (WNV) for 2008, bringing the state’s total number of WNV cases to 100 with three deaths. The new case is in Jones County. MSDH reports both confirmed and probable cases to the public. The Mississippi Board of Animal Health also reports one case of Eastern Equine Encephalitis (EEE) in a horse in Perry County.

Since March 2008, WNV cases have been reported in Calhoun, Clarke, Forrest (4), George (2), Grenada, Harrison (2), Hinds (22), Jackson, Jasper (3), Jones (16), Lamar (2), Lawrence, Leake (3), Leflore (5), Lincoln (4), Madison (7), Marion (3), Monroe (2), Neshoba (7), Panola, Pearl River, Rankin (3), Scott (4), Simpson, Sunflower, Washington and Wayne counties. Deaths have been reported in Forrest, Hinds and Leflore counties. Six cases of LaCrosse Encephalitis (LAC) have been reported in Adams, Amite, Harrison, Hinds, Madison and Yazoo counties with one case of Jamestown Canyon virus in Lamar County. Six cases of EEE and two cases of WNV have been reported in horses.

The MSDH conducts statewide mosquito testing with its most intensive surveillance during the peak WNV mosquito reproduction months of July, August and September. It is important to remember that mosquito-borne diseases, including WNV, occur statewide and throughout the year.

The MSDH encourages all Mississippians to take the following precautions to reduce the risk of contracting WNV and other mosquito-borne illnesses: remove sources of standing water; avoid mosquito-prone areas, especially between dusk and dawn when mosquitoes are most active; wear protective clothing (such as long-sleeved shirts and pants) when in mosquito-prone areas; and apply a DEET-based mosquito repellent according to the manufacturer’s directions.

Symptoms of WNV infection are often mild and may include fever, headache, nausea, vomiting, a rash, muscle weakness or swollen lymph nodes. In a small number of cases, infection can result in encephalitis or meningitis, which can lead to paralysis, coma and possibly death.

For more information on WNV and other mosquito-borne illnesses, a checklist to reduce the mosquito population in and around homes, and a brochure on WNV, visit the MSDH website at HealthyMS/westnile or call the WNV toll-free hotline from 8 a.m. until 5 p.m. Monday through Friday at 1-877-WST-NILE (1-877-978-6453).

Mississippi State Department of Health Continue reading →

An investigational vaginal gel intended to prevent HIV infection in women has demonstrated encouraging signs of success in a clinical trial conducted in Africa and the United States. Findings of the recently concluded study, funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, were presented at the Conference on Retroviruses and Opportunistic Infections in Montreal.

The study investigators found the microbicide gel – known as PRO 2000 (Indevus Pharmaceuticals, Inc., Lexington, Mass.) – to be safe and approximately 30 percent effective (33 percent effectiveness would have been considered statistically significant). This is the first human clinical study to suggest that a microbicide – a gel, foam or cream intended to prevent the sexual transmission of HIV and other sexually transmitted infections when applied topically inside the vagina or rectum – may prevent male-to-female sexual transmission of HIV infection.

“Although more data are needed to conclusively determine whether PRO 2000 protects women from HIV infection, the results of this study are encouraging,” says NIAID Director Anthony S. Fauci, M.D.

The Phase II/IIb clinical trial, which enrolled more than 3,000 women, is NIH’s first large clinical study of a microbicide.

“An effective microbicide would be a valuable tool that women could use to protect themselves against HIV and one that could substantially reduce the number of new HIV infections worldwide,” Dr. Fauci adds.

“The study, while not conclusive, provides a glimmer of hope to millions of women at risk for HIV, especially young women in Africa,” adds lead investigator Salim S. Abdool Karim, MBChB, Ph.D., from the Center for the AIDS Program of Research in South Africa, who presented the findings at CROI. “It provides the first signal that a microbicide gel may be able to protect women from HIV infection.”

Currently, women make up half of all people worldwide living with HIV. In sub-Saharan Africa, women represent nearly 60 percent of adults living with HIV, and in several southern African countries young women are at least three times more likely to be HIV-positive than young men. In most cases, women become infected with HIV through sexual intercourse with an infected male partner. An effective microbicide could provide women with an HIV prevention method they initiate. This would be particularly helpful in situations where it is difficult or impossible for women to refuse sex or negotiate condom use with their male partners.

The study, known as HPTN 035, began in 2005 and enrolled 3,099 women at six sites in Africa and one in the United States. The clinical trial tested two candidate microbicide gels for safety and their ability to prevent HIV infection: PRO 2000 (0.5 percent dose), and BufferGel (ReProtect Inc., Baltimore). The U.S. Agency for International Development provided funding to manufacture BufferGel for the HPTN 035 study. PRO 2000 inhibits the entry of HIV into cells; BufferGel boosts the natural acidity of the vagina in the presence of seminal fluid, which can help to inactivate HIV and other pathogens.

The volunteers in HPTN 035 were divided at random into four equal-sized groups:
Those using BufferGel prior to engaging in sexual intercourse

Those using PRO 2000 before engaging in sexual intercourse

Women using placebo gel prior to engaging in sexual intercourse

Those who did not use gel before engaging in sexual intercourse

All participants received detailed information about the possible risks and benefits of trial participation before enrollment and were monitored monthly while in the study, which averaged 20 months. In addition, all the women were counseled on safe sex practices, given condoms, and tested and treated for sexually transmitted infections throughout the study.

Participants reported regular use of the investigational gels (81 percent of sex acts) and nearly all (99 percent) said they would use the products if approved for HIV prevention. Condom usage was also high throughout the course of the trial (74 percent).

In the final analysis, 194 women in the study became infected with HIV. Of these infections, 36 occurred in the PRO 2000 group, 54 in the BufferGel group, 51 in the placebo group and 53 in those who did not use gel. Based on these data, PRO 2000 was 30 percent effective, while BufferGel had no detectable preventive effect on HIV infection. Both PRO 2000 and BufferGel were found to be safe.

HPTN 035 was conducted by the Microbicide Trials Network (MTN), an HIV/AIDS clinical trials network established in 2006 by NIAID with co-funding by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health, all components of the NIH. Prior to the establishment of the MTN, the study was led by the NIAID-funded HIV Prevention Trials Network (HPTN), from which the study gets its name.

Roberta J. Black, Ph.D., chief of the Microbicide Research Branch in NIAID’s Division of AIDS, says, “Although a statistically significant protective effect was not observed, HPTN 035 successfully met its goal of determining whether either of the two candidate microbicides had sufficient promise to be considered for testing in a larger Phase III clinical study.”

Study participants are being informed of the findings and counseled on the continued need to follow safe sex practices in order to avoid possible HIV exposure. Women who became infected with HIV during the trial were counseled and referred to appropriate medical care and support, including antiretroviral therapy. These same women were also given the opportunity to participate in MTN 015, a clinical study examining the nature of HIV progression and treatment response in HIV-infected women who were using topical microbicides or oral antiretrovirals as an HIV preventive measure when they acquired HIV infection.

A separate clinical study sponsored by the Medical Research Council (MRC) and the Department for International Development of the United Kingdom that is currently testing PRO 2000 (0.5 percent dose) in preventing HIV infection among women in Africa could provide further insight into the microbicide’s effectiveness. That Phase III study involving nearly 9,400 women is set to conclude in August 2009.

###

For more information about the HPTN 035 clinical study, see www3.niaid.nih/news/QA/HPTN_035_qa.htm.

NIAID conducts and supports research – at NIH, throughout the United States, and worldwide – to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at niaid.nih.

The National Institutes of Health (NIH) – The Nation’s Medical Research Agency – includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments and cures for both common and rare diseases. For more information about NIH and its programs, visit nih.

News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at niaid.nih.

Source: Kathy Stover

NIH/National Institute of Allergy and Infectious Diseases Continue reading →

A targeted campaign of testing and counseling aimed at those who are at high risk for HIV would be more effective than the mass patient screening proposed by the Centers for Disease Control and Prevention (CDC), according to an analysis by David Holtgrave, PhD, an expert on HIV prevention at the Johns Hopkins Bloomberg School of Public Health. Holtgrave determined that the CDC’s testing strategy is likely to cost $864 million for one year. For the same price, a targeted testing and counseling approach would identify more than three times as many people with HIV and could prevent four times as many new HIV infections compared to the CDC’s testing strategy. Holtgrave’s study is the first to examine the cost-effectiveness of the CDC’s testing plan and is published in the June 2007 edition of the journal PLoS Medicine.

The CDC estimates that 25 percent of Americans with HIV do not know they are HIV positive. Because they are unaware, they do not seek treatment and are at greater risk of spreading HIV to others. To identify more Americans with HIV, the CDC has recommended that doctors in the United States test all patients aged 13 to 64 for HIV at every health care visit, unless the patient opts out, or specifically declines to be tested. In order to meet the demands of more testing, doctors can forgo the HIV risk reduction counseling that usually accompanies HIV testing.

“While the CDC’s recommended opt-out testing offers some public health benefit, the data shows there would be substantially more benefit from a more targeted program that includes rather than discards risk reduction counseling – including more diagnosed infections and more transmissions prevented,” said Holtgrave, who is professor and chair of the Bloomberg School’s Department of Health, Behavior and Society.

Using standard methods of cost-effectiveness analysis, Holtgrave estimates that CDC’s recommended opt-out testing program would cost $864 million. For the same cost, a program of targeted counseling and testing would diagnose 188,170 new HIV infections, compared with 56,940 that would be detected through CDC’s testing plan, assuming 1 percent of the population tested is HIV positive. Additionally, targeted counseling and testing would prevent an estimated 14,553 new HIV infections at a cost of $59,383 per infection prevented, compared to 3,644 from opt-out testing at a cost of $237,149 per infection prevented. Further, Holtgrave says that targeted testing and counseling perform better than opt-out testing in several key outcomes even when the rate of HIV infection in the community is 0.3 percent.

“It is important that everyone living with HIV knows their serostatus so that they might access life-saving HIV treatment. The question now is to determine the most effective testing strategies for identifying people with HIV. Our work sought to answer that question,” said Holtgrave.

###

For public health news updated throughout the day, visit jhsph.edu/publichealthnews.

Contact: Tim Parsons

Johns Hopkins University Bloomberg School of Public Health Continue reading →

UroToday- Hyaluronic acid is a putative protective barrier of the urothelium. A damaged glycosaminoglycan layer may increase the possibility of bacterial adherence and infection. This damage is proposed to be a causative factor in the development of bladder pain syndrome/interstitial cystitis, urinary tract infection, and hemorrhagic cystitis. Iavazzo and colleagues from Athens, Greece and Boston, Massachusetts reviewed the available data regarding the use of exogenous hyaluronic acid as an alternative treatment of these conditions.

Nine relevant studies were identified and evaluated. Hyaluronic acid was administered intravesically at a dose of 40mg in 40cc normal saline weekly for 4 6 weeks. Patients with noted improvement received two additional monthly doses. The available data suggest that the total short term response of patients with interstitial cystitis is from 30% to 73% and the long-term (3 year) response of such patients could reach 55%. One study reported that the total response to the treatment in patients with hemorrhagic cystitis is 71%. In patients with recurrent urinary tract infection intravesical hyaluronic acid was associated with absence of recurrence in 100% and 70% of patients during 5 month and 1 year follow up respectively.

The authors note that only three of the nine reviewed studies were randomized controlled trials and in only two was hyaluronic acid compared to placebo. They conclude that the limited evidence available does not permit any conclusions with regard to the efficacy of hyaluronic acid treatment.

It should be noted that hyaluronic acid is not approved in the United States. In the summer of 2003 Bioniche Life Science Inc and in the spring of 2004 Seikagaku Corporation completed large double blind, placebo controlled, multicenter clinical studies of their hyaluronic acid preparations (40mg or 200mg per cc respectively) in North America and neither showed significant efficacy of sodium hyaluronate compared to placebo. These negative studies have not been published in peer reviewed literature.

Iavazzo C, Athanasiou S, Pitsouni E, Falagas ME

European Urology. 51(6):1534-1541, June 2007.
doi:10.1016/j.eururo.2007.03.020

Reported by UroToday Contributing Editor Philip M Hanno, M.D

UroToday – the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to:
www.urotoday

—————————-
Copyright © 2007 – UroToday
Reproduced for blog with permission of UroToday.
—————————- Continue reading →

Talks to establish a fund to support the HIV-positive Libyan children who allegedly were infected with the virus by five Bulgarian nurses and a Palestinian physician have been postponed by about a week because U.S. representatives did not come to the meeting scheduled for Sunday, Libyan officials said on Sunday, Reuters South Africa reports (Reuters South Africa, 1/15). The six health workers were sentenced to death by firing squad in May 2004 for allegedly infecting the children through contaminated blood products. Libyan Supreme Court President Ali al-Alus on Dec. 25, 2005, overturned the convictions two days after Bulgaria, Libya, the U.S. and the European Union agreed to establish a fund to support the HIV-positive Libyan children. The agreement did not mention the accused health workers, and Bulgarian officials said that the fund is part of an international effort to find an end to the situation. The size of the fund was expected to be disclosed on Dec. 28, 2005, during talks between Bulgaria and Libya, but on Dec. 28, 2005, officials announced that the negotiations had been postponed until mid-January (Kaiser Daily HIV/AIDS Report, 1/3). Idriss Lagha, chair of the Association of the Families of the HIV-Infected Children, said, “The talks between Bulgarian and Libyan officials were scheduled to take place [on Sunday] in the Libyan capital but they were postponed to January 21 because the U.S. representatives did not attend the meeting.” According to Reuters South Africa, neither Lagha nor other Libyan officials explained why the representatives did not participate in the talks (Reuters South Africa, 1/15). Bulgarian Foreign Minister Ivailo Kalfin on Thursday said that Bulgaria would not give compensation to the families of the HIV-positive children “because the Bulgarian nurses are not guilty.” He added that the country is “ready to participate in the action plan of the European Union” and will help train medical workers and supply aid to Libya, AFP/Yahoo! News reports (AFP/Yahoo! News, 1/12).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

The U.N. World Food Programme and U.N. Food and Agricultural Organization recently launched a manual that aims to teach AIDS orphans in sub-Saharan Africa about farming and other skills, BuaNews/AllAfrica reports. There are about 40 million orphans in sub-Saharan Africa, 11.4 million of whom have lost their parents to AIDS-related illnesses. The manual provides information on how to establish farming schools where orphans can learn how to create sustainable livelihoods and long-term food security.

The program aims to teach children practical skills, such as local agricultural methods, as well as how to protect themselves from HIV transmission and other diseases, BuaNews/AllAfrica reports. Since 2004, the program has targeted more than 7,000 children in 11 African countries: Cameroon, Kenya, Malawi, Mozambique, Namibia, Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. As part of the program, WFP also provides essential food support to children attending classes. Robin Jackson, chief of the WFP’s HIV/AIDS service, said, “Providing a nutritional meal to children in the schools is both an incentive for them to attend lessons and gives them an energy boost to participate actively.”

Marcela Villarreal — FAO’s focal point for HIV/AIDS and director of the organization’s Gender, Equity and Rural Employment Division — said, “Children and youth bear the heaviest burden of the AIDS crisis.” She added that the “schools are an attempt to give orphans the means and confidence to survive in an often difficult environment” (BuaNews/AllAfrica, 12/11).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

Researchers from the U.S. and abroad have developed an orally administered Salmonella-based vaccine that protects mice against aerosolized anthrax and may also have human implications. They report their findings in the journal Infection and Immunity.

Anthrax is a deadly disease that affects wildlife, livestock and humans and presents a serious threat as a potential biological weapon. Currently, there is a vaccine licensed for use in the US and the United Kingdom, and although effective, it requires multiple injections over several months, is expensive to produce and is only available to military personnel. A safe, effective and long-lasting vaccine available to civilians is necessary to protect mass populations in the event of an attack.

In the study researchers produced Salmonella enterica serovar Typhimurium expressing differing levels of the necessary protective antigen to induce anthrax immunity and orally immunized groups of mice. Following immunization the mice were then challenged with aerosolized anthrax spores. Five of the six mice that received the vaccine containing full expression of the antigen were protected against infection, while the vaccine with reduced antigen levels only provided up to 25 % protection.

“In the present study, we have shown for the first time that orally administered Salmonella expressing PA is able to protect mice against infection caused by airborne B. anthracis,” say the researchers.

(M.G.M. Stokes, R.W. Titball, B.N. Neeson, J.E. Galen, N.J. Walker, A.J. Stagg, D.C. Jenner, J.E. Thwaite, J.P. Nataro, L.W.J. Baillie, H.S. Atkins. 2007. Oral administration of a Salmonella enterica-based vaccine expressing Bacillus anthracis protective antigen confers protection against aerosolized B. anthracis. Infection and Immunity, 75. 4: 1827-1834).

###

Tips from the Journals of the American Society for Microbiology

Contact: Carrie Patterson

American Society for Microbiology Continue reading →