News (Updated April 23, 2006)
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By Will Boggs, MDTue Apr 18, 12:28 PM ET
Liver disease and death rates are worse with hepatitis C virus (HCV) infection on top of HIV infection than with just HIV or HCV, especially among white patients, according to a new report.
"We need to better understand why the co-infected patients do so poorly and the underlying mechanism for apparent racial disparity in their outcome," Dr. Kyong-Mi Chang, told Reuters Health.
"We also need better drugs that directly target HCV," added Chang, from the University of Pennsylvania and Philadelphia Veterans Affairs Medical Center.
Chang's team examined the impact of dual infection and race in 265 veterans with HCV/HIV co-infection, 251 infected with HCV only, and 227 others with HIV only.
Over a three-year period, mortality was significantly greater among HCV/HIV-co-infected patients than among patients mono-infected with either HCV or HIV, the researchers report in the American Journal of Gastroenterology.
Specifically, after taking into account a variety of factors, mono-infected patients were only about one-third as likely to die as dual-infected patients.
During the study period, twice as many white patients died compared to black patients, the report indicates.
Also, the average age at death in white patients (46 years) was significantly younger than that in black patients (52 years).
Since dual-infected patients fare so poorly, Chang said, the team aims to treat them "as much as possible and monitor them closely for liver dysfunction." He said specialists in liver disease and infectious diseases "as well as pharmacists (also social work and mental health support), is needed to optimize therapy for these complex patients."
SOURCE: American Journal of Gastroenterology, April 2006.
Thu Apr 20, 7:13 PM ET
Blood tests could be more effective in detecting people with latent tuberculosis than the standard skin test, Italian researchers said on Friday.
Many people with latent TB infection never develop the respiratory disease but detecting cases and providing treatment will be a key to eradicating the illness that kills 2 million people worldwide each year, according to public health experts.
Scientists at the University of Modena and Reggio Emilia in Italy who analysed the efficacy of three tests said the skin test alone was not adequate.
"To help control and possibly eliminate tuberculosis in low-prevalence areas, a specific and sensitive test for latent infection is needed," said Dr Luca Richeldi, who headed the study, in The Lancet medical journal.
"Two new blood tests ... might be more accurate than the tuberculin skin test."
Tuberculosis is a contagious airborne disease that affects about 9 million people each year. The World Health Organization (WHO) has warned that TB has reached alarming proportions in Africa where co-infection with HIV makes a lethal combination.
A person with tuberculosis can infect others with the TB germs, or bacilli, by coughing, sneezing, talking or spitting.
Every second another person is newly infected with TB bacilli. A person with active TB will infect 10-15 others every year if no treatment is given, according to the WHO.
Countries in sub-Saharan Africa have the highest incidence of the disease while half the world's cases are in Bangladesh, China, India, Indonesia and Pakistan.
Patients with TB are treated with the DOTS (Directly Observed Treatment, Short-course) program -- an approach adopted by WHO that involves government commitment, patient surveillance and drug treatment.
Certain groups with latent TB including babies, young children, the elderly, people living with HIV and illegal drug users, are more likely to develop active TB and may need treatment.
Richeldi and other scientists who worked on the study said the blood tests could be used either in combination with the skin test or as a substitute to increase detection of latent TB.
"The choice of which diagnostic test to use should depend on the population being tested, the purpose of testing, and resources available," Richeldi added.
Thu Apr 20, 2006 01:37 PM ET
NEW YORK (Reuters Health) - A study of men who became HIV-positive while
incarcerated in Georgia prisons show that two activities -- male-male sex and
tattooing -- increase the risk of HIV infection more than 10-fold, investigators
report.
J. Taussig, of the Georgia Department of Corrections, and colleagues point out that 2 percent of prison inmates have HIV, making it nearly five times more common than among with the US general population.
To identify factors associated with the increased risk of becoming infected in the prison population, the researchers studied 88 male inmates who were HIV-negative when they went into Georgia prisons but became infected during incarceration.
Taussig and the research team compared this group with randomly selected uninfected prisoners, and with men with a similar sentence length and time already served. All the subjects completed audio computer-assisted self-interviews with no personally identifying information.
The findings are reported in the Morbidity and Mortality Weekly Report published by the Centers for Disease Control and Prevention.
Analysis of the information showed that male-male sex in prison, age older than 26 years, having served at least 5 years, and having a no more than normal body-weight were significantly associated with becoming HIV-positive. Receiving a tattoo in prison and black race were also tied to the risk of acquiring HIV.
Many of the men who had consensual sex reported using condoms or improvised barrier methods such as rubber gloves or plastic wrap.
When asked their opinions about how to reduce HIV infection rates in prison, the inmates suggested making condoms available, providing HIV education, and safe tattooing.
While condoms are considered contraband in most US prisons, the authors note that prisons in two states and jails in five cities currently make condoms available.
The Georgia Department of Corrections is considering modifications to existing HIV prevention education, and housing HIV-infected inmates separately. However, the investigators point out that these strategies have potential problems -- including the likely disclosure of inmates' HIV status and of HIV transmission by individuals who are unaware they are infected.
SOURCE: Morbidity and Mortality Weekly Report, April 21, 2006.
BETHLEHEM, Pa. (AP) -- Health care contracting services company Novation, a unit of VHA Inc., on Wednesday signed a deal with Abbott Laboratories to make OraSure Technologies Inc.'s rapid HIV antibody test available throughout its healthcare network.
The Oraquick Advance Rapid HIV 1/2 antibody test can quickly test for antibodies to both HIV-1 and HIV-2. It has received Food and Drug Administration approval for use on oral fluid, finger stick or venipuncture whole blood and plasma specimens.
Abbott is the exclusive distributor of the product in the United States.
The single-source new technology agreement should expand the test's use in certain hospitals, OraSure President and Chief Executive Douglas A. Michels said in a prepared statement.
Abbott's contract with Novation began on April 1 and will run through March 31, 2009.
Shares of OraSure added 14 cents to $10.45 in morning trading on the Nasdaq. Abbott Laboratories shares fell 40 cents to $41.28 on the New York Stock Exchange.