PARIS (AFP) - French doctors have issued a highly encouraging report about a test treatment which slashed levels of the AIDS virus among a small group of HIV-infected volunteers.

The prototype is called a therapeutic vaccine but this is something of a misnomer, for it is not a preventive vaccine in the conventional sense, which aims at protecting people from infection.

Instead, it is more of a treatment, seeking to reduce levels of the human immunodeficiency virus (HIV) among individuals who already infected.

Researchers recruited 18 Brazilian patients who were chronically infected with HIV and who were not receiving antiretroviral treatment.

The volunteers received a mixture of their own dendritic cells and inactivated HIV -- viruses which had been killed by chemicals and thus were not infectious -- in the aim of priming their immune system.

Dendritic cells are early defensive cells that rush out to meet an intruder and destroy it with enzymes.

They then carry a chemical "tag," an antigen, on the surface of their cell that corresponds to the signature of the intruder. It is this tag which helps alert lymphocytes, the heavy artillery of the immune system.

HIV, a slippery foe, is able to sidestep the dendritic cells, although how this is done is unclear.

The goal of the experimental treatment, using the inactivated HIV, was thus to stimulate the dendritic cells so that they recognised the virus.

The treatment was delivered in three injections, each a fortnight apart. There were no side effects.

Four months after the first dose, the viral load -- the quantity of HIV in the blood -- had fallen on average by 80 percent.

A year after the jabs, eight out of the 18 patients still showed viral loads that had diminished by more than 90 percent.

Four of them had a viral load of less than 1,000 particles per millilitre, "which, in theory, means they are not infective," chief researcher Jean-Marie Andrieu, a cancer professor at the Saint-Peres Biomedical Centre in Paris, told AFP.

The count of CD4 lymphocytes, which are infiltrated and destroyed by the virus, initially rose after the injections but then fell back to their baseline.

These results suggest that dendritic-cell therapy could be a "promising strategy" for treating people with HIV, says Andrieu's team.

The next step is to widen the trial so that it includes more volunteers, some of whom will not receive the treatment in order to see if it is truly as encouraging as it seems.

The study was published on Sunday in Nature Medicine, a journal of the Nature Publishing Group in London.

There are 39.4 million people with AIDS or HIV around the world, according to the latest UN estimates.

There is no vaccine to prevent infection, nor any cure. Antiretroviral drugs keep the virus at bay, but they can have toxic side effects. If the patient stops taking them, the virus rebounds.

By DANIEL YEE, Associated Press Writer

ATLANTA - Despite the government's promise to "break the back" of the AIDS epidemic by 2005, about 40,000 Americans test positive for the HIV infection every year — the same number as a decade ago.

The figure is double the annual goal of 20,000 new HIV cases laid out by the Centers for Disease Control and Prevention nearly four years ago. Nearly a million people in the United States now have the AIDS virus.

"We have a ways to go before we reach the mark of reducing new infections by half in the United States," said Dr. Ronald Valdiserri, who heads the CDC's HIV and AIDS prevention program.

Still, Valdiserri described the infection rate as "relatively stable." CDC released the new data Wednesday as part of the agency's commemoration of World AIDS Day.

"Clearly we want to continue, and are continuing, to fund programs to reach out to people who are high-risk and are not infected," he added.

In 2001, the CDC's campaign focused on outwardly healthy people who did not realize they had HIV — about a fourth of those infected. Officials then said targeting them was key, because if they knew they were infected, they would be more likely to take steps not to spread the virus.

Such an effort "could possibly break the back of the epidemic in the United States," the CDC's Dr. Robert Janssen said then.

But the agency found that just targeting people who didn't know they had the AIDS virus was not enough. So last year, the CDC shifted gears, focusing on counseling those who knew they had HIV in an attempt to get them not to spread the virus.

Some advocacy groups say that effort fails to focus on drug users, or very sexually active young men.

"It just doesn't seem like much is really happening," said Terje Anderson, executive director of the Washington-based National Association of People Living With AIDS. "There just is a lack of imagination or spark in terms of the kinds of programs they support. I think they are politically afraid."

One AIDS expert said it's difficult for health officials to measure exactly how many new infections there are each year.

"Forty thousand is an estimate that is averaged over time. The changes can't be tracked easily from year to year," said Dr. James Curran, dean of Emory University's Rollins School of Public Health and the CDC's former AIDS chief during the epidemic's peak in the 1980s.

Valdiserri said the CDC is working on how to accurately determine how many people are infected each year but the system is still under development. Despite that, more attention needs to be paid to AIDS, Curran said.

"What has concerned many of us in the United States is the lack of attention to the domestic AIDS problem and complacency on behalf of high-risk groups," Curran said, adding that more counseling, testing and education is needed.

The CDC believes up to 950,000 people in the United States are infected and up to 280,000 of them don't know it, Valdiserri said.

The rate of HIV diagnoses in the United States increased slightly — by 1 percent — between 2000 and 2003, from 19.5 people per 100,000 population to 19.7 per 100,000 in the 32 states surveyed by the CDC.

But the increase in diagnoses was substantially greater for gay and bisexual men — a 11 percent rise between 2000 and 2003. The increase in HIV diagnoses, along with recent outbreaks of syphilis among that group in major U.S. cities, has concerned health officials, who fear that gay and bisexual men may be growing weary of sexually transmitted disease prevention messages and are abandoning safe sex practices.

Advocacy groups blame a lack of federal money for part of the failure to make a dent in the HIV rate.

"The reality is, to cut the number of infections, we need to do more — you can't always do more with less. We desperately need more resources," Anderson said.

When the AIDS epidemic began to unfold in the 1980s, U.S. HIV infections grew quickly. Although infections peaked after 1984, they have remained level since the early 1990s. Drug therapies have enabled many infected with HIV to live relatively normal lives, but more than 18,000 Americans died of AIDS in 2003, according to the latest data available.

TOKYO (Reuters) - More than 10 percent of Japanese teenagers who were screened for a sexual disease that can cause infertility tested positive, a newspaper reported, adding to concerns about increasing sexual activity among Japan's youth.

An average of 11.4 percent of high school students on the main northern island of Hokkaido tested positive for chlamydia, an infection which often displays no symptoms, the Yomiuri Shimbun daily reported Thursday.

The screening, led by Hirohisa Imai, a doctor at Asahikawa Medical University, targeted 3,190 male and female students at 13 high schools in Hokkaido, whose patterns of teen sexual activity mirror those of the nation as a whole, the Yomiuri said.

Chlamydia can cause ectopic pregnancy and infertility in women, and urethritis and testicular swelling in men.

Some 20 to 30 percent of Japanese 16-year-olds have had sex, and nearly a quarter of these have had four or more partners, according to Masako Kihara, an AIDS expert and associate professor at Kyoto University.

Kihara said she was unaware of the survey but that the figure of 10 percent did not particularly surprise her, given that chlamydia is the most prevalent sexual disease among teenagers.

"If it really is spreading this fast, it shows that there's a lot of unprotected sex going on, and that other sexual diseases could also be spread," she said.

Of particular concern to authorities is AIDS.

In 2003, 976 new HIV/AIDS cases were reported, the highest annual figure and about a tenth of all new cases since 1985. Of new HIV cases, at least 33 percent involved people under 29.

© Reuters 2004. All Rights Reserved.

Cipla anti-AIDS drugs back on WHO approved list

Lamivudine and duovir, which combines lamivudine with zidovudine in one dose, have been important to the strategy to broaden treatment of HIV/AIDS patients in poor countries, the officials said.

The life-extending drugs are back on the list of WHO-approved products after fresh inspection proved they were equivalent to their patented counterparts, the United Nations agency said, pledging continued "rigorous assessment and monitoring" of anti-AIDS drugs known as antiretrovirals.

"These two extremely important drugs are once again on the list and recommended by us for all our U.N. partners in developing countries," Jim Kim, the director of WHO's HIV department, told a news briefing ahead of World AIDS Day on Wednesday. "We can stand behind them with great confidence."

A year ago the organisation started a campaign to get life-extending drugs to 3 million people in the developing world by the end of 2005. Only 440,000 of the 6 million AIDS patients are getting them, according to the latest figures, but new figures are due to be released in January.

"Lamivudine and duovir were absolutely essential to overall rollout of treatment programmes," Kim said.

It remains "very, very difficult" to reach the treatment target by the end of next year, because some countries which Kim declined to name are lagging "very far behind", he said.

50 DRUGS ON LIST

Some 50 anti-retroviral drugs -- both generic and patented -- are on WHO's list, set up two years ago to guide buying by agencies battling the epidemic in Africa and Asia.

Earlier this month, two other Indian firms, Hetero Drugs and Ranbaxy opted to withdraw their generic antiretrovirals following concerns about laboratory tests.

A total of 16 products -- 10 of Ranbaxy, India's largest pharmaceutical company by sales, and six of Hetero -- remain "delisted".

Both companies say they plan to repeat the studies and resubmit the results for consideration by WHO.

WHO officials said the process of reviewing and relisting a drug takes at least four months.

"We hope that more will follow as soon as companies are ready with new data and inspections. It is short-term pain for long-term gain," said Hans Hogerzeil, acting director of WHO's essential drugs and medicines department.

The WHO has said that countries should suspend the use of de-listed medicines and switch to other pre-qualified products. But if these are difficult to obtain immediately, it has recommended patients continue the use of de-listed products.

India to Begin Trials of HIV Vaccine on Humans

Tue Nov 30, 2004 12:16 PM ET

BOMBAY, India (Reuters) - India, home to the world's second largest HIV population after South Africa, is set to begin human trials of a new vaccine against the virus in January, a research institute said Tuesday.

The country has over 5.1 million people living with HIV/AIDS and experts saying the number could quadruple by 2010.

Human trials of vaccines against different strains of the virus are already being conducted in the United States, Europe, Africa and South America. The Indian trial will focus on sub-type C of the virus, the most common in the country. "It will be the first test in India of a HIV vaccine on humans," said Ramesh Paranjape, a deputy director of the National AIDS Research Institute (NARI) based in Pune, around 100 miles south of Bombay.

In August the World Bank warned the disease would become the single largest cause of death in the world's second most populous country unless there was a change in treatment policy and progress on prevention.

"A good, safe vaccine will help preventive efforts considerably so we are excited about beginning the trials," Paranjape told Reuters.

India's HIV problem has assumed serious proportions despite health programs to halt its spread. Over the years, HIV/AIDS has moved beyond traditionally high-risk groups such as homosexuals, commercial sex workers and drug users.

The virus is spreading into families, infecting mothers and children, and because of the widespread lack of awareness about the illness, many people do not even know they are infected.

Experts say the most alarming trend is the spread of the disease to villages, with rural India accounting for 59 percent of infections compared with 41 percent in cities.

The first phase of testing of the vaccine, named Adeno Associated Virus based HIV sub-type C, will be conducted on about 30 adult volunteers, Paranjape said.

The NARI scientists will monitor the volunteers over a period of one year to test for side-effects and the immune system's response to the vaccine.

"It is a very significant step," said Anjali Nayyar, country director of the International AIDS Vaccine Initiative, a private non-profit organization which is providing technical support for the trials.

"A vaccine is important for the Indian population as the country needs low-cost intervention to fight AIDS."