HIV and AIDS HIV Prevention HIV Treatment Science, Research & Innovations Tuberculosis (TB)

Some progress on XDR front

Written by Health-e News

South African scientists have made a breakthrough which could help to understand how the XDR TB strain is resistant to drugs. Read highlights from the latest CDC Prevention Update here.

SOUTH AFRICA: South African scientists sequence deadly TB genome

South African scientists have sequenced the genome of a deadly strain of extensively drug-resistant TB (XDR TB).

Using technology purchased from the United States for R5-million (US $750,000), scientists working for a government-sponsored research center decoded and sequenced the strain.

“We have taken a sample of [XDR TB] from a KwaZulu-Natal patient and sequenced the entire genome of the strain of TB,” said Carl Montague, the health portfolio manager of Lifelab, which funds the National Genomics Platform (NGP).

“[It] took us just over a week; using other technology it would have taken up to a year,” Montague said.

Researchers hope the breakthrough will lead to improved diagnostic tools for the strain and an understanding of how XDR TB is resistant to drugs. XDR TB was reported last year in KwaZulu-Natal, an area hard-hit by HIV/AIDS. Three hundred people are known to have developed XDR TB, and 188 of them died, according to Lifelab CEO Blessed Okole.

James Sakwa, Manager of NGP, said that scientists are far from finding a treatment, but sequencing the genome is “the very first step toward a better drug.” Scientists are analyzing the sequence and hope to use it to develop a rapid test to diagnose the disease. Finding an effective drug could take up to ten years.

Okole said the technology could prove useful in probing drug resistance in other diseases such as HIV. “We are going to use it for HIV drug resistance, and we already have a project in line with that,” Okole said. (Fran Blandy, Agence France Presse)

 

UNITED STATES: Hallmark joins Bono’s efforts against AIDS in Africa

Kansas City-based Hallmark Cards unveiled a line of 23 greeting cards and other products affiliated with the fundraising initiative (Product) Red, founded by Bono of U2 and Bobby Shriver, the nephew of John F. Kennedy.

Donations from product sales will go to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Eight percent of Hallmark’s charges to retailers for the products will go to a fund to help fight HIV/AIDS in Africa and to provide jobs and economic support to communities where the products are made.

Hallmark said the project marks the “largest social-impact initiative” in the company’s history. Hallmark estimates that the donation from the sale of every $4.99 (Product) Red greeting card will fund a single-dose treatment of medicine to reduce mother-to-child HIV transmission. An additional 150 (Product) Red cards and gift items are slated to appear in stores and online in January.

Since (Product) Red’s inception in March 2006, participating companies, including Sprint Nextel, have raised more than $45 million, mainly by donating an average 40 percent of profits from the sales of selected products.

The Global Fund has raised about $10 billion and committed $7 billion to help prevent or treat AIDS, malaria, and tuberculosis in 136 countries. (Gene Meyer, Kansas City Star)

 

KENYA: More than half of Kenya’s 102 000 children need AIDS drugs

Kenya’s top doctor has said just 13 000 of the country’s 102 000 children with HIV/AIDS have access to antiretroviral (ARV) treatment, while more than 6 ,000 are in urgent need of the medicines.

Dr. James Nyikal, Director of Medical Services, acknowledged this is a major setback in Kenya’s fight against AIDS.

 “Although Kenya has made significant progress in increasing access to care and treatment for adults, children have remained underserved despite the burden of HIV among this population,” Nyikal said at the launch of a Clinton Foundation-supported program to place an additional 10 000 children on ARV therapy by year’s end.

In August, Kenya reported the nation’s AIDS prevalence rate dropped to 5.1 percent last year, from 5.9 percent in 2005, due to more adults on ARVs.

Since 1984, at least 1,5 million Kenyans have died from AIDS, official figures show. (Agence France Presse)

 

THAILAND: Married Thais account for 40 Percent of new HIV infections: Survey

More than 40 percent of the 17 000 new HIV/AIDS cases in Thailand last year were among married couples, the health ministry’s disease control department reported this week.

Of the 7 000 married people who were diagnosed with HIV in 2006, 40 percent were wives who reported they were infected through their husbands, while 10 percent of the cases were husbands who said they became infected by their wives, according to the ministry’s latest survey.

Extra-marital affairs and men having sex with prostitutes accounted for the rest of the infections.

Overall, new infections in Thailand decreased from 18 000 in 2005.

“Despite the decrease of overall new infections, there are some signs that the AIDS problem in Thailand might get worse again,” said Thawat Suntrajarn, Director-General of the Disease Control Department. The spike in infections among married couples is “worrisome,” he added.

The ministry had hoped the new figures would show a more considerable drop to 14 000, said Thawat. The survey also found a very low level of condom use among couples in 2005, at 44-52 percent. (Agence France Presse)

 

AFRICA: Only 60% of Africa’s AIDS patients still being treated two years later

Just 60 percent of AIDS patients in Africa continue to take antiretrovirals (ARVs) two years after starting treatment, a new study reports.

Of those no longer taking the life-saving medicines after two years, 40 percent died, and the remainder missed appointments, failed to pick up the drugs, or possibly transferred to another clinic.

A small percentage stopped taking ARVs but continued to seek medical care at the clinics where they began treatment, found Sydney Rosen of Boston University’s School of Public Health and colleagues.

“I don’t want people losing heart from this, even though 60 percent isn’t fabulous,” said Rosen. However, he noted, nearly all the patients on ARVs would have died without them. “If you think of this in terms of deaths avoided and orphans avoided, then this could be a success story.”

The researchers examined 32 publications reporting on 74 192 patients in 13 African countries from 2000 to 2007.

Many of the studies were conducted in sub-Saharan Africa, particularly South Africa, which has the world’s largest HIV/AIDS caseload.

Compared to the 80 percent patient retention rate in the West after two years, Africa’s 60 percent is “a fairly gloomy conclusion,” said Dr. Charlie Gilks, Director of Treatment at the World Health Organization’s AIDS Division. “We clearly should be doing a lot better than 60 percent, but that is much more difficult than just identifying patients and getting the first pills into their mouths,” noted Gilks, who was not connected with the study.

Gilks said the rate may increase when patients do not have to pay for treatment. The study analyzed programs in which patients paid for drugs and others in which the drugs were free or partially subsidized. In addition, some of study data were several years old, he said. Today, Gilks suggested, more patients may be continuing treatment though the evidence to prove it is not yet available.

AIDS experts said the report highlights the importance of preventing HIV infection in the first place. “The best treatment is prevention,” said Daniel Halperin of Harvard University’s School of Public Health. “If we can prevent this epidemic, then that will solve a lot of the treatment issues eventually. Otherwise, we may not be able to keep up with so many patients.”

The study, “Patient Retention in Antiretroviral Therapy Programs in Sub-Saharan Africa: A Systematic Review,” was published in the Public Library of Science Medicine journal. (Maria Cheng, Associated Press)

 

UGANDA: US should halt AIDS funds for homophobic Uganda: Human Rights Watch

New York-based Human Rights Watch has asked the United States to reconsider funding HIV/AIDS programs in Uganda, where it claims recipients of such money violate the rights of homosexuals.

In a letter to US officials on Oct. 11, HRW said Ugandan officials and media have intensified attacks on the rights of lesbian, gay, bisexual, and transgender (LGBT) people. It cited an anti-condom, anti-gay pastor, whose church has received US funds for anti-AIDS abstinence and fidelity programs, saying he listed names and pictures of gay rights activists on a Web site.

In addition, a local tabloid last month published the first names, workplaces, and other details of 39 alleged gay men under the headline “Homo Terror,” pledging to “name and shame top gays in the city.”

“The US government should condemn these threats and clarify that it does not support using its HIV/AIDS funding to promote homophobia,” the letter said.

“When the US funds abstinence-only programs in Uganda, it tells people that LGBT people’s sexualities are dangerous and must be denied,” said HRW’s Scott Long.

“US politicians and pocketbooks underwrite hatred in Uganda,” he said. “The US has no business lending an aura of respectability to policies that undermine human rights and public health.”

“Supporting prejudice with cash is an approach with deadly consequences for all,” said Long. In the past, HRW has called on the Ugandan government to decriminalize homosexuality and asked officials to stop making homophobic statements.

In August, Ugandan authorities backed a march by some 100 Christian and Muslim clerics in Kampala to condemn homosexuals. Homosexuality is illegal in Uganda, punishable by imprisonment up to life. (Agence France Presse)

 

INDIA: Bank plans probe of HIV tests in India

World Bank officials recently announced the agency will investigate allegations that India’s National AIDS Control Organization (NACO), which the bank supports, failed to alert the public about defective HIV test kits that returned high numbers of false negatives.

An Ohio doctor who visited India last year on the bank’s behalf, Kunal Saha, said in August that he had discovered documents from 2004 and 2005 suggesting the kits produced too many false negatives. He further alleges he saw suspect kits still on medical facilities’ shelves six months ago.

Saha warned that Indians falsely assured they are HIV-negative could expose others to infection, and he wants the bank and NACO to issue a public health alert in India about the test kits. Last year, Indian officials filed criminal charges against a company that distributed the tests, a type used to confirm initial HIV test diagnoses.

The bank’s managing director, Graeme Wheeler, and the bank’s medical director for South Asia, Kees Kostermans, said the agency will hire two independent consultants to investigate the complaints and conduct a review of the India test kit program. They did not say when the consultants will be hired, and they noted a systematic review would take time. The bank has spent hundreds of millions of dollars on HIV prevention in India.

Kostermans said the bank needed to analyze a wider sample of data to assess the quality of testing and prevent future problems. He acknowledged lapses of time and record-keeping would make tracking down patients logistically chaotic.

“What is the point in assigning new consultants to re-visit the same issues?” Saha asked on Friday in an e-mail to Wheeler. NACO “has shown little inclination to act expeditiously to solve this issue,” he wrote.

“The major issue is to protect public health, not protect the reputation of NACO, which seems to be the priority,” said Beatrice Edwards of the Washington-based Government Accountability Project, which monitors the bank. (Carrie Johnson, Washington Post)

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