HIV/AIDS Conference: Treatment Must Be Started Sooner

People with HIV need to start antiretroviral treatment sooner, according to South African and international specialists gathered for a major Aids conference in Cape Town this week.

Dr Pedro Cahn, a past president of the International Aids Society, which is meeting in Cape Town, said: “Everyone agrees that a CD4 of 350 should be the minimum standard.”

In fact, most patients start therapy with far lower CD4 counts, said Dr Francois Venter, president of the HIV Clinicians Society of Southern Africa, as they tend to seek medical help only when they fall sick, and not as the result of regular testing.

If patients with CD4s of 350 were offered treatment, the number of people needing the drugs would soar. In the past seven years, about four million people worldwide have been put on antiretrovirals, and about six million more need treatment at the CD4 threshold of 200.

Dr Wafaa El-Sadr, director of the International Centre for Aids Care and Treatment Programmes in the US, said the world had seen a dramatic decline in Aids deaths since 1996 — but now non-Aids -related mortality was increasing.

She said that people with HIV were at higher risk of dying from non-Aids related diseases as they aged, like stroke or renal failure, than those without the virus. El-Sadr said studies had shown that deferring treatment increased the risk of death. Courtesy The Times Of London.

Your Momma Was Right: Wash Your Hands!

Unwashed hands probably have led to an outbreak of hepatitis A in several cities in Illinois. While yet uncomfirmed, the probable initial source of the outbreak may be a McDonalds Restaurant in Milan, Il. Public officials are invterviewing people who are ill in an effort to determine the cause.

So far the Illinois Department of Public health has confirmed 19 cases and two suspect cases of the contagious disease.

Hepatitis A is rarely fatal, and most people recover in a few weeks without any complications. It does not have potential to permanently damage the liver, as other forms of hepatitis do

However HIV Poz people should make sure they're up to date on their Hep A and Hep B shots. Having the shots will prevent you from being infected. As many retroviral drugs are metastasized in the liver, it's vital to avoid diseases that can cause liver problems. As of yet, there is no shot for Hep C which can be fatal.

Feds: States Must Give Licenses To Poz People

Aspiring barbers, masseuses, and home health care aides cannot be denied professional licenses because they have AIDS or HIV, federal authorities said Thursday.

The Justice Department is advising state authorities that it is a violation of the Americans with Disabilities Act to stop someone with the HIV virus from getting such licenses or not admitting them to occupational training schools.

For instance, some states require cosmetologists be free from contagious, communicable or infections diseases. The government says that type of regulation is outdated and was not intended to bar people with HIV.

The original goal of such a rule was to prevent the spread of tuberculosis and other diseases, not prevent people with the HIV virus from working in certain fields. Because HIV is not spread through casual contact, barring people with the virus from such professions is discriminatory, officials said.

"People with HIV or AIDS should not be denied access to their chosen profession because of outdated laws or unfounded stereotypes and fears," said Loretta King, the acting head of the Justice Department's Civil Rights Division.

The Supreme Court has found people with AIDS or HIV are covered under the law barring discrimination against people with disabilities. Courtesy AP.

Lawsuit: HIV POZ Man Denied Hair Transplant By Florida Doc

A South Florida man claims he was refused a hair transplant because he is HIV positive, and now he's suing the doctor who denied him the new do for discrimination.

Diego Del Rio went to the Age Defying Surgical Center in Fort Lauderdale to approve his appearance, but Dr. Brett Bolton turned him down once he learned of Del Rio's condition.

"Their medical staff told me 'We will not do the procedure because you are HIV positive.' I told them, 'This is discrimination,' and they stated 'No it's not,'" Del Rio said.

Del Rio had undergone one hair transplant before at another facility, but ADSC allegedly told Del Rio that they don't accept patients with a history of HIV or hepatitis.

Del Rio's lawyer, Matthew Dietz, said this policy is in direct contradiction of a 1988 Florida law.

"The big picture here is that people cannot be in any way discriminated against because of their aids or their HIV status," Dietz said. "There's no excuse because there's not one doctor in the state of Florida that doesn't know this. Issues like this should not happen in this day and age."

Bolton wouldn't comment and referred all questions to his lawyer, who said he also wouldn't speak because the lawsuit is pending.

Courtesy NBC Universal.

Research: Why Women Descend Into AIDS More Quickly Than Men

Researchers at Massachusetts General Hospital in Boston say they have discovered why HIV progresses to AIDS much sooner in women than in men.

HIV-infected women often get full blown AIDS much sooner than infected men.

A Massachusetts General Hospital study headed by Dr. Angele Meier, found women with HIV had a 1.6% higher risk of developing AIDS.

Researchers also found a woman's immune system reacts much stronger to rid the body of the virus than a man's. This long term hyper immune system response may increase a woman's descent into advanced AIDS.

June 27th Is National HIV Testing Day

The National Association of People with AIDS (NAPWA) started National HIV Testing Day (NHTD) in 1995. Every year, on June 27th, local organizations across the nation engage with communities to promote early diagnosis and HIV-testing.

The Centers for Disease Control and Prevention (CDC) estimates that 250,000 of the one million people living with HIV/AIDS in the United States are unaware of their status. NAPWA realizes that lack of access to treatment and care along with social stigma can make living with HIV difficult. With early diagnosis, uncertain individuals will know their HIV-status and should be placed into appropriate treatment and care.

During NHTD, we work with our partners, which include thousands of community-based organizations, businesses, health departments, elected officials, media, and individuals to encourage routine HIV-testing and to promote culturally-apt messages for those affected by and living with HIV/AIDS.

HIV Rates Rise With Gay Intolerance

Bans on same-sex marriage can be tied to a rise in the rate of HIV infection, a new study by two Emory economists has found.

In the first study of the impact of social tolerance levels toward gays in the United States on the HIV transmission rate, the researchers estimated that a constitutional ban on gay marriage raises the rate by four cases per 100,000 people.

“We found the effects of tolerance for gays on HIV to be statistically significant and robust — they hold up under a range of empirical models,” says Hugo Mialon, assistant professor of economics.

“Laws on gay marriage are in flux and under debate,” adds Andrew Francis, also an assistant professor of economics, citing the recent decision by the California Supreme Court to uphold a ban on same-sex marriage. “It’s a hot issue, and we are hoping that policymakers will take our findings into account.”

The study used data from the General Social Survey, which has tracked the attitudes of Americans during the past four decades. The economists calculated that a rise in tolerance from the 1970s to the 1990s reduced HIV cases by one per 100,000 people, and that laws against same-sex marriage boosted cases by 4 per 100,000.

“Intolerance is deadly,” Mialon says. “Bans on gay marriage codify intolerance, causing more gay people to shift to underground sexual behaviors that carry more risk.”

Francis and Mialon previously did an analysis of the optimal penalty for sexually transmitting HIV. Published in March 2008, the study was recently named outstanding paper of the year by the American Law and Economics Review.

The researchers developed a game theory model for sexual behavior, which showed that laws in some states regarding the sexual transmission of HIV are generally inefficient at slowing the spread of the disease.

In Georgia, for instance, failing to inform a partner that you are HIV positive prior to having sex is a felony punishable by up to 30 years in prison. The same penalty can apply even if the person who is HIV positive uses precautions such as a condom during sex, and even if the sexual partner does not contract HIV. The law does not apply, however, to people who do not know that they are HIV positive and transmit the virus.Courtesy of Emory University.

AIDS Activists Protest Proposed HIV Funding Cuts In California

Valley AIDS activist rallied in downtown Fresno Monday to protest proposed funding cuts to HIV/AIDS programs.

Hundreds gathered in front of the State of California office on Mariposa St. against an estimated $80.1 million budget cut to HIV/AIDS services for Californians either living with or at risk for the disease.

Last month California’s department of finance released details of the governor’s proposed cuts of general funds from the state office of aids.

The budget cut includes $12.3 million in general fund support to the aids drug assistance program, and eliminates general fund support for other programs totaling more than $67.8 million.

Gov. Arnold Schwarzenegger proposed cutting funding to the programs to help balance the state budget, but AIDS activists say this could be a death sentence for many Californians.

Under the governor’s current proposal HIV/AIDS programs such as the Aids Drug Assistance Program, the Early Intervention Program, and HIV counseling and testing are set for reductions or elimination. Courtesy CBS47tv.

Overly Restrictive U.S. Govt Rules Keeping Canadians from U.S. AIDS Conference

Housing Works, an AIDS non-profit based in New York, is reporting on their website that up to 60 Canadians living with HIV have been denied entry into the United States, contrary to stated U.S. policy that foreigners living with HIV would no longer be barred from entering the country. The groups are calling on Secretary of State Clinton to resolve the matter and on President Obama to do away with Department of Health and Human Services (DHHS) regulations that are effectively keeping the HIV travel ban in place.

The 60 Canadians had planned to attend the North American Housing and HIV/AIDS Research Summit in Washington, D.C. from June 2 to June 5.

In July 2008, President Bush signed a law authorizing the Department of Health and Human Services to lift the decades-long ban on foreigners living with HIV entering the United States. The U.S. is one of only 14 countries* in the world that bar entry to persons with HIV, a fact that has drawn broad condemnation from both domestic and international human rights organizations.

Yet the ban still has not yet been stricken from DHHS regulations; instead, the Department of Homeland Security put into place a series of measures designed to “streamline” the process for entry into the U.S. for people living with HIV. In March, DHHS officials indicated that granting a “designated event HIV waiver” for the Housing Summit was underway. Such waivers are designed to allow people living with HIV to attend conferences in the U.S.

On Friday, May 22, 11 days before the summit start date, the Ottawa Embassy informed the OHTN that each of the 60 people in its delegation to the Washington, D.C. AIDS Housing Summit would have to comply with the new visa process.

The visa process requires, among other things, a face-to-face interview; a photo; a $131 money order from a specific Canadian bank; an agreement not to extend the visit for any reason; completion of a health form, and a pledge that the applicant has adequate health coverage. Because the group was notified so close to the conference time, organizers said it would be nearly impossible to meet the requirements set by Homeland Security. It remains to be seen whether any of the participants made it to the conference which starts today in Washington..

Politician: HIV Poz People Should Be Branded

A Swaziland MP who last week suggested that HIV positive people be branded on the buttocks on Thursday distanced himself from the statement, saying he was misquoted by the media.

An apologetic Timothy Myeni told reporters in Johannesburg that he had not thought through his posing of "a mark" for HIV-positive Swazis last week at a workshop on ways of fighting the scourge in the small mountain kingdom.

"I want to disassociate myself from the statement that has been doing rounds in the media saying I suggested that people with HIV should be branded. That is not what I said," said Myeni, who also sings with a popular gospel group.

"I posed a question to the workshop facilitator saying maybe those who have been found with the virus must have a mark so that they can get quick medical attention."

Myeni added that he had immediately retracted his question after it was shot down by workshop participants.

The widely-reported comments sparked an uproar in Swaziland, one of the world's poorest nations with the highest HIV prevalence in the world under the rule of Africa's last absolute monarch King Mswati III.

"I am very sorry for the damage that has been caused by the statement, I never imagined that it will be interpreted this way," added Miyeni.

Copyright AFP

NYT: First Hand Account Of Doctors And Infection Risks

When we think of dangerous work, doctoring isn’t usually what comes to mind. Of course, police and firefighters, construction site workers and window washers face daily risks, but doctors?

As Dr. Pauline Chen writes in her latest Doctor and Patient column, caring for patients with contagious diseases puts every health care worker on the front lines of a potentially deadly outbreak. Whether it’s a physician treating swine flu or a nurse working amidst the deadly SARS outbreak in Asia, health care workers face far higher risk of exposure than the rest of us. Follow the link to the article in the New York Times.

http://www.nytimes.com

HIV + 'ers File Suit Over Lost Medical Records

Four HIV-positive patients whose records were left behind on an MBTA train by a Massachusetts General Hospital employee are suing the hospital, contending their privacy was breached.

In March, the hospital notified 66 patients who received care at its Infectious Disease Associates outpatient practice that billing records bearing their names, Social Security numbers, doctors, and diagnoses had been lost by a manager who was riding the Red Line. She had brought the paperwork home for the weekend, but left it on the train when she returned to work Monday morning, March 9, according to a hospital security report.

Last week two of the 66 patients filed a breach-of-privacy suit in Suffolk Superior Court against the hospital and the unidentified billing manager. Two more have since joined them. All four unnamed patients are HIV-positive.

The plaintiffs' lawyer, John Yasi, said in an interview he has filed a motion to make the suit a class action that could cover all 66 patients, a significant number of whom are HIV-positive.

"The damages that jump out are the emotional distress surrounding the loss of obviously very sensitive medical information and, secondarily, the loss of personal security information," he said. "A Social Security number in reality may lead to identity theft, which we all know is a nightmare."

Mass. General officials declined to be interviewed, but said in a statement that doctors had called patients to apologize. "We have learned valuable lessons from this difficult situation," the statement said. "We are strengthening our efforts to protect patient health information through such means as enhanced training programs and by identifying and limiting situations that could put health information at risk."

Courtesy Boston Globe

CNN: Elton John Speaks Out About HIV/AIDS

Elton John may be famous for smash hits such as "Tiny Dancer" and scores for films such as "The Lion King," but he's also made a name for himself in HIV/AIDS activism.

The singer-songwriter established the Elton John AIDS Foundation in the United States and the United Kingdom to support HIV prevention programs, efforts to eliminate stigma and discrimination associated with the disease, and care and support services for people living with the condition. The foundation has raised more than $150 million. John has said that Ryan White, an Indiana teenager who died of HIV/AIDS in 1990, inspired him to create this foundation.

John sat down with CNN Chief Medical Correspondent Dr. Sanjay Gupta before speaking Tuesday at the Bio International Convention in Atlanta, Georgia.

Here is the link to the complete article on CNN.

http://www.cnn.com/2009/HEALTH/05/19/elton.john.aids/

Georgia Receives 63.9 Million Dollars For HIV/AIDS

The Ryan White HIV/AIDS Program has awarded Georgia $63.9 million in federal grants for use in the treatment and care of people living with the disease.

The federal program provides health services funding for infected people who don’t have sufficient coverage or financial resources. Overall, more than $1.79 billion was given nationally.

In Georgia, recipients include county public health departments and community organizations such as AIDGwinnett, a Duluth-based program that provides medical care, testing, counseling, meal delivery and other services.

The grants will be used to provide outpatient health services, drug assistance, health insurance payments and support services like transportation and housing. Organizations that work with afflicted individuals say this infusion of money is much needed.

In 2007, there were more than 18,000 people with HIV/AIDS living in Georgia. Georgia ranks sixth among states and Washington with the number of HIV-positive people.

“Ryan White was the Indiana teen with hemophilia who contracted the disease though a blood transfusion. He attracted international attention for his fight to remain in school. There was a movie made about his life, and his cause was backed by a number of celebrities, including pop star Michael Jackson.

The program is administered by the Health Resources and Services Administration, which is an agency within the U.S. Department of Health and Human Services. It helps more than 529,000 people annually receive the care and services needed to live healthier lives, according to a release by the agency. Courtesy Atlanta Journal Constitution.

Study: Smoking And HIV Don't Mix

New research suggests that HIV Positive smokers may have an enhanced risk of emphysema, and tend to suffer a swifter declone in lung function.

The research was presented by Syed Kadri, a medical student at Ohio State University Medical Center, on Sunday, at the 105th International Conference of the American Thoracic Society in San Diego.

Mr. Kadri and colleagues are directing a prospective study to evaluate declines in lung function among HIV-positive patients. The patients, mostly men in their 40s, half of whom were smokers, were assessed at baseline for two measures of respiratory status, and had been followed for two years at the time of reporting.

At the end of two years, the 63 patients displayed marked declines in lung function. "This is the type of decline you might expect to see in elderly individuals who have a long history of smoking," said Mr. Kadri. "These results indicate that HIV-positive patients are more susceptible to lung-related problems than HIV-negative individuals and that HIV-positive smokers are even more susceptible to developing early emphysema. We don't know when these differences begin to manifest in HIV-positive individuals who smoke, but the severity is likely a function of the time that they have lived with the disease."

The researchers have begun a new leg of the study, to analyze the effects of smoking cessation in the same cohort as those in the current study. "We hope this next phase will show us whether lung function improves with smoking cessation in HIV-positive individuals and what factors are associated with successful cessation," said Mr. Kadri.

Physicians treating patients with HIV should be aware that they are at much higher risk for emphysema, and counsel them more about smoking cessation." Courtesy American Thoracic Society.

Who Will YOU Walk For?

This Sunday is the Minnesota AIDS Walk to benefit Minnesota AIDS Project, a Twin Cities non-profit that helps those with HIV and AIDS.

There's still time to join in the walk, volunteer for the walk or just give to the walk.

Follow the link for more information.

I hope to see you there!

http://community.mnaidsproject.org/Page.aspx?pid=317

Study: Acyclovir Does Not Reduce HIV Risk

Acyclovir, a drug that suppresses herpes simplex virus-2, does not reduce HIV risk when taken by people infected by HIV and herpes, U.S. researchers said.

The majority of people with HIV infection also have herpes simplex virus-2 infection. Multiple studies have shown that frequent genital herpes recurrences increase the amount of HIV in the blood and genital tract.

The HIV virus is also shed from genital herpes ulcers and individuals with such ulcers transmit HIV to others more efficiently, the researchers said.

Researchers at the University of Washington in Seattle conducted studies among 3,408 African HIV discordant couples, in which one partner had HIV and the other did not.

In all the couples, the partner who had HIV also had herpes simplex virus-2 infection. The study took place at 14 sites in seven countries in eastern and southern Africa -- Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda and Zambia.

In the primary analysis of HIV transmissions determined by laboratory testing to have occurred within the couple and not acquired from an outside partner, there were 41 infections in the acyclovir arm and 43 in the placebo arm -- not a significant difference, researchers said.

More Tales Of Dirty Medical Equipment

Two doctors allegedly involved in the reused syringe scandal in Nevada face more legal troubles - accused of defaulting on $300,000 worth of equipment leases.

Kingsbridge Healthcare Finance claims in Clark County Court that Vishvinder Sharma and Dipak Desai leased colonoscopes, video processors, gastroscopes and other items for their Spanish Hills Surgical Center, but defaulted in May 2008.

Sharma and Desai are at the center of what is believed to be Nevada's largest class of medical malpractice cases, with at least 5,000 plaintiffs.

In 2008, The Southern Nevada Health District urged more than 40,000 patients to get tested for hepatitis B and C and HIV after accusations surfaced that doctors and nurses at the Endoscopy Center of Southern Nevada reused syringes and vials of anesthesia over a four-year period.

Other clinics, including the Spanish Hills Surgical Center, were later accused of reusing syringes as well. Both facilities, along with at least one other, were shuttered by authorities last year. Courtesy Courthouse News Service.

Assisted Living Facility Sued For Allegedly Rejecting HIV POZ Senior

Reverend Dr. Robert Franke, a 75-year-old retired university provost and Unitarian minister has filed suit against a North Little Rock Arkansas assisted living facility after he was allegedly forced from the facility due to his HIV status.

Franke had moved into Fox Ridge of North Little Rock after fulfilling all residency requirements — including submitting medical evaluation forms from a local physician.

But the day after Franke moved in, Fox Ridge officials allegedly forced him from the facility when they learned he has HIV, despite the fact that he requires no special medical attention beyond daily medication and regular check-ups with a physician. A Fox Ridge staffer went so far as to tell Franke's daughter, Sara Franke Bowling that her father's personal effects could stay, but that the "body" had to be out by the end of the day.

The lawsuit was filed in U.S. District Court for the Eastern District of Arkansas against Fox Ridge, by Lamda Legal on behalf of Franke and Bowling. The suit asks for damages for Franke and Bowling under the Fair Housing Act, the Arkansas Civil Rights Act and the Arkansas Fair Housing Act and, by seeking intervention from the court, intend to prevent Fox Ridge from continuing to engage in this kind of discriminatory conduct.

"I was stunned," says Bowling. "The people at Fox Ridge were supposed to make sure that he was comfortable and cared for, and instead they shunned and rejected him, making him feel like a complete outcast."

According to Lamda Legal, Fox Ridge is licensed by the state to provide Dr. Franke with the kind of assistance he and his daughter were seeking for him. "This isn't about money to me," says Franke. "I want to make sure something like this doesn't happen to anyone else — because no one should ever be made to feel the way I did."

Lambda Legal, a national organization, based in New York City, is "committed to achieving full recognition of the civil rights of lesbians, gay men, bisexuals, transgender people and those with HIV through impact litigation, education and public policy work" Information courtesy Lamda Legal

9 1/2 Minutes

Dr.David Holtgrave from Johns Hopkins Bloomberg School of Public Health, in an op-ed piece on Huffington.com, gives an impassioned plea to the Obama Adminstration to release more funds in the fight against HIV.
For years HIV advocates have lamented the lack of interest in HIV/AIDS during the Bush Administration, and had hoped that with the Obama Adminstration, changes would be forthcoming.

But last Thursday President Obama released a deeply disappointing 2010 budget proposal with only a small increase in domestic HIV prevention funding. The $53 million in new funds requested of Congress is less than one-tenth of what is needed to drive down HIV infection rates in the United States, and is even less than President Bush's most recent annual requests to Congress.

For the complete text, follow the link to Huffingtonpost.com

Huffingtonpost.com

SF Chronicle: Emergency Room Visit And The Surprise HIV Diagnosis

Another reminder, this one from an article in the San Francisco Chronicle, on the importance of being tested for HIV.

Emergency rooms are now routinely testing patients for HIV infection. While the chances of being infected is low, the longer HIV remains undiagosed, the more damage it does to a persons immune system.

Here's an excerpt from the article.

After three days of a nasty cough and persistent headache, a 42-year-old man recently visited San Francisco General Hospital's emergency room, expecting to leave with a flu diagnosis.
Images

The patient, whose name is not being used to protect his privacy, was anxious to return to his job as a hardwood floor installer the next afternoon. But after an hour in the emergency room, and noticing the concerned looks of nurses who conducted a slew of tests, he began to wonder whether his symptoms indicated an illness more critical - perhaps tuberculosis.

"When they came in wearing masks and with social workers," he said later, "that's when I knew it was more serious."

An avid surfer and father of a 16-year-old son, he learned in late March the shocking news: He'd tested positive for HIV. The doctors wore masks because he also had a case of pneumonia. His low T-cell count and high viral count suggested the HIV had been active for years, quietly warring with his immune system.

Full article is at the link.

San Francisco Chronicle

The Future: Prick Your Finger, Check Your HIV

People living with HIV could soon monitor their own condition at home using a hand-held device, similar to ones used by diabetics .

Scientists at three of London's largest research centers have been granted 3 million dollars to develop a hi-tech, finger prick blood-testing gadget.

The device's tiny mechanical sensors - microcantilever arrays - measure HIV levels to warn of impending flare ups.

A display then alerts the user if there is any need for them to visit a doctor.

Investigator Dr Anna-Maria Goretti, an NHS consultant and co-investigator based at the Royal Free Hospital, said: "If patients neglect to take their treatments or need prompting to see their GP the device will provide a simple way of letting them know.

"It will really empower HIV patients to keep a close eye on their health and their treatments."

Instead of routinely seeing a specialist every three or so months "just in case", they would only need to see their doctor when things were going wrong.

As well as reducing visits to the doctor, it could also be of real benefit in developing countries where rapid and affordable ways to monitor HIV patients are urgently needed, say the researchers.

The microcantilever arrays are each coated with substances that stick to the HIV and other proteins, which are markers associated with disease progression.

Accommodating these markers causes the highly-sensitive sensors to bend like a diving board and this bend indicates the level of virus in the body, explained lead investigator Dr Rachel McKendry of University College London and the London Centre for Nanotechnology.

Lisa Power of the Terrence Higgins Trust said: "This is certainly a very good idea. If you have diabetes you can check your blood sugar levels.

"Similarly, it would be very useful if HIV patients could check their own viral measures, say, once a month."

"It would not replace specialist advice, but it would be a way to reduce a patient's dependence on doctors."

Obama and HIV, The Disappointing First 100 Days

Peter Staley wonders why some very basic moves that would have established the president's bona fides early on in HIV policy have simply languished undone. Like, ahem, removing the HIV travel ban. It was backed by Bush, overwhelmingly passed by the last Congress, passed last summer ... and yet the Obama administration has barely moved on it. Yes, there has been a very welcome boost to HIV research funding and one leading gay appointee, John Berry. But the rest is an awkward, inactive silence.

http://blogs.poz.com/peter/archives/2009/05/obamas_silence_on_ai.html

Study: Survival Rates For Liver Transplants Similar Among HIV Neg And Poz Patients

A British-led study has determined survival rates among HIV positive and HIV negative patients are similar following liver transplantations.

The research led by Kosh Agarwal at the Institute of Liver Studies at Kings College Hospital in London showed no difference in survival rates at one and five years between HIV negative and HIV positive patients, suggesting a good prognosis for HIV positive patients following liver transplant.

However, those patients that were co-infection with hepatitis C virus and HIV had significantly lower survival rates when compared to those without hepatitis C infection. Survival rates at 1 and 5 years were 73 percent and 53 percent in HIV positive patients with hepatitis C versus 87 percent and 69 percent in HIV negative patients with hepatitis C.

The study was presented last week in Copenhagen, Denmark

Obama Taps HIV Specialist To Lead AIDS Fight

President Barack Obama has named as his global AIDS coordinator an HIV treatment specialist with 25 years experience fighting the disease and engaging policymakers over the scourge.

Obama tapped Eric Goosby, a professor at the University of California, San Francisco and a chief executive of Pangaea Global AIDS Foundation since 2001 to coordinate the billion-dollar battle against the spread of the disease.

The White House in a statement said Goosby played a crucial role in national HIV/AIDS treatment plans in South Africa, Rwanda, China and Ukraine.

During the administration of president Bill Clinton he served as deputy director of the White House National AIDS Policy Office, and over his career has developed extensive relationships with multinational groups including UNAIDS and the World Health Organization.

Goosby will oversee PEPFAR, the President's Emergency Plan for AIDS Relief. Under PEPFAR the United States has committed more than 25 billion dollars worldwide to battle the spread of AIDS since its inception in 2003.

Financial Times: 1.7 Million With HIV May Lose Treatment

An article in the Financial Times of London highlights the growing impact of the worlds financial crisis on those suffering from HIV/AIDS.

Life-saving drug treatment for up to 1.7m people with HIV is under threat because of funding pressures triggered by the global financial crisis, according to an analysis released yesterday by the World Bank.

A survey of the impact of the economic downturn on 69 of the globe's poorest countries showed that 15 believed they were "highly exposed" to the risk of interrupting anti-retroviral medicines from declines in external and domestic funding

Financial Times Article

D.C. AIDS/HIV Clinic At Center Of Political Controversy

The Washington Post on Friday examined issues surrounding efforts by the Whitman-Walker Clinic to "expand into a full-service health care provider as it struggles with declining revenue."

According to the Post, Washington, D.C., Council Member David Catania (I), has said that with these efforts, Whitman-Walker is abandoning its ties to the city's gay community and that the clinic is being mismanaged and could close.

The Whitman-Walker Clinic ahead of a meeting on Monday provided Catania with more than 2,000 documents, and Catania has pledged to "explore substantial allegations of mismanagement." In reaction to Catania's allegation, the clinic's board of directors recently ordered an independent audit.

According to the audit, Whitman-Walker Clinic is responding to the changes in HIV/AIDS in the city, the Post reports. "We see a whole bunch of people in the District of Columbia -- gay, straight, black, white -- now at risk, and our job is we need to retool how we talk about this," Whitman-Walker CEO Donald Blanchon said (Craig, Washington Post, 4/24).

CDC: More Americans Than Ever Living With HIV/AIDS

A new estimate of how many Americans have the AIDS virus puts the number at about 1.1 million, the U.S. Centers for Disease Control and Prevention said on Thursday.

The CDC numbers, based on 2006 data, show the population living with HIV is growing as people become newly infected and as more patients survive thanks to HIV drugs.

The report also suggests that past estimates that more than 1 million Americans were living with HIV overstated the actual total number of people with HIV infections at the time.

The agency used different methods than it has in the past to calculate the number. Its most recent nationwide estimate of 1 million had been given for 2003, and using the new methods the CDC figured that 994,000 were living with HIV that year.

The CDC report reinforced previous findings that the epidemic disproportionately affects blacks of both sexes as well as gay and bisexual men.

The CDC estimated that about one in five -- 232,700 of the 1.1 million people infected with the human immunodeficiency virus that causes AIDS -- did not know they were infected. The total U.S. population is 300 million.

The CDC previously reported that more people are becoming infected each year than previously estimated, with 56,300 new HIV infections in the United States in 2006. Previous estimates put the number of new infections at about 40,000 a year.

Of all the people infected with HIV, 48 percent were men who have sex with men, the CDC said. While male-to-male sexual contact was the leading cause of HIV infections, heterosexual sex -- mostly women having sex with men who are injection drug users -- accounted for 28 percent of HIV-infected people.

Injection drug use, which spreads the blood-borne virus via contaminated needles, contributed 19 percent of the HIV cases.

Blacks make up 12 percent of the overall population but accounted for 46 percent of those infected with HIV (510,100 people). About 35 percent of those with HIV were white and 18 percent were Hispanic, according to the CDC.

Black women were nearly 18 times more likely than white women to be infected with HIV, while black men were six times more likely than white men, the CDC said. Hispanics were 2.6 times more likely than whites to be infected.

In 2006, about 14,000 Americans died of AIDS. At the end of 2006, the disease had killed nearly 546,000 Americans since being first recognized in the early 1980s.

To make the new estimates, the CDC used information on new HIV diagnoses taken from 40 states with the best data and AIDS diagnoses and deaths taken from all 50 states, as well as a statistical method called "back-calculation."

Globally, 33 million people have HIV and 25 million have died of it.

Gilead Sciences To Test New Drug Designed To Compete Against Atripla

Pharmaceutical maker Gilead Sciences is scheduled to begin a Phase II clinical trial of its single-tablet, once-daily regimen of elvitegravir, GS 9350 and Truvada for the treatment of HIV-1 infection. If successful, the drug will compete in the marketplace with Atripla, which is currently the only one pill a day treatment of HIV.

The Phase II study is a 48-week clinical trial that will evaluate the safety and efficacy of a single-tablet versus Atripla. In the study, 75 HIV infected adults with no prior drug treatment and with viral loads greater than or equal to 5,000 copies/mL and CD4 cell counts greater than 50 will be given either the Gilead drug or Atripla. The study will attempt to determine if the Gilead drug is equal to more effective than Atripla, which has proven successful at lowering viral loads to less than 50 copies/ml.

Gilead is also examining GS 9350 as a stand-alone boosting agent for other antiretrovirals, in particular, protease inhibitors. Later this quarter, Gilead also plans to initiate a Phase II clinical trial evaluating the safety and efficacy of GS 9350-boosted atazanavir compared to ritonavir-boosted atazanavir each in combination with Truvada. Ritonavir is currently reported to be the only boosting agent available for HIV therapy. Source Gilead Sciences (with editing by editor).

VA: Three Patients Now Confirmed HIV Poz After Botched Procedures

Three patients exposed to contaminated medical equipment at Veterans Affairs hospitals have tested positive for HIV, the agency said Friday.

Initial tests show one patient each from VA medical facilities in Murfreesboro, Tenn.; Augusta, Ga.; and Miami has the virus that causes AIDS, according to a VA statement.

The three cases included one positive HIV test reported earlier this month, but the VA didn't identify the facility involved at the time.

The patients are among more than 10,000 getting tested because they were treated with endoscopic equipment that wasn't properly sterilized and exposed them to other people's body fluids.

The VA also said there have been six positive tests for the hepatitis B virus and 19 positive tests for hepatitis C at the three locations.

There's no way to prove patients were exposed to the viruses at its facilities, the agency said.

"These are not necessarily linked to any endoscopy issues and the evaluation continues," the statement said.

The VA has said it does not yet know if veterans treated with the same kind of equipment at its other 150 hospitals may have been exposed to the same mistake before the department had a nationwide safety training campaign.

An agency spokeswoman has said the mistake with the equipment was corrected nationwide by the time the campaign ended March 14. The problems discovered in December date back more than five years at the Murfreesboro and Miami hospitals.

The VA's disclosure Friday was the department's first comment since April 3, when the VA reported the one positive HIV test.

VA spokeswoman Katie Roberts, in an email reply, said the HIV results "still need to be verified" in additional tests.

The Friday statement said the VA is "continuing to notify individuals whose letters have been returned as undeliverable, and working with homeless coordinators to reach veterans with no known home address."

The statement also said the VA has assigned more than 100 employees at the three locations to "ensure that affected veterans receive prompt testing and appropriate counseling."

All three sites used endoscopic equipment made by Olympus American Inc., which has said in a statement it is helping the VA address problems with "inadvertently neglecting to appropriately reprocess a specific auxiliary water tube." Courtesy Time Magazine.

I Guess You Had To Be There

The Tennessean newspaper published this short article on the eve of a film screening.

Do you know the difference between HIV and AIDS? Do you know how many people are infected worldwide? Do you know whether you can trust an HIV test?

How do you know?

Filmmaker Brent W. Leung — born in 1980, just before the earliest outbreaks of the disease — wanted answers. "You might say I am a member of the first HIV/AIDS generation. I've never known a world without it," he introduces himself in his documentary, House of Numbers.

Leung's candid interviews with HIV/AIDS experts reveal more dissent than agreement about the epidemic.

As Leung's journey takes him around the world he finds only more questions.

Does HIV even exist? That's debatable.

If it exists, does it cause AIDS? That's debatable.

Is there a definitive way to diagnose AIDS? That's debatable.

Test results can vary

Can you test positive in one country and negative in another? Yes.

Rapid-screening tests, which test only for antibodies to HIV, are used in most developing countries, while more advanced Western medical testing uses a screening test and a confirmatory test to eliminate false positives.

But even in Western countries, Leung interviews several individuals tested again and again, each time with a different outcome.

In the end, Leung wonders: Are HIV/AIDS statistics overinflated by poor testing and poor diagnosis? If so, are the billions of dollars spent on AIDS research and drugs useful?

Watching the debate between scientists, statisticians, politicians, advocates, and of course, sufferers will challenge any viewer's existing beliefs about HIV/AIDS. And regardless, there is still no cure. But one of the most poignant, revealing moments of House of Numbers is Leung's interview with a South African woman.

"A lot of people here is very sick and is very dying," she said.

"What kind of sickness do you see around here?" Leung asks.

"It's HIV/AIDS," she explains.

"What is AIDS?" Leung asks.

With frustration, she exclaims, "We don't know. We don't know!"

Guess it's gotta kill you before you believe HIV/AIDS exists, huh?

More Clinic Errors, More Risk Of Exposure To HIV And Hepatitis

Following on the news that three Veterans Adminstration hospitals may have put patients at risk for HIV and hepatitis infections, yet another health care provider been uncovered reusing medical equipment.

More than five thousand former patients of Siouxland Urology in Dakota Dunes South Dakota may have been exposed to HIV and hepatitis.

The possible exposure occured when the clinic reused one time use saline bags used in cystoscopy procedures. The error was caught earlier this year during a routine check by the South Dakota Department Of health.

"It is a very low risk that a patient would be exposed, however the potential for exposure exists," said Bob Stahl with the South Dakota Department of Health.

And for now officials with Siouxland Urology are giving their patients free blood tests. Results could take up to two weeks to get back.

According to the Department of Health, the Siouxland Urology Center has been put on a "provisional" license.

The Urology Center has since passed a revisit by the department of health.

HIV Drugs Get Cheaper Overseas - Remain Expensive In U.S.

The cost of AIDS medicines in poor countries is to come down further, following a new bulk purchase arrangement negotiated with a group of generic drug manufacturers.

The Clinton Foundation HIV/AIDS Initiative and the international drug-purchasing consortium Unitaid said on Friday they had struck deals offering steeper discounts on a range of life-saving treatments.

The price of most affordable generic second-line drug regimen -- needed when patients develop resistance to initial treatment -- falls to $590 annually, from more than $700 a year ago.

And a one-pill, once-daily first-line regimen based on the drug tenofovir is now available for $210 annually, down 30 percent from 2008.

In total, new price agreements have been struck for 41 adult and paediatric formulations at an average reduction of 16 percent compared to 2008.

There is no cure for the human immunodeficiency virus (HIV) that causes AIDS, but combinations of drugs can keep the virus from replicating and damaging the immune system.

An estimated 33 million people globally are infected with the AIDS virus, most of them living in Africa and other developing countries. Courtesy Reuters

GSK And Pfizer To Combine HIV Drug Biz

Drug makers Glaxo Smith Kline (GSK) and Pfizer announced Thursday they were spinning off their HIV meds a jointly owned company in a bid to make their current and future drugs more profitable. The Financial Times reported the story on Thursday.

GSK and Pfizer to merge HIV portfolios

Chicago Tribune: Living With HIV In The Rural South

The Chicago Tribune has an excellent article about the struggles of living with HIV in a small town in the South. Here is an excerpt from the artlcle.

Sheila Holt moved to Henderson N.C. from New Jersey two years ago to take care of her ailing mother. But as a former heroin addict with HIV, she found that rebuilding her life in the South was harder than she had imagined.

She was shocked that the wealth of services, such as housing, transportation and medications, available to her as an HIV patient in Newark were lacking in Henderson. In the North, she said, people talked openly about the disease without fear of reprisal. In the South, she could not sit at the dinner table with her family or talk to her neighbors about the disease without the risk of being shunned.

With no job and few housing options in this rural area, she lived for months in the basement of her mother's home, slipping upstairs only when her stepfather was at work. She eventually qualified for Medicaid, which pays for the 10 medications she takes every day. And she receives a disability check that helps cover the rent for her sparsely furnished apartment, tucked away on the backside of a public housing complex.

In the eyes of many, including her stepfather—a part-time minister—HIV and AIDS are a sin, she said.

To see the entire article, follow the link courtesy the Chicago Tribune.

http://www.chicagotribune.com

Study: 350 Is The MINIMUM Threshhold To Start Drug Therapy

A new analysis of more than 45,000 people with HIV in Europe and North America suggests that the minimum CD4-cell count threshold for initiation of combination antiretroviral therapy should be 350 and above. This is currently the upper limit of levels for starting therapy recommended in many countries.

The findings are published in an article in an upcoming edition of The Lancet, written by Jonathan Sterne, Professor of Medical Statistics and Epidemiology, University of Bristol, and colleagues from the When To Start Consortium of observational cohort studies of people with HIV.

The authors analysed data from 18 prospective studies from Europe and North America, of which 15 provided eligible patients who had not previously been treated with antiretroviral drugs. Patients were included if they had started therapy while AIDS-free, with a CD4-cell count of less than 550 and with no history of injecting-drug use on or after January 1, 1998.

Deferring combination therapy until a CD4-cell count of 251-350 was associated with a 28 per cent higher rate of AIDS and death than starting therapy in the range 351-450 range.. The adverse effect of deferring treatment increased with decreasing CD4-cell count threshold. Deferred initiation of combination therapy in the above ranges was also associated with higher mortality rates (13 per cent), though the effect on mortality was less than the effect on the combined endpoint of AIDS and death.

The authors said: “When patients and their physicians consider starting antiretroviral treatment, they must balance its beneficial effects on rates of progression to AIDS and death with several other issues. Antiretroviral drugs can be inconvenient to take, and have side effects that include nausea, diarrhea and headache. Combination antiretroviral therapy is associated with serious toxic effects including redistribution of body fat, hepatitis, renal failure and an increased risk of cardiovascular disease. However, these toxic effects are to an extent avoidable through choice of drug regimen.

“Unfortunately, many patients are not diagnosed with HIV until their CD4 count has fallen well below 350, sometimes even below 200. It is important that people at possible risk of having HIV get tested regularly so that if found to be infected they can receive the necessary care and treatment." according the authors statement.

"Because we found evidence that deferring treatment until the patient’s CD4-cell count is less than 350 was associated with increased progression rates, and in view of diminished concerns about toxic effects and resistance, our results suggest that 350 should be the minimum threshold at which antiretroviral therapy should be started.” University of Bristol News Release.

Has HIV Become More Virulent?

Damage to patients’ immune systems is happening sooner now than it did at the beginning of the HIV epidemic, suggesting the virus has become more virulent, according to a new study in the May 1, 2009 issue of Clinical Infectious Diseases.

Conventional wisdom says several years will pass between HIV infection and the need for antiretroviral therapy. However, clinicians have observed that patients are entering HIV care with lower initial CD4 cell counts than in previous years and now often require antiretroviral therapy soon after entering care, raising the question of whether HIV has become more virulent.

Researchers studied data from more than 2,000 HIV-positive active-duty military personnel, retirees, and dependents between 1985 and 2007 who had tested HIV-negative within the previous four years. When they looked at patients’ first CD4 count after HIV diagnosis, they found that it decreased from an average of 632 cells/mm³ in 1985-1990 to 514 cells/mm³ in 2002-2007. Additionally, 25 percent of patients diagnosed with HIV in recent years already had fewer than 350 CD4 cells/mm3, the threshold for when antiretroviral therapy should begin, compared to only 12 percent of patients in the late 1980s.

The authors note that the trend seems to have stabilized, perhaps due to the widespread introduction of highly active combination antiretroviral therapy.

This is the first study from the United States which shows that the immune cells among recently diagnosed HIV patients has dramatically fallen during the HIV epidemic. These findings are similar to those found in the study from Europe, which suggests that these trends may be widespread.

“Unfortunately, it may no longer be true that there is a time period of several years between diagnosis and the need for treatment – instead this time-span is shortening” said study author Nancy Crum-Cianflone MD, of the San Diego Naval Medical Center. “Early diagnosis is important for several reasons including that patients can enter into medical care and begin treatment before the immune system becomes weak and opportunistic infections develop.” Courtesy Science Daily

Gilead May Try To Block Atripla Generic

Gilead Sciences Inc. said it is considering whether to file a patent infringement lawsuit against Teva Pharmaceutical Industries Ltd. following Teva's announced intent to manufacture and market a generic version of HIV drug Atripla.

The potential lawsuit wouldn't be the first time the drug companies have sparred over HIV and AIDS drugs. Gilead, a leading maker of AIDS treatments, sued Teva in December 2008 to prevent it from making a generic version of HIV drug Truvada until 2021. Teva was seeking U.S. Food and Drug Administration approval to sell a copy of the drug, Gilead's biggest product.

In 2008, Gilead reported Truvada sales increased 33% to $2.11 billion. Atripla sales, meanwhile, rose 74% to $1.57 billion during the year.

In its latest submission on Monday, Teva entered an application to the FDA to make a generic version of Atripla, which is currently sold in the U.S. through a joint-venture between Gilead and Bristol-Myers Squibb Co.

Teva alleges two of the patents licensed to Gilead are invalid, unenforceable and wouldn't be infringed by Teva's manufacture, use or sale of the product described in its latest submission.

Gilead, meanwhile, said Atripla is protected by 15 patents and said all 15 would need to be invalidated or expire before a generic version of the drug could be marketed.

Last year, Teva challenged the validity of the same two patents in its generic drug application for Truvada. The lawsuit in that case is still ongoing. Courtesy CNN.

VA Patient Tests HIV POZ After Treatment; Va Not Sure Of Cause Of Infection

Seventeen patients who were treated with improperly sterilized equipment at Department of Veterans Affairs medical centers in Augusta GA, Murfreesboro, TN and Miami FL have tested positive for a viral infection, the VA announced Friday.

Of the 17 infections, 11 were hepatitis C, five were hepatitis B and one was HIV.

More than 3,100 veterans have been notified of their test results out of the 10,555 sent letters notifying them of the problem, the VA said in a news release.

The VA stressed that it is still unclear whether the infections stemmed from getting an endoscopy exam at the VA. The risk of hepatitis transmission from an endoscopy exam is "extremely small" and there are no reports of HIV being passed that way, according to the release. Testing is ongoing, and the three VAs have added personnel to "ensure that affected veterans receive prompt testing and appropriate counseling," according to the release.

The problems at Augusta's Charlie Norwood VA Medical Center occurred in the ear, nose and throat clinic between Jan. 2 and Nov. 6 of 2008. The endoscopy equipment was sterilized with a solution not recommended by the manufacturer, officials said. Problems at Murfreesboro's VA discovered in December led to a systemwide review in March that uncovered the problem in Miami, press secretary Katie Roberts said. Courtesy Augustachronicle.com

Expose: When An AIDS Charity Does More Harm Than Good

Propublica.org has an excellent expose article about an Illinois HIV/AIDS charity that crossed the radar when they recently advertised in The New York Times.

What raised a red flag about the charity was the claim on "The Center For AIDS Preventions" website that birth control pills could prevent HIV infection. The site also initially touted herbal medications as an alternative to retroviral therapies (that information has sent been removed).

Follow the link for the full article.

http://www.propublica.org/article/shady-aids-charity-with-a-big-web-campaign-324

Good Dental Hygiene May Be Key To Supressing HIV

Good dental health may help prevent AIDS, say Japanese researchers.

The link, they say, could be periodontal, or gum, disease.

The researchers found that periodontitis-causing P. gingivalis bacteria can trigger a pathway that causes reactivation of latent HIV-1, the virus that causes AIDS. P. gingivalis is among the most widely existent bacteria worldwide. The reactivation of the latent HIV could cause progression to full blown AIDS, the report hypothesized.

The findings were to be presented April 3 in Miami at a meeting of the International & American Association for Dental Research.

The results suggest that periodontal disease might contribute to the systemic dissemination of HIV and emphasize the essential role of maintaining oral hygiene and controlling oral diseases to help prevent AIDS, according to background information in a news release from the association. Courtesy Health Daily News.

Obama Administration Asked To Include GLBT'ers In Global HIV Policy

The International Gay and Lesbian Human Rights Commission sent a letter to Secretary of State Hillary Clinton on Tuesday calling for more inclusive U.S. sexual and reproductive health policies overseas. The group said that policies could be improved through the appointment of a global AIDS coordinator sensitive to LGBT concerns, particularly the widespread antigay discrimination that limits access to HIV/AIDS education and services.

“In recent years, U.S. policy has by and large neglected the needs of LGBT people worldwide,” Cary Alan Johnson, executive director of IGLHRC, said in a statement about the letter to Secretary Clinton. “The Obama administration should use this moment of great change to bring U.S. HIV funding overseas into harmony with our stated commitments to science, human rights and inclusion.”

In particular, IGLHRC asked Clinton to ensure that the President’s Emergency Plan for AIDS Relief – a cornerstone of U.S. global reproductive health policy - is changed to allow greater access for LGBT people. Even after its recent reauthorization, PEPFAR, which was created by the Bush administration and channels most of the U.S. HIV funding, continues to promote abstinence-only-until marriage programs, including programs operated by conservative religious institutions that teach homosexuality is wrong.

Research from IGLHRC in 2007 showed that less than $1 million out of $15 billion allocated for HIV services was spent on HIV prevention and treatment programs for men who have sex with men in Africa.

IGLHRC asked Secretary Clinton to consider the needs of the worldwide LGBT community when appointing a new global AIDS coordinator. The group said the coordinator should be someone who understands that comprehensive anti-discrimination legislation is key to the fight against HIV/AIDS, and that more funding is urgently needed for programs that target LGBT people. Courtesy The Advocate

Generic Version Of Truvada Approved For Overseas Sales

Mylan Inc. said Monday its generic version of Gilead Science Inc.'s HIV drug Truvada has received tentative marketing approval.

The company said its version was granted tentative approval under the President's Emergency Plan for AIDS Relief. Truvada is a combination of two drugs, emtricitabine and tenofovir disoproxil fumarate, and total sales of the product grew to $2.11 billion in 2008. That made Truvada Gilead's best-selling product.

Mylan's generic is made by its Indian subsidiary, Matrix Laboratories. (Truvada still has patent protection in the U.S. The generic product will most likely be sold only in overseas markets).

India And Living With HIV

Mysore, India: The very thought of AIDS may seem awfully frightening. But meet this bunch of people tested positive with HIV and chances are you will end up feeling that HIV can be overcome and the patients too can lead a contended life. However, what keeps them going is the sheer determination to live.

Meet S Noori, 60, managing trustee of South India Positive Network (SIPN) and Asylum for AIDS orphaned children from Chennai, who is living with the disease for 22 years. If anybody asks her age, her cryptic reply is: "you are asking my age or my my AIDS age?" It is an indication that she has taken the disease in her stride and conquered it.

She has a sordid saga of entering into prostitution at a tender age of 14 after she was orphaned following the untimely death of her parents. "With no alternative left for survival I took up the profession and got afflicted with this deadly disease," she says, adding initially it was tough to face the people. "But later I realized that I should face the people and live along with the AIDS," she says advising other patients to treat this deadly disease as any other disease and live with it. Noori also visits foreign countries to create awareness among the sex workers on HIV.

Laksmi and Rashida, sex workers from Gujarat, are living with the disease for six years, but they were reluctant to disclose it. "After coming here to participate in the Positive Habba Festival, we have decided to disclose about our suffering. Our only worry is about our children getting the right life partners. All that we tell the society is `Live and let the AIDS patients live harmoniously'," they say. Over 500 HIV positive sex workers from seven states are participating in the festival. Courtesy Times Of India

Vets May Have Been Exposed To HIV Virus Via Colonoscopy

Worried military men and women flooded Miami Veterans' Hospital telephone hot lines Tuesday after Monday's announcement that improperly cleaned colonoscopy equipment might have exposed them to hepatitis and HIV.

The hospital received 2,662 telephone calls, and 351 veterans visited VA clinics in Miami and Fort Lauderdale to ask about their status and to schedule testing, said Dr. John Vara, the Miami VA's chief of staff.

On Monday, the VA disclosed that water tubes and reservoirs used in colonoscopies and endoscopies were being rinsed between procedures, but not disinfected as required by manufacturer's specifications. About 3,260 South Florida veterans had medical procedures since May 2004 using the faulty procedure.

Vara said Tuesday there was a ''very small but more than negligible chance'' the veterans could have been exposed to viruses that cause Hepatitis B, Hepatitis C and HIV.

In a colonoscopy, he said, a flexible tube called an endoscope carries a light and camera into the intestines to look for possibly cancerous tumors or polyps.

The endoscope also has a channel that carries water to clear the vision for the camera.

In these cases, the pump and reservoir that are used to move the water were rinsed after being used but were not disinfected as required, Vara said.

That creates a slight chance that back-flow from the pump could carry tiny amounts of virus into the patient, he said.

Dr. Mark Larson, gastroenterologist at the Mayo Clinic in Rochester, N.Y., said the infection would be unlikely to spread unless a cut or tear inside the intestine allowed the virus to enter the bloodstream.

Even so, he noted, ``it doesn't take a lot of virus to spread things like hepatitis and HIV." Courtesy Miami Herald.

RIse In HIV Rates Alarms Canadian Health Officials

An alarming rise in the number of HIV-positive cases in Saskatchewan has the province's chief medical officer examining all elements of transmission of the virus, including prostitution.

Dr. Moira McKinnon told CBC News that prostitutes who are infected with HIV and have unprotected sex are contributing to the spread of the virus.

On Monday, CBC News broke the story that McKinnon viewed 174 new cases of HIV in Saskatchewan last year — a 40 per cent jump from 2007 — as a "crisis" in public health.

McKinnon identified drug users, particularly those who share needles, and HIV-positive prostitutes as two groups that need attention.

"It's intertwined," McKinnon said. "The sex industry and the drug industry. We know that there are sex workers out there that are infected."

She said prostitutes pose a particular challenge.

"They've been ordered to change their behavior," McKinnon said. "We have to monitor compliance with that behavior and that's difficult to do."

McKinnon said one option is to charge prostitutes who knowingly engage in unprotected sex, without disclosing their HIV status, although she acknowledged such a charge could be difficult to prove.

Barb Lawrence, of Regina's Street Workers Advocacy Project, said criminal prosecution is the wrong approach.

"We're facing a really significant problem in this community and demonizing one small group is not the answer," Lawrence said.

McKinnon said she will be working with officials in the Ministry of Justice and police services to look for ways to push HIV-positive prostitutes off the streets.

They will also examine how other jurisdictions have dealt with the problem, McKinnon said Courtesy CBC

WHO Report: HIV Patients 20 Times More Susceptible To Tuberculosis

A new report by the World Health Organization shows a close link between tuberculosis and HIV.

The World Health Organization reports nearly 9.3 million people became ill with tuberculosis in 2007, of these new cases it says 1.4 million or 15 percent were linked to HIV.

The TB Control report finds one out of four TB deaths, or nearly one-half million deaths, is HIV related. That is twice as many as previously recognized.

WHO HIV/AIDS Department Director Kevin De Kock says the burden of HIV-TB is unequally distributed. "About 79 percent of all HIV-associated TB cases occur in sub-Saharan Africa - 79 percent and about 11 percent in Southeast Asia," said Dr. De Kock.

"Of the five countries in the world with the greatest number of new tuberculosis cases annually, two of them have generalized HIV epidemics. And, that is South Africa, a country with a large population and very high HIV prevalence rate and Nigeria," he added.

Dr. De Kock notes Nigeria has a lower prevalence of HIV than South Africa, but because of its very large population, many people are infected with the disease.

He says people living with HIV have a risk of developing tuberculosis that is about 20 times higher than that compared with people who do not have HIV. He says it is important that people with HIV be tested for tuberculosis so they can get the proper treatment to cure the disease and prevent it from spreading.

"HIV-infected people are highly vulnerable to getting TB and if they get a variety of TB that is resistant against drugs, they have very high case fatality rates, very high death rates," said Dr. De Kock. "We have seen outbreak of such events in South Africa, in other countries related to hospitals, anti-retroviral therapy clinics, prisons and so on. Just to point out, this is a reflection of weak TB programs and inadequate health systems that these situations arise."

The WHO report reveals a sharp increase in HIV testing among people who have tuberculosis, especially in Africa. As a consequence, it says more people are receiving the treatment they need, although the numbers remain small.

The World Health Organization warns drug-resistant forms of tuberculosis are growing and pose some of the greatest problems. In 2007, it estimates 500,000 people had multi-drug resistant tuberculosis, but less than one percent of them were receiving treatment.

The World Health Organization says great progress against both tuberculosis and HIV has been made in the past few years. But, it notes tuberculosis still kills more people with HIV than any other disease. It says more work and money is needed to scale up effective interventions for the prevention, treatment and care of TB worldwide. Source Voice Of America

Condoms: HIV Stopper Or Waste Of Rubber?

The Vatican Wednesday defended Pope Benedict’s opposition to the use of condoms to stop the spread of AIDS as activists, doctors and politicians criticised it as unrealistic, unscientific and dangerous.

Benedict, arriving in Africa, said on Tuesday that condoms “increase the problem” of AIDS. The comment, made to reporters aboard his plane, caused a worldwide firestorm of criticism.

“My reaction is that this represents a major step backwards in terms of global health education, is entirely counter-productive, and is likely to lead to increases in HIV infection in Africa and elsewhere,” said Prof Quentin Sattentau, Professor of Immunology at Britain’s Oxford University.

“There is a large body of published evidence demonstrating that condom use reduces the risk of acquiring HIV infection, but does not lead to increased sexual activity,” he said.

The Church teaches that fidelity within heterosexual marriage and abstinence are the best ways to stop AIDS.

Asked about the criticism, Vatican spokesman Father Federico Lombardi said the pope was “maintaining the position of his predecessors”.

The Vatican also says condoms can also lead to risky behaviour but many contest that view.

Kevin De Cock, director of the World Health Organisation’s HIV/AIDS department, said there is no scientific evidence showing that condom use spurs people to take more sexual risks.

But there are those with differing opinions.

Edward Green, the director of Harvard University's AIDS Prevention Research Project, says Pope Benedict XVI was correct when he said that condoms not only don't reduce incidences of AIDS and HIV, but can exacerbate them.

Green said: "Theoretically, condoms ought to work, and theoretically, some condom use ought to be better than no condom use, but that's theoretically."

In 25 years of researching the spread of AIDS on the African continent, he said, "We just cannot find an association between more condom use and lower HIV reduction rates."

Part of the reason, he said, may be a phenomenon known as "risk compensation." If people use a certain technology to reduce risk, this may lead them to take on greater risk. Examples: People put on sun block, then think they can stay out longer in the sun. People wear seat belts, then think they can drive faster.

In sex, too, he said, people may be willing to engage in more risky behaviors because of the availability of condoms. This can "disproportionally erase" the benefits of condom use.