Estimated worldwide HIV infections: 53 640 776 at 4.15pm on Wednesday September 3
Sobering: Two unusual cases of HIV transmission within two Australian families are reported in the latest issue of AIDS.
The first case involves a 16-year-old girl and her 18-year-old sister. The younger sister became aware of her HIV-infection after donating blood in 1999. She had never had sex, nor any other risk-factor for acquiring HIV. The elder sister was found to be HIV-positive. The only risk factor was their occasional sharing of a razor.
The second case involves a 55-year-old woman and her son in his early thirties. The mother had been married for 25 years and reported no sexual partners other than her husband, who was HIV-negative. The son reported unprotected sex during a spell in Thailand. He moved home for six months and during that time had active psoriasis. The only risk factor for the mother appeared to be applying topical creme to her son’s psoriasis lesions, which were reported to be dry and did not bleed.
Source: Aidsmap.com
Estimated worldwide HIV infections: 53 539 087 as of 2.46pm on Wednesday August 27
Twist in the tale: Letters in the latest issue of the journal Aids tell contrasting tales about HIV treatment in developing countries. Médecins Sans Frontières (MSF) writes that treatment can be delivered as effectively as in industrialised countries; another letter describes a private clinic in KwaZulu-Natal where constraints led to many patients receiving sub-optimal treatment.
Jean-Michel Tassie and colleagues from MSF outline the experience of the patients who started highly active antiretroviral treatment in seven projects across the developing world. Treatment was clearly effective in most of those who could tolerate it.
A contrasting picture emerges from a study that reviewed the records of a private primary care clinic in rural KwaZulu-Natal, where 72 patients were prescribed antiretrovirals between March 1999 and February 2002. Only 57 patients received anti-retrovirals. Of those, only 31, all with medical aid, were treated with triple therapy.
Source: www.aidsmap.com
Estimated worldwide HIV infections: 53 436 309 as of 11.21am on Wednesday August 20
South Africa is perfecting cheaper and more effective HIV tests, according to reports on diagnostic tests presented at the recent First South African Conference on Aids in Durban.
Two reports were delivered on new lab tests that may dramatically improve and speed the diagnosis and response to active TB. Two other presentations were concerned with cutting costs. One related to a potential lower-cost alternative to viral load testing, the other to a procedure that has made CD4 cell testing more widely available in South Africa because it is a third less expensive than the standard test, which can cost anywhere from R150 to R300.
The standard CD4 cell test is pricey because it is performed on an expensive piece of equipment called a flow cytometer. The South African method uses a haematology analyser to measure white blood cells count simply and cheaply. The approach is cheaper and is usually more accurate than the standard test.
Source: www.aidsmap.com
Estimated worldwide HIV infections: 53 334 718 at 10.01am on Wednesday August 13
Double trouble: Researchers at the University of Cape Town have found further evidence suggesting that patients infected by more than one strain of HIV before seroconversion — when the body starts to produce antibodies to the virus — are more likely to progress rapidly to Aids.
Earlier this year researchers at the University of Washington reported similar findings in four individuals with dual HIV infection who had progressed to Aids or death within two years of infection.
Dual infection can be a consequence of co-transmission, infection with two strains at the same time, or superinfection, when a second HIV infection occurs in an already infected person. The two viruses may be from the same subtype, though genetically highly divergent from each other.
People who become infected during unsafe sex with multiple partners could potentially have a very different clinical outcome from those who become infected during the occasional unsafe sexual encounter.
Source: aidsmap.com
Estimated worldwide HIV infections: 53 247 835 at 9.18am on Thursday August 7
Passing the test: Nevirapine is generally safe and well tolerated by children, reports a United Kingdom paper published in the latest edition of the journal AIDS, but the investigators found that effective control of the virus was improved when they received a higher dose than recommended by the drug’s manufacturer.
Investigators at St Mary’s hospital in London and the North Manchester hospital reviewed the cases of 74 children who were prescribed nevirapine as part of an anti-retroviral programme between 1997 and 1999. The investigators wanted to establish the drug’s safety and its effect on HIV disease progression, CD4 cell count, HIV viral load, and which dose of nevirapine proved the safest and most effective.
Both the liquid suspension and the pill were well tolerated.
A dose of nevirapine higher than the manufacturer’s recommended 300mg daily was found to be significantly associated with achieving and maintaining an undetectable viral load by the end of the study.
Source: www.aidsmap.com
Estimated worldwide HIV infections: 53 133 869 at 11.25am on Wednesday July 30
Resistance: Taking between 60% and 90% of prescribed anti-retrovirals is the surest way to acquire resistance to the drugs, according to the results of a clinical study presented at a recent conference on HIV pathogenesis and treatment in Paris.
The researchers say that 90% adherence is the equivalent of missing no more than five doses in four weeks of a twice-daily regimen, or three doses a month of a once-daily drug.
But a high viral load and, to a lesser extent, a low CD4 cell count were also found to have a lesser bearing on the emergence of resistance. That suggests anti-retroviral therapy does not completely stop viral replication and therefore the emergence of resistance.
A significant minority of those who adhered to anti-retroviral therapy more than 95% of the time were found to have sub-optimal levels of drugs in blood samples taken after therapy began, suggesting that drug interactions or absorption also play a part in the emergence of resistance.
Source: www.aidsmap.com