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Issue No. 47 | November 12, 2010

News and Features

HHS Pediatric Guidelines Panel Accepting Nominations for New Member

The Department of Health and Human Services (HHS) Panel on Pediatric Antiretroviral Therapy and Management Guidelines (the Pediatric Guidelines Panel) is accepting nominations for a new member with clinical research and/or practice expertise in the management of HIV infection in children. The ideal candidate shall have scientific expertise in pediatric/adolescent HIV infection as evidenced by, for example, participation in pediatric clinical research networks and meaningful contributions to peer review journals related to pediatric HIV infection. One Panel vacancy is anticipated.

The Pediatric Guidelines Panel is a Working Group of the Office of AIDS Research Advisory Council (OARAC) of the National Institutes of Health (NIH). The Panel is composed of approximately 25 members including clinicians, researchers, academicians, and HHS representatives with expertise in pediatric HIV management, as well as community representatives with knowledge of HIV infection in children. The Panel meets monthly via teleconference (and occasionally in person) to evaluate emerging scientific data to update the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. The latest guidelines were released on August 16, 2010, and are available on the AIDSinfo Web site.

The successful candidate shall serve a 3-year term (with option for renewal) beginning January 2011. Panel members are not compensated for their time commitment, and travel support is not provided for participation.

The nomination should include a curriculum vitae and a letter of nomination or letter of interest outlining what qualities and contributions the candidate may bring to the Panel. Please submit nominations no later than December 22, 2010, to Lynne M. Mofenson, M.D., Panel Executive Secretary, at or; or to the National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd, Room 4B11, Rockville, MD 20852; or Fax to 301-496-8678.

NIH Scientists Shed Light on Immune Reconstitution Inflammatory Syndrome

“Newly published research by scientists at the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, sheds light on a poorly understood, acute illness called Immune Reconstitution Inflammatory Syndrome (IRIS) that develops in some HIV-infected individuals soon after they begin antiretroviral therapy.

“IRIS affects certain HIV-infected individuals whose immune systems are heavily damaged by the virus and who have a treated or undiagnosed AIDS-associated infection. When these individuals start antiretroviral therapy and their immune cells begin to regenerate, the immune system unexpectedly produces an exaggerated response that unmasks or worsens the symptoms of the co-infection. IRIS has become a notable challenge in treating HIV disease …

“To find immunologic patterns that distinguish individuals who develop IRIS from those who do not, the researchers analyzed blood samples from HIV-infected individuals …

“The analysis showed that the individuals who developed IRIS had a higher proportion of activated T cells before starting antiretroviral therapy compared with those who did not develop IRIS. …

“A companion study describes a new animal model that can be used to directly analyze the immunologic mechanisms that cause IRIS. This model employs mice infected with Mycobacterium avium, a pathogen frequently seen in HIV-infected individuals who develop IRIS. To mimic the immunologic condition of IRIS-susceptible HIV-infected individuals, the researchers began with mycobacterium-infected mice that had extremely low numbers of T cells. The scientists found that rebuilding the population of T cells in these mice, as usually occurs during antiretroviral therapy in humans, triggered an IRIS-like disease.”

More information is available:

FDA Approves Tesamorelin (Egrifta) to Treat Lipodystrophy in HIV-Infected People

“The U.S. Food and Drug Administration today approved Egrifta (tesamorelin) to treat HIV patients with lipodystrophy, a condition in which excess fat develops in different areas of the body, most notably around the liver, stomach, and other abdominal organs. The condition is associated with many antiretroviral drugs used to treat HIV.

“Egrifta, the first FDA-approved treatment for lipodystrophy, is a growth hormone releasing factor (GRF) drug that is administered in a once-daily injection. …

“Egrifta was evaluated in two clinical trials involving 816 HIV-infected adult men and women with lipodystrophy and excess abdominal fat. Of these, 543 patients received Egrifta during a 26-week, placebo-controlled period. In both studies, patients treated with Egrifta experienced greater reductions in abdominal fat as measured by CT scan, compared with patients receiving another injectable solution (placebo). Some patients reported improvements in their self image.

“The most commonly reported side effects in the studies included joint pain (arthralgia), skin redness and rash at the injection site (erythema and pruritis), stomach pain, swelling, and muscle pain (myalgia). Worsening blood sugar control occurred more often in patients treated with Egrifta than with placebo.”

More information is available: