News (Updated October 12, 2008)

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Drug-resistant HIV strains turning up in China

Fri, Oct 10 03:20 PM

By Tan Ee Lyn

HONG KONG (Reuters) - Drug-resistant HIV strains are turning up in parts of China as the virus stretches beyond high-risk groups and gains a stronger foothold in the general population, a leading Chinese AIDS researcher said.

Chen Zhiwei, director of the AIDS Institute in Hong Kong, described the trends as "alarming" and warned that Chinese AIDS patients could get in trouble because there were very few HIV drugs available in China.

"All these drug-resistant mutations are in China now, they are emerging in Chinese patients. The major worry is whether the drug-resistant virus (strains) will spread," Chen said.

"We are studying whether that is happening, but that will be the case if you don't provide proper treatment," he told Reuters.

"If drug resistant virus (strains) spread in China, we don't have enough selection of (drugs) that are made available," Chen said, adding that researchers had urged China to import more varieties of HIV drugs.

China has only seven of the more than 20 different HIV drugs available, which means patients end up with limited options once they develop resistance to certain drugs.

Although HIV infection is incurable, cocktails of the drugs can control the virus. But drug adherence is bad in China's rural regions due to poor patient knowledge, inaccessible healthcare and a lack of health workers to explain to patients the importance of keeping to drug regimens.

Chen's warning comes after he and his colleagues published an article in Nature last week, detailing how HIV infections were rising sharply among women and gay and bisexual men in China.

There were some 700,000 HIV/AIDS cases in China as of October 2007, up 8 percent from 2006. Some 38 percent of cases were attributed to heterosexual contact, more than triple the 11 percent in 2005 -- when the bulk of infections were occurring among injecting drug users and through blood transmissions.

GENERAL POPULATION AT RISK

Cases among gay and bisexual men jumped to 3.3 percent in 2007 from 0.4 percent in 2005 nationally.

In a separate study of southwestern Yunnan province -- a region notorious for HIV infections among drug users -- the scientists found that women now make up 35 percent of those infected, up from 7.1 percent before 1996.

"The virus is moving into the general population. Signs are prevalent among women and vertical transmission (from mother to foetus)," he said.

"We have to find a way to stop this or the change will be like South Africa. If there is no good prevention, transmissions will suddenly explode," said the scientist. Chen said the porous southern Chinese border was a concern. An HIV strain circulating in Yunnan is also found in Thailand and Myanmar, which could be partly explained by Chinese women working as prostitutes in Indochina, he said.

"They travel to and from Indochina. They work in Thailand, then they bring the virus back," he said.

Travellers crossing the southern border may be responsible.

"Last year, we randomly tested travellers and found 30 people from Myanmar, Laos and Vietnam who were HIV positive. We try to test the bridging population and see what's going on," Chen said.

 

Little HIV protection from circumcision for gay sex: study

Tue Oct 7, 11:04 PM ET

Circumcision, which has been found to reduce by about one-half the transmission of HIV between heterosexuals, appears to offer far less protection for men engaging in homosexual intercourse, according to a new study.

The research published in the October 8 issue of The Journal of the American Medical Association compiled 15 discrete studies of more than 50,000 male subjects in Africa.

The report by the US Centers for Disease Control and Prevention noted that male circumcision appears to reduce by between 50 and 60 percent the likelihood of female-to-male transmission of the potentially deadly AIDS virus.

But among men who report having male sexual partners, researchers found little difference in the rate of HIV infection between those who were circumcised and those who were not.

Of 53,567 subjects in the study, 52 percent were circumcised, meaning that they had had all or some of the foreskin removed from the penis.

The study's authors wrote that circumcision appears to provide "not statistically significant" protection from HIV in men who engage in anal sex with other men. The researchers said however that more research may be necessary to quantify the amount of protection -- or lack thereof -- provided by circumcision.

That view was echoed in an editorial that accompanied the article. A team of peer reviewers from Vanderbilt University concluded that "circumcision would likely be insufficiently efficient to be universally effective in reducing HIV risk, and will have to be combined with other prevention modalities to have a substantial and sustained prevention effect."

The findings did suggest however, that male circumcision may offer men engaging in heterosexual intercourse some protection against sexually-transmitted infections, such as syphilis or chlamydia.

 

First human case of HIV '100 years ago'

Published Date: 02 October 2008

By Emily Pykett

GENETICISTS have pinpointed the origin of the Aids virus to the turn of the 20th century, decades earlier than it was previously believed to have emerged.

Human tissue samples from Africa show that the most pervasive global strain, HIV-1, probably jumped from chimpanzees to humans some time between 1884 and 1924, with the best estimate being 1908. Scientists previously believed the virus originated in around 1930.

Research published today in the journal Nature suggests the rise of large cities in west-central Africa was a major factor in the spread of the virus. The first major settlements were founded by European colonialists in the late 1800s, but populations did not start to exceed 10,000 until after 1910.

Key to the work was the discovery of an infected lymph node specimen, taken in 1960 from a woman in Leopoldville in the Belgian Congo, now Kinshasa , the capital of the Democratic Republic of the Congo .

It is the world's second-oldest genetic sequence of HIV and was compared by scientists with dozens of other previously known samples to build up a "family tree" for the viral strain, confirming a common ancestor existed around 1900.

Professor Michael Worobey, of Arizona University , last year with his colleagues showed that a similar sub-type of HIV probably arose from a single strain that was carried from Africa to Haiti , before spreading to the United States and onwards.

He said: "I would bet that cities, and the high-risk sexual behaviours found in them, are necessary to allow one of these sporadic viral jumps to get a toehold in the human population."

Professor Paul Sharp, of Edinburgh University 's Institute of Evolutionary Biology , said: "The interpretation that HIV-1 was spreading among humans for 60 to 80 years before Aids was recognised should come as no surprise.

"If the epidemic grew roughly exponentially from only one or a few infected individuals around 1910 to the more than 55 million estimated to have been infected by 2007, there were probably only a few thousand HIV-infected individuals by 1960, all of them in central Africa ."

The sample was recovered from the 1958-62 archives of the Department of Anatomy and Pathology at the University of Kinshasa . The boxes were transferred to the University of Arizona , where eight lymph node, nine liver and ten placenta samples from 1958-60 were selected for HIV screening. It is hoped that more HIV-1-infected specimens in the archival banks of west central African hospitals can help scientists to trace the evolution of Aids viruses.

 

Pfizer continues realigning with 3 new units

By LINDA A. JOHNSON, AP Business WriterTue Oct 7, 11:33 AM ET

Pfizer Inc., continuing its drive to create more focused business units, told employees worldwide Tuesday it is replacing its current geographic divisions with new ones centered on primary care, specialty care and operations in emerging markets.

The shift is aimed at enabling the world's biggest drugmaker to respond better to the needs of doctors, patients and government and other payers, while increasing innovation and holding the independent business units accountable for meeting targets, Pfizer spokesman Ray Kerins said.

The new units, which will begin operating at the beginning of next year, will have complete responsibility for functions including strategic planning, sales and marketing, and even drug development — testing experimental compounds in people and tinkering with them to come up with the best dose.

Research operations, including identifying potential compounds and testing in the laboratory and in animals, will remain independent, according to Kerins.

"We believe this is where the company can best unlock the value for our customers," he said.

Some employees may see slight shifts in their duties, but job cuts are not part of the plan, he said. Under a major restructuring announced in January 2007, the company already has eliminated more than 13,500 jobs, closed numerous plants and reduced annual costs, compared with 2006 levels, by $1.2 billion out of its goal of cutting $2 billion in spending. Those cuts are being made ahead of expected generic competition in late 2011 for blockbuster cholesterol fighter Lipitor, which generates more than $12 billion a year — one-quarter of Pfizer's revenue.

The letter tells employees there's no guarantee there won't be future job cuts, but that the current evolution is meant to give the company a flexible cost base and make it more responsive to new opportunities and the public's needs, according to Kerins.

Like many global corporations, New York-based Pfizer has operated business units organized by geography, with divisions and executives in charge of sales in the United States, Europe and other regions.

Under the new plan, announced in a letter from the company's top executives, sales and other functions will now be handled globally, with the exception of the new unit devoted to emerging markets. Those are countries with large populations that are now spending more on health care — China, India, Russia and Brazil and others — that most drugmakers now are targeting more aggressively.

The primary care unit will have salespeople focusing on family doctors and products such as Pfizer's Lipitor and impotence pill Viagra.

Meanwhile, the specialty care unit will market drugs such as Pfizer's HIV medicine Selzentry and will seek feedback from doctors, patients, advocacy groups and others concerned about particular diseases where better treatments are needed.

The new units are part of a shift that began in 2007, when then-new CEO Jeffrey Kindler rolled out the concept, called "Our Path Forward," and Pfizer began creating specialized units. Those now include units devoted to animal health, established products that have lost patent protection but still sell well globally and an oncology unit.

Those three units and the three new ones will each be run by a general manager with responsibilities like those of a chief operating officer.

Some of the new units are headed by new executives lured from Pfizer competitors. Meanwhile, some of those competitors have made similar realignments to improve their bottom lines in recent years. GlaxoSmithKline, Johnson & Johnson, Merck & Co. and Bristol-Myers Squibb Co. have all started more flexible, focused units to some extent.

 


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