Medical Forum / General / General / December 2007
ESTIMATES OF U.S. HIV CASES RISE 50 PERCENT: REPORTS
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Dr. Jai Maharaj - 03 Dec 2007 08:35 GMT Estimates of U.S. HIV cases rise 50 percent: reports
Reuters Saturday, December 1, 2007
Washington (Reuters) - The government is raising its estimate of how many Americans are becoming infected with the AIDS virus every year by 50 percent, according to newspaper reports on Saturday.
The federal Centers for Disease Control and Prevention now believes the number of new HIV infections each year is between 55,000 and 60,000 -- up from the 40,000 figure used for the past decade, The Washington Post reported.
The Post cited two unidentified people in contact with the scientists preparing the new estimate.
It said the higher figures were based on data from 19 states and large cities that were extrapolated to the nation as a whole. The CDC has not made the new estimate public.
The Wall Street Journal also reported the CDC's expected upward revision, citing unidentified outside researchers and public health officials.
The Journal said Robert Janssen, director of the CDC's Division of HIV/AIDS Prevention, declined to comment on the new estimates, saying they could change.
The newspapers attributed the revision to new testing technology developed by the U.S. public health agency, which also revised its methodology to make estimates more precise.
"The higher estimate is the product of a new method of testing blood samples that can identify those who were infected within the previous five months. With a way to distinguish recent infections from long-standing ones, epidemiologists can then estimate how many new infections are appearing nationwide each month or year," the Post said.
(Writing by Doina Chiacu; Editing by Richard Balmforth)
More at: http://www.reuters.com/article/domesticNews/idUSN0134528720071201?feedType=RSS&f eedName=domesticNews
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manasavachakarma - 03 Dec 2007 20:38 GMT HIV+ to get 2nd line of treatment
New Delhi, Dec. 2: People who are living with HIV/AIDS can breathe a sigh of relief with the National AIDS Control Organisation has agreed to provide second-line AIDS treatment. Union health minister, Mr Anbumani Ramadoss, announced that the government would from January 1 launch the life-saving second line Anti-retroviral Treatment (ART).
India is believed to have about 2.5 crore people affected with HIV/ AIDS and only about 1 lakh are receive first line ART. The first-line treatment is cost-effective. The second-line drugs are more advanced and up to 16 times costlier that the first-line ART.
Source deccan.com
manasavachakarma - 03 Dec 2007 23:00 GMT The so called "HIV vaccine researchers" work for the wishyes american drug companies who will have nothing to sell if a vaccine became a reality. Or else they are driven by the 'nobel motto'. ----------------- http://www.deccanherald.com/Content/Dec42007/snt2007120339209.asp
The elusive HIV vaccine The amount of HIV-related research notwithstanding, a vaccine for the dreaded virus still remains a dream. The possibility of having one in the near future seems to be very bleak too.
"We hope to have a vaccine against AIDS ready for testing in about two years," said Margaret Heckler, US health and human services secretary on 23rd April 1984 while announcing the discovery by Dr Robert Gallo of the National Cancer Institute, of virus which causes AIDS.
It is over two decades now. We have no vaccine for HIV yet and the possibility of having one in the near future seems to be bleak!
Last month, Merck and its partners called off their ambitious T-cell vaccine concept based HIV clinical trial after it failed to provide convincing results. "We were all in shock and devastated," puts Dr Peggy Johnston, a lead scientist at the National Institute of Allergy and Infectious Diseases.
Worldwide estimation of people living with HIV is over 39.5 million, including about 2.3 million children. Over 4.3 million people were newly infected in 2006 alone! United Nations HIV program finds 95 per cent of the infected people in developing countries!
The National Institute of Health spends over 500 millions each year on HIV-related research. No vaccine search program in the past was as intense as the one with HIV. Scientists know almost everything by now on HIV as a result of its passionate study over the past two decades.
Yet, it looks we know very little about HIV and its infection. Blame is partly on HIV and partly on us. We seem to invite HIV, no reason, why? And condemn the killer molecules - GP120 of HIV and CCR5 of ours!
There are many variants in HIV and they invade human immune system in several/ different phases. The chief form, HIV-1, initially prefers macrophages, a type of immune cells. It binds through a molecule know as GP120 (a viral surface glyco-protein) to the protein molecule CD4 on the macrophage surface. This interaction alters the GP120 conformation to reveal a binding site for CCR5, a key surface protein. This triggers conformational changes in the GP41 (another viral glyco- protein) to mediate fusion of viral and host cell membranes. Once bound, it enters cells to reproduce. Subsequent strains produced have GP120 molecules capable of recognising one more surface protein called CXCR4 on T-cells, another type of immune cells along with macrophages. Later strains of the virus may preferentially infect T-cells and destroy them. This leads to the collapse of the immune system of the body which is nothing but the onset of AIDS. Another form, HIV-2, can recognise CXCR4 directly and this can quickly lead to AIDS. Hampered immune system leaves the body defenseless and susceptible for the attack by all other disease causing microbes and cancer.
In order to prevent HIV from taking over, antibodies (defense protein molecules in the body) must recognise and neutralise viral particles. Viral surface glyco-protein, a composite of three copies each of GP120 and GP41, is the only target available for antibodies. The remarkable diversity, rearrangements, glycosylation and conformational flexibility of this surface protein allows virus to elude body's defense mechanisms. Additionally, HIV-1 mutates at an incredibly fast rate leaving scientists frustrated in the attempt of finding a vaccine.
Despite this sneakiness, virus must retain minimum identity of its surface glyco-protein to mediate CD4 and CCR5 binding, should it need to enter the cell. Scientists have recently identified such a conserved region in the GP120 and shown the crystal structure of B12, a neutralising antibody.
Unlike most other parts of the protein, which change constantly, the newly discovered protein site appears to be stable and vulnerable to attack, scientists wrote in one of the issues of this years Nature, a science journal. There is something special about HIV infection that relates to CCR5, the protein molecule found on the surface of our own immune cells. CCR5 (chemokine C-C motif receptor 5) and many other related cytokine receptors such as CXCR4 are basically involved in the signaling process. Researches learnt that cytokines (small signaling proteins and peptides which bind to CCR5) suppress HIV infection, indicating the involvement of CCR5 in the infection process.
Also, it was found that some people who have only one normal copy of CCR5 gene are tolerant to HIV as the infection is achieved using over 1000 times more virus than ordinarily required! Those who altogether lack normal copies of CCR5, but have a mutated version (CCR5 delta 32) are just immune to HIV. How lucky are they! No one is sure why or when such a mutation was selected.
Although it was hypothesised that CCR5 mutation was the result of a recent plague epidemic, a latest study found the occurrence of mutated CCR5 in Bronze Age skeletal remains from many burial sites in Europe. Why do we need CCR5 at all when a mutated version has no significant effect on normal functioning? CXCR4, on the other hand, is found to be more critical as mice with cells engineered to be CXCR4-deficient died during gestation! CCR5 and related proteins appear to have profound implications for the future treatment of HIV infection and AIDS. For example, if stem cells with defective CCR5 gene could be successfully transplanted into HIV infected individuals, they would produce immune cells that would be naturally immune to HIV-1 infection!
"Creating an HIV vaccine is one of the great scientific challenges of our time," puts Dr Elias Zerhouni, director of the National Institute of Health. Can we conquer these killer molecules in any way? We shall live with hope! RSP Rao
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