XDR-TB spread person-to-person, not by failure of drug

XDR-TB spread person-to-person, not by failure of drug treatment


First published on http://www.aidsmap.com/ on 26 Feb 2015


Keith Alcorn

N Sarita Shah presenting at CROI 2015. Photo by Liz Highleyman, hivandhepatitis.com

The vast majority of people with extensively drug-resistant tuberculosis (XDR-TB) diagnosed in the world’s most extensive outbreak have acquired their infection from another person, not as the result of the failure of treatment for multidrug-resistant strains of tuberculosis (MDR-TB), N Sarita Shah told the Conference on Retroviruses and Opportunistic Infections (CROI 2015) in Seattle, USA, on Wednesday.

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PrEP and ART could almost eliminate HIV infection

Combining PrEP and ART could almost eliminate HIV infection, east African study finds


First published on http://www.aidsmap.com/ on 26 Feb 2015


Gus Cairns
Jared Baeten presenting at CROI 2015. Photo by Liz Highleyman, hivandhepatitis.com

Jared Baeten presenting at CROI 2015. Photo by Liz Highleyman, hivandhepatitis.com

Giving both pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) to heterosexual couples where one partner has HIV (serodiscordant couples) can almost eliminate the chance of infection in the HIV-negative partner, a study presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2015) in Seattle, USA, yesterday has shown.

This study was a first in a number of ways. It is the first to combine the ideas of PrEP and of ‘treatment as prevention’ in a systematic and sequenced way. It is the first large study in Africa to use a ‘risk score’ specifically to target the intervention to those most at risk of HIV. And it is the first study of treatment as prevention to document near-elimination of HIV transmission not just from the HIV-positive partner in a serodiscordant couple, but also from extramarital partners. Read more

Early HIV treatment reduces risk of serious illness and death by 44%

Starting HIV treatment at CD4 count above 500 reduces the risk of serious illness and death by 44%, African Temprano trial shows


First published on http://www.aidsmap.com/ on 26 Feb 2015


Keith Alcorn

Christine Danel presenting at CROI 2015. Photo by Liz Highleyman, hivandhepatitis.com

Starting HIV treatment at a CD4 cell count above 500 reduced the risk of serious illness including tuberculosis (TB), and death, by 44% when compared to starting treatment according to World Health Organization (WHO) guidelines, results from the seven-year Temprano study show. The findings were presented on Wednesday at the Conference on Retroviruses and Opportunistic Infections (CROI 2015) in Seattle, USA.

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AfA Look Back 2014

As the year draw to a close, we would like to take this chance to look back on a wonderful year, filled with activities, sweat and joy.

So here’s a huge thank you to all our volunteers, members and advocates. We couldn’t have done it without you. Let’s do it (even) better in 2015.

—————

Song – Broke for Free – Night Owl http://freemusicarchive.org/music/Broke_For_Free/Directionless_EP/

The Normal Heart (Update – Photo Album)

AFA (Action for AIDS, Singapore) presents a special, free, by invitation only screening of ‘The Normal Heart’ courtesy of HBO. The event took place on 10 Sep 2014 at Golden Village, Great World City.

Academy Award® nominee Mark Ruffalo, Matt Bomer, Taylor Kitsch, Emmy® winner Jim Parsons and Academy Award® winner Julia Roberts star in THE NORMAL HEART. Directed by Emmy® winner Ryan Murphy and written by Academy Award® nominee Larry Kramer, adapting his groundbreaking Tony Award-winning play of the same name, the drama tells the story of the onset of the HIV-AIDS crisis in New York City in the early 1980s, taking an unflinching look at the nation’s sexual politics as gay activists and their allies in the medical community fight to expose the truth about the burgeoning epidemic to a city and nation in denial.

 

 

 

 

 

 

Ruffalo portrays Ned Weeks, who witnesses first-hand a mysterious disease that has begun to claim the lives of many in his gay community and starts to seek answers. Matt Bomer plays Felix Turner, a reporter who becomes Ned’s lover. Taylor Kitsch plays Bruce Niles, a closeted investment banker who becomes a prominent AIDS activist. Jim Parsons plays gay activist Tommy Boatwright, reprising his role from the 2011 Broadway revival. Roberts plays physician Dr. Emma Brookner, a survivor of childhood polio who treats several of the earliest victims of HIV-AIDS.

 

Gay and MSM Community Sexual Health Survey Singapore 2014

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HIV infection is spreading rapidly in our community. In 2013 56% of the newly detected HIV infections were among gay and other men who have sex with men (MSM). We estimate that over 5% of all MSM in Singapore are HIV infected. The situation is especially urgent because HIV is infecting more young men, many of whom have not yet started their careers.

Effective information and prevention programmes are needed to slow down the spread of HIV. We are therefore seeking to improve our understanding of sexual health behaviour and attitudes. The Information you provide in this survey is anonymous and will assist us and our partners to plan programmes and deliver services to meet your needs, and the needs of other MSM.

 

What is a 4th gen HIV test?

The AFA Anonymous Testing Services have been providing simple, quick and affordable HIV testing utilising 3rd generation test kits for both blood and oral fluids. In an effort to improve our services, the AFA anonymous testing clinic and mobile testing services will be introducing the 4th generation test kits.


What’s the difference between 4th and 3rd gen test kits?

Fourth-generation tests kits look for both antibodies AND antigens.

  • P24 Antigens are proteins on the surface of the HIV particle.
  • Antibodies are produced by the immune system in response to the HIV antigens. They fit together like a lock and key.

 

Immune response of HIV infection

3rd generation tests take 6-8 weeks and only tests for antibodies.

4th generation tests are accurate 14 days after exposure, because this is when the p24 antigen becomes high enough to measure; effectively reducing the window period by average of 14 days.

A negative result at 28 days is good news but it is not conclusive. UK guidelines (BASHH) say that an early negative result at 28 days (1 month) needs to be confirmed with a second test 90 days (3 months) after the exposure.

Ask for the 4th Generation Test at one of the following services provided by AFA at $40 per test.

Click to learn more about each service.


More about p24 antigen

One distinctive HIV antigen is a viral protein called p24, a structural protein that makes up most of the HIV viral core, or ‘capsid’. High levels of p24 are present in the blood serum of newly infected individuals during the short period between infection and seroconversion, making p24 antigen assays useful in diagnosing primary HIV infection.

Antibodies to p24 are produced during seroconversion, rendering p24 antigen undetectable after seroconversion in most cases. Therefore, p24 antigen assays are not reliable for diagnosing HIV infection after its very earliest stages. However, HIV infection can be reliably diagnosed earlier with combined antibody/antigen tests than with purely antibody-detecting tests, and fourth-generation antibody/antigen tests are now the standard screening assay in the UK and some other countries.

More about HIV antibodies

Antibodies are protein molecules produced by the immune system in response to allergens, infectious organisms (including viruses, bacteria, fungi and parasites), and sometimes (in autoimmune disorders) the body’s own components.

Infectious organisms and allergens display characteristic proteins called antigens. The immune system recognises and responds to antigens by generating corresponding antibodies. An antibody is designed to ‘fit’ only one particular antigen, rather like a key in a lock. (The word ‘antigen’ in fact derives fromantibody generation.) By locking on to the antigen-bearing intruders, antibodies aim to render them harmless, to kill them outright, or to ‘tag’ them for destruction by other components of the immune system.

One or two weeks after initial exposure to HIV, antibodies to HIV antigens begin to appear in the blood, at concentrations which continue to increase for several more months. These antibodies persist for life, providing distinctive markers which can be identified by HIV screening tests

Novel immune-suppressant vaccine

A novel and relatively simple vaccine that can be administered orally has managed to completely block rectal infection with SIV, the monkey equivalent of HIV, in rhesus macaques and produced rapid re-suppression of viral load in monkeys who were previously infected with SIV.

The vaccine, whose success at blocking infection was described by its own designers as ‘surprising’ and ‘unexpected’, appears to work by stimulating the production of a previously unknown group of CD8 T-cells that stopped the monkeys’ CD4 cells from recognising SIV as a foreign invader, thereby preventing an immune response to SIV. This suppressant effect – which works in the opposite way to a traditional vaccine – means that the SIV is deprived of the SIV-specific immune-activated CD4 cells it needs in order to proliferate and establish an infection in the body.

The vaccine consisted of inactivated SIV administered alongside doses of familiar bacteria – in the first case the TB-suppressant bacterium BCG, and subsequently with gut bacteria of the Lactobacillus genus, including one type commonly used in probiotic supplements. This suggests that if human studies replicate the success seen in monkeys (by no means assured in vaccine studies) the vaccine could be administered in a drink.

Two initial safety trials are now planned in humans. In one, HIV-negative volunteers at low risk of HIV will be given the vaccine to see if it stimulates the same immune- and virus-suppressant responses. In the other, HIV-positive volunteers on fully-suppressive antiviral therapy will be given the vaccine and then taken off ART six months later if test tube results suggest the vaccine has produced such responses.

First published – Aug 26 2014 – AIDS Map

AIDS 2014 : Closing

At the closing ceremony, the organisers reflected upon the accomplishments and tragedy that contributed to the make-up of a conference where, according to Chris Beyrer, the president of the International AIDS Society,

“ the conference than anywhere else before where the separations betweens scientists, clinicians… and people living with HIV and activists truly went away.”.

Melbourne Lord Mayor Robert Doyle said that the way the city had embraced Australia’s largest-ever health conference touched his heart and recounted stories involving delegates being at the receiving end of acts of kindness by Melburnians.

After Barré-Sinoussi passed on her best wishes to the first openly-gay president of the International AIDS Society, Chris Beyrer, the New Yorker thanked his colleague and Melbourne for hosting the conference and praised Australia’s response to the epidemic while also highlighting it could continue to show the way in the future.

“The whole [HIV and AIDS] movement is grateful to Melbourne, grateful to Australia and we really hope that the Melbourne Declaration is going to be a living document that is going to continue to inform our response, “ Beyrer said.

Beyrer turned his attention towards the next International AIDS Conference to be held in Durban, South Africa in 2016, the first in the sub-continent since 2000, and welcomed the first female African co-chair of the event.


Related Speeches from the Closing Session