News (Updated September 7, 2008)

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Gene may hold key to neutralizing HIV: U.S. study

Thu Sep 4, 2008 3:39pm EDT

By Julie Steenhuysen

CHICAGO (Reuters) - The AIDS virus is especially hard to fight because few people develop antibodies to neutralize it, but U.S. researchers said on Thursday they have found an immunity gene that may offer a new way to fight back.

They said the gene Apobec3 helps mice develop antibodies against an HIV-like virus, and they think the same gene in humans could lead to a potent vaccine against the human immunodeficiency virus or HIV.

"This gene is central to HIV biology," Dr. Warner Greene of the Gladstone Institutes at the University of California, San Francisco, said in a telephone interview.

So far, efforts to make a vaccine against HIV have failed.

In humans, HIV devotes one of its 9 genes to disabling Apobec3 proteins, which may help explain why people with HIV rarely make antibodies against the virus, he said.

HIV is a retrovirus, which means it copies bits of its own genetic code into the DNA of the host.

"If we could prevent HIV from destroying this key pivotal host factor, we might allow HIV-infected patients to develop neutralizing antibodies like they do in mice," he said.

"It's a translation from mice to men. That's the challenge now," said Greene, whose study appears in the journal Science.

Green's lab and others have been hunting for the gene in mice that allows them to fight off the Friend virus, a retrovirus similar to HIV.

Working with a team at the National Institute of Allergy and Infectious Diseases, the researchers conducted a series of experiments in which they genetically engineered mice to lack the Apobec3 gene. "Sure enough, when we knocked out the Apobec3 gene, they lost their ability to recover from Friend virus infection," Greene said.

He said the discovery of Apobec3's role in retroviral immunity is exciting because genes in this region are active in people who resist HIV infection, suggesting they are making effective antibodies against the virus.

"Blocking this degradation of Apobec3 is probably the most promising new drug target in HIV biology," Greene said.

Antibodies are key to warding off viral infections, and most vaccines against viral diseases stimulate the body to make antibodies against the target virus.

Greene said efforts at developing an HIV vaccine have largely focused on building up a kind of immune cell called a T-cell to attack the virus.

"Those types of approaches are not proving adequate. We are desperately seeking better approaches to creating neutralizing antibodies," he said, adding, "Maybe this will help us."

The AIDS virus infects an estimated 33 million people globally and has killed about 25 million since the pandemic started in the 1980s.

There is no cure but drugs can suppress the virus and allow patients to lead a near-normal life. Without treatment, the virus destroys the immune system, leaving patients susceptible to infections and cancer.

(Editing by Maggie Fox and Todd Eastham)

 

All types of sexual activity carry some STD risk

Tue Sep 2, 2008 1:29pm EDT

NEW YORK (Reuters Health) - Sexual activity other than intercourse carries some risk of sexually transmitted disease, and doctors should make sure their patients understand that, according to the American College of Obstetricians and Gynecologists (ACOG).

Many people may engage in "noncoital" sexual activities such as oral sex, mutual masturbation and anal sex to prevent pregnancy and cut the risk of STDs. However, all of these sex acts come with some degree of STD risk, and it's still important for people to protect themselves, according to an ACOG expert committee.

"Most people, including adolescents, are unlikely to use condoms during oral sex, which places them at risk for acquiring an STD," Dr. Richard Guido, one of the report authors, said in an ACOG statement. "This unlikelihood is partly because of a greater perceived safety compared with intercourse."

Writing in the journal Obstetrics & Gynecology, the panel advises doctors to ask patients -- adults and teenagers -- about all of their sexual activities, and to counsel them on how to reduce their STD risks. Although this "is a sensitive issue to address for both patients and physicians, it's important to discuss sexuality frankly and without judgment so that we can help our patients fully protect themselves against STDs," Guido added.

While oral sex is generally safer than vaginal or anal sex, the ACOG committee notes, it is not without risk. The viruses that cause genital herpes, genital warts and hepatitis can all be transmitted through oral sex. The same is true of the bacterial STDs syphilis, gonorrhea and chlamydia.

When it comes to HIV transmission, receptive anal sex carries the highest risk, followed by receptive vaginal sex, according to ACOG. However, there have been cases of HIV linked to oral sex.

"Noncoital sexual activity is not necessarily 'safe sex'," Guido and his colleagues write in the report.

They advise "correct and consistent" condom use for all types of sexual activity, but especially vaginal and anal sex. Staying in a mutually monogamous relationship, and getting tested for STDs before starting a new relationship, are among the other ways to curb STD transmission. Another precaution, the committee notes, is to clean sex toys between uses.

It's recommended that all sexually active women age 25 or younger be screened for chlamydia once a year, while all sexually active teenagers should be screened for gonorrhea. Other screening tests are done based on individuals' STD risk factors or any symptoms they may have.

The ACOG committee points out that lesbian women should be screened on the same basis as heterosexual women.

"Most lesbians have been sexually active with men at some point," Guido said. "Even without this sexual history, there are some STDs that can be transmitted between two women during sexual activity."

SOURCE: Obstetrics & Gynecology, September 2008.

 

Brazil rejects Gilead 's AIDS drug patent

03 Sep 2008 20:22:50 GMT

RIO DE JANEIRO , Sept 3 (Reuters) - Brazil has rejected a patent request for an AIDS drug made by U.S. firm Gilead <GILD.O>, opening the way for cheaper, generic versions to be used in the country's fight against the disease.

A health ministry spokesman said on Wednesday the patent request for the drug Tenofovir had been rejected, confirming a statement from the patent office announcing the decision on grounds that it lacked technological inventiveness.

The ministry said in April the drug, used by 31,300 patients in Brazil as part of the country's free treatment program, was "in the public interest." That was seen as an indication the patent request would be rejected.

Brazil may now import generic versions of the drug under a clause in World Trade Organization rules to sidestep drug patents in the name of public health.

No one at Gilead was immediately available for comment.

The medical group Doctors Without Borders said the decision could boost access to HIV/AIDS medicine in Brazil and throughout the developing world.

"Securing wider access to TDF (Tenofovir) is absolutely crucial," Tido von Schoen-Angerer of the group's Access Campaign, said in a statement.

"In the past, Brazil 's production of ARV (antiretroviral) drugs has helped to bring down prices of ARVs globally. We hope this will happen again."

The group said an Indian-made generic version of Tenofovir approved by the World Health Organization cost $158 per person per year, compared to $1,387 charged by Gilead in Brazil .

After climbing in the 1990s, Brazil 's HIV infection rate has steadied at around 0.5 percent and the number of new cases and deaths have been declining. Experts attribute the success to the government's promotion of condoms, free treatment, and the use of generic drugs.

In 2007, Brazil sidestepped a patent on Merck & Co Inc's <MRK.N> AIDs drug Efavirenz to import a cheaper generic drug from India . (Reporting by Stuart Grudgings; Editing by Todd Benson and Alan Elsner)

 

Circumcision problems impair HIV prevention -study

01 Sep 2008 15:27:43 GMT

Source: Reuters

By Laura MacInnis

GENEVA, Sept 1 (Reuters) - African health workers need more training and better tools to circumcise men and boys safely for HIV prevention, according to a World Health Organisation (WHO) study chronicling "shocking" rates of complications.

As many as 35 percent of males circumcised by traditional practitioners in Kenya's Bungoma district suffered complications such as bleeding, infection, excessive pain and erectile dysfunction from the procedure, the WHO researchers found.

"Other common adverse effects reported were pain upon urination, incomplete circumcision requiring recircumcision, and laceration," they wrote, estimating 6 percent of patients had life-long problems as a result.

Although male circumcision is universally practised in Bungoma, the study said many clinicians there lacked sharp and clean instruments and few were formally trained. Even in public clinics, the complication rate was 18 percent.

The findings, published on Monday in the WHO Bulletin, raised questions about whether the availability of male circumcision should be extended quickly as part of a strategy to fight HIV backed by the WHO and its sister U.N. agency UNAIDS.

"Extensive training and resources will be necessary to build the capacity of health facilities in sub-Saharan Africa before safe circumcision services can be aggressively promoted for HIV prevention," the authors wrote.

"Our results showing 35 percent of traditional circumcisions resulting in adverse events, many of them serious and permanent, should also serve as an alarm to ministries of health and the international health community that focus cannot only be on areas where circumcision prevalence is low."

Studies have shown male circumcision could be 70 percent effective in protecting men against HIV infection.

Africa is the centre of the AIDS epidemic and countries such as Uganda are looking to increase their male circumcision rates to stem the spread of the disease.

The authors of the WHO study, Kenyan expert Omar Egesah, and Robert Bailey and Stephanie Rosenberg of the United States , physically examined 298 of the 1,007 participants in their study, and intervened when they observed complications.

The WHO study concluded that health workers should be trained in sterilisation techniques, surgical procedures, pain management, post-operative care and counselling about wound care before male circumcision is pursued on a large scale. (Editing by Andrew Dobbie)


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