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Expert: Using antiretroviral drugs early may curb HIV/AIDS spread

Source:  CNN

San Diego, California (CNN) — Antiretroviral drugs that are being used to prolong the lives of patients infected with HIV/AIDS could also be greatly effective in slowing its spread, epidemiologist Brian Williams said.

The concentration of the virus drops by a factor of 10,000 with antiretroviral treatment, resulting in 25 times the reduction of infectiousness, said Williams, formerly of the World Health Organization and now at the South African Centre for Epidemiological Modelling and Analysis. That means that if more people with HIV received this therapy early, there would be fewer new cases of the disease, he said Saturday at the annual meeting of the American Association for the Advancement of Science.

“We could effectively stop transmission within five years,” Williams said.”

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CROI: Couples Strategy Cuts HIV Transmission

Source:  Medpage Today

“SAN FRANCISCO — Antiretroviral treatment is highly effective at reducing risk of HIV transmission to uninfected partners, prospective data has affirmed.

The 92% reduction in risk of transmission dropped the incidence of in-couple transmission from 2.23% to 0.39%, found Deborah Donnell, PhD, of the Fred Hutchinson Cancer Research Center in Seattle.

She presented the observational analysis of clinical trial data here at the Conference on Retroviruses and Opportunistic Infections.”

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CROI: Study Finds Few Differences in Competing Drug Regimens

Source:  Medpage Today

“SAN FRANCISCO — Four years of clinical data indicate that patients infected with human immunodeficiency virus and treated with the integrase inhibitor raltegravir (Isentress) fare as well as patients treated with efavirenz (Sustiva), researchers here reported.

“There is no difference between these patients in efficacy after [192 weeks], but the side effects on lipids favor raltegravir,” said Eduardo Gotuzzo, MD, director of infectious diseases at Hospital Nacionale Cayetano Heredia, in Lima, Peru.”

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Increased testing leads to decrease in viral load and infections in San Francisco, and in late diagnosis in Washington

Source:  Aidsmap

“The HIV infection rate in San Francisco appears to be falling, and the fall is associated with a reduction in the average viral load in HIV-positive people, due to more people on treatment, the 17th Conference on Retroviruses and Opportunistic Infections (CROI) heard on Wednesday.

Dr Moupali Das from the San Francisco Department of Public Health (DPH) told the conference that the reduction in infections was ultimately due to an increased frequency of HIV testing. It is estimated that only one in seven people with HIV in the city is unaware of their infection, one of the lowest undiagnosed rates in the world.”

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Herpes Therapy Slows HIV Progression

Source:  Medpage Today

“Treating herpes simplex type 2 (HSV-2) slows the progression of HIV in people infected with both, researchers have found.

In a large randomized trial in Africa, giving the herpes drug acyclovir (Zovirax) reduced the risk of HIV progression by 16% among people not yet eligible for antiretroviral therapy, according to Jairam Lingappa, MD, of the University of Washington in Seattle, and colleagues.

The finding comes after earlier research — some of it from the same trial — showed that treating herpes simplex does not reduce the risk of transmitting HIV, Lingappa and colleagues said online in The Lancet.”

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Rights of vulnerable people and the future of HIV/AIDS

Source:  The Lancet

“Since the identification of Pneumocystis (carinii) jirovecii pneumonia in five homosexual men in San Francisco in 1981, which led to the first description of what has become known as AIDS, our understanding of the syndrome has come a long way. Although the disease briefly acquired the somewhat divisive monikers gay-related immune deficiency (GRID) and 4H (after the populations affected: Haitians, homosexuals, haemophiliacs, and heroin users), the story in the past three decades has been one of a pandemic that has touched most social groups in every country.
Continue reading ‘Rights of vulnerable people and the future of HIV/AIDS’

SID: Melanoma in U.S. Shows Rapid Increase

Source:  Medpage Today

“MONTREAL, May 11 — The incidence of melanoma in the U.S. increased rapidly over a 12-year period — across socioeconomic lines and for all tumor thicknesses — according to a study reported here.

During the study period from 1992 to 2004, the incidence of all thicknesses of melanoma increased from 18.2 per 100,000 to 26.3 per 100,000 (95% CI 25.7 to 27.0) — an annual increase of 3.1% (P<0.001), the report said.

A total of 70,596 new cases was reported over the period.”

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Studies may demonstrate need for middle-aged, older men to visit physician to detect melanoma.

Source:  Dermatology Daily

“Reuters (4/21, Steenhuysen) reports that, according to studies published in the April issue of the Archives of Dermatology, men over the age of 40 should visit their physician to check for signs of melanoma. Physicians can detect melanomas at an early stage when they are easier to treat. This is important, because death rates from melanoma are increasing, particularly in among middle-aged and older men.

For the first study, Susan M. Swetter, MD, of Stanford University, and colleagues “interviewed 227 men aged 40 and older within three months after they had been diagnosed with melanoma,” HealthDay (4/20, Edelson) explained. “A quarter of them had tumors more that two millimeters thick — about a third of the thickness of a pencil eraser, but enough to mark a dangerous borderline for effective treatment.” The team “found that men whose melanomas were detected by physicians tended to be older, and that 46 percent of the physician-detected melanomas were on the back.” In an accompanying editorial, June K. Robinson, MD, of the Northwestern University Feinberg School of Medicine, pointed out that “detecting a melanoma early, while it is thin, is an essential first step in surviving the skin cancer.”

WebMD (4/20, Warner) added that “a second analysis ” demonstrated that “physician detection of melanomas is most common among men over 65, men with a history of atypical moles, or men with cancers in areas they can’t see, like their backs.” Specifically, the investigators “found that men whose melanomas were detected by a doctor tended to be older (57 percent were 65 or older compared with 42 percent of those who detected the cancer themselves and 34 percent whose melanoma was detected by someone else).” The authors theorized that “older men tend to visit their doctor more frequently than younger men. They may also have poorer eyesight for self-detection and are less likely to have a partner to look at their skin.”

HIV Hides In Bone Marrow Say Researchers

Source:  Medical News Today

Researchers in the US have discovered that a latent form of HIV hides in progenitor cells in bone marrow, avoids detection by the immune system and retains the ability to reproduce and spread when the coast is clear (eg when treated people stop taking anti-HIV drugs). The researchers hope their discovery will lead to new and more effective treatments that target these latent reservoirs and that eventually those infected won’t have to take anti-HIV drugs all their lives.

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