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Medical Forum / Diseases and Disorders / AIDS / June 2007WTF
Why Is 'TB-Alert UK' Not Warning About XDR-TB In South Africa? By Adriana Stuijt Exclusive to Rense.com 6-5-7 THE NETHERLANDS -- The following message was sent by retired SA medical journalsit Adriana Stuijt to the TB-Alert UK organisation (email: awareness@tbalert.org) -- as follows: "As a retired medical journalist in South Africa who covered the Aids-epidemic from its very start in 1984, I believe that the SA government is deliberately keeping silent about the out-of-control XDR-TB epidemic which is now entering the mainstream population in this country and even beginning to kill previously healthy people. Their last official news update with the latest death-toll figures date back to April 2007. From my own information, at least 1,000 people have already died in SA of XDR-TB thus far and enb estimated new 30 patients a day are being diagnosed with it countrywide, in every SA province. And those are just the patients who report to TB- clinics: the World Health Organisation warned just a few weeks ago that they don't know exactly how widespread XDR-TB has become in South Africa. "Shouldn't TB Alert be warning very actively in many high-profile TV and news media interviews about the fact that more than 1,054 people per 100,000 of the KwaZulu-Natal population are now being diagnosed as infected with XDR-TB? At least two TB-hospitals are so overrun with XDR-TB patients now that they have turned their entire hospitals into XDR-TB hospices - sending 'ordinary TB' patients to other hospitals for treatment. Isn't TB-Alert UK worried about the fact that the SA government is so anti-science that it now is actually suing a TB-hospital in Gauteng with demands that they release thirteen so-called 'forcibly detained' XDR-TB patients because their 'human rights are being violated?" The management of Sizwe Hospital for tropical diseases in Johannesburg won't release these patients because they are untreatable with existing medicines and thus remain highly infectious -- they continue to pose a dangerous health risk to society if they were to be released. View the SA state-broadcaster SABC-TV's news item about this class-action law suit against Sizwe hospital in Johannesburg here: http://youtube.com/watch?v=Zz5lI3Hc5Xc It is very clear to me by now that the South African government maintains such an unscientific and indeed confused policy towards the XDR-TB epidemic that this confusion is allowing this untreatable and very deadly strain to spread very rapidly into the entire population - not only hiv-infected or/and TB co-infected people are dying from this, but also previously perfectly healthy people now get it from their own home environments. XDR-TB has escaped from its previous TB-hospital setting and entered the general population, TB-experts are warning in the Western Cape area, where the fifth patient has just died. My contacts in SA inform me that XDR-TB is also terrifying the population at large mainly because the SA authorities send out such confusing signals: terrified 'ordinary TB" patients and nursing staff even fled from hospitals as soon as XDR-TB patients arrived; and in some provinces such as Gauteng and KwaZulu-Natal, XDR-TB patients are increasingly sent home for "treatment" because there aren't enough hospitals beds to accommodate them all. This particular strain called SA-1 is a mutation with the hiv-virus and the TB-bacillus and has a 100% mortaility rate in South Africa. I am personally aghast at this very rapid spread of this epidemic in SA-- this was the country's fourth outbreak since 2003. The previous ones all were contained -- but this one, first identified in October 2006 in Pongola, KwaZulu-Natal, has entered the main- stream population. The first outbreaks in the Western Cape in 2003 and 2004 of this particular HIV/TB mutant strain were contained because that particular province's health department acted with strong urgency and using the best scientific methods, even tracing down Patient Zero's contacts all the way to Zambia and finding others in Zimbabwe... Due to the rather odd lack of recent publicity about this from the South African health department itself since April 2007 -- I also wonder whether the UK and indeed the European health authorities are even aware of this very real infection danger of XDR-TB posed for travellers to and from South Africa? XDR-TB much more dangerous and infectious than bird-flu... so why this media silence of about the fact that XDR-TB is now taking on epidemic proportions in South Africa? Authorities like yourselves cannot rely on the SA health authorities to provide you with the latest, truthful facts: after all, the SA authorities also failed to report the first two outbreaks of this particularly virulent XDR-TB strain (SA1 strain) in 2003 and 2004 to the World Health Organisation and to the Centres for Disease Control - even though it was contained, it should also have been reported as a completely new strain. The last official health department SA news release about this epidemic was in April 2007 and there has been a deafening silence ever since -- however my own very excellent medical contacts in South Africa warn that things are going rather badly out of control now, and that local clinics and hospitals especially in KwaZulu Natal, but also in the Eastern Cape and Gauteng provinces, now either follow their own science-ruled guidelines or are trying to make sense of the rather confusing government guidelines which won't let them isolate any of the diagnosed XDR-TB patients if they refuse treatment and also place severe financial constraints on their use of the correct medicines. In Europe, are there adequate TB-prevention controls in place at all our ports of entry, for instance, or are just 10% of the southern-African travellers being 'checked for TB-infections' as was still the case a year ago? And are the travellers to South Africa -- the World Cup 2010 with its 350,000 soccer fans to that country springs readily to mind -- being warned about this XDR-TB outbreak -- and do they now about the fact that even healthy people (not just hiv-infected people as is being claimed by the SA health authorities) can be infected with this quite easily by carriers who just have to cough the bacillae into the atmosphere around them? I know of at least three perfectly healthy people -- one a baby and am 18-year-old youth in the Western Cape who both died at home and; a 41-year old Afrikaner woman who died of XDR-TB at a private clinic in Klerksdorp, North West province; in other words these three people were infected by unknown carriers inside their own environment, both were NOT hiv-positive, had never been treated for TB before and also had no other immune-deficiencies. None of the available antibiotics had any effect on their condition and they died very quickly, in fact hospitals in the Eastern Cape are now warning that the second-line drugs being tried on XDR-TB patients there are having 'very toxic side-effects". It's worrying that TB-Alert is not ringing the alarm bells about this in all the UK news media? Yours sincerely Adriana Stuijt retired medical journalist - ex-Johannesburg Sunday Times MainPage http://www.rense.com This Site Served by TheHostPros > Why Is 'TB-Alert UK' Not Warning > About XDR-TB In South Africa? [quoted text clipped - 24 lines] > weeks ago that they > don't know exactly how widespread XDR-TB has become in South Africa. As this is an air born disease, and highly infectious, it is a real worry. RamRod Sword of Baal wrote... > As this is an air born disease, and highly infectious, it is a real worry. But it isn't more contagious than regular TB, just more deadly to AIDS patients. As for infectiousness, less-contagious HIV afflicts more people than TB of all types. Rather than focusing on XDR-TB, they should focus on neutralizing the HIV patients who incubate it. Just like malaria can't be eliminated until the mosquitoes that complete the parasite's life cycle have been exterminated, they can't get rid of XDR-TB until the AIDS patients have been exterminated. > RamRod Sword of Baal wrote... >> As this is an air born disease, and highly infectious, it is a real [quoted text clipped - 7 lines] > the parasite's life cycle have been exterminated, they can't get rid > of XDR-TB until the AIDS patients have been exterminated. More rubbish from crack baby, anyone can get XDR-TB, you only need to be by an infected person and catch the bug. "RamRod Sword of Baal" <RamRod@truth_only.com> wrote in message > " Death" <Death@yourdoor.net> wrote in message > > out-of-control XDR-TB epidemic ... > > As this is an air born disease, and highly infectious, it is a real worry. Indeed, Personal behavior risks for this dis-ease is just breathing the air unlike filthy behavior that spreads HIV. What is your opinion about quarantining the XDR-TB infected? > "RamRod Sword of Baal" <RamRod@truth_only.com> wrote in message > [quoted text clipped - 9 lines] > unlike filthy behavior that spreads HIV. > What is your opinion about quarantining the XDR-TB infected? Now there is a leading question, and I know I am leaving myself wide open here. Yes I do believe that people with this disease should be quarantined because it is an air born disease, and highly contagious. It could spread like wildfire though the community, and there is no cure and no treatment as far as I know. Persons doing something as simple as being on a bus, train or plane would be at risk if an infected person was on there with them and coughing. What is your opinion. "RamRod Sword of Baal" <RamRod@truth_only.com> wrote in message > " Death" <Death@yourdoor.net> wrote in message > >> > > What is your opinion about quarantining the XDR-TB infected? > > Now there is a leading question, and I know I am leaving myself wide open > here. It seems simple enough to me, yes or no. > Yes I do believe that people with this disease should be quarantined because > it is an air born disease, and highly contagious. > > It could spread like wildfire though the community, and there is no cure and > no treatment as far as I know. That sounds like AIDS doesn't it? >Persons doing something as simple as being on > a bus, train or plane would be at risk if an infected person was on there > with them and coughing. A simple act of bleeding AIDS infected blood is just as risky for the people being bled on. Plane crashes, car accidents, an operation, and the ole catch all of sh.t happens. > What is your opinion. Find a big island and send all non-curable dis-eased people there where they could live out a life without infecting others. England and France found such islands to separate the un-wanted, un-nessary and the un-needed. > "RamRod Sword of Baal" <RamRod@truth_only.com> wrote in message >> [quoted text clipped - 6 lines] > > It seems simple enough to me, yes or no. Yes, but you were telegraphing that you were going to ask about HIV. >> Yes I do believe that people with this disease should be quarantined >> because [quoted text clipped - 5 lines] > > That sounds like AIDS doesn't it? No, AIDS is not something you catch is a crowded bus train or plane, unless you are having sex............ Which is rather unlikely >>Persons doing something as simple as being on >> a bus, train or plane would be at risk if an infected person was on there [quoted text clipped - 3 lines] > for the people being bled on. Plane crashes, car accidents, > an operation, and the ole catch all of sh.t happens. Having AIDS infected blood on one does not cause you to catch AIDS, or become HIV infected, unpleasant as it is, in fact it has happened to me, and I am not infected. For infected blood from someone to infect you, it would need you get into an open wound on your body, which makes it a lot more difficult, so in your scenario, you have to have two people, both with open wounds, one HIV the other not in a crash of some sort, hardly the same as someone sneezing or coughing in a crowded place. >> What is your opinion. >> [quoted text clipped - 4 lines] > un-nessary > and the un-needed. .............and where will you find an island that is not inhabited that can take 40 million people, or a country that would accept, or support 40 million sick people? BTW not all the people who are HIV know that they are infected, so even if you tested the whole world, the problem is that you would not get them all, and so it would mean endless testing to 'catch' them all, a logistic nightmare, to say nothing of such people not volunteering to go to your 'leper' colony. FYI Australia is not your 'leper colony' you are looking for. ---------------------------------------------------------------------------- You might benefit your knowledge on HIV transmission by reading this........... http://www.aproposinc.com/hap/catch.htm or http://kidsgrowth.net/resources/articledetail.cfm?id=14 > No, AIDS is not something you catch is a crowded bus train or plane, ^^^^^ > unless you are having sex............ > > Which is rather unlikely Just to be accurate, there is the famous "Mile High Club." B/ >> No, AIDS is not something you catch is a crowded bus train or plane, > ^^^^^ [quoted text clipped - 5 lines] > > B/ I did say unlikely................... >>> No, AIDS is not something you catch is a crowded bus train or plane, >> ^^^^^ [quoted text clipped - 7 lines] > > I did say unlikely................... I just saw a CSI rerun a few days ago. Perpetrator of a snuff film was found to have the same "phylogenetic analysis" of HIV as his victim, and it was shown he contracted it when her arterial blood sprayed into his eyes. "Not very likely," Grissom said, "but it does happen." Sheesh. B/ Brian Mailman wrote... > RamRod Sword of Baal wrote... >> I did say unlikely................... [quoted text clipped - 3 lines] > it was shown he contracted it when her arterial blood sprayed into his > eyes. "Not very likely," Grissom said, "but it does happen." Do they have parades for such cases, or are they only held for sexually transmitted cases? As for genetic analysis, it would be wonderful if they could accurately trace the lineage of a particular individual's strain. The government could devote at least as much money for a viral DNA database as it does for its criminal DNA databases, and devote as many resources to catching the perpetrator. Within seconds of a new positive HIV test result, the health authorities could identify who transmitted the virus and arrest him for having violated whatever law that needs to be passed to forbid AIDS patients from having sex with healthy people. >As for genetic analysis, it would be wonderful if they could accurately >trace the lineage of a particular individual's strain. Unsurprisingly 'HIV' genetic analysis is useless. There's an interesting article about HIV prosecutions in the UK here: <http://www.positivenation.co.uk/issue130/regulars/news/news130.htm>. At the time the article was published (the beginning of 2007) all successful HIV transmission prosecutions had been based on suspects pleading guilty. And on the one occasion the prosecution were forced to put their case in court the suspect was found not guilty. I understand there has been one additional HIV transmission prosecution since the article was published, however I'm not aware of the details. >The government could devote at least as much money for a viral DNA >database as it does for its criminal DNA databases, and devote as many >resources to catching the perpetrator. Those who preach the HIV religion tell us HIV goes through every possible mutation several times a day in host, so it's not very surprising DNA evidence is useless. >Within seconds of a new positive HIV test result, the >health authorities could identify who transmitted the virus and arrest >him for having violated whatever law that needs to be passed to forbid >AIDS patients from having sex with healthy people. So, you're suggesting that it would be okay for people diagnosed HIV+ to have sex with "healthy people" providing they don't fall within the narrow definition of AIDS? Oh, what are "healthy people" anyway? Would you consider someone who weighs over 350 pounds a "healthy" person?  Signature<http://www.hiv-poz.co.uk/> Moible: +447939991519 Martin wrote... >>Within seconds of a new positive HIV test result, the >>health authorities could identify who transmitted the virus and arrest [quoted text clipped - 7 lines] > Oh, what are "healthy people" anyway? Would you consider someone who > weighs over 350 pounds a "healthy" person? Sorry, I made the usual slip of using "AIDS" and "HIV" as synonyms. Of course I meant "HIV patients. " But I really don't consider "AIDS" to be inaccurate, as Immune Deficiency begins shortly after the virus is Acquired, but it seems as though you believe some specific arbitrary quantification of immune suppression must be defined to qualify as AIDS. And by "healthy," I meant someone not infected with the HIV virus. The other person might still have everything from syphilis to warts to herpes to leprosy, but the taxpayers will not permit them to add expensive HIV to their collections. >Martin wrote... >>So, you're suggesting that it would be okay for people diagnosed HIV+ [quoted text clipped - 3 lines] >>Oh, what are "healthy people" anyway? Would you consider someone who >>weighs over 350 pounds a "healthy" person? >Sorry, I made the usual slip of using "AIDS" and "HIV" as synonyms. It happens often. It's one of the reasons millions of people die each years from HIV/AIDS. The deaths are nothing more than a careless classification. >Of course I meant "HIV patients. " But I really don't consider "AIDS" to >be inaccurate, as Immune Deficiency begins shortly after the virus is >Acquired, but it seems as though you believe some specific arbitrary >quantification of immune suppression must be defined to qualify as AIDS. This "arbitrary quantification" you speak of isn't mine, and is nothing to do with me. It's set by the high priests of HIV who carved it in to stone after hearing it from the HIV God. Okay, that may be a bit over-dramatic, however terms such as HIV and AIDS have vague definitions that vary throughout the world. Personally, I have no qualms about having my HIV reclassified as AIDS. There would be many advantages for me if it was. Technical classifications mean that it's harder to get AIDS in Europe than it is in some other parts of the world. >And by "healthy," I meant someone not infected with the HIV virus. The >other person might still have everything from syphilis to warts to herpes >to leprosy, but the taxpayers will not permit them to add expensive HIV >to their collections. So, everyone who hasn't been diagnosed HIV+ is healthy? Your terminology is as wooly as the HIV=AIDS=Death lot. Signature<http://www.hiv-poz.co.uk/> Moible: +447939991519 Martin wrote... > So, everyone who hasn't been diagnosed HIV+ is healthy? Your > terminology is as wooly as the HIV=AIDS=Death lot. Really. Compared to HIV, just about everything qualifies as healthy. Still, however we redefine words to suit the ideological needs of the moment, the fact remains that it is not a good idea to allow HIV+ people to have sex with HIV- people. Unless the HIV- sex partner is some rich f.ck who can post a bond equal to the current value of 50 years of HIV medical treatment, he/she/other should not be allowed to take that risk. Any negative who would consent to the risk is either so uninformed as to qualify as retarded or is so insane as to qualify for involuntary commitment to a mental hospital. Let's discuss the concept of allowing adults to make their own choices in life. The political left has long been a promoter of nanny state legislation, with the noble goal of protecting stupid people from their stupidity. So we have mandatory seat belt and helmet laws, with no consideration at all given to the rights of adults to choose whether to wear seat belts or motorcycle helmets after being properly informed about the risks. And yet the same leftwad safety nazis who would throw you in jail for not wearing a seat belt would never dream of supporting a law requiring an HIV patient to wear a condom. The same leftwad safety nazis would also ban every weapon from guns to knives to pepper spray, yet they have no problem with a literal biological WMD roaming free and causing more injuries than all the other categories combined. >Martin wrote... >> So, everyone who hasn't been diagnosed HIV+ is healthy? Your >> terminology is as wooly as the HIV=AIDS=Death lot. >Really. Compared to HIV, just about everything qualifies as >healthy. Still, however we redefine words to suit the [quoted text clipped - 4 lines] >HIV medical treatment, he/she/other should not be allowed to >take that risk. Is this the crux of your argument? You object to the money wasted on HIV and AIDS? If that's the case, I totally agree with you. Every penny or cent spent on HIV and AIDS is wasted. But that's the fault of government, big business, and gay pressure groups. Don't blame those of us diagnosed HIV+ for that. Many of us are victims of it too. >Any negative who would consent to the risk >is either so uninformed as to qualify as retarded or is so >insane as to qualify for involuntary commitment to a mental >hospital. Not when you realise there isn't really any risk at all. >Let's discuss the concept of allowing adults to make their >own choices in life. The political left has long been a >promoter of nanny state legislation, with the noble goal of >protecting stupid people from their stupidity. I don't think the state could get more nanny-like than to lock up people you prefer not to have sex with. You shouldn't feel too cosy cuddling up with the right. They hate faggots like you even more than you hate people who have been diagnosed HIV+. And your argument of not doing anal sex because you don't want to get sh.t on your cock won't have much sway with them. >And yet the same leftwad safety >nazis who would throw you in jail for not wearing a seat >belt would never dream of supporting a law requiring an HIV >patient to wear a condom. Erm, the Nazis weren't left-wing. Signature<http://www.hiv-poz.co.uk/> Moible: +447939991519 "Martin" <martin@hiv-poz.co.uk> wrote in message > Not when you realise there isn't really any risk at all. US Health Officials fear rise in syphilis cases among MSM will lead to increasing HIV infection rates Friday, May 11, 2007 The number of syphilis cases is increasing among men who have sex with men in the U.S., which could boost the population's risk of contracting HIV. The number of syphilis cases is increasing among men who have sex with men (MSM) in the U.S., which could boost the population's risk of contracting HIV, CDC officials said, Reuters Health reported this week. According to the officials, the number of syphilis cases in the U.S. reached an all-time low in 2000. However, the number of cases has risen annually from 2000 to 2005, the most recent year for which the agency has figures. CDC analysts estimate that in 2000, MSM accounted for 7% of syphilis cases in the country but accounted for more than 60% in 2005. According to CDC, syphilis incidence in the overall population was 2.1 cases per 100,000 people in 2000, compared with three cases per 100,000 people in 2005, or 8,724 cases. Khalil Ghanem of Johns Hopkins University's School of Medicine said, "The most devastating consequence of this increase in syphilis cases [among MSM] would be an increase in the rates of HIV infection." He added, "Syphilis and HIV have a close, deadly symbiotic relationship." According to James Heffelfinger, a CDC epidemiologist, syphilis can increase the risk of HIV transmission by twofold to fivefold. "We are seeing that syphilis is on the rise among a very specific subset of [MSM]: those who are having a great deal of sex with multiple sex partners," Joel Ginsberg, executive director of the Gay and Lesbian Medical Association in San Francisco, said "Among these men, there seems to be decreased condom use, perhaps related to an attitude of 'I already have HIV, so why bother?' or because HIV is seen as a chronic disease that can be managed well with medications." According to Ginsberg, many MSM in this subset are HIV-positive or learn their HIV-positive status for the first time when they find out they have syphilis. According to Reuters Health, Ghanem "faulted" the homosexual and bisexual communities, public health leaders and the medical establishment for failing to get across a message of prevention, citing "safe-sex fatigue" after the advent of antiretroviral drugs. "Once these wonder drugs came along, [HIV-positive people] no longer saw HIV as a death sentence, and clinicians, unfortunately, became more lackadaisical about conveying prevention messages," Ghanem said. He added that use of crystal methamphetamine is associated with unsafe sexual practices linked to syphilis. The Washington Post on Tuesday examined the number of syphilis cases in Maryland; Washington, D.C., and Virginia. The article is available online. Sources 1. Number of Syphilis Cases Rising Among MSM in U.S., Could Increase Risk of HIV Transmission, CDC Officials Say. Kaiser Daily HIV/AIDS Report. May 08, 2007. 2. W Dunham. Syphilis rise in gay, bisexual men causes worry. Reuters Health. May 8, 2007. SOURCE: HIVandHepatitis.com http://www.hivandhepatitis.com/recent/2007/051107_a.html >"Martin" <martin@hiv-poz.co.uk> wrote in message >> Not when you realise there isn't really any risk at all. >US Health Officials fear rise in syphilis cases among MSM will lead to increasing HIV infection >rates [quoted text clipped - 6 lines] >which could boost the population's risk of contracting HIV, CDC officials said, Reuters Health >reported this week. This is a silly scare tactic. Note how the heading uses the word 'will,' but the article uses the word 'could.' It's simply more evidence that HIV either doesn't exists or is totally harmless, so it has to be linked with something else. Is syphilis an AIDS defining illness? Perhaps it won't be long before it's added to the ever expanding list. Of course you believe being gay is an AIDS defining condition, and that you're the exception which proves the rule. Signature<http://www.hiv-poz.co.uk/> Moible: +447939991519 "Martin" <martin@hiv-poz.co.uk> wrote in message > Of course you believe being gay is an AIDS defining condition, ... Yes. Note the resistant infections. Whole new ball-game now. Fact Sheet: Primary Three-Class Antiretroviral-Resistant HIV Infection Excerpted from Fact Sheet provided by the New York City Department of Health and Mental Hygeine. Q: What is Three-Class Antiretroviral-Resistant HIV? A highly resistant strain of human immunodeficiency virus (HIV) has been diagnosed for the first time in a New York City resident who had not previously undergone antiviral drug treatment, the Department of Health and Mental Hygiene (DOHMH) announced today. The strain of three-class antiretroviral-resistant HIV (3DCR HIV), does not respond to three classes of anti-retroviral medication. Because it does not respond to the most commonly used antiretroviral drugs, treatment is much more difficult. In addition, this strain of the virus appears to rapidly progress and may shorten the interval between HIV infection and the onset of AIDS. Q: To which anti-viral drugs is this HIV strain resistant? Strains with 3DCR HIV are resistant to the three of the four types of anitiviral drugs -- nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and protease inhibitors, that, in combination, are most commonly used to treat HIV infection. Q: Why is this case of such great concern? While drug resistance is increasingly common among people who have been treated for HIV, 3DCR HIV in a previously untreated person is extremely rare, and the combination of this pattern of drug resistance and rapid progression to AIDS has not previously been seen. In this case there appears to have been rapid progression to AIDS. Usually, AIDS occurs more than ten years after infection with HIV. In this case, the onset of AIDS appears to have occurred within two to three months, and at most 20 months, after HIV infection. Q: When did the Health Department find out about this case? The case is a man who reported multiple male sex partners and unprotected anal intercourse, often while using crystal methamphetamine (crystal meth). He was first diagnosed with HIV in December 2004, with the diagnosis of 3DCR HIV made shortly thereafter. The patient has developed AIDS and is currently undergoing treatment. Q: If this is a 3-drugs resistant strain, what kind of treatment is this person receiving? The patient's virus showed susceptibility to a recently approved drug in a new class of antiretroviral medication -- the fusion inhibitors. This drug is being used in combination with other anti-HIV medication. Q: Why is this different from other strains of HIV? This strain has the ability to use two different sites to bind to T-cells (the target cells for HIV infection) thus depleting the T-cell population more rapidly than usual. At the same time, its resistance to all three of the most commonly used antiretroviral drug classes limits treatment options. Q: What does it mean that this strain of HIV rapidly progresses to AIDS? It rapidly depletes the immune system, making the patient vulnerable to opportunistic infections. Q: How do I find out if I have HIV? Free, confidential STD exams and treatment, and confidential or anonymous HIV testing is available. Q: How do I find out if I have this strain of HIV? If you learn that you are infected with HIV, your doctor can order tests that show whether your virus is resistant to antiretroviral drugs. The Health Department is now recommending that doctors order resistance testing for all persons newly diagnosed with HIV infection. Q: How can I protect myself against this strain of HIV? Everything that you do to protect yourself against HIV should work against this particular strain of HIV. Q: What should I expect from my doctor? This case along with rising syphillis rates and recent reports of lymphogranuloma venereum (LGV) in men who have sex with men (MSM) reflects a high level of unsafe sex, often coupled with drugs use in the MSM community. Doctors should offer HIV testing to everybody. Doctors should ensure that partners are identified, notified and tested. Substance abuse, including methamphetamine and cocaine use, is associated with increased sexual risk taking. Doctors should counsel HIV-infected and uninfected men at risk to reduce unsafe sexual behavior and address drug use and mental health problems. There is an urgent need to improve adherence amoung patients receiving Highly Active Anti-Retroviral Therapy (HAART) in order to prevent further development and spread of drug-resistant HIV. Adherence improves with simpler regimens, housing support, mental health services, and drugs and alcohol treatment. Patients with flu-like symptoms may actually be in the early stages of HIV-infection. This is called acute retroviral syndrome. Many of these patients will still be antibody-negative. It is imperative that doctors order viral load testing on antibody-negative persons with symptoms of flu and risk factors for HIV. Doctors and patients who need help with notifying partners should go to inspot.org. Q: Is the case in New York City an isolated incident or something that will show up in more people? At this time there is only one reported case and it is not clear if this is a particularly strong form of HIV or if the person who had it is particularly weak. This site contains HIV prevention messages that may not be appropriate for all audiences. If you are not seeking such information, or may be offended by such materials, please exit this website. I knew quite a few people who were really worried about "Mad Cow disease" in the 90s and early 00s. Not only do they never talk about that any longer, but they also don't pay much attention to the stories about "drug resistant" "HIV" or TB, and many have laughed at the "Bird Flu pandemic" stories. They have gone to the proverbial well more than once too often. > I knew quite a few people who were really worried about "Mad Cow > disease" in the 90s and early 00s. Not only do they never talk about > that any longer, but they also don't pay much attention to the stories > about "drug resistant" "HIV" or TB, and many have laughed at the "Bird > Flu pandemic" stories. They have gone to the proverbial well more > than once too often. AIDS 2006 | Highly Resistant TB Strains Appearing Among HIV-Positive People in South Africa, Study Says [Aug 18, 2006] Tuberculosis strains that are resistant to first- and second-line drugs -- known as XDR-TB -- have appeared among HIV-positive people in the South African province of KwaZulu-Natal, according to a study presented Thursday at the XVI International AIDS Conference in Toronto, the New York Times reports. Gerald Friedland of Yale University and colleagues examined the sputum samples of 536 people living with TB in the town of Tugela Ferry in the Msinga district of KwaZulu-Natal that were collected between January 2005 and March 2006. They found that 221 -- or 41% -- of the study participants had multi-drug resistant TB, and of these, 53 had XDR-TB. All of the people with XDR-TB were HIV-positive, the Times reports. According to study co-author Neel Gandhi of the Albert Einstein College of Medicine at Yeshiva University, most of the people with XDR-TB were carrying a genetically similar strain (Altman, New York Times, 8/18). According to the study, 52 of the 53 people with XDR-TB died, most within 30 days of having their sputum collected. The average survival period among the people with XDR-TB was 16 days, according to the researchers (Chase, Wall Street Journal, 8/17). According to Friedland, most of the participants who died had progressed to AIDS, and about half contracted the disease at hospitals or clinics. Because most of the people with XDR-TB had never been treated for TB, the researchers concluded that they did not develop resistance to treatment but had contracted the resistant strains from other people. Implications XDR-TB is a "potential time bomb," Friedland said, adding, "It's an extremely serious thing. I don't want to convey a sense of panic -- it's not Ebola. It's urgent, but it's not the same." According to Gandhi, there has been little research into the prevalence of XDR-TB in Africa or among HIV-positive people (New York Times, 8/18). He added that the emergence of XDR-TB in parts of Africa with high HIV prevalence could hinder the efficacy of antiretroviral drugs, as well as the DOTS strategy for treating TB, and undermine success in the fight against the two diseases. Peter Small, head of TB programs at the Bill & Melinda Gates Foundation, said that XDR-TB could be the "Achilles heel" of current treatment methods if increased efforts are not made to control it (Wall Street Journal, 8/17). Health officials from South Africa, the World Health Organization and other public health organizations plan to meet within the next few weeks to devise a plan for tackling XDR-TB, Friedland said (New York Times, 8/18). Spread of TB Among HIV-Positive People Worldwide Undermines Effectiveness of Antiretrovirals, Experts Say The spread of TB among HIV-positive people worldwide is undermining the effectiveness of antiretrovirals, experts at the AIDS conference said Wednesday, CP/CBC News reports. More than one-third of HIV-positive people worldwide also have TB, which causes the deaths of 250,000 HIV-positive people annually, Helene Gayle, co-chair of the conference and president of CARE, said. She called for the acceleration of prevention efforts that address both TB and HIV, saying that HIV-positive people should be guaranteed access to TB services and that all TB patients should be tested for HIV (Ubelacker, CP/CBC News, 8/16). Kevin De Cock, director of the World Health Organization's HIV/AIDS Department, called for TB management to be placed "at the head of AIDS management" (Berman, VOA News, 8/17). He added that unless the issue of TB/HIV coinfection is addressed aggressively, "we risk dealing with the specter of drug resistance and multi-drug resistance" (CP/CBC News, 8/16). Richard Chaisson, a professor of infectious diseases at Johns Hopkins University, said there is an urgent need for research into new TB drugs, diagnostics and vaccines for HIV-positive people, as well as studies and effective models to deliver the services to those who need them. Also at the conference, Lucy Chesire, an advocate from Kenya for HIV-positive people with TB, said HIV-positive people should urge their governments to allocate more resources to TB control and to ensure collaboration on TB and HIV activities (WHO/International AIDS Society release, 8/16). Kaisernetwork.org is serving as the official webcaster of the conference. View the guide to coverage and all webcasts, interviews and a daily video round up of conference highlights at http://www.kaisernetwork.org/aids2006. A webcast of a session examining the relationship between HIV/AIDS and TB is available online. Martin wrote... > Erm, the Nazis weren't left-wing. These are "leftwad nazis," almost the same thing in that they wish to control everything you do. For all the passionate ideology behind the rivalry between the Russian Communists and German Nazis, there really was no difference in how the people in each regime lived - opressed and spied on by secret police. > >> It could spread like wildfire though the community, and there is no cure ....... > > That sounds like AIDS doesn't it? > > No,... No? Are you telling me there is a cure for AIDS and no one told me ? |
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