While sailing down the "Super Highway we call "The Net" I occasionaly come upon some interesting items in the news. I've decided to use this page to reprint some of these items. I make no opinions on these items. I will leave the opinions up to your desgretion. I hope that you find things that make you think on this page.
"AIDS virus can outsmart all treatments - study"
Reuters NewMedia, Inc.; Sunday May 31, 5:00 pm EST
STANFORD, Calif., May 31 (Reuters) - The AIDS virus has the potential to outsmart virtually all the drug treatments now approved in the United States to treat it, according to a study released on Sunday. "There is a problem with drug resistance, and we can't fool ourselves," said Stanford University's Dr. Robert Shafer, lead author of the new research published in the June 1 issue of Annals of Internal Medicine.
Shafer's team found that patients previously treated with multiple drugs to tackle HIV, the virus which causes AIDS, can develop full resistance to all available medications -- a finding which could indicate a developing "split" in the AIDS epidemic. "There are the newly infected patients, who have benefited tremendously from powerful new drug combinations that can effectively shut down viral replication," the researchers said in a news release. "And then there are the patients with HIV strains resistant to one or more drugs. The potent new drug combinations may not work in these individuals, for whom new approaches are needed."
The researchers conducted genetic analyses of viral samples taken from four patients infected with HIV-1, the most common U.S. strain of HIV. All of the patients had been on HIV drug treatment for between four and nine years. They also tested 11 different drugs against the viral samples to determine whether the samples were susceptible to treatment. All of the patients had initially taken the drug AZT and then added or substituted new drugs as they appeared, including the new class of protease inhibitor drugs which have shown promising results in preventing viral replication.
Shafer said the study revealed high resistance to five drugs, including three protease inhibitors, and a lower level of resistance to three other drugs, known as reverse transcriptase inhibitors. "Over the six months, (the viral samples) were stable, they replicated well, and the (patients') viral loads remained high," Shafer said.
He said that although his study focused on only four patients, he had subsequently genetically sequenced viral samples from 400 patients in the San Francisco area and found largely similar results."We have to realize that there is so much cross-resistance that while there may be 11 approved drugs and three to four in the (drug development) pipeline, there really aren't 14 or 15 different options," Schafer said. "The academic community has to face that and convince the drug companies of that. Unless we recognize the fact that certain things aren't going to work, there won't be the incentive to go back and develop new drugs."
Copyright (c) 1998 Reuters Limited. All rights reserved.
AIDS expert Robert C. Gallo, director of the Institute of Human Virology, and colleagues report in the journal Nature Medicine that they have isolated a crude substance from the urine of pregnant women which may act against AIDS, cancer, and anemia. The researchers have named the substance, which they believe to be a protein, hCG-associated factor (HAF). HAF seems to attach to a hormone produced in large quantities in the first trimester of pregnancy, human chorionic gonadotropin (hCG). Researchers discovered that pregnant mice had some resistance to Kaposi's sarcoma. Tests of hCG in AIDS patients showed that the hormone caused the tumors to shrink and HIV levels in the bloodstream to decline in some subjects. The hormone also stimulated the body to produce more red and white blood cells. The researchers used "clinical grade" extracts for their study, but when they tried purified extracts of hCG manufactured through recombinant DNA technology, none of the positive results were observed. When the scientists filtered the crude extracts and isolated the impurities, they found two "fractions" which had the positive effects when injected into mice. The tumors were reduced by 80 percent compared to untreated mice, and blood cells grew at 1.5- to three times their regular rate in cell culture tests.
WESTPORT, Jan 21 (Reuters) - HIV prevention interventions targeted to gay and bisexual male adolescents are cost effective at $6,000 per quality-adjusted life year (QALY) saved, according to a report in the January 1 issue of the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology.
Drs. Guoyu Tao of the Centers for Disease Control and Prevention in Atlanta, Georgia, and Gary Remafedi of the University of Minnesota in Minneapolis, evaluated the economic aspects of the University of Minnesota Youth and AIDS Projects intervention program. Over a 5-year period, 501 male participants between the ages of 13 and 21 years old participated in a pre-and post-intervention survey that measured changes in HIV risk behavior.
The investigators developed an HIV transmission model to estimate the number of cases of HIV seroconversion expected over a 10-year period based on reports of unprotected anal intercourse. The overall costs, taking into account medical treatment savings, were estimated at $1.1 million. "The number of HIV infections averted and QALY's saved were projected to be 13 and 180, respectively," and the incremental cost-effectiveness ratio to be $6,180 per QALY saved. In many instances, a QALY cost of <$30,000 is considered cost effective.
Drs. Tao and Remafedi believe that "[i]t is likely that the actual benefits of the intervention exceeded our projections." For example, the calculations were made based on the assumption that participants would return to pre-intervention risk behaviors 1 year after completing the program. Therefore, they conclude that "...an HIV prevention program can be cost-effective even if the effects on behavior are partial and short term."
� 1998 Reuters Health Information Services, Inc. All rights reserved.
December 1997 Reprinted from the CDC Newsletter
In 1996, for the first time in the history of the HIV/AIDS epidemic, the number of Americans diagnosed with AIDS declined, according to a report published in the Morbidity and Mortality Weekly Report (MMWR) in September. According to this report, �Update: Trends in AIDS Incidence�United States, 1996,� the incidence (new cases diagnosed per year) of AIDS among people over age 12 declined 6% between 1995 and 1996, from 60,620 cases to 56,730 cases. This decline reflects recent advances in treatment of HIV infection that have lengthened the healthy life span of people living with HIV and the success of HIV prevention and education efforts that have helped to reduce the number of Americans becoming infected with HIV. �This is remarkable evidence that our efforts in prevention and treat- ment are allowing more people to live free of HIV while we are extending the healthy lives of those who are infected,� said DHHS Secretary Donna Shalala. �We must not let up in our determination to put an end to this epidemic by reducing new infections, developing more effective treatments, and ultimately, developing a vaccine and a cure.� The impact of combination drug therapies�including the use of protease inhibitors�has been evidenced throughout this year as AIDS deaths in the United States have continued to decline. These new data not only confirm the trend of declining AIDS deaths but also indicate that, for many people, the progression from HIV infection to AIDS diagnosis in the first place. Despite these positive new trends, there still are reasons for concern. While AIDS incidence declined 15% among white gay and bisexual men, the incidence of AIDS among hetero- sexuals continued to rise, increasing 11% among men and 7% among women. AIDS incidence declined or leveled in all racial and ethnic groups; the largest drop (13%) occurred among whites, followed by Hispanics (5%) and African Americans (0%). There was a significant decline in AIDS incidence among gay and bisexual men who also inject drugs (17% among whites and 13% among African Americans). �To succeed in the fight against HIV, we have to continue to focus on both prevention and treatment,� said Dr. David Satcher, Director of CDC. �Today�s findings show we are making progress, but to keep reduc- ing AIDS, we need to maintain a comprehensive effort to provide treatment to those infected while continuing to work to prevent new infections in the first place.� According to CDC, the challenge of prevention will be even greater as the number of people living with HIV and AIDS grows. CDC reports that the number of people living with AIDS (also known as AIDS preva- lence) increased 11% between 1995 and 1996. As of December 1996, there were 235,470 Americans reported to be living with AIDS. As progression from HIV infection to AIDS diagnosis slows, the number of people living with HIV (HIV prevalence) also will increase. In response to the changing epidemic, CDC is taking steps to improve the nation�s ability to monitor HIV prevalence and incidence, given the new era in HIV treatment. �We are approaching a turning point in the way we need to track this epidemic,� said Dr. Helene Gayle, Director of CDC�s National Center for HIV, STD, and TB Prevention. �As our ability to treat HIV infection has advanced, reports of AIDS cases have become less indicative of recent trends in the epidemic. We must improve our ability to monitor HIV infection in order to continue to effectively track the epidemic as it evolves so that we can appropriately target resources for prevention and treatment.� Currently all 50 states require the reporting of AIDS diagnoses and AIDS deaths to the CDC. Thirty states also require the reporting of HIV infections among adults and/or children. CDC plans to continue working with state health depart- ments, health care providers, and the community to ensure that HIV/AIDS surveillance data accurately reflect the epidemic. (See previous articles.) Other important trends in AIDS incidence between 1995 and 1996 include the following: � AIDS incidence decreased among men (down 8%), but continued to increase among women (up 2%). � AIDS incidence declined in all regions of the country, with greater proportionate declines in the Midwest (10%), the West (12%), and the Northeast (8%) than in the South (1%). � By exposure group, AIDS incidence declined among all groups except people infected heterosexually. � The greatest proportionate declines in AIDS incidence occurred among white MSM (15%) and white and black MSM-IDUs (17% and 13%, respectively). � The greatest proportionate in- creases occurred among black and Hispanic men and women infected heterosexually. Among black and Hispanic men infected hetero- sexually, increases were 19% and 13%, respectively. Among black and Hispanic women infected hetero- sexually, increases were 12% and 5%, respectively. �Clearly this new era of HIV and AIDS prevention brings with it new challenges. Chief among these is the need to ensure that our successes reach all populations. We must ensure that we reach women, youth, and minority communities with effective prevention and quality care,� said Dr. Gayle. For further information, the MMWR report is available on the Internet through the DHAP home page at www.cdc.gov/nchstp/ hiv_aids/dhap.htm. Also, single copies are available from the CDC National AIDS Clearinghouse�call 1-800-458-5231 and request Inventory No. D522. z
October 23, 1997
WASHINGTON (AP) -- Researchers have identified a natural molecule that prevents HIV from infecting cells, a basic discovery they say could lead eventually to powerful new types of AIDS drugs or even a vaccine. The molecule, discovered by a team led by famed AIDS researcher Robert Gallo, works against HIV by physically blocking the portal used by the virus to invade lymphocytes and other types of blood cells. Gallo's team at the Institute of Human Virology at the University of Maryland, Baltimore, earlier identified three similar molecules, all called chemokines. But the new molecule is much more effective because it protects all the cell types attacked by HIV, Gallo said. Flooding the body with these chemokines could create a barrier between HIV and its target cells, and, thus, prevent the virus from spreading its deadly infection, Gallo said. But he emphasized that before chemokines can be tried against HIV in humans, the molecules must be extensively tested in monkeys against a related virus called SIV. Such testing could take several years. Discovery of the new chemokine comes just as doctors report that some AIDS virus is developing a resistance to the three-drug combination that has successfully suppressed HIV in thousands of patients. That combination of reverse transcriptase and protease inhibitors works against the virus inside the target cell. The study by Gallo and his team will be published Friday in the journal Science.
Copyright 1997 The Associated Press
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