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Issue No. 24 | June 10, 2011

News and Features

NIH Scientists Attenuate B-Cell Exhaustion in Chronic HIV

“Healthy B cells have a balanced mix of surface proteins that the immune system can use, like the gas pedal and brake of a car, either to activate the cell or to damp down its activity. However, in people with long-term HIV infection who have not begun antiretroviral therapy, their B cells—responsible for producing anti-HIV antibodies—display a surplus of inhibitory receptors, the surface proteins used to apply the brakes on a B cell. Scientists from the NIAID Laboratory of Immunoregulation led by Lela Kardava, Ph.D., Susan Moir, Ph.D., and Anthony S. Fauci, M.D., NIAID Director and Chief of the laboratory, wanted to know if this phenomenon can help explain why B cells become 'exhausted' and essentially shut down in people who are HIV-infected but treatment-naive.

“To test their hypothesis, the scientists used molecules called small interfering RNAs (siRNAs), which acted at the genetic level to prevent exhausted B cells from replenishing inhibitory receptors. After treatment with siRNAs, the exhausted cells responded more normally to conditions that typically would spur a B cell into action … demonstrating that the excess of inhibitory receptors may explain why exhausted B cells are so unresponsive.

“Because B cells generally are difficult to manipulate, the new siRNA-based approach may hold promise for scientists seeking to develop therapies to improve the human antibody response against HIV and other pathogens by altering the expression of specific B-cell genes.”

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CDC Releases Extended HIV Surveillance Report

“On the 30th anniversary of the epidemic, to characterize trends in HIV infection and AIDS in the United States during 1981--2008, CDC analyzed data from the National HIV Surveillance System. …

“For this report, AIDS data reported to CDC by the end of June 2010 from 50 states and DC were analyzed to determine the annual number of AIDS diagnoses, deaths among persons with AIDS, and persons living with AIDS from 1981 through 2008. … Additionally, by using 1) HIV and AIDS data for persons aged ≥13 years at diagnosis from 40 states that have had confidential name-based HIV infection reporting since at least January 2006 and 2) AIDS data from 11 areas, CDC estimated the annual number of persons living with HIV infection using extended back-calculation … .

“At the end of 2008, an estimated 1,178,350 persons aged ≥13 years were living with HIV infection, including 236,400 (20.1%) whose infections had not been diagnosed ... . Most (75.0%) persons living with HIV were male, and 65.7% of the males were men who have sex with men (MSM). HIV prevalence rates among blacks or African Americans (1,819.0 per 100,000 population) and Hispanics or Latinos (592.9) were approximately eight times and two and a half times the rate among whites (238.4) ... .”

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Spring 2011 Issue of mental health AIDS Now Available

The quarterly biopsychosocial research update on HIV and mental health, mental health AIDS, is sponsored by the Center for Mental Health Services (CMHS) of the Substance Abuse and Mental Health Services Administration (SAMHSA) and is disseminated free of charge through the SAMHSA Web site.

The Spring 2011 issue features an article titled, “HIV Prevention 2011: Hits, Misses, & Hopes.”

In this article, recent advances in biomedical HIV prevention research, including the positive findings from the iPrEx and CAPRISA 004 studies, are contrasted with the less successful findings of several studies that focused on behavior change interventions.

Despite this, behavioral health research in the field of HIV prevention continues to evolve because behavior change remains integral to a combination approach to HIV prevention. Biomedical, behavioral, and structural interventions must be used in combination and tailored to the HIV epidemic at the local level in order to decrease HIV transmission. 

Finally, the article discusses a study that employed a mental health-focused HIV prevention model in the primary care setting, which included training HIV-infected peer advocates to administer an individually tailored counseling intervention for sexual safety and general coping to HIV-infected men who have sex with men (MSM).

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