Australian healthcare company Stirling Products Limited (ASX:STI) is pleased to announce another milestone in the expansion of the licensed (pending joint venture approval) botanical products to markets outside of Ukraine. Immunoxel (Dzherelo) has been granted approval in South Africa. This approval will allow immediate sales of the phytoconcentrate as an immune adjuvant for TB and HIV treatment.

Immunoxel (as Dzherelo) is now classified under the complementary medicines category by the Medicine Control Council (MCC) of the Department of Health of the Republic of South Africa.

Negotiations will now proceed with potential partners to initiate product marketing throughout South Africa.

Earlier this year Immunoxel was approved in its first Asian market country, Mongolia, where product sales commenced last month.

Immunoxel has been shown to be safe and very effective in a variety of clinical conditions including but not limited to seasonal flu, influenza, acute respiratory infections, TB, hepatitis, HIV, autoimmune conditions, and malignancies.

Drug-resistant TB is on the rise throughout the world and is most frequently seen in the countries of the former Soviet Union, Asia, throughout the African continent and especially South Africa.

Conventional TB chemotherapy success rates are significantly lower in patients with Multi Drug Resistant (MDR) TB and Extensively Drug Resistant (XDR) TB. Recent US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) surveys indicate that in the worst-affected countries, 10% of MDR-TB cases were XDR-TB. Current treatment of drug resistant TB can take up to 18-24 months. The disease is difficult and expensive to treat and outcomes are frequently poor. No significant new class of anti-TB drugs has been introduced in past 40 year! s and existing drugs are practically useless against advanced drugresistant TB.

Mr. Volodymyr Pylypchuk, Director of Ekomed the Company’s Licensor, commented: “South Africa is burdened by one of the worst tuberculosis and HIV epidemics in the world. Our commercial partner Zodiac Capital has been working diligently and we are very excited to announce that that their effort paid off. Our Immunoxel works through completely novel immune mechanism and to the best of our knowledge is the only and most effective adjuvant to TB and AIDS drugs. The approach that we have developed drastically shortens treatment duration and can save countless lives right now. Our clinical studies conducted in Ukraine during last ten years have shown convincingly that we can offer reliable, cost-effective solutions to the global TB and HIV crisis.”

Immunoxel is one of 26 phytopharmaceutical (botanical) products being commercialised globally under a Zodiac Capital Limited License Agreement that, subject to shareholder approval at a meeting s cheduled for 29 May 2009, the Company has agreed to joint venture with Zodiac Capital Limited as has previously been advised to the market.

Source
Stirling Products Limited

The Government today responded to the independent inquiry into contaminated blood supplies in the 1970s and 1980s.

In a Written Ministerial Statement, Public Health Minister Dawn Primarolo set out the Government’s response to the Archer Inquiry into individuals infected by HIV and hepatitis C through infected NHS blood and blood products.

The response includes:

- there will be a significant increase in annual payments to £12,800 for individuals infected with HIV, in addition to the £45 million already given out in lump sums and discretionary payments;

- further support for the Haemophilia Society of £100,000 per year for the next five years; and

- a commitment to review the financial relief for individuals affected by hepatitis C in five years.

Tough measures are already in place to prevent similar events happening in the future. To ensure all patients with bleeding disorders who may have been infected have been identified, a look back exercise will be undertaken.

Minister for Public Health, Dawn Primarolo said:

“I would like to offer my deepest sympathy to all those who suffered in this tragic episode. Sadly, it was not possible to effectively test for these viruses in the 1970s and early 80s and we deeply regret that these events occurred following NHS treatment.

“Steps to safeguard blood products against HIV and hepatitis C have been in place since 1985. Every reasonable step to minimise risks from blood transfusion has been taken and robust screening measures are in place to protect patients.

“In addition to the £150 million already given out in lump sums and discretionary payments to those infected with HIV and hepatitis C, financial help for those infected with HIV will rise to £12,800 per year.”

The full response to Lord Archer’s report has been placed in the Library of the House.

In keeping with the Government’s commitment to make information available that relates to this period, the remaining 468 relevant documents have been placed on the Department of Health website.

Source
The Macfarlane Trust and Eileen Trust

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Patients being tested for HIV from a mouth swab placed in their mouth can now get their results in just 20 minutes.

Barts and the London NHS Trust is the first organisation in the United Kingdom to run the test which is now being considered for use by other London NHS trusts and has generated interest from overseas healthcare organisations.

The swab test - using a special absorbent toothbrush placed in the gum line - picks up HIV antibody markers from oral fluid. It is referred to as a “point of care” test and removes the need to wait a week for blood test results, reducing anxiety on behalf of patients and enabling clinicians to provide rapid access to further care and treatment where required.

A research study of the test was completed in March 2009 and has been successfully trialled at Ambrose King clinic at The Royal London Hospital, Whitechapel and at Barts Sexual Health Clinic at Barts Hospital in the City of London. Around 200 people at the Trust’s clinics have undergone the test since March and about 250 patients per month are expected to take it in future.

The trial at Barts and The London was part of a large scale research study of 1,500 patients which compared the rapid oral fluid HIV test alongside laboratory-run HIV blood testing.

The study found that the oral fluid point of care test performed comparably to routine HIV serological testing, with 75% of those questioned stating they would prefer an oral fluid test rather than undergoing blood tests. 40% of respondents thought that availability of an oral fluid test would have encouraged them to test for HIV sooner.

Head of Sexual Health Advising at the Trust, Merle Symonds said:

“Patients much prefer this saliva test. The effect of the quick result reduces the anxiety of waiting tremendously. Whereas other clinics do a finger prick test, this oral test is quicker and very popular.

“Approximately a third of people in the UK who are HIV-positive are currently unaware of their condition. There are still very real problems due to people who are not testing until they have become unwell as a result of undiagnosed HIV infection. This means that treatment that is now widely available may not work as effectively.

“Making testing for HIV quicker and easier is a real step towards getting people to test sooner. As this test doesn’t require us to take blood or send samples to a laboratory, we can begin to look towards testing outside traditional clinical areas. We are already offering this test to people in some of our outreach services run in non-healthcare settings.”

The test is currently being offered to all people from areas of high HIV prevalence and to men who have sex with men, in addition to those who are sexually active with either group.

It is important to note that the test picks up HIV antibody markers only in saliva samples from the gum line not the HIV virus itself. So for example, it is not possible to contract the HIV virus from kissing.

Notes

- Barts and The London is one of Britain’s top teaching hospital trusts. Our mission is literally to bring excellence to life - to give patients the best possible care so that they can live better, fuller, longer lives.

- Our world-renowned hospitals - St Bartholomew’s (Barts) in the City, The Royal London in Whitechapel and The London Chest in Bethnal Green - have made and continue to make an outstanding contribution to modern medicine. Read more about our full portfolio of services at http://www.bartsandthelondon.nhs.uk.

- Our £1 billion new hospitals programme is set to transform healthcare facilities locally. When completed the new hospital at The Royal London will be the biggest new hospital in the country, while the new buildings at Barts will house a brand-new cancer hospital and cardiac centre.

Source
Barts and The London

A recently released AIDS Vaccine Advocacy Coalition report says that although there has been a renewed focus on discovery, innovation and basic science in vaccine research, action is needed to ensure that research funding continues during the economic downturn, VOA News reports. AVAC executive director Mitchell Warren said the report is “about putting all the pieces together … not just the search for an AIDS vaccine, but in fact the entire HIV prevention response.” He added, “[T]he good news is we have some new pieces of the puzzle, and we’re expecting additional new pieces of understanding through research this year.”

Warren said that AVAC believes HIV/AIDS vaccine research is in “one of the most exciting times,” with “new energy, new commitment to unlocking some of the basic scientific roadblocks that have impeded our ability to find a vaccine.” For example, a study released earlier this week examined efforts to produce a vaccine through genetic transfer. Regarding the study, Warren said, “It doesn’t mean we have an AIDS vaccine, but it means we have an entirely new approach to trying to deliver protection.”

Warren said that the field of HIV/AIDS vaccine research has shown a renewed commitment since Merck canceled its vaccine trial in 2007. According to Warren, the new AVAC report examines knowledge gained from the Merck study, which has provided “an unimaginable amount of information.”

Meanwhile, the effect of the economic crisis on research funding is concerning, Warren said, adding, “I believe that every dollar spent is going to be held up to a greater scrutiny as budgets tighten and as funders have to re-examine their priorities.” According to Warren, without renewed funding commitments, “we will not only incur a much greater public health catastrophe, but I would argue that the economic catastrophes to come, if we don’t respond aggressively to HIV, will actually have repercussions that will … make the economic crisis pale in comparison” (DeCapua, VOA News, 5/18).


The report is available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Thailand’s Office of Welfare Promotion, Protection and Empowerment of Vulnerable People earlier this week held a public hearing to discuss various risks facing the country’s children, including HIV/AIDS, Thailand’s The Nation reports. The office plans to present a draft report on the state of child rights in the country. The report will be sent through the Foreign Affairs Ministry to the United Nations’ Convention on the Rights of the Child in July, according to ministry deputy director Saran Samarnphan. Young people were among some of the attendees at the public hearing, according to The Nation.

Youth representative Natkamon Tumpaeng said that the government has not provided adequate sex education to young people, which has resulted in unwanted pregnancies and the spread of HIV. He said, “Without sex education, many youths have clearly engaged in unsafe sex.” Passacha Pachuen, a public relations official for a council on children and youth in the Surin province, said that at many schools, teachers are forcing sex on students. “Many teachers demand sex or other favors from their students in exchange for good grades,” Passacha said. In addition, Amnat Siangsawas, the deputy chair of the council of youth and children in the city of Nakhon Sawan, said that a lack of resources often leads many children into the labor market, where they are being exploited. Amnat added that officials should “put in place mechanisms that will help them” (The Nation, 5/13).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Researchers have successfully blocked SIV, the simian version of HIV, using a new technique that could help lead to the development of an effective HIV/AIDS vaccine, the Children’s Hospital of Philadelphia. The team also included scientists from Nationwide Children’s Hospital in Columbus, Ohio, and the New England Primate Research Center in Boston.

Johnson and colleagues developed a genetically altered virus that carried the vaccine candidate and injected it into the muscles of monkeys. The vaccine prompted the muscles to produce a protein that is designed to bind to SIV and prevent it from infecting cells (Goldstein, Philadelphia Inquirer, 5/18). After treating nine monkeys with the vaccine candidate for one month, the researchers injected them with SIV. Six monkeys were not administered the vaccine candidate before being injected with SIV. None of the immunized monkeys developed AIDS, while three showed indications of SIV infection. Researchers detected high concentrations of the proteins in their blood one year later. All six non-immunized monkeys became infected with SIV, and four died during the trial (Schmid, AP/Austin American-Statesman, 5/18). The DNA used in the carrier virus can deliver DNA into the cells of both monkeys and humans, according to the Inquirer.

Johnson said that the results of the trials were so encouraging that he plans to request approval from FDA to begin clinical trials in humans, the Inquirer reports. However, he said that there is “no guarantee that things that work in monkeys will work in humans,” adding that an HIV/AIDS vaccine could be 10 years away (Philadelphia Inquirer, 5/18). Recent HIV/AIDS vaccine failures prompted the researchers to try a different route that involved “bypassing the natural immune system that was the target of all previous HIV and SIV vaccines candidates,” Johnson said. “Some years ago I came to the conclusion that HIV was different from other viruses … and we might not ever be able to use traditional approaches,” he added (AP/Austin American-Statesman, 5/18).

Peggy Johnson — head of the HIV Vaccine Research Branch at NIH’s National Institute of Allergy and Infectious Diseases, which helped fund the study — said, “As a concept, I think this is very promising.” She added, “We need to make the genes as humanized as possible so that the human body doesn’t react to that.” According to Peggy Johnson, tests will be needed to prove that the vaccine candidate can protect against sexually acquired HIV (Fox, Reuters, 5/17). Beatrice Hahn, an HIV/AIDS researcher with the University of Alabama-Birmingham, said that the study’s findings indicate that there is “a light at the end of the tunnel,” adding, “It shows thinking outside the box is a good idea and can yield results, and we need perhaps more of these nonconventional approaches” (AP/Austin American-Statesman, 5/18).

Hildegund Ertl, a virus expert at the Wistar Institute in Philadelphia, said, “It is a very innovative approach but currently, in my mind, still far from clinical use.” Ertl added that because most people have been exposed to adeno-associated viruses through cold viruses, they would be “likely to mount an immune response” to the vaccine. According to Phillip Johnson, most people have not been exposed to the strain of the adeno-associated virus that the researchers used as the carrier. He added that they “will be certainly looking at that as part of our Phase I testing in humans” (Philadelphia Inquirer, 5/18).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

The Denver Post on Friday examined efforts to establish needle-exchange programs in Colorado to reduce the risk of HIV and hepatitis C among injection drug users. According to the Post, 185 cities in Colorado have needle-exchange programs, but legislation that would have legalized needle exchanges statewide did not advance in the Legislature this year. “The issue is more complex than it perhaps first appears,” Evan Dreyer, a spokesperson for Gov. Bill Ritter (D), said, adding that “law enforcement and the Colorado Department of Public Health and Environment both expressed serious reservations” about a proposal that would have legalized needle-exchanges statewide.

A coalition of public health officials, treatment providers and advocates are increasing efforts to establish a needle-exchange program in Denver, the Post reports. The Denver Drug Strategy Commission in February recommended that Mayor John Hickenlooper consider a pilot needle-exchange program, DDSC Director Karla Maraccini said. The commission is looking at different programs to develop a model following Hickenlooper’s request for additional research. However, Denver District Attorney Mitch Morrissey has concerns that a local needle-exchange program would violate state law, according to Morrissey’s spokesperson Lynn Kimbrough. Eric Brown, a spokesperson for Hickenlooper, added, “Anything in contradiction to city or state law would have to be carefully considered.”

Proponents of needle-exchange programs say they prevent HIV and hepatitis C, but opponents say they condone injection drug use. Mark Thrun, director of HIV prevention for Denver Public Health, said, adding that needle-exchange programs prevent IDUs from “getting these chronic, potentially fatal diseases” and give public health workers “an opportunity to link them into treatment; and it lessens the economic burden on the already overburdened health care system.” Thrun noted that several studies have found that needle-exchange programs do not encourage or prolong injection drug use and make IDUs more likely to seek treatment. In addition, a 2005 CDC study found that 86% of exchange programs make treatment referrals and that more than 80% offer counseling and testing for HIV/AIDS and hepatitis C.

Nancy Steinfurth, executive director of the Hep C Connection, noted that an estimated 10% of HIV cases and 70% of hepatitis C cases are transmitted through needles (Auge, Denver Post, 5/15).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

In a bid to reduce levels of undiagnosed HIV in Cardiff, HIV and sexual health charity Terrence Higgins Trust (THT) is encouraging people who may have been at risk to attend a local service offering one-hour HIV testing. One in four people who have HIV in the UK are undiagnosed, and there are now more people living with the condition than ever before.

THT’s ‘Fastest’ service is free and confidential, and involves taking a finger-prick blood test which is analysed straight away, with the results provided within one hour. Those who attend the clinic will be given information and support before and after the test, and anyone who tests positive will be given full support in choosing a treatment centre. They will also be given information on the range of support services available, including counselling and peer support.

Gavin Mooney, Centre Manager for THT in Cardiff, said: “With recent medical advances, it’s now possible for people with HIV to live long and healthy lives. However, if they leave it too late to get tested, they’re setting themselves up for serious health problems and the risk of early death. In the UK, gay men and Africans are the groups most at risk of contracting HIV, but if you’ve had unprotected sex you may have put yourself at risk, so we’d urge you to get tested as soon as possible.”

THT clinics and workers also offer information and advice on STIs and safer sex, as well as giving out free condoms.

The Fast Test service takes place at THT’s Cardiff centre at 435-451 Cowbridge Road East. Each week, there are sessions on Tuesdays from 6.00pm to 8.00pm. The number of tests that can be done at each session are limited, so people are advised to arrive early.

Source
Terrence Higgins Trust

AIDS Vaccine Day, May 18, marks the occasion in 1997 when U.S. President Bill Clinton challenged researchers to come up with an AIDS vaccine within the following decade, stating that such a vaccine was the only way to eliminate the threat of AIDS. Twelve years later, the goal of an effective HIV vaccine remains unfulfilled, but the need for one remains urgent. AIDS is the number four killer in the world and number one in sub-Saharan Africa. Despite education and prevention campaigns, every day 7,500 people become infected with HIV. Antiretroviral drugs can prolong the lives of those who are infected, but they are not cures, and because of their cost and logistical difficulties, they reach only a minority of those who need them. And for every two individuals who go on antiretroviral treatment, five become HIV infected. As with any major viral pandemic, a vaccine remains the best hope of ending, and not just mitigating, AIDS.

Development of an effective AIDS vaccine will require time and perseverance. Many of today’s licensed vaccines took decades to develop and were the product of many failed attempts. That’s how science works. With each miss, or near hit, researchers learn something-if only what not to do-that advances their progress.

As a result of this kind of incremental learning, we are facing an exciting time in AIDS vaccine science. AIDS vaccine research and development has focused on two arms of the immune system: the arm that dispatches T-cells to seek and destroy human cells that have become HIV infected, and the arm that stimulates the production of antibodies to block HIV from infecting cells in the first place. Today, there are promising new advances on both fronts.

In the past decade, most HIV vaccine development has focused on the T-cell arm, also called cellular immunity. Although vaccine candidates of this type, in the absence of an antibody response, are unlikely to fully prevent HIV infection, in animal studies they have been shown to reduce the amount of virus circulating in the body of the animals that become infected after vaccination. Thus, such a vaccine might keep HIV in check, slowing or preventing progression to AIDS and, perhaps, reducing the chances of transmitting HIV to another person. The only AIDS vaccine candidate of this type to reach efficacy testing failed to show efficacy in the STEP trial in 2007. However, for the first time, researchers have shown in animal studies that a handful of new T-cell vaccine strategies under development can control the amount of virus in infected animals better than approaches previously tested in clinical trials. A subset of these improved T-cell approaches are in early development, heading toward clinical trials.

The greatest scientific challenge impeding AIDS vaccine development is the antibody problem: how to design a vaccine that elicits antibodies that neutralize the many types of HIV in circulation so that the vaccine is protected from infection. But here, too, there is progress to report. Scientists have identified new antibodies capable of neutralizing a wide spectrum of HIV types circulating worldwide. These antibodies may now provide the keys to new vulnerable targets on the surface of HIV, which can be exploited for vaccine design.

There is also an interesting concept now in preclinical testing that aims to use vector-mediated gene transfer to maintain in the body large amounts of broadly neutralizing antibodies against HIV over long periods of time.

Of course, these developments will not lead us directly to an AIDS vaccine. There is much work to do, and more failure ahead, certainly. But the point is, despite disappointments, overall, AIDS vaccine science is progressing.

It does so because of a wide array of participants in the HIV vaccine effort, among them: researchers and technicians who devote themselves to the mission, study and trial participants who make the selfless contribution of volunteering for research, community workers who lend their voices and ears, political leaders who pave the way and donors who make the whole enterprise happen. On the occasion of World AIDS Vaccine Day, we at IAVI salute these individuals and our many partners for their dedication to making an AIDS vaccine a reality.

Source
IAVI

HIV-positive patients who don’t seek medical attention until they have a serious AIDS-related condition can reduce their risk of death or other complications by half if they get antiretroviral treatment early on, according to a new multicenter trial led by researchers at the Stanford University School of Medicine.

The study results could lead to widespread changes in treatment for HIV patients, particularly those diagnosed at an advanced stage, experts say.

“Even in San Francisco, one of the first epicenters of HIV in the United States, we still find that many people still present late in the course of their illness with an opportunistic infection,” said Mitch Katz, MD, San Francisco’s director of health, who was not involved in the study. “This study shows that it is life-saving to treat those persons with antiretroviral drugs while they are still in the hospital. The results of this study will change practices throughout the world.”

Some 60,000 to 70,000 newly HIV-infected individuals are identified every year in the United States, according to recently revised figures from the federal Centers for Disease Control and Prevention. A growing number of these patients, particularly minorities, youth, injection-drug users and those in poor rural areas, are being diagnosed late in the disease process when they’ve already developed life-threatening conditions, said Andrew Zolopa, MD, associate professor of infectious diseases and geographic medicine at Stanford and first author of the study. When these patients come for treatment of these complications, doctors are often reluctant to give them anti-AIDS drugs at the same time, fearing the two therapies could interfere with one another.

“A lot of people wait, thinking, ‘Let’s get the patient out of acute crisis, and then we’ll deal with the underlying HIV infection later,’” said Zolopa. “But that answer is wrong. If we’re more aggressive with HIV drugs, we can reduce AIDS-related complications and death by 50 percent. It’s a substantial clinical benefit.”

The study was conducted by the AIDS Clinical Trials Group, the world’s largest clinical trial organization. Results will be published May 18 in the online journal PLoS-ONE.

William Powderly, MD, dean of medicine at the University College Dublin School of Medicine, said the study addresses one of the last, longstanding unknowns in the management of AIDS.

“Clinicians have long grappled with the question of whether or not early treatment with antiviral drugs will help people who come to the hospital with advanced infections, such as pneumonia,” said Powderly, MD, the study’s senior author. “The answer is clearly yes. Early antiviral treatment for HIV improves the clinical outcome, including the likelihood of surviving in the next few months. It probably does so by improving the immune system and therefore adds to the ability to resist these infections.”

The study findings, presented in abstract form at an earlier scientific meeting, are already starting to change clinical practices. The International AIDS Society, the CDC and the British AIDS Society all have adopted guidelines that recommend that early antiretroviral treatment be considered in patients with an opportunistic infection, Zolopa noted.

The study involved 262 patients at 39 sites across the United States, from Puerto Rico to Seattle. An additional 20 patients were enrolled in a hospital in Johannesburg, South Africa. Eighty-five percent of the patients were men whose median age was 28. They were an ethnically diverse group: 37 percent were black, 36 percent Hispanic, 23 percent white and 5 percent Asian.

The patients all had one or more opportunistic infection, with the most common ones being pneumocystis jirovecii pneumonia, cryptococcal meningitis and serious bacterial infections. Patients with tuberculosis were excluded from the study because it was unclear what the optimal antiviral treatment was for these patients, Zolopa said.

The patients, who were enrolled between May 2003 and August 2006, were separated into two groups: those who got antiretroviral treatment early and those for whom this treatment was delayed until their opportunistic infections had been dealt with. The patients were all offered antiretroviral drugs free of charge. The drugs for the study were supplied by Abbott Laboratories (lopinavir/ritonavir), Gilead Sciences (tenofovir and emtricitabine) and Bristol-Myers Squibb (stavudine).

The patients in the early intervention arm of the study were treated with ARVs within an average of 12 days, while those in the deferred group received the treatment within an average of 45 days after the start of treatment for the opportunistic infection. Among the patients treated early, there were 20 (14.2 percent) who died or developed another significant AIDS-related complication. That compared with 34 patients (24.1 percent) in the deferred group who died or suffered a new complication.

In addition, the patients in the early treatment group saw a much swifter recovery of their immune systems. The early group patients saw their T-cell counts, a measure of the immune cells destroyed by the AIDS virus, increase to more than 100 within four weeks. In the deferred treatment group, it took 12 weeks for the patients’ T cells to reach that same level, the researchers reported.

“I was quite impressed at how rapidly these T cells could rise in these patients,” Zolopa said. “By starting ARVs early you can effectively reduce the window of vulnerability where another AIDS-related complication could develop.”
Zolopa said there was no difference between the two sets of patients in their adherence to their prescribed regimens. One concern in treating patients with ARVs soon after being diagnosed with AIDS is that they might not stick to their treatments and could then develop drug resistance. But adherence did not prove to be an issue, he noted.

“Starting the therapies early didn’t scare people off,” he said.

According to Zolopa, the study results probably provide some guidance for patients in developing countries, though each country would have to determine its own strategy for initiating ARVs in patients with advanced AIDS.

“These results do have important implications across the globe,” he said.

Although the study did not include patients with tuberculosis, the most common AIDS-related complication among patients in sub-Saharan Africa, early ARV treatment has been shown in other, more recent studies to be of value in those patients with TB, Powderly said.

Zolopa said implementing the study findings could entail some logistical challenges, as hospitals will have to develop interdisciplinary teams, including pulmonary specialists, emergency physicians, pharmacists and others, in coordinating early treatment for these critically ill patients as they come into the system.

Other researchers in the study are Janet Andersen, ScD, and Lauren Komarow, both with Harvard School of Public Health; Ian Sanne, MD, of the South African College of Physicians; Alejandro Sanchez, MD, of the USC Keck School of Medicine; Evelyn Hogg with Social & Scientific Systems, Inc.; and Carol Suckow with the Frontier Science and Technology Research Foundation.

The study was funded by the National Institutes of Health through the Division of AIDS.

Source
The Stanford University School of Medicine

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