August 30, 2006

•  AIDS 2006 RECAPS

More coverage of the XVI International AIDS Conference continues to roll in at The Body. We're still adding recaps of news and research from the conference to our complete AIDS 2006 index; new photos and descriptions to our extraordinary photojournal; and plenty of new podcasts and transcripts to our Podcast Central page. Stop in at any of these pages, or head to The Body's AIDS 2006 home page for a glimpse at our full range of coverage from this massive conference!

What Was the Best and Worst From AIDS 2006? Toronto Newspaper Offers Its Picks
At a meeting as massive as the XVI International AIDS Conference, it can be hard to keep track of the most notable events that took place. The Toronto Star took a stab, however; it's put together a list of the top 10 "hits and misses" from the weeklong conference. The major scientific highlight? Encouraging results on MK-0518, a new type of HIV medication in development known as an integrase inhibitor. Read the full article for more highlights. (Web highlight from the Toronto Star)


Experts at International Conference Cite Gradual Progress in Fight Against AIDS
Ten times more people in Africa are getting life-saving HIV medications today than three years ago, but that still leaves most people in the region without access to treatment, said advocates and experts at AIDS 2006. "The moral imperative of universal access to HIV treatment has never been clearer," said Dr. Helene Gayle, outgoing president of the International AIDS Society. "Treating people is a public health issue, since it prevents further HIV infections," said noted researcher Dr. Julio Montaner during a conference presentation. A computer model used in Dr. Montaner's study showed that, if access to HIV treatment was made universal, the number of HIV-positive people could be reduced from 40 million to fewer than one million over the next 45 years. (Web highlight from Reuters Health)

•  EXCLUSIVE PODCASTS FROM AIDS 2006

AIDS 2006 Through an Activist's Eyes: The Body Interviews Mark Milano
Long-time AIDS activist Mark Milano was front and center in many of the protests that took place in Toronto during AIDS 2006, from a takeover of Abbott Laboratories' exhibition booth to a public skit mocking the United States' use of free-trade agreements to prevent the creation of cheap generic drugs in poor countries. During the conference, Milano took a few moments to talk with The Body and explain why he joined the protests -- and what he and other activists at the conference were fighting for.

Want to see photos of some of the protests that took place during AIDS 2006? Check out The Body's exclusive AIDS 2006 Photojournal for a closer look.


A 23-Year-Old U.S. Woman With HIV Talks About Growing Up With the Virus
At AIDS 2006, we had the opportunity to meet extraordinary HIVers from every corner of the world. One of them is Nina Martinez, a 23-year-old woman living in Georgia who was infected with HIV through a blood transfusion as a baby. In this exclusive interview with The Body, Nina -- who was attending her first International AIDS Conference -- explains how her status impacted her childhood, her studies and her goals in life. "I think the more people that speak up about it, and normalize it -- I think it will be good for the epidemic." Martinez says. "That's why I'm here."

For many more podcasts of interviews with HIVers, advocates, researchers and more, be sure to visit The Body's Podcast Central at AIDS 2006.

•  HIV TREATMENT

Efavirenz-Based Regimens Beat Kaletra-Based Regimens in Head-to-Head Trial
Efavirenz (Sustiva, Stocrin) and Kaletra (lopinavir/ritonavir) are two of the most popular HIV meds prescribed for people who are just starting therapy. For years, doctors have assumed that Kaletra is the more powerful med -- and is thus a better bet for people who start treatment with a low CD4 count or a high viral load. But in the first major, non-industry-sponsored trial to compare the two drugs head to head, a higher percentage of people taking efavirenz maintained an undetectable viral load through 96 weeks -- even if they had more advanced HIV disease. Edwin DeJesus, M.D., reports for The Body from AIDS 2006.


Lopinavir/Ritonavir Monotherapy Still a Risky Proposition, Research Suggests
There's been plenty of excited whispering over the past couple of years about the possible resurgence of "monotherapy" -- HIV treatment using a single, potent medication. In the latest research from AIDS 2006 on this strategy, scientists have found that many people who have had undetectable viral loads for a long time on their current regimen can safely switch to a regimen consisting only of Kaletra (lopinavir/ritonavir). However, the strategy certainly has its risks: Many doctors are concerned that Kaletra monotherapy is less effective than combination drug therapy, and that it may increase the likelihood that people will develop protease inhibitor resistance if their viral load rebounds. As a result, the monotherapy idea is still very much in the experimental stage, reports The Body's Paul Sax, M.D.


Needle-Free Fuzeon Finds Fans Among HIVers, Study Shows
A study presented at AIDS 2006 has shown that a needle-free method of taking T-20 (enfuvirtide, Fuzeon) may be safe and effective over the long term. Created as an alternative for HIVers with moderate to severe injection-site reactions, needle fatigue, a fear of needles or a physical disability that prevents the use of standard syringes, the Biojector 2000 is placed against the skin and uses a carbon dioxide pump to push T-20 through the skin. The first six months of data from the study of 726 HIVers show that 75 percent found the Biojector 2000 preferable to the current needle-and-syringe delivery method. (Web highlight from aidsmap.com)


HAART Still Effective 10 Years On, but Some Causes for Concern Emerge
Ten years after its introduction, combination HIV drug therapy remains effective, although many people are still starting treatment late in the course of their infection, say researchers from the United Kingdom in a study published in The Lancet. Although many experts were worried that the spread of drug resistance would curb the lifesaving effects of modern HIV treatment, this has not occurred, the researchers say -- although they added that the number of deaths among HIVers didn't appear to decrease during the course of the study either. The study also noted that tuberculosis has become a dangerous coinfection in some people, and that HIVers on average have been starting treatment with more advanced disease in recent years. The study is based on data from more than 22,000 HIV-positive people in Europe and North America who started treatment between 1995 and 2003.


Researchers Find New Key to How HIV Disarms Immune System
HIV turns off a molecular "switch" on CD4 and CD8 cells, effectively disabling the immune system's ability to fight off HIV infection, U.S. researchers have found. New studies show that HIV activates a molecule on T cells that makes it harder for CD4 and CD8 cells to replicate. Scientists hope that the finding may lead to new drugs that deactivate this molecule and spur immune response to HIV, but they're very guarded in their optimism: "One has to proceed with real caution because if you turn back on an immune regulatory switch that the body has decided to turn off, you could trigger serious immunological problems," said Dr. Bruce Walker, lead investigator of one of the studies.

For more on this story, check out this recap from BBC News.

•  COMPLEMENTARY THERAPIES

Many Londoners Risk Their Health With Alternative Therapies; Researchers Call for Better Doctor-Patient Communication
One in 10 people who visit HIV clinics in London take complementary or alternative treatments that could endanger their health, according to a study presented at AIDS 2006. The investigators distributed questionnaires at several large HIV treatment centers in London and received 293 responses. Almost two-thirds of the respondents were taking herbal or alternative remedies. The investigators advised 11 percent of the respondents to stop using their complementary or alternative therapies, usually because of potentially dangerous side effects from echinacea, and sometimes because they were taking products that can lower the levels of HIV medications in the blood (e.g., garlic supplements, kava and St. John’s wort). Of the people in this study using alternative and complementary therapies, only 54 percent had discussed it with a health care provider first. (Web highlight from aidsmap.com)


Medical Marijuana Advocates Set Up Shop at AIDS 2006
The faintest hint of marijuana could be found in the air at AIDS 2006, as activists took advantage of Canada's relatively pot-friendly policies to make a pitch for the drug as a painkiller. In the United States, of course, medical marijuana is illegal under federal law, although some states permit its use by people with certain diseases. By contrast, although marijuana is not completely legal in Canada, the federal government runs a medical marijuana program and acknowledges its use as an effective painkiller. "This is the first time that an exhibit of this kind has been at the AIDS conference," said a spokeswoman for the Medical Marijuana Information Resource Center. "It's possible that it may be the only time, until we see a global shift around the policies governing this plant." (Web highlight from Reuters Health)

•  HIV-RELATED COMPLICATIONS

Study Finds Increased Incidence of Anal Cancer in HAART Era; Increased Screening Needed
The incidence of anal cancer -- which is caused by certain types of human papillomavirus (HPV) -- has increased dramatically in France since the introduction of combination HIV therapy (HAART), according to research presented at AIDS 2006. Of 97 new cases of anal cancer diagnosed during the study, 90 percent were diagnosed between 1996 and 2003, after the advent of life-saving combination therapy. The researchers concluded that there has been "a significant increase in the incidence of anal cancer since the introduction of [combination HIV therapy] into standard care for patients in France." They added that their results, along with findings from previous studies, show that combination therapy doesn't appear to reduce a person's risk of developing anal cancer. They attributed the increased incidence to the fact that potent HIV therapy has extended the lives of HIVers -- meaning, ironically, that many more people are now living long enough for pre-cancerous abnormalities to grow into anal cancer. (Web highlight from aidsmap.com)

•  HIV TRANSMISSION & PREVENTION

U.S. Senator Obama Takes Televised HIV Test in Africa
While on a two-week tour of Africa, rising U.S. Senator Barack Obama (D-Ill.) and his wife took HIV tests in Kenya, and encouraged thousands of onlookers to do the same. "If a U.S. senator can get tested and his wife can get tested, then everybody in this crowd can get tested. Everybody in this city can get tested," Obama said. Obama, the only African American in the U.S. Senate, received a warm reception in Kenya, where his father grew up and is buried.

Shortly after starting his two-week Africa trip, Obama echoed the criticism of leaders halfway across the world at the conclusion of XVI International AIDS Conference, who accused the South African government for dragging its feet on providing HIV treatment to its citizens. Speaking at a hospital outside the South African capital of Cape Town, Sen. Obama called for South Africa to end its denial of the epidemic. "It's not scientifically correct," Obama said of the South African health minister's promotion of dietary nutrients over HIV medications. "It's not an issue of Western science versus African science. It's just science. And it's not right." Click here for more on this story.


California Senate Approves Distribution of Condoms in Prisons
The California Senate voted 22-16 to approve a bill that would allow the distribution of safer-sex tools, such as condoms and dental dams, to prison inmates. The bill's author, Assemblyman Paul Koretz (D), says it's a step forward in HIV and sexually transmitted disease prevention for the whole state. Koretz pointed out that the rate of HIV infections among inmates is many times that of the general population; prohibiting safer-sex practices within jails endangers the public once inmates are released, he said. However, opponents of the bill say that condom distribution would only encourage sexual intercourse in prison, an activity that is illegal in California. The bill now goes to Gov. Arnold Schwarzenegger, who will decide whether to sign or veto it.


Microbicides Needed For Women Who Aren't Protected by "ABC" Approach, Advocate Says
"Asking women to simply abstain, be faithful, or use condoms is not practical. Nor is it enough, especially when ... 75 percent of new infections are acquired from a spouse or regular partner," said Graça Machel of the Foundation for Community Development at the opening of a recent conference on microbicides. The international conference, which takes place every two years, brought together community leaders and scientists from throughout the world to discuss the latest in microbicide research and policy. Want to read Machel's full speech? This article provides a transcript.


Japan Reports Record Number of New HIV Infections
From April to June of this year, there were 248 new HIV infections diagnosed in Japan. This is the largest number since mid-2004, according to Health Ministry official Yasuaki Hashimoto, and may indicate the country's HIV infection rate is accelerating. Japan is officially home to 17,000 HIVers -- that's one out of every 7,529 citizens. While this rate is far lower than that of other countries in Asia, experts argue that the number of people with HIV in Japan is severely underreported; they estimate the true number to be two to four times the official report. Hashimoto said that the record increase in new diagnoses could be due to recent HIV awareness campaigns and wider availability of HIV testing.

•  HIV ON TELEVISION

Film on Global AIDS Makes U.S. Television Debut on Aug. 31
Caught up in the daily realities of the global fight against AIDS, it's easy to lose sight of more general questions about the pandemic’s past and future: How is the pandemic intertwined with human rights? How can we respond on a global level to what is possibly the worst plague in human history? A Closer Walk, a film by Academy Award nominee Robert Bilheimer, tries to address these questions by interviewing men and women affected by HIV across four continents. The film will make its United States television debut on PBS on Thursday, Aug. 31, 2006; times and availability vary, so be sure to check your local listings. Narrated by actors Glenn Close and Will Smith, A Closer Walk -- which took Bilheimer three years to film -- features more than 50 interviews with people living with HIV, as well as activists and leaders such as the Dalai Lama, Bono, United Nations Secretary-General Kofi Annan and UNAIDS Director Peter Piot.

To see whether (and when) your local PBS affiliate is airing A Closer Walk, click here.

During his first three months of filming in Haiti, South Africa and Uganda, Robert Bilheimer kept a journal recounting how deeply affected he was by the experience of documenting the harsh realities of AIDS in the developing world. Click here to access Bilheimer’s journal, which he compiled in a series of letters.

•  HIV-RELATED POLICY IN THE UNITED STATES

U.S. Senator Clinton Blocks Renewal of Ryan White CARE Act
While HIVers and AIDS advocates in the United States nervously await the renewal of the Ryan White CARE Act -- which allocates money for AIDS organizations and services throughout the United States -- the act has become caught up in the net of election-year politics. The act technically expired a year ago, but has been extended while politicians wrangle over the details. The most heated discussion surrounds a proposed new funding formula, which would use HIV diagnoses instead of AIDS diagnoses to determine which areas of the United States get the most cash. That has politicians like Hillary Clinton (D-N.Y.) fuming, since her state was one of the focal points of the epidemic in the 1980s and 1990s -- meaning it's now home to a large number of people with advanced HIV (i.e., AIDS), and thus stands to lose funding if the new formula goes into effect. By contrast, rural states -- which have relatively few AIDS cases, but a growing number of new HIV diagnoses -- stand to gain funding from the formula switch. Critics of Clinton say that she isn't just looking out for HIVers in her state, however: They point out that many of the states that stand to lose funding (like California and Florida) could be major swing states in the 2008 presidential election, and that she's just trying to curry favor by fighting on their behalf. (Web highlight from the Washington Post)