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Trial HIV vaccine cuts infection

Thu, 24 Sep 2009 09:14:00 +0100

[24 Sep 2009] An experimental HIV vaccine has for the first time cut the risk of infection, researchers say.

The vaccine - a combination of two earlier experimental vaccines - was given to 16,000 people in Thailand, in the largest ever such vaccine trial.

Researchers found that it reduced by nearly a third the risk of contracting HIV, the virus that leads to Aids.

It has been hailed as a significant, scientific breakthrough, but a global vaccine is still some way off.

The study was carried out by the US army and the Thai government over seven years on volunteers - all HIV-negative men and women aged between 18 and 30 - in some of Thailand's most badly-affected regions.

The vaccine was a combination of two older vaccines that on their own had not cut infection rates.

Half of the volunteers were given the vaccine, while the other half were given a placebo - and all were given counselling on HIV/Aids prevention.

The results found that the chances of catching HIV were 31.2% less for those who had taken the vaccine.

"This result is tantalisingly encouraging. The numbers are small and the difference may have been due to chance, but this finding is the first positive news in the Aids vaccine field for a decade," said Dr Richard Horton, editor of the Lancet medical journal.

"We should be cautious, but hopeful. The discovery needs urgent replication and investigation."

The findings were hailed by the World Health Organization (WHO) and the Joint United Nations Programme on HIV/Aids (UN/Aids).

They said while the results were "characterised as modestly protective... [they] have instilled new hope in the HIV vaccine research field".

Some 33 million people around the world have HIV.

Research into a vaccine has been made difficult because HIV is very good at hitting the immune system, the BBC's health correspondent, Jane Dreaper, reports.

Global AIDS conference kicks off in Australia

Sun, 22 Jul 2007 09:35:00 +0100

The world will not be able to celebrate enormous advances in HIV diagnosis and treatment until the United Nations' long-term goal of universal access to drugs and other prevention measures is reached, leading international AIDS researchers said Sunday. SYDNEY, Australia:

"We are dealing with a preventable disease and 11,000 people are contracting HIV/AIDS every day. We are dealing with a treatable disease and more than 3 million people are dying every year," said Pedro Cahn, the president of the International AIDS Society.

"Science has given us the tools to prevent and treat HIV effectively. The fact that we have not yet translated this science into practice ... is a shameful failure on the part of the global community."

Lower prices for drugs that combat HIV, the virus that causes AIDS, have significantly improved access to treatment for people in poor countries, but recent World Health Organization figures show the numbers are still far short of the U.N.'s goal of universal coverage by 2010.

Last year, some 2 million people in developing countries were receiving the anti-retroviral drugs that help treat the HIV infection, a 54 percent increase over 2005. But overall, only 28 percent of the world's HIV patients are receiving the life-prolonging drugs.

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said the world health community could not celebrate the great breakthroughs in the treatment of the AIDS virus since it was first diagnosed 26 years ago until greater steps are made to prevent the disease.

"Of the projected 60 million infections that will occur by 2015, fully half of them are projected to be able to be prevented with already known and proven prevention methods," Fauci told reporters in Sydney.

"Before we celebrate 26 years since the beginning of extraordinary accomplishments, we're actually going to be judged as a society in what we do in the next 20-26 years," he said. "We cannot sustain a successful effort with HIV without prevention."

More than 5,000 delegates from 133 countries have converged on Sydney, Australia, for the Fourth International AIDS Society Conference on HIV Pathogenesis and Treatment, which runs through Wednesday.

Researchers from across the globe will present their findings on the benefits of circumcision for cutting HIV rates through to the latest developments in anti-retroviral drugs. Conference participants will also be urged to sign a declaration aimed at raising more money for HIV research.

The so-called Sydney Declaration calls on national governments and bilateral, multilateral and private donors to allocate at least 10 percent of all HIV-related funding to research.

"We believe that without such funding we will fail to maintain a sustained and effective response to the AIDS pandemic," the declaration says.

The conference organizers say this will help speed up the implementation of new drugs and technologies to prevent, diagnose and treat the infection.

Future of Gay Men's HIV Prevention in Your Hands

Fri, 08 Dec 2006 22:44:47 +0000

A proposal for radical changes in the provision of HIV prevention work for gay men has been put forward and you can have your say.

This is the first time gay men in London have being asked to give their views on the commissioning of HIV services in London. If the proposed HIV prevention work does not meet the needs of gay men, the community suffers and increasingly scarce resources are wasted. To ensure that these prevention services are appropriate it is vital that that the users of these services, gay men themselves, have a voice.

The major changes that are proposed include:

An end to health information adverts and HIV prevention adverts in the gay press
A substantial reduction in the number of leaflets and booklets available

In place of current services the following would be provided:

Every gay man in London would be assessed on an annual basis by a face-to-face health assessment conducted on the gay scene or HIV organisations. This assesment would seek to identify risk behaviours and any gaps in men�s HIV prevention knowledge Personal data and details of risk behaviour collected and systematically stored on a central database
A new programme of research to interview all men testing for HIV or STIs and all HIV positive gay men to develop a database of risk factors and situations which lead to exposure of HIV

GMFA has been asked to host a consultation with gay men in London to get your views on these changes. GMFA believe the thoughts and opinions of a diverse group of gay men matter, and this is a rare opportunity for your views to be heard by those who hold the future of funding for gay men�s health in their hands. We�re asking you to fill out a questionnaire which will have a real impact on the future of HIV prevention for gay men in London.

All responses will be anonymous and must be received by 14th December.

For a copy of the questionnaire and details of the proposed changes, please email samantha.nicklin@gmfa.org.uk or download the Commissioning Intentions and Feedback documents by going to www.gmfa.org.uk/consultation.

Many thanks,
Sam
Samantha NicklinCampaigns Manager

Tel: 020 7738 6872

GMFA - The Gay Men's Health Charity
Improving gay men's health by increasing the control they have over their lives.

Unit 43Eurolink Centre49 Effra RoadLondon SW2 1BZ

Metromate: London's sexual health directory for gay men. www.metromate.org.uk
GMFA's guide to gay sports clubs and social groups. www.gmfa.org.uk/theguide

Registered charity No: 1076854

Results of international HIV/AIDS Trial

Thu, 07 Dec 2006 10:01:00 +0000

International HIV/AIDS Trial Finds that Risks of Death, AIDS and Other Major Diseases Increase on Episodic Antiretroviral Therapy

�

National Institute of Allergy and Infectious Diseases (NIAID)

http://www.niaid.nih.gov/

�

EMBARGOED FOR RELEASE

Media Contact: Laurie K. Doepel

Wednesday, Nov. 29, 2006

(301) 402-1663

5:00 p.m. Eastern Time

�

niaidnews@niaid.nih.gov

Results from one of the largest HIV/AIDS treatment trials everconducted show that a specific strategy of interrupting antiretroviral therapy morethan doubles the risk of AIDS or death from any cause. In the study, theinvestigators used two predetermined levels of CD4+ T cells, the primary immunecell targeted by HIV, to guide them in respectively suspending or restartingthe study participants on antiretroviral therapy.

A report describing this research�which involved 318 clinical sitesin 33 countries--appears in this week�s issue of The New England Journal ofMedicine. The trial, known as Strategies for Management of Anti-RetroviralTherapies, or SMART, was funded by the National Institute of Allergy andInfectious Diseases (NIAID), part of the National Institutes of Health.

�The SMART trial has providedimportant new data that will help physicians and their HIV-infected patientsmake treatment decisions," says NIAID Director Anthony S. Fauci, M.D."The study reflects an extraordinary global collaboration among hundredsof dedicated AIDS clinicians and thousands of their patients, all of whomshould be commended for their contributions to this pivotal HIV/AIDS treatmentstudy.�

As HIV/AIDS has evolved into a chronic disease without a cure,lifelong antiretroviral therapy has become the norm. Lifelong therapy, however,can be difficult to adhere to as well as expensive. For these reasons, therehas been a concerted research effort to test treatment interruption strategies thatmay enhance patients� quality of life and limit adverse drug effects. The experimentalstrategies vary in their approach to when to interrupt therapy. Some, likeSMART, use a specific CD4+ count as a guide; others schedule regular timeperiods during which treatment is stopped (for example, alternating one monthoff and three months on).

SMART was designed to determine which of two different HIV treatmentstrategies would result in greater overall clinical benefit. Volunteers withchronic HIV infection--nearly all of whom had taken antiretroviral therapy(ART)--were assigned at random to one of two groups. In the �viral suppression�group, ART was taken on an ongoing basis to suppress HIV viral load; in the �drugconservation� group, participants received episodic ART in an effort to reducedrug side effects and preserve treatment options. In the latter group, ART wassuspended whenever CD4+ counts were above 350 cells per cubic millimeter (mm3)and ART was started only when levels of CD4+ cells dropped below 250 cells/mm3. (For moredetails see http://www.smart-trial.org.) The CD4+ count thresholds for stopping and starting ART were chosen based onpreviously reported associations between CD4+ counts and risks of opportunisticdiseases and death.

Beginning in January 2002, the trial recruited 5,472 volunteers: 2,720were assigned at random to the drug conservation group and 2,752 to the viralsuppression group. The participants were followed for an average of 16 months.

In early 2006, NIAID announced that enrollment into the trial hadbeen halted after review of the interim data by an independent data and safetymonitoring board (DSMB) found that those participants receiving episodictherapy had a significantly increased risk of disease progression. �Diseaseprogression� was defined as the development of an opportunistic disease (AIDS)or death from any cause. The Executive Committee of SMART recommended that ARTbe re-initiated in ART-experienced participants in the drug conservation group.Follow-up is currently scheduled to continue through July 2007.

At the time the trial was stopped, 120 participants in the drugconservation group compared with 47 on continuous antiretroviral therapy had developeddisease progression. The difference represents a 2.6-fold increased risk forthose receiving episodic treatment. Notably, the drug conservation group hadsignificantly more major adverse events, specifically, cardiovascular, kidneyand liver disease, complications previously associated with ART. The studyinvestigators had hoped that these complications would be seen less frequentlyin those trial volunteers receiving less drug.

�Quite unexpectedly, our results show that interrupting therapyincreases the risk of serious non-AIDS-related events,� says Wafaa El-Sadr,M.D., M.P.H., M.P.A., of the Harlem Hospital Center and Columbia University inNew York City, one of the co-chairs of the trial. �This is a major lessonlearned for designing any HIV/AIDS treatment trial: It is important to evaluateall causes of death, not just death from AIDS, and to also evaluate other majornon-fatal clinical diseases, not just those considered AIDS-related opportunisticdiseases.�

The University of Minnesota�s James Neaton, Ph.D., the other co-chairand chief biostatistician for the trial, notes, �The SMART study demonstratesthe tremendous advantages inherent in conducting large enough trials to preciselyassess risks and benefits of any treatment strategy in a diverse population. First,the study ended much earlier than we expected. Second, we could analyze thedata according to many variables--age, race, sex, HIV risk behavior, and baselineCD4+ count, among other factors. Importantly, among every subgroup we looked at,the conclusion remained consistent: CD4+ count-guided episodic antiretroviraltherapy as implemented in the SMART study carries increased health riskscompared with continuous therapy.�

The SMART study was coordinated by four international centers: theMedical Research Council Clinical Trials Unit in London; the Copenhagen HIVProgram in Denmark; the National Centre in HIV Epidemiology and ClinicalResearch at the University of New South Wales in Sydney, Australia; and the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA) in Washington, DC. The statistical and data management center was based at the University of Minnesota in Minneapolis.

Fred Gordin, M.D., of the VA Medical Center in Washington, DC, the CPCRA director, says, �The study participants understood that our goal was to testa strategy that we hoped might simplify their treatment and prevent someadverse side effects. SMART has better focused the discussion of what questionswe can and should be addressing in this important area of HIV/AIDS treatmentresearch.� A workshop held by the NIH Office of AIDS Research in July in London assessed the current state of research on intermittent therapy strategies (http://www.oar.nih.gov/public/NIH_OAR_STI_IT_Report_Final.pdf).

Initial analyses indicate that most but not all of the excess riskin the drug conservation group can be explained by CD4+ count and viral loaddifferences. Jens Lundgren, M.D., Director of the Copenhagen HIV Programme andthe Copenhagen international coordinating center, says, �The continuedfollow-up of patients and planned research on patient specimens will help usbetter understand the differences between the treatment groups that we observed.�

David Cooper, M.D., D.Sc., of the National Centre in HIVEpidemiology and Clinical Research at the University of New South Wales, the Sydney international coordinatingcenter director, notes, �The prospect of lifelongtreatment is difficult for people with HIV. We are gratified that the SMART studyhas so clearly delineated the risk and benefits of these two strategies, and weare committed to continuing to try to find ways to improve treatment strategiesfor those with chronic HIV disease.�

Janet Darbyshire, M.Sc., FRCP and Director of the MRC ClinicalTrials Unit and the London international coordinating center comments, �Thisquestion could not have been answered so quickly without the collaboration andactive participation of the 318 clinical sites and thousands of patients

worldwide whichcontributed to SMART. Such collaborations are essential if we are to answersome of the key strategic questions about how to best manage HIV disease.�

Further information concerning the SMART study findings can be foundin a Questions and Answers document (http://www3.niaid.nih.gov/news/QA/NEJMsmart_QA.htm). Earlier NIAID news releases describing the initiation of theSMART trial and the stopping of enrollment into the trial can be viewed at http://www3.niaid.nih.gov/news/newsreleases/2002/smart.htmand http://www3.niaid.nih.gov/news/newsreleases/2006/smart06.htm, respectively.

NIAID is a component of the NationalInstitutes of Health. NIAID supports basic and applied research to prevent,diagnose and treat infectious diseases such as HIV/AIDS and other sexuallytransmitted infections, influenza, tuberculosis, malaria and illness frompotential agents of bioterrorism. NIAID also supports research on basicimmunology, transplantation and immune-related disorders, including autoimmunediseases, asthma and allergies. �

The National Institutes of Health (NIH)�TheNation's Medical Research Agency�includes 27 Institutes and Centers and is acomponent of the U. S. Department of Health and Human Services. It is theprimary federal agency for conducting and supporting basic, clinical andtranslational medical research, and it investigates the causes, treatments andcures for both common and rare diseases. For more information about NIH and itsprograms, visit http://www.nih.gov.

###

Reference:The Strategies for Management of Antiretroviral Therapy (SMART) Study Group. CD4+count-guided interruption of antiretroviral treatment. The New EnglandJournal of Medicine 355(22): 2283-96 (2006).

�

News releases,fact sheets and other NIAID-related materials are available on the NIAID Website at http://www.niaid.nih.gov.

The National Institute of Allergy and InfectiousDiseases

is a component of the National Institutes of Health,

U.S. Department of Health and Human Services

Isn't it Time To Share?

Wed, 22 Nov 2006 10:00:14 +0000

We have been seeing the decline in HIV services ...

... across London for some time now as every borough tries to cut expenses in areas such as HIV. At the same time there is a boom of voluntary organizations that instigated by local governments or by their own initiative are trying to replace some of these services and safeguard or advocate on behalf of those affected. EHH forum happens to be one of those groups. We, with the backing of the primary care trusts from Hammersmith and Fulham, Ealing and Hounslow, do try to support and advocate but first and most be a presence for people with HIV when there are less and less resources available. We are mainly volunteers living with HIV and therefore fully aware of the hardships and difficulties affecting so many of us.

Now there are groups representing almost every minority in our communities, but perhaps we should ask ourselves if we as groups are interacting and working together enough in areas such as sharing strategies and resources. Perhaps we should start applying the principle of all for one and one for all. It is true that we all suffer the consequences of a common denominator: HIV.

Back in the 80�s and 90�s we came together and didn�t mind sharing whatever help or support there was available to us. Now it would seem as every party pulls to its own side with an almost subconscious disregard for each other. In some boroughs as much as 20% of government monies that go to sexual health are shared between Gay men�s sexual health and African communities yet this isn�t enough to cover all the needs of these groups and of others that are completely neglected such as is the case of young people at risk, mental health and drug and alcohol abuse.

We must go back and think how it used to be and how it still is for so many of us living with HIV. The improvement of antiretroviral therapies has meant for many the reintegration into working life, but there are still many suffering discrimination, lack of opportunities, stigma, lack of self esteem and poverty.

If we are all fighting to improve the lives of those people and help improve or create those services that are still desperately needed then isn�t time to share ? Isn�t it time to stop thinking that it is just our particular group that has needs and keep to the elemental fact that we are all just men and women? Let�s go back to basics. Gay, straight, black, white... Let�s not become hungry animals fighting each other for scraps. Let�s share the scraps.

Carlos H Tello

Tips For A Healthy Winter

Wed, 22 Nov 2006 09:59:09 +0000

Boosting your immune system

Get enough sleep, and get help if you have problems getting to sleep, staying asleep or waking up refreshed in the mornings.
Identify sources of stress in your life and try out ways of managing them that are right for you, for example yoga, walking for 30 minutes a day, positive self talk programmes, acupuncture, counselling or coaching.
Reduce the refined sugars, artificial sweeteners and hydrogenated oils in what you eat � they stress the body and lower your immunity.
Get checked for any vitamin & mineral imbalances � if you can�t do this, at least add a daily good quality multi vitamin, some vitamin C, and some essential fatty acids to your daily routine. The Nutricentre offers discounts for customers living with HIV. You may find similar schemes run by the HIV support services you use.
Buy some homeopathic Aconite 30c from your chemist; if you get a chill, take it as soon as possible. It won�t interfere with your medication like some herbal supplements.

For more information on any of these suggestions, email Clarity Health at ehhforum@clarityhealth.co.uk

World AIDS Day 2006

Wed, 22 Nov 2006 09:58:11 +0000

Please join us!

1 December we will be marking World Aids Day with a stall inside the Kings Street Shopping Centre in Hammersmith and with a party at the Hammersmith Town Hall.

We hope it will be as successful as it was last year. You are all welcome. There will be entertainment, guest speakers and food.

Clarity Health

Wed, 22 Nov 2006 09:56:19 +0000

Kerr Wilson is the director of Clarity Health since 2001

After many years suffering with Asthma, Kerr became involved with alternative medicine leaving his business career in order to study Homeopathy, Nutrition and NLP (Neuro Linguistic Programming)
C� Kerr, what is the aim of Clarity Health ?
K� Clarity Health has grown out of a need expressed by many clients over the last fifteen years, to have easy access to a range of effective health therapies.
C� How does it work?
K� We help clients to identify and treat the underlying causes of their health problems by using techniques of Homeopathy, bio energetic stress testing, Nutrition, NLP and Health Coaching.
C� Where is Clarity Health based ?
K� Near Kings Cross. Our phone number 0800�0830726 or email to kerr@clarityhealth.co.uk
C� How can Clarity Health help people living with HIV ?
K�My experience is that many complementary health therapies are very effective at helping managing the side effects of anti-retroviral therapy. These also help to better manage the indirect effects of living with HIV, such as stress, poor sleep, lack of energy and loss of purpose in life.
C� is this substitute for conventional medicine ?
K� No, but it can enhance traditional medical approaches.
C� what can a person be expected to pay ?
K� it depends on the individuals income.
C� How successful is Clarity Health?
K� In fact we are looking at bringing in other health professionals to work as associates. This means that our clients will have a wider range of therapies to chose from.
C� Who can benefit from using Clarity Health services ?
K� Any person wishing to take more responsibility for their health, understand how their bodies work better and be healthier. We welcome everyone.
Carlos H Tello

STILL KICKING! The River House Lesson...

Wed, 22 Nov 2006 09:54:53 +0000

River House

Almost 15 years after being diagnosed with HIV I am still breathing. Whoa! When so many of my friends died in the early days I have somehow survived the great plague. Oh, you will say it is because of the colourful pills I swallow mornings and evenings like a good little boy. You are right: my viral load and CD4 count prove that meds work.
But � What you don�t know though is the care and support I have received over these years at the River House. It has made all the difference between struggling to survive and living reasonably well. What is this place? It is a drop in centre in Hammersmith which offers, under one roof, an unique range of services from nutritious meals to complementary therapies as well as social and welfare advice.
I don�t need to tell you about the disabling nature of the virus, the tiredness, the nausea, the neuropathy and the side effects of the meds. You know all that. Some days I feel so lousy I can�t even cook a meal! So I go to River House. Not only to eat the fabulous food Cathy cooks, but also because the staff is there on hand to provide whatever practical and emotional support I need.
What sort of support? I hear you say. Well if I am physically tired and stressed, Debbie will sort out an appointment with a massage therapist to help me regain my fitness. If I am depressed or feeling mentally low, Helen or Joseph will chat with me. It is like a big family. They always welcome you, they care! And you have the other service users. Over the years they become your mates with whom you share experience and wisdom or just a laugh.
This of course means nothing to the accountants that run the NHS. What do they know about my living with HIV? Feeling isolated? Without consultation, my local PCT in Kensington and Chelsea announced at the end of August that it was stopping funding River House by the end of September. �14000 per year or a drop of water in an ocean! They said K&C residents could use the Lighthouse in Ladbroke Grove.
Have you been to the Lighthouse lately? It is an empty shell that has been stripped of its soul and many of its services. Thank you THT for your good work! So we fought, wrote letters to councillors and MPs, organised a couple of meetings with one of the HIV commissioners and do you know what? Through a consortium, he gained support for the funding of River House to carry on until the end of the financial year. Better, in the future, funding of HIV organisations and charities by Kensington and Chelsea PCT will be addressed and (hopefully) decided within a forum made up of HIV service users living in the borough and the HIV commissioners.
The lesson is clear: when we act collectively we can have our say and influence decisions, even in the face of unaccountable and powerful lobbies or invisible accountants. It is up to every one of us to take up the challenge and attend the forum. Let us be visible, proud to be alive and empowered.
Alain Louis Marie

Service User Involvement

Wed, 22 Nov 2006 09:52:29 +0000

A River House Perspective

River House was established 18 years ago with the vision of being a pioneering resource centre for people affected by HIV/AIDS, providing and hosting services of the highest quality.
The project is proud to be here today living into its vision and playing a vital role in the Social and Health Care of individuals and communities affected by HIV/AIDS.
With a service user membership of well over 1000 individuals, River House continues to build on its ethos of putting people first and hearing the voices of its members. The project was set up in a way that has always taken on board service users opinions; hence, their involvement has always played a part in the organisation.
To ensure that we work in partnership with our service users, staff are always present to allow for direct dialogue and feedback; a service users� comments book is readily available allowing for entries of comments on all aspects of the project�s work; there are active Service Users Reps on the Board of Trustees allowing for direct Service Users� voices and opinions in decision making and forward planning; we host Service Users surgeries before a board meeting, allowing for there to be a gathering of agenda issues to present to meetings; we carry out periodic Service Users consultation; and monitor Service Users attendance or take-up of services to inform and validate service provisionsToday the political arguments and funding decisions are coming at organisations like River House fast and furious. Having recently been faced with a funding crisis, River House was moved by the determination of Service Users� involvement in presenting their needs, challenging the system and working in partnership for positive resolutions.
We believe that without our members' voices (on the good, the indifferent and the bad), we would not be in the position we are in today � �supported by those who turn to us for support.�
Helen Cox, Project Coordinator