HIV drug resistance seen in central China: expert

Thu Nov 22, 2007 5:47 AM ET

HONG KONG (Reuters) - Significant numbers of people living with HIV in central China have developed full-blown AIDS despite receiving free anti-retroviral (ARV) drugs, a leading AIDS researcher said on Thursday.

"Recent studies found that a significant portion of patients still developed AIDS after two years of treatment due to the problem of drug resistance," said Chen Zhiwei, director of the newly-opened AIDS Institute at the University of Hong Kong.

Before moving to Hong Kong, Chen was based in the United States where he collaborated with researchers in China to conduct surveillance on HIV drug resistance. Chen said the patients were in central China, but he did not specify which provinces.

"In the past four years, we have been working on it and trying to understand how the nation provides free HIV drugs to farmers and villagers and what actually happened after those years of treatment," Chen told a news conference.

Hundreds of thousands of farmers in the central Chinese province of Henan were infected in the 1990s through schemes in which people sold blood to unsanitary, often state-run health clinics, making the province the centre of China's AIDS epidemic.

Antiretroviral drugs help keep the HIV virus in check and can prevent the progression to full-blown AIDS. But regimens can be complicated and sufferers can easily develop drug resistance if they miss doses. Those who develop resistance to first-line drugs will have to resort to stronger, more expensive treatments.

However, HIV drug resistance is a difficult problem in China as there are few second-line drugs to choose from due to high costs. Chinese pharmaceuticals are also unable to produce many of them due to patent laws.

Activists say those who can afford it, procure drugs from overseas, while the rest simply wait to die.

Chen said the new AIDS Institute would work on possible AIDS vaccines and try to understand and curb the development of the disease in Hong Kong and China.

The United Nations AIDS agency slashed its global estimates this week of how many people were infected from nearly 40 million to 33 million, mainly due to revised figures from India. But UN officials quickly warned that the world risks a resurgence of the AIDS epidemic if countries let their guard down.

(Reporting by Tan Ee Lyn; Editing by Sanjeev Miglani)

Beijing sees jump in HIV/AIDS cases

Wed Nov 21, 2007 12:35 PM GMT

BEIJING (Reuters) - China's capital has registered nearly 973 new HIV/AIDS cases so far this year, a jump of more than 50 percent from 2006, state media reported on Wednesday.

"Incidents of the disease are still on the rise in Beijing and it is spreading from the high-risk groups of people to the general population," Xinhua news agency quoted Jin Dapeng, head of the Beijing Municipal Health Bureau, as saying.

Needle sharing and sex were the main transmission routes in the 2008 Olympics host city.

Preventing the spread of the disease among migrants from rural areas -- who often have no fixed address and little access to health care -- was a new challenge for the city, Jin said.

"Beijing has yet to work out a specific policy on AIDS prevention among migrants. It will be a priority in our future work," he said.

The United Nations estimates that the number of HIV/AIDS sufferers in China is about 650,000.

Although the prevalence is low, AIDS prevention groups say the situation among some pockets of the population and in some regions is serious.

The country has become increasingly open about AIDS in recent years, after initially denying the spread of the disease. But in some areas the epidemic is still stigmatized and civil society groups engaged in AIDS prevention work are periodically harassed.

(Reporting by Lindsay Beck, editing by David Fogarty)

Beijing hotels told to stock all rooms with condoms

Fri Nov 23, 2007 10:17 AM GMT

BEIJING (Reuters) - Beijing, preparing to host the 2008 Olympics, has ordered hotels to provide condoms in all bedrooms in a bid to stop the spread of HIV/AIDS after cases of infection soared 54 percent in the first 10 months of this year.

Announcing the move, the official Xinhua news agency made no direct reference to the Games, saying only that all the Chinese capital's 700 hotels must comply by the end of 2008.

With many thousands of visitors due to crowd into the city for the Olympics, which run from August 8 to August 24, every hotel is likely to be sold out.

While hotel managers must provide condoms for their guests, Xinhua said, they are not required to make a loss. The city health bureau said it was up to them how much to charge.

The State Council (Cabinet) urged local governments last year to provide access to condoms in all public places..

Beijing health authorities said this week that the city had registered 973 new HIV/AIDS cases between January and October. Needle sharing and unprotected sex were the main sources of transmission.

State media reported a total of 18,543 new cases of HIV/AIDS across the country in the first half of this year, close to the total for the whole of 2006

(Reporting by Beijing newsroom, editing by Nick Macfie and Roger Crabb)

77 people infected with AIDS in Shanghai this year

Since the beginning of this year, a total of 77 AIDS-infected people have been to the Shanghai Municipal Public Health Clinic Center to seek medical treatment. In the past, most of the newly infected AIDS patients in Shanghai were at a relatively old age and they usually had received little education. This year, however, many of the infected people are around 20-40 and many of them are regarded as highly-educated people. Among them, there are 14 people who were even born in the 1980s, the Shanghai Morning Post reported.

The knowledge of these people about sex health and about AIDS prevention is rather limited. They might know some basic rules on AIDS prevention, such as using condoms. However, being young in age, they easily become sexually excited and when they have sex, they might forget to follow the basic rules. Some just have unprotected sex, resigning themselves to luck that they might not be infected, said Sun Hongqing, director of the AIDS Treatment Department under the Shanghai Municipal Public Health Clinic Center.

At the center, several young people who were infected with AIDS said they still couldn't face the fact and they didn't know how to deal with their life. They said they often felt depressed now, fearing that they would have to face a lot of discrimination in society, so they preferred to keep a low profile and saw their friends and relatives very little now.

December 1 will mark the World AIDS Day. In future, doctors will introduce more psychotherapies in AIDS treatment, such as methods that will teach patients how to properly face the fact and how to relieve their physical pains brought by AIDS medicines, said Cheng Liang, a professor at the Shanghai Municipal Public Health Clinic Center.

(China News Service November 22, 2007)

Poor education an AIDS factor

A majority of the city's HIV carriers and AIDS patients have a poor educational background, say experts from the Shanghai Public Health Center.

Research found that most people affected with HIV had middle school education or below.

"People with better education always have higher awareness of self-protection and a better understanding of how to prevent AIDS and other sex-related diseases," said the health center's Lu Hongzhou.

Cases of HIV/AIDS reported in Shanghai last year were nearly 70 percent higher than those in 2005, Shanghai Health Bureau officials said. By November 20 last year, the city had registered 621 new HIV carriers, compared with the previous year's 370. It also reported 46 new AIDS patients, double 2005's figure.

Shanghai's first HIV case was reported in 1987, and the total reached 2,313 last year with 100 deaths.

According to last year's figures, more than 80 percent of HIV carriers were from out of town, and in that group intravenous drug use was the main cause. For people living in the city, the chief culprit was unprotected sex.

The bureau is opening methadone maintenance centers in seven districts.

(Shanghai Daily November 23,2007)

HK group rolls out campaign to fight HIV stigma

Wed Nov 21, 2007 11:50 AM GMT

HONG KONG (Reuters) - Four Hong Kong celebrities and a politician threw their weight behind a campaign aimed at stamping out prejudice against people living with HIV/AIDS by asking: If I were HIV positive, would you still love me?

Starting on Wednesday, posters of the five -- who include actor Daniel Wu and politician Alan Leong, captured individually in black and white -- will feature for a month on buses, subway platforms, newspapers and magazines.

Each portrait will also ask, in the local dialect, a question that starts with: "If I were HIV positive..."

"If I were HIV positive, would I be offered the leading role in a movie?" asks the Daniel Wu poster. "If I were HIV positive, would my cartoons still make you laugh?" asks cartoonist Alice Mak.

While HIV/AIDS is widely discussed in many Western countries, it is still an invisible blight in many places in Asia, where ignorance, fear and prejudice about the disease abounds.

"People are afraid of being labelled and isolated," campaign organiser Loretta Wong of the non-government group AIDS Concern told a news conference.

"Many of us are ignorant about the disease and some think they can be infected through shaking hands or having a meal together with a sufferer," added politician Leong.

"These misunderstandings create obstacles to the prevention of the disease ... people are scared to get tested or even seek treatment and that could help spread the disease."

AIDS Concern also hopes to take the campaign to schools and universities to urge people to confront any preconceptions about the disease.

"Perhaps we can ask our bosses, if I were HIV-positive, would I still have work?" Wong said.

(Reporting by Tan Ee Lyn; Editing by Miral Fahmy)

British queen visits AIDS clinic in Uganda

U.N. slashes AIDS estimates in latest report

Tue Nov 20, 2007 5:56 AM GMT

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - The United Nations has slashed its estimates of how many people are infected with the AIDS virus, from nearly 40 million to 33 million.

In a report to be issued on Tuesday, the U.N. says revised estimates on HIV in India account for a large part of the decrease.

The agency admitted it overestimated how many people are infected with the incurable virus, and said better methods of collecting data show it is not quite as common as feared.

"The single biggest reason for this reduction was the intensive exercise to assess India's HIV epidemic, which resulted in a major revision of that country's estimates," the report said.

After originally estimating some 5.7 million people were infected in India, the U.N. more than halved that estimate, to 2.5 million.

But the numbers nonetheless show the epidemic is overwhelming and that efforts to fight HIV must still be stepped up, said officials at the U.N. AIDS agency UNAIDS.

"These improved data present us with a clearer picture of the AIDS epidemic, one that reveals both challenges and opportunities," UNAIDS Executive Director Dr. Peter Piot said in a statement.

"Unquestionably, we are beginning to see a return on investment -- new HIV infections and mortality are declining and the prevalence of HIV levelling. But with more than 6,800 new infections and over 5,700 deaths each day due to AIDS, we must expand our efforts in order to significantly reduce the impact of AIDS worldwide."

The new numbers suggest that some 33.2 million people are infected with the human immunodeficiency virus -- about 30.8 million adults and 2.5 million children.

DOUBLING IN ASIA

UNAIDS estimated that 1.7 million people became newly infected in sub-Saharan Africa this year, a significant reduction since 2001.

But Africa remains by far the continent hardest hit by AIDS, with 22.5 million people infected with HIV.

"Eight countries in this region now account for almost one-third of all new HIV infections and AIDS deaths globally," said UNAIDS.

"In Asia, the estimated number of people living with HIV in Vietnam has more than doubled between 2000 and 2005 and Indonesia has the fastest growing epidemic."

The report gives two reasons for the downward revisions -- one is better data and the other is an actual decrease in the number of new infections.

"UNAIDS and (the World Health Organization) are now working with better information from many more countries," UNAIDS said.

The number of new HIV infections each year likely peaked in the late 1990s at 3 million and was estimated at 2.5 million for 2007, UNAIDS said.

"This reflects natural trends in the epidemic, as well as the result of HIV prevention efforts. Of the total difference in the estimates published in 2006 and 2007, 70 percent are due to changes in six countries: Angola, India, Kenya, Mozambique, Nigeria, and Zimbabwe," the report said.

"In both Kenya and Zimbabwe, there is increasing evidence that a proportion of the declines is due to a reduction of the number of new infections which is, in part due to a reduction in risky behaviours."

The U.N also changed its estimate on how long it takes to die of AIDS if not treated from 9 years to 11 years.

South Africa has world's highest number with AIDS: UN report

Former Soviet Union sees most new HIV infections: report

Fri Nov 23, 2007 5:13 PM GMT

LONDON (Reuters) - Former Soviet states had the largest number of new HIV infections last year in the European region, mainly due to shared drug needles, an EU report said on Friday.

Former Soviet states reported 59,866 new cases of HIV, which causes AIDS, or 210.8 infections per million people, the European Centre for Disease Prevention and Control said.

That was more than all the new cases in Western and Central Europe combined. The report defined Eastern Europe as the 15 countries of the former Soviet Union.

"Although this rate is lower than the epidemic peak observed in 2001, the number of reported new HIV ... diagnoses has increased in recent years," the EU agency said.

"Over a quarter of the new HIV diagnoses were among young people aged 15-24 years and 41 percent of the cases were reported amongst females."

Earlier this week, the United Nations slashed its estimates of how many people globally are infected with the AIDS virus from nearly 40 million to 33 million, mainly due to revised figures for India.

The agency also said the evidence showed the epidemic is creeping back in countries that have become less vigilant, mainly industrialized nations where many people with AIDS have access to drugs that can extend their lives.

In the EU study, Western Europe reported 25,241 new HIV cases, a rate of 82.5 infections per million, while Central European countries had 1,805 HIV cases, or 9.4 infections per million. Heterosexual contact was the main driver of transmission in those areas.

The agency also estimated about 30 percent of people living with HIV in Europe are unaware they are infected, which means they likely engage in risky behavior that can spread the virus.

"It is anticipated that higher testing rates across Europe will link more HIV infected people to prevention and treatment services," the study said.

(Reporting by Michael Kahn, editing by Michael Winfrey)

New HIV numbers give better picture of epidemic

The 2007 AIDS epidemic update, jointly published by UNAIDS and the World Health Organisation (WHO), puts the number of people living with the virus at 33.2 million, a significant decrease from the 2006 estimate of 39.5 million. However, applying an "improved methodology", UNAIDS has also revised the 2006 figure to 32.7 million.

The overall percentage of people living with HIV appears to have levelled off, but because infected people are generally living longer, the global number continues to rise.

Based on "improvements in country data collection and analysis, as well as a better understanding of the natural history and distribution of HIV infection", the new report puts the annual number of new infections at 2.5 million, down from a peak of over 3 million a year in the late 1990s.

Critics have long accused UN officials of exaggerating the scale of the epidemic in order to secure more funding to combat the disease, but UNAIDS attributes the revisions mainly to the development of more sophisticated methodology for calculating HIV estimates, and more accurate and representative surveys for tracking infections.

Previously, epidemiologists relied mainly on data from antenatal clinics to calculate HIV prevalence rates, but the age groups of the women tested, and the fact they were clearly having unprotected sex, meant these numbers tended to overestimate HIV infections in the general population.

Many countries are now conducting more representative population-based household surveys, with the result that in India, for example, the estimated number of HIV infections has come down by more than half.

"The data for measuring the HIV epidemic ... has considerably expanded and improved in recent years," commented Ron Brookmeyer, Professor of Biostatistics at the US-based Johns Hopkins Bloomberg School of Public Health. "Nevertheless, there is a need to further improve the representativeness of the underlying data."

A better understanding of the natural dynamics of an epidemic has also helped to account for the lower estimates - HIV prevalence tends to reduce over time as the number of new infections in a population reaches a "saturation" point and deaths resulting from AIDS increase.

The report attributes at least some of the drop in prevalence to HIV-prevention efforts. Infections among young pregnant women attending antenatal clinics have declined over the last five years in 11 of the 15 most affected countries, and studies looking at risk behaviour among young people also show encouraging results in countries such as Zimbabwe, Kenya, Botswana, Malawi and Zambia.

"Prevalence is dropping in a lot of countries," noted Prof John Hargrove, director of the Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA) at the University of Stellenbosch, South Africa. "There's absolutely no question, for example, that HIV prevalence in Zimbabwe has been dropping like a stone in recent years, but there is some resistance from people in the First World to accepting that."

UNAIDS officials were at pains to point out that the global AIDS epidemic still represented a public health crisis of devastating proportions, especially in the eight southern African countries where national adult HIV prevalence exceeded 15 percent.

"Unquestionably, we are beginning to see a return on investment," said UNAIDS head Dr Peter Piot in a statement. "But with more than 6,800 new infections and over 5,700 deaths each day due to AIDS, we must expand our efforts in order to significantly reduce the impact of AIDS worldwide."

Despite revised estimates for several sub-Saharan African countries, including Nigeria, Zimbabwe, Kenya and Angola, the region remains the one most affected by the epidemic, accounting for more than two-thirds of all people living with HIV and more than three-quarters of all AIDS deaths in 2007.

Unlike elsewhere in the world, the majority of people living with HIV in sub-Saharan Africa (61 percent) are women. Although access to life-prolonging antiretroviral treatment has improved, AIDS is still the region's number one cause of death.

According to Hargrove, many countries in the region still lack adequate HIV-prevalence data, and techniques for estimating the proportion of new infections in a cross-section of HIV-positive people are still not reliable enough. "The one thing we really need is to develop better methods for measuring the rate at which new infections are occurring."

U.N. warns AIDS could spike if countries drop guard

Tue Nov 20, 2007 4:38 PM GMT

By Michael Kahn

LONDON (Reuters) - The world risks a resurgence of the AIDS epidemic if countries let their guard down, United Nations officials cautioned on Tuesday.

Lower estimates of how many people are infected with the virus, and more effective treatments, are causing countries to relax their vigilance, they said.

Earlier, the U.N. AIDS agency slashed its estimates of how many people are infected from nearly 40 million to 33 million, mainly due to revised figures for India. It said better methods of collecting data showed it is not quite a common as feared..

But officials said evidence also showed the epidemic was creeping back in countries that have become less careful, mainly industrialised nations where many people with AIDS have access to drugs that can extend their lives.

"We are seeing a return of the epidemic," Paul De Lay of UNAIDS told reporters. "We are seeing that in the U.S., we are seeing that in the UK, we are seeing that in Germany and we are seeing that in the developing world also."

Each day there are more than 6,800 new HIV infections and 5,700 AIDS-related deaths, ensuring that the disease will pose a major health concern for years, UNAIDS said.

"The sheer scale of the epidemic compared to other diseases is so much more vast," De Lay said. "The epidemic is just waiting to come back if programs are reduced."

The U.N. agency said the single biggest reason for this reduction was a push to better assess India's HIV epidemic. After originally estimating some 5.7 million people were infected in India, the U.N. more than halved that estimate, to 2.5 million, in July.

Experts and AIDS advocacy groups have long criticized the agency's numbers as too high, and some said there was no way to tell if the new report was any better without universal testing.

Kevin De Cock, director of the World Health Organization's Department of HIV/AIDS said the implications for dealing with the disease were the same despite the lower estimates.

"This remains the leading infectious disease challenge to public health even if some of these figures are adjusted," he told reporters in a telephone briefing . "We are facing decades of this problem."

(Reporting by Michael Kahn and Maggie Fox; editing by Robert Hart)