/ 12 September 2003

HIV/Aids barometer – September 2003

Estimated worldwide HIV infections: 53 953 874 as of Thursday September 25 at 9.56am

Rebound: Immune activation caused by infection with syphilis can stimulate latent reservoirs of HIV and cause viral load to rebound to low levels, according to a recent report on Aids. Researchers say syphilis should be considered as a cause of low-level rebound in patients with previously undetectable viral load.

The case concerned a gay man who had maintained an undetectable viral load for 18 months after starting highly active anti-retroviral therapy. However, low-level HIV viral load was detected on three instances at four-weekly intervals in 2001. Without a change in HIV-treatment regimen the man’s viral load again became undetectable and has remained so for 17 months.

Coinciding with the low rebound in viral load, the patient reported low-grade fevers after several unprotected casual sexual contacts and syphilis was diagnosed.

Researchers say the man’s low-level rebound may have originated from activated reservoirs of previously infected cells.

Source: www.redribbon.co.za, Aidsmap

Estimated worldwide HIV infections: 53 843 866 as of Wednesday September 17

Change of tune: South Africa’s Medicines Control Council (MCC) has issued a statement stressing that the use of nevirapine for the prevention of mother to child transmission is not ‘banned” in South Africa, following the publication of full results from the controversial HivNet 012 study last Friday.

In July the MCC warned nevirapine’s manufacturer, Boehringer-Ingelheim, that the drug’s approval would be rescinded in South Africa unless the company came up with additonal data to support a licence within 90 days.

The MCC was concerned that the standards of data collection in the HivNet 012 study were lax and that important safety information might be missing.

However, South African researchers protested that additional information was available, and called on the MCC to rethink its decision. The MCC has now revealed that it is discussing the data with researchers, and has extended the period allowed to Boehringer-Ingelheim to present further information.

Source: Aidsmap, redribbon.co.za

Estimated worldwide HIV infections: 53 640 776 at 4.15pm on Wednesday September 10

Fat protects: Women who are overweight experience slower HIV progression and have higher CD4 cell counts than women who are underweight, according to research published in the September 1 edition of Clinical Infectious Diseases.

Investigators involved in the HIV Epidemiology Research study recruited 799 HIV-positive women to establish if there was an association between body mass index (BMI) and several clinically important HIV disease outcomes.

Investigators established that a higher baseline BMI was associated with a delay in the time taken for the CD4 cell count to fall below 200. Odds ratios also indicated that women with higher BMI were less likely to experience HIV-related events, ‘whether clinical, immunological or mortality related”.

The odds of death in women who were underweight were 3,1 times greater than in obese women.

Source: Aidsmap.com