AIDSinfo At-a-Glance: Offering Information on HIV/AIDS Treatment, Prevention, and Research, A Service of the U.S. Department of Health and Human Services (DHHS)http://aidsinfo.nih.govinfo.nih.gov is pleased to provide you with a weekly update of highlights about what has happened in the world of HIV/AIDS treatment, prevention, and research. We hope you find this encapsulated view of HIV/AIDS news useful.]]>60<![CDATA[ Participate in the AIDS.gov World AIDS Day Conference Call]]>AIDS.gov is hosting a conference call to provide Federal staff and grantees an update on the state of the HIV/AIDS epidemic in the United States and a brief overview of the global epidemic.

Capacity is limited to the first 3,500 callers, and participants must register by November 15. A podcast and transcript will be available shortly after the call on the AIDS.gov Web site.

More information is available:

 

]]>11/6/2009<![CDATA[ Challenges and Approaches to Future HIV Research Outlined]]>“In a new article in Health Affairs, Anthony S. Fauci, M.D. and Gregory K. Folkers, M.S., M.P.H., discuss the urgent imperative both to scale up proven tools of HIV treatment and prevention, and to develop bold new interventions—from curative therapies to vaccines and other new prevention modalities.  Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health. Mr. Folkers is health scientist and chief of staff in the Immediate Office of the Director, NIAID.

“The authors note that only a fraction of people who need HIV treatment, prevention and related services is receiving them.  Even if access to scientifically proven HIV services were greatly improved by increased funding or improved efficiencies, slowing and ultimately ending the HIV/AIDS pandemic also will likely require major advances in two areas. First, curing a sizable proportion of those already infected with the virus such that lifelong therapy is not required; and, second, developing more powerful prevention tools to slow the rate of new infections. The authors assert that the scientific challenges related to these two goals are the most important issues in HIV/AIDS research today.”

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]]>11/6/2009<![CDATA[ Study of Investigational Integrase Inhibitor in Healthy Volunteers Indicates Safety]]>“S/GSK1349572 is a novel integrase inhibitor with potent in vitro anti-HIV activity, a different in vitro resistance profile than other integrase inhibitors, and a favorable preclinical safety and pharmacokinetics (PK).…In the single-dose study, 2 cohorts of 10 subjects (8 active, 2 placebo) received suspension doses of 2, 5, 10, 25, 50 and 100 mg in an alternating panel design. In the multiple-dose study, 3 cohorts of 10 subjects (8 active, 2 placebo) received suspension doses of 10, 25 and 50 mg once daily for 10 days....S/GSK1349572 was well tolerated. Most adverse events (AEs) were mild, with few moderate AEs reported.…PK was linear over dosage range studied.…The half-life was approximately 15 hours.…The PK profile suggests once daily, low milligram doses will achieve therapeutic concentrations.”

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]]>11/6/2009<![CDATA[ Larger Foreskin Surface Area Linked to Increased Risk of HIV Infection in Men]]>“Male circumcision reduces HIV acquisition in men. We assessed whether foreskin surface area was associated with HIV acquisition prior to circumcision….In two randomized trials of male circumcision, the surface area of the foreskin was measured after surgery using standardized procedures. Nine hundred and sixty-five initially HIV-negative men were enrolled in a community cohort who subsequently enrolled in the male circumcision trials, provided 3920.8 person-years of observation prior to circumcision. We estimated HIV incidence per 100 person-years prior to circumcision, associated with foreskin surface area categorized into quartiles….Mean foreskin surface area was significantly higher among men who acquired HIV (43.3 cm2, standard error 2.1) compared with men who remained uninfected (36.8 cm, standard error 0.5, P = 0.01)….The risk of male HIV acquisition is increased among men with larger foreskin surface areas.”

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]]>11/6/2009<![CDATA[ Volunteer for a Research Study to Help Fight Influenza]]>The National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH) is looking for volunteers to participate in influenza clinical studies. The studies help scientists learn ways to prevent, diagnose, and treat seasonal and pandemic influenza, including H1N1. Clinical studies are available for people with both healthy immune systems and weakened immune systems, which includes individuals who are infected with HIV.

 

Influenza studies are being conducted at the NIH Clinical Center in Bethesda, MD, and at sites across the country. Visit the following Web sites for the latest in NIAID-supported influenza research and detailed information on clinical trials seeking new volunteers:

 

]]>11/6/2009<![CDATA[ Results of Two Studies: Interleukin-2 Plus Antiretroviral Therapy Yields No Clinical Benefit as Compared with Antiretroviral Therapy Alone]]>“Used in combination with antiretroviral therapy, subcutaneous recombinant interleukin-2 raises CD4+ cell counts more than does antiretroviral therapy alone. The clinical implication of these increases is not known. …We conducted two trials: the Subcutaneous Recombinant, Human Interleukin-2 in HIV-Infected Patients with Low CD4+ Counts under Active Antiretroviral Therapy (SILCAAT) study and the Evaluation of Subcutaneous Proleukin in a Randomized International Trial (ESPRIT). In each, patients infected with the human immunodeficiency virus (HIV) who had CD4+ cell counts of either 50 to 299 per cubic millimeter (SILCAAT) or 300 or more per cubic millimeter (ESPRIT) were randomly assigned to receive interleukin-2 plus antiretroviral therapy or antiretroviral therapy alone. …The primary end point of both studies was opportunistic disease or death from any cause. ...Over a median follow-up period of 7 to 8 years, the CD4+ cell count was higher in the interleukin-2 group than in the group receiving antiretroviral therapy alone--by 53 and 159 cells per cubic millimeter, on average, in the SILCAAT study and ESPRIT, respectively. ...Despite a substantial and sustained increase in the CD4+ cell count, as compared with antiretroviral therapy alone, interleukin-2 plus antiretroviral therapy yielded no clinical benefit in either study.”

 

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]]>11/6/2009<![CDATA[ Study Concludes Survival Disparities are Most Pronounced for Hispanic and Latino HIV-Infected Individuals]]>

"Most persons with human immunodeficiency virus (HIV) infection in the United States present to care with advanced disease, and many patients discontinue therapy prematurely. We sought to evaluate sex and racial/ethnic disparities in life-years lost as a result of risk behavior, late presentation, and early discontinuation of HIV care, and we compared these survival losses for HIV-infected persons with losses attributable to high-risk behavior and HIV disease itself. ...With use of a state-transition model of HIV disease, we simulated cohorts of HIV-infected persons and compared them with uninfected individuals who had similar demographic characteristics. We estimated non-HIV-related mortality with use of risk-adjusted standardized mortality ratios, as well as years of life lost because of late presentation and early discontinuation of antiretroviral therapy (ART) for HIV infection. Data from the national HIV Research Network, stratified by sex and race/ethnicity, were used for estimating CD4(+) cell counts at ART initiation.…The high-risk profile of HIV-infected persons, HIV infection itself, as well as late initiation and early discontinuation of care, all lead to substantial decreases in life expectancy. Survival disparities resulting from late initiation and early discontinuation of therapy are most pronounced for Hispanic HIV-infected men and women. Interventions focused on risk behaviors, as well as on earlier linkage to and better retention in care, will lead to improved survival for HIV-infected persons in the United States.”

 

More information is available:

]]>11/6/2009<![CDATA[ CDC Updates Interim Recommendations for H1N1 Influenza for HIV-Infected Adults and Adolescents]]>"HIV-infected adults and adolescents, especially persons with low CD4 cell counts or AIDS, can experience more severe complications of seasonal influenza. Among patients hospitalized with confirmed 2009 influenza A (H1N1) infections in the United States, the prevalence of certain underlying conditions, including immunosuppressing conditions, has been higher than in the general population suggesting HIV-infected adults and adolescents also might be at higher risk for complications related to infection with 2009 influenza H1N1. ...

"This guidance will be updated as more information becomes available, including information on the risk of 2009 H1N1 flu-related complications among HIV-infected adults and adolescents."

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]]>11/6/2009<![CDATA[ Published Results of Thai HIV Vaccine Study Available]]>“In a community-based, randomized, multicenter, double-blind, placebo-controlled efficacy trial, we evaluated four priming injections of a recombinant canarypox vector vaccine (ALVAC-HIV [vCP1521]) plus two booster injections of a recombinant glycoprotein 120 subunit vaccine (AIDSVAX B/E). The vaccine and placebo injections were administered to 16,402 healthy men and women between the ages of 18 and 30 years in Rayong and Chon Buri provinces in Thailand. ...In the intention-to-treat analysis involving 16,402 subjects, there was a trend toward the prevention of HIV-1 infection among the vaccine recipients, with a vaccine efficacy of 26.4% (95% confidence interval [CI], -4.0 to 47.9; P=0.08). … In the modified intention-to-treat analysis involving 16,395 subjects (with the exclusion of 7 subjects who were found to have had HIV-1 infection at baseline), the vaccine efficacy was 31.2% (95% CI, 1.1 to 51.2; P=0.04). Vaccination did not affect the degree of viremia or the CD4+ T-cell count in subjects in whom HIV-1 infection was subsequently diagnosed. …This ALVAC-HIV and AIDSVAX B/E vaccine regimen may reduce the risk of HIV infection in a community-based population with largely heterosexual risk. Vaccination did not affect the viral load or CD4+ count in subjects with HIV infection. Although the results show only a modest benefit, they offer insight for future research.”

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]]>11/6/2009<![CDATA[ Abacavir/Lamivudine and Tenofovir/Emtricitabine Equal in Efficacy, Not in Side Effects]]>“We compared [tenofovir/emtricitabine] TDF-FTC and [abacavir/lamivudine] ABC-3TC in a randomized, open-label, 96-week trial in which either fixed-dose-combination was substituted for current nucleoside treatments in human leukocyte antigen-B*5701-negative adults with human immunodeficiency virus loads <50 copies/mL. … Of 441 patients who were screened, 357 were treated; 98% were men, the mean age was 45 years, 30% were receiving TDF, 20% were receiving ABC, and 24% were receiving a protease inhibitor. Virological failure was uncommon (5.6% for ABC-3TC and 3.9% for TDF-FTC; difference, 1.7%; 95% confidence interval [CI]). … No participant developed AIDS, whereas 18 (5%) participants developed a serious non-AIDS event (rate, 2.79 events per 100 person-years; 95% CI, 1.76-4.43), of which 4 were fatal. … In this population, TDF-FTC and ABC-3TC had similar virological efficacy, but ABC-3TC was associated with more serious non-AIDS events, particularly cardiovascular events.”

More information is available:

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]]>11/6/2009<![CDATA[ October 15 is National Latino AIDS Awarenes Day]]>"'National Latino AIDS Awareness Day is a reminder of HIV and AIDS’ heavy impact on the Latino community.  Every nine and a half minutes someone new is infected with HIV, and almost one-fifth of people who are living with HIV and AIDS are Latino.'

"'The rate of new HIV infections among Hispanic men is more than double that among white men, with gay and bisexual men particularly affected.  Also the rate of new HIV infections among Hispanic women is nearly four times that of white women.  These people aren’t statistics -- they are our friends, neighbors, and people we love -- and the Centers for Disease Control and Prevention (CDC) says the number of Latinos living with AIDS is growing.'

"'National Latino AIDS Awareness Day serves as another important reminder.  HIV and AIDS are preventable.  Taking an HIV test gives you the power to stop HIV transmission.  If you know your HIV status, you can take steps to protect your partner.  If you find out you are HIV-positive, then you can get life-extending treatment.  CDC recommends that everyone between the ages of 13 and 64 get tested for HIV.'"

More information is available:

]]>11/6/2009<![CDATA[ NIH Begins H1N1 Vaccine Trial in HIV-Infected Pregnant Women; HIV-Infected Youth and Children's Trial to Begin Soon]]>"The first clinical trials to test whether the 2009 H1N1 influenza vaccine can safely elicit a protective immune response in pregnant women launched [October 8, 2009], and a trial to conduct the same test in HIV-infected children and youth will begin [in the coming weeks]. The International Maternal Pediatric Adolescent AIDS Clinical Trials Group is conducting the studies, which are sponsored and funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), both part of the National Institutes of Health.

"'These studies are important because HIV infection and pregnancy both increase the risk for a poor immune response to the normal 15-microgram dose of seasonal influenza vaccine given to the general population,' says NIAID Director Anthony S. Fauci, M.D. 'Moreover, children, young people and pregnant women are at higher risk for more severe illness from the 2009 H1N1 influenza virus than other groups, and HIV-infected individuals in these populations may be particularly vulnerable.'

"'Because of the increased vulnerability of these populations, these trials are testing whether  doses of licensed 2009 H1N1 influenza vaccine that are higher than doses being tested in other groups can safely elicit protective immune responses in HIV-infected children, youth and pregnant women,' adds Lynne Mofenson, M.D., chief of the Pediatric, Adolescent and Maternal AIDS Branch in NICHD.

"One trial will enroll 130 HIV-infected pregnant women ages 18 to 39 years who are in their second or third trimester (14 to 34 weeks) of pregnancy. The other trial will enroll 140 children and youth aged 4 to 24 years who were infected with HIV at birth."

More information is available:

 

]]>11/6/2009<![CDATA[ Study Offers New Lead for Antiretroviral Drug Development]]>"Nef is an HIV-1 accessory protein essential for AIDS progression and an attractive target for drug discovery. Lack of a catalytic function makes Nef difficult to assay in chemical library screens. We developed a high-throughput screening assay for inhibitors of Nef function by coupling it to one of its host cell binding partners, the Src-family kinase Hck. Hck activation is dependent upon Nef in this assay, providing a direct readout of Nef activity in vitro. Using this screen, a unique diphenylfuropyrimidine was identified as a strong inhibitor of Nef-dependent Hck activation. This compound also exhibited remarkable antiretroviral effects, blocking Nef-dependent HIV replication in cell culture. Structurally related analogs were synthesized and shown to exhibit similar Nef-dependent anti-viral activity, identifying the diphenylfuropyrimidine substructure as a new lead for antiretroviral drug development. This study demonstrates that coupling non-catalytic HIV accessory factors with host cell target proteins addressable by high-throughput assays may afford new avenues for the discovery of anti-HIV agents."

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]]>11/6/2009<![CDATA[ Cardiovascular Risk Factors in Treatment-Naïve People with HIV Infection]]>"Various studies have been conducted to evaluate the role of antiretroviral therapy in the onset of cardiovascular risk among HIV-1-infected patients, while fewer data are available regarding antiretroviral-naïve patients. Our objective was to evaluate the cardiovascular risk among naïve subjects examining traditional risk factors, immunovirologic parameters, assessing the Framingham risk score (FRS), and detecting the presence of subclinical carotid lesions by means of color Doppler ultrasonography. One hundred seventy-two antiretroviral-naïve patients underwent color Doppler ultrasonography.... Thirty-six patients (20.9%) had lesions at ultrasonographic investigation. The presence of lesions was significantly related to male gender (p = 0.005), age (p = 0.003), sedentary life (p = 0.05), Centers for Disease Control and Prevention (CDC) group C or CD4(+) less than 150 cells/mm(3), and viral load (VL) > 100,000 copies per milliliter (p = 0.04). The presence of subclinical carotid lesions showed a highly significant direct association with the estimated FRS (p < 0.002). The presence of subclinical atheromasic lesion results was also high among antiretroviral-naïve patients.... Our data support the hypothesis that HIV infection per se is a risk factor for atherosclerosis. We recommend an ultrasonographic assessment both among patients with FRS 6% or more and among those in advanced stage of disease."

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