News (Updated March 20,
2004)
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By Patricia Reaney
LONDON (Reuters) - Cases of multi-drug resistant tuberculosis in the former Soviet Union are rising at an alarming rate and pose a global problem, the World Health Organization said Tuesday.
Estonia, Kazakhstan, Latvia, Lithuania, parts of the Russian Federation and Uzbekistan, where up to 14 percent of new patients have strains of the disease resistant to the most powerful drugs (MDR), are among the top 10 world TB hotspots.
"Tuberculosis remains a major public health problem globally," Dr Paul Nunn, of the WHO, told a news conference.
"The former Soviet Union is the multi-drug resistant (MDR) tuberculosis capital of the world. The rate of drug resistance, and multi-drug resistance there is about 10 times that of the rest of the world."
Nunn said the rising number of MRD-TB cases followed the collapse of public health infrastructure after the political and economic changes over the last several years.
"We worry about MDR because, untreated, it is a death sentence," he added.
300,000 NEW CASES A YEAR
A new WHO report on TB, an infectious airborne disease that affects nine million people each year and kills two million, focuses on the growing problem of MDR-TB.
Population growth, worldwide travel and MDR-TB have contributed to the increase in TB. Experts estimate that 300,000 new cases of MDR-TB are diagnosed each year.
The highest prevalence of MDR-TB also coincides with the world's fastest growing HIV infection rates in Eastern Europe and Central Asia. Tuberculosis is one of the main opportunistic infections that kills AIDS sufferers.
"We know that HIV causes an increase in the transmission of tuberculosis. We are obviously concerned that in this context HIV will cause increased transmission of multi-drug resistant tuberculosis," said Nunn.
Patients with TB are treated with the DOTS (Directly Observed Treatment, Short-course) program -- a multi-level approach adopted by WHO that involves government commitment, patient surveillance and treatment with the drugs isoniazid and rifampicin.
But people with MDR-TB do not respond to one or more of the main drugs and require different, more toxic and expensive treatments. Nearly 80 percent of MDR-TB cases are "super strains," resistant to at least three or four of the main drugs used to cure TB.
The WHO report warns of the global danger of MDR-TB and calls for expansion of the DOTS program, increased funding for a DOTS Plus program, a specific treatment program for drug-resistant disease, and more investment in better surveillance of the disease and laboratory research.
"The response to this situation has to be global," Dr Mario Raviglione, director of WHO's Stop TB Department, said at the launch of the report.
"It is in the interest of every country to support rapid scale-up of TB
control if we are to overcome MDR-TB. Passport control will not halt drug
resistance; investment in global TB prevention will," he added.
© Reuters 2004. All Rights Reserved.
Fri 19 March, 2004 09:56
LONDON (Reuters) - People in central Africa who hunt monkeys and apes for food and trade are being infected with animal viruses and researchers fear their transmission could spark a future epidemic similar to AIDS.
Scientists who documented the transmission of a monkey virus to humans in Africa, called Friday for measures to end the hunting of wild primate populations to lessen any potential threat of new diseases in humans.
"It is in all our interests to put into place economic alternatives to help people move away from hunting and eating these animals," said Dr Nathan Wolfe, of the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.
"In addition to preserving endangered species, such development efforts will reduce the ongoing cross-species transmission of retroviruses and other pathogens that could spark future epidemics similar to HIV," he added.
In a collaborative effort, Wolfe and colleagues from the Cameroon Ministry of Health, the US Centers for Disease Control and Prevention and other institutions traced the transmission of an infection called simian foamy virus (SFV).
Like HIV, which causes AIDS, SFV is a retrovirus that can integrate its genetic material into the genome of its human host.
"We're showing that these retroviruses are regularly crossing into humans," Wolfe, who reported the findings in The Lancet medical journal, said in an interview.
"Transmission of retroviruses to humans is not limited to a few isolated occurrences which led to HIV. This is a regularly occurring phenomena," he added.
Scientists know from historical evidence that these types of viruses have the potential to cause a pandemic. HIV is thought to have been transmitted in a very similar way.
The scientists found antibodies for SFV in one percent of 1,099 people from nine rural villages in Cameroon that they had tested who had been exposed to non-human primate blood.
The villagers were infected with multiple forms of SFV from distinct primate species. Infections were from several different areas which suggests the cross-species transmission of these viruses is widespread.
"From our perspective, I think we are talking about the tip of the iceberg," Wolfe added.
New diseases, including AIDS, SARS, Ebola and birdflu, have resulted from infections in animals that have crossed into humans.
But reducing the hunting of primates could prove difficult because bushmeat is a multi-million dollar industry and a key source of food and livelihood for poor people.
In a commentary on the research, Dr Martine Peeters, of the Institute for Research and Development in Montpellier, France said infections from animals are among the most important public health threats facing humanity.
"The risk of acquiring such infections is expected to be highest in individuals who are regularly in contact with primates, by hunting or preparing primates for food or by keeping primates as pets," she said.
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Mon Mar 15, 2:17 PM ET
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WASHINGTON (Reuters) - Patients infected with the virus that causes AIDS have a sharply higher risk of clogged arteries, and the disease appears to progress especially quickly, U.S. researchers reported on Monday.
They said infection with the virus, HIV, should be considered a risk factor for heart disease, especially atherosclerosis -- clogging and hardening of the arteries.
"Our finding suggests that it would be reasonable to consider HIV infection a cardiac risk factor," Dr. Priscilla Hsue, assistant professor of medicine at the University of California San Francisco, said in a statement.
"Other risk factors, such as high cholesterol and high blood pressure, need to be aggressively treated in HIV patients -- even if it means changes in their HIV medications to control cholesterol levels," she said.
HIV infection is incurable and eventually always fatal, but it can be controlled with expensive and often complicated drug cocktails. These mixtures keep patients healthy, but can have side-effects that include raised cholesterol and changes to the metabolism.
Writing in the American Heart Association journal Circulation, Hsue and colleagues said they studied 148 HIV-infected patients. The patients on average were 45 years old, infected for 11 years, and treated with cocktails including protease inhibitors for an average of 3.3 years.
They were compared with 63 uninfected adults matched for age and gender.
The researchers used ultrasound to measure the thickness of the carotid arteries, which are found in the neck and supply blood to the brain. Thickness of this artery is a good indication of atherosclerosis.
The average carotid artery was significantly thicker in the HIV patients than the normal healthy "controls," and buildup of fatty plaque were found in 45 percent of the HIV patients, compared with 24 percent of controls.
A year later the arteries had grown thicker in some of the HIV patients, and the rate of thickening was faster than in non-infected patients.
"In the HIV patients, the extent of atherosclerosis was associated with classic cardiac risk factors such as age, cholesterol levels, cigarette smoking and high blood pressure," Hsue said.
The AIDS virus itself could be a cause, she said, because those patients with the most damaged immune systems had the worst atherosclerosis.
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Wed Mar 17, 3:51 PM ET
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ROME (AFP) - Clinical testing on humans has begun in Italy of a possible vaccine against AIDS, the Italian National Institute of Health (ISS) said.
The Italian-made prototype of the AIDS vaccine is being administered to volunteers in Rome and Milan, a scientist working on the research team said.
This first-stage of testing is intended to establish whether the vaccine, developed by a team headed by virologist Barbara Ensoli, is harmless, a member of the team, Valeria Fiorelli, told AFP.
She did not say how many subjects were participating in the test nor what their state of health was.
Fiorelli said "recruitment (of test subjects) began in November 2003 and is still ongoing".
The Italian daily Corriere della Sera reported in its Tuesday edition that the research team was having trouble finding enough test subjects, and that the scientists wanted at least 32 volunteers who were not infected with the virus and 53 people who were HIV-positive.
HIV is the virus that leads to full-blown AIDS. An estimated 40 million people are infected with HIV/AIDS worldwide, with about 26.6 million of them in sub-Saharan Africa, according to the latest UN estimates.
The Corriere della Sera also said the first phase of human testing was due to run until the end of the year.
AIDS researchers in several countries are working trying to develop a vaccine, but with no success so far.
The Italian vaccine, unlike other versions, focuses on the use of a protein which regulates the reproduction of the HIV-1 virus within the human. Other vaccines have targeted the outer layer of the virus itself.
"Experimental studies on animals have shown that the administration of this Tat protein has no toxic effect and induces a complete immune response capable of blocking the replication of the virus and, as a result, the development of the disease," the ISS said in a statement.