Posts tagged HIV transmission

Finding Safer HIV Treatments for Children

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HIV treatments for children is different from treating adults – particularly, for those under three years of age. Doctors have little in the way of guidelines for such treatment. Studies focus on determining which treatments are the most beneficial, with the least long term damage.

Often HIV positive women who are pregnant are given the pharmaceutical drug nevirapine to protect the fetus from transmission. Unfortunately, the drug prevents HIV transmission by only 50%. However, in the event the child does contract HIV, research indicates that, once born, these children can transition from the common treatment for infants to the drug used to treat adults. The drug used for adults is efavirenz, and is not usually administered to persons under the age of three. For infants, a completely different class of drug is used as HIV therapy. Lopinavir/ritonavir is the recommended choice, thus far, for HIV-positive children under three. However, when little ones– those who had exposure to nevirapine in the womb– were given efavirenz, research yielded favorable results.

Researchers were pleasantly surprised by the effectiveness that the changeover brought about. Viral rebound was similar as with the use of the lopinavir/ritonavir. More promising than those results were the CD 4 T-cell counts. These are immune cells that are targeted by the virus. This deadly attack greatly reduces the number of these important immune cells. In children treated with efavirenz, the CD 4 T-cell count was higher than in children provided with the recommended drugs for their age group. In under a year’s time, liver function also proved better than those on the traditionally used medications.

In conclusion, so far, as long as an infant has their infection under control, HIV treatments for children using nevirapine can safely be transitioned to efavirenz. From the studies completed and research gathered, researchers still need further studies to show more results. At this time, the results appear promising though. Experts also plan to investigate long-term effects. In the meantime, finding gentler and more effective ways to treat little ones is high on the priority list.

Increased HCV in HIV-Positive MSM

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Disturbing increases in the number of Hepatitis C infections among certain groups have researchers scrambling to find an effective means of combating it. The virus that causes Hepatitis C (HCV) is blood borne, making injectable drug use a common way to contract the infection. The latest trend, though, is not among people who inject drugs. It is among men who have sex with men (MSM) and are HIV positive. Just why this is happening and how to curb the upward swing in HCV numbers is what researchers are looking into controlling HIV.

Of course, people who inject drugs are certainly at risk for infection, so for the studies that had been performed on this topic, only those who did not abuse injectable drugs were followed so as not to skew the results. Unfortunately, throughout the last decade or so, the number of HIV-infected MSM who have contracted HCV had steadily increased. The problem is that, in recent years, those numbers have increased at a more rapid pace than had been previously predicted.

One risk factor has to do with those who abuses non-injectable drugs. Such drugs as methamphetamine also increased the risk for HCV infection nearly 29 fold. During the studies, a number of participants had repeat HCV infections. These individuals are 20 times more likely to be re-infected. They would contract the virus, seek out treatment, but then contract the disease once again. Not surprising then, high-risk sex behavior and drug abuse saw the highest increases when it came to Hepatitis C.

Projected numbers are not promising for the future either. Currently, out of 1,000 HIV-positive MSM about 20 will present with a Hepatitis C infection over the course of one year. The number of new HCV infection cases is only going to increase. Many believe that this is in part due to lack of education and prevention programs. Just what needs to be taught and which types of programs would prove effective remains to be seen. Education about safe sex practices and drug abuse are being developed to target this growing population. Further study on the matter is underway for controlling HIV.

DC Proves Needle Exchanges Have Value for Prevention

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Sometimes, less is more. For HIV prevention programs, this is truly the case in needle exchange programs. One simple idea, in concept and execution, has saved one city millions of dollars and has prevented over 100 new cases of HIV in just two short years.

The needle exchange program is one of the easiest ways to help prevent HIV (and other viral infection) outbreaks and new cases in general. Along with that, it is by far one of the most cost effective tools on the war front against AIDS today. The program’s success is also helping in the ongoing debate over program funding. One study has put that success into numbers.

Simple idea, big results – that sums up the program. Basically, patients who need prescription medications that are administered via needles must return their used needles before they are given their next doses. For a while, the government aided in the funding for these and similar programs. Congress placed a ban on programs such as this in 1998. The ban prohibited the use of federal funds for needle exchange programs. States and their cities were, of course, allowed to use their own funds to support the programs, but many were unable to do so.

In late 2007, this ban was lifted in DC. Almost immediately, the Department of Health reinstituted the needle exchange program and programs for HIV testing, plus programs for aid addiction treatment. Once the ban lifted and the programs went into effect, researchers began to track the programs’ progress.

When comparing the numbers, from those during the ban to those after, impressive results were seen. The team first determined how many new injection drug use (IDU) cases presenting with HIV has occurred. Using the information they had gathered, an estimated 296 cases of HIV would have presented during two more years of the program funding ban. This is compared to the 176 injection drug users who did become infected with HIV with the programs in effect. Lifting the ban saved over 100 people from possibly contracting HIV in just two short years! There are financial benefits as well. Treatment for 120 people would have cost millions. It is estimated that taxpayers saved $44.3 million.

DC is not the only area benefiting from these types of programs. Regions across the US are reporting similar results.

Consistent HIV Treatment Reduces Heterosexual Transmission

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Recent studies show that HIV treatment that is effective in suppressing the disease works well at preventing the spread of the disease between heterosexual partners. These Canadian findings were the result of a trial funded by NIAID.

The idea of lessening HIV transmission with treatment is not entirely new. In fact, one study from 2011 revealed that the risk of spreading HIV to a partner is reduced by 96 percent when treatment starts early and is taken consistently. The study focused specifically on heterosexual couples in which only one partner was HIV positive.

More than 1,700 heterosexual couples across four continents signed up to be a part of the clinical trial. As a part of the study, all of the couples received training on how to avoid transmission of HIV. Infected individuals were assigned at random to either begin immediate antiretroviral treatment or to delay starting treatment until immunocompromised. Approximately 600 couples did not complete the entire trial, but the data from the other 1,100+ was sufficient to get results. What was learned?

The healthy partner was 93 percent less likely to contract HIV if the infected partner began treatment immediately. In the case of couples where the treatment was begun early on, only eight partners ended up being infected. In fact, four of those individuals were diagnosed early on, showing that the longer treatment went on, the less likely the health partner was to be infected.

It is also important to note that in all four individuals who were infected later on, the partner receiving treatment had not had the disease fully suppressed for one reason or another. In the case of those for whom the treatment worked, there was no transmission after the early part of the study. Another important discovery was that, for those who waited to start treatment, it took longer to suppress the virus, thus leaving a longer window where transmission risk was higher.

The moral of the story: to protect your partner, start treatment early and stick with it to ensure suppression.

Cocaine’s Effect on the Immune System and HIV Infection

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Research out of UCLA links cocaine use to a weakened resistance to HIV. What was involved in the study? And what does it mean by at-risk individuals? Read on to learn how cocaine use increases your chances of HIV infection.

It is well documented that there are surprising similarities between the immune systems of mice and humans. That makes them the perfect test subject when it comes to studying infection and deadly diseases. Therefore, a study that had previously only been performed in a dish has now been tested with live subjects. What was the result? Let’s consider the process first.

In previous lab tests, it was determined that the use of cocaine over a period of just three days is enough to affect the immune system. The body starts out with cells that can put up quite a fight with HIV. These immune cells are called CD4 T cells. The cocaine exposure, however, blocks the normal working of these cells by stimulating two of the cell’s receptors.

For five days, mice were given injections. Half were given cocaine, and the other half was given a placebo with saline. Next, HIV was introduced via injections, and then the cocaine/placebo routine continued for another 14 days. At the end of the study, they not only discovered that the mice who were given cocaine had higher concentrations of the virus in their system but also that nearly half of the mice given a placebo had undetectable amounts of the disease.

The CD4 T cells, however, were not affected as suspected. On the contrary, it was the CD8 T cells that seemed to cease functioning. Either way, though, the fact remains that cocaine made it tougher for the immune system to defend itself against HIV.

This study continues to highlight the connection between illicit drug use and HIV infection. It reveals that anyone who uses cocaine is placing themselves at higher risk for infection. While ceasing drug use is the best option, frequent testing is important for one who pursues an at-risk lifestyle.

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