LONDONNews (Updated
April 19, 2009)
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Wed Apr 15, 2009 11:48am
EDT
NEW YORK (Reuters Health)
- From 1985 to 2007, the CD4+ cell counts seen at diagnosis in HIV-infected
patients in the US have fallen, suggesting that the virus may be adapting to the
host and becoming more virulent, according to a report in Clinical Infectious
Diseases.
These findings agree with
those of other researchers, who have reported that patients starting treatment
for HIV infection in recent years may have lower CD4+ cell counts at diagnosis
and require antiretroviral therapy earlier in the course of disease, Dr. Nancy
Crum-Cianflone, from the
The study results stem
from an analysis of data for 2174 patients who tested positive for HIV
antibodies and were enrolled in the TriService AIDS Clinical Consortium HIV
Natural History Study. None of the subjects had received antiretroviral
treatment and had their CD4+ counts measured within 6 months of their HIV
diagnosis. CD4+ cells are immune cells that are used to assess the severity of
the infection. As HIV infection progresses, CD4+ cell counts decrease.
The average initial CD4+
cell counts during the periods 1985-1990, 1991-1995, 1996-2001, and 2002-2007
were 632, 553, 493, and 514 cells per microliter, respectively. During the same
periods, the percentage of subjects with initial CD4+ cell counts below 350
cells per microliter were 12 percent, 21 percent, 26 percent, and 25 percent.
The reduction in initial
CD4+ cell counts was similar in African American and in white patients, the
report indicates. Similar trends were also noted for the CD4+ cell count
percentage and the total count of lymphocytes, a type of white blood cell
involved in the immune response.
In an accompanying
editorial, Dr. Maria Dorrucci, from Istituto Superiore di Sanita,
This, they note, may
relate to how virulence is assessed, adding that "it is unclear whether
simple immunological or virological proxies for virulence can be expected to
adequately capture the whole complexity of HIV virulence" and the
susceptibility of the patient to HIV infection.
SOURCE: Clinical
Infectious Diseases, May 2009.
Thu Apr 16, 7:52
PM
LONDON
The
new combined company will sell 11 existing drugs produced by the two firms,
holding a 19 percent share of the market and generating annual sales of about
1.6 billion pounds (1.8 billion euros, 2.4 billion dollars), Britain-based GSK
said.
Initially
controlled 85 percent by GSK and 15 percent by Pfizer, it will also focus on
research and development of new HIV treatments and formulations, including
developing six new drugs already in the pipeline.
"We
are creating a new global leader in HIV and reaffirming our ongoing commitment
to the treatment of the disease," said Pfizer chief Jeff Kindler.
GSK
chief executive Andrew Witty said the agreement marked a "definitive
step" to deliver more medicines, more efficiently.
"At
the core of this specialist business is a broad portfolio of products and
pipeline assets, which can be more effectively leveraged through the new
company's strong revenue base and dedicated research capability," he said.
"HIV
remains a global threat with increasing incidence and viral resistance. This new
company will be better placed to meet these challenges and improve access to
treatments."
By The Associated Press
The Associated Press Sat Apr 18, 2009
A summary of US federal
government figures on syphilis and HIV:
• The rate of primary
and secondary syphilis — the most infectious stages of the disease — reached
an all-time low in 2000 then started a climb over the next seven years, the most
recent time period available from the Centers for Disease Control and
Prevention.
• The rate increased
15.2 percent between 2006 and 2007 — from 3.3 cases per 100,000 people to 3.8
cases. The actual number increased from 9,756 to 11,466.
• Men who have sex with
men represented 65 percent of the primary and secondary syphilis cases in 2007.
• More than 1 million
people in the
• About 56,300 Americans
become infected with HIV each year.
___
Source: Centers for
Disease Control and Prevention
By DAVID CRARY, AP
National Writer Thu Apr 16, 2009
Yet despite global
promotion by the United Nations and other organizations, its usage is still
minuscule, even as women bear an ever-growing share of the AIDS epidemic.
Advocates hope the
dynamics will change following last month's approval by the Food and Drug
Administration of the FC2, a new version of the female condom produced by the
Chicago-based Female Health Co.
About 35 million female
condoms were distributed worldwide last year, but that compares to more than 10
billion male condoms, which are far cheaper and, at least initially, easier to
use. However, in some nations with high HIV rates, many men refuse to wear
condoms, putting women at risk.
Though it looks similar to
its predecessor — a soft, transparent sheath with flexible inner and outer
rings — the FC2 is made from synthetic rubber rather than polyurethane, making
it cheaper to produce.
Mary Ann Leeper, former
president of Female Health Co. and now its strategic adviser, said the FC2 also
is less noisy during use. Complaints about squeaky noises were among the factors
that slowed acceptance of the original version.
The cost of the FC2 is
one-third less than its predecessor, and may go lower, enabling health
organizations to distribute many millions more than at present. For now, the
price is about 60 cents compared to less than 4 cents for mass-distributed male
condoms — a difference that's an issue in the developing world.
The FC2 had been accepted
previously by some international organizations, and the Female Health Co.
distributed 14 million of them abroad last year along with 21 million of the
older version. Advocates of the female condom praised the FDA announcement
because it opens the door for the U.S. Agency for International Development (USAID),
one of the largest global providers of condoms, to distribute the FC2 overseas.
"This is a tremendous
victory," said Susie Hoffman, an assistant professor of clinical
epidemiology at
"In the
"But if presented in
the right way, many women do like it," Hoffman said. "To find these
people and help them and train them, you need systematic programming, which
costs money."
Resistance is less of a
problem in some developing nations. The U.N. Population Fund, government
agencies and nonprofits are aggressively promoting female condoms in places such
as
Women's groups in
"The mindset is
changing, but there are still a lot of challenges," said Bidia Deperthes,
the Population Fund's HIV technical adviser for condoms. "Accessibility is
still minimal. There's a huge demand, and we're not meeting it."
Deperthes hopes that with
FDA approval of the FC2, the number of female condoms distributed globally could
climb to 50 million this year. If the numbers keep rising, she said, the cost to
public-sector distributors for each FC2 could drop as low as 25 cents.
Jeff Spieler, a science
adviser with USAID's Office of Population and Reproductive Health, said the
female condom's future may depend on whether its promoters can develop a
private-sector market. Its commercial price in the
Another challenge is a
stigma associated with the female condom in some places because prostitutes are
among those deemed to benefit most from using it. On the other hand, advocates
of the female condom say it has invaluable safe-sex potential for married women
whose husbands are unfaithful and shun male condoms.
Serra Sippel, executive
director of the Center for Health and Gender Equity in
"We'd love to see the
profile raised, to have commercials about it and normalize it so people aren't
embarrassed," she said.
Mary Ann Leeper said the
Female Health Co. is seeking a corporate partner to help market the FC2. She
suggested that concern about HIV/AIDS may generate interest among women in
communities with high infection rates.
The female condom's
advocates stress that it will never be the "magic bullet" that by
itself turns the tide in fighting AIDS. But, they say, it should be a bigger
part of the arsenal.
"It's not going to be
the one answer," Hoffman said. "But it's got a lot more to contribute
than it has to date."
Thu Apr 16, 2009 8:03pm
EDT
The Clinton Foundation
HIV/AIDS Initiative and the international drug-purchasing consortium Unitaid
said Friday they had struck deals offering steeper discounts on a range of
life-saving treatments.
The price of most
affordable generic second-line drug regimen -- needed when patients develop
resistance to initial treatment -- falls to $590 annually, from more than $700 a
year ago.
And a one-pill, once-daily
first-line regimen based on the drug tenofovir is now available for $210
annually, down 30 percent from 2008.
In total, new price
agreements have been struck for 41 adult and paediatric formulations at an
average reduction of 16 percent compared to 2008.
There is no cure for the
human immunodeficiency virus (HIV) that causes AIDS, but combinations of drugs
can keep the virus from replicating and damaging the immune system.
An estimated 33 million
people globally are infected with the AIDS virus, most of them living in
(Reporting by Ben
Hirschler; Editing by Erica Billingham)