America’s pharmaceutical research and biotechnology companies are testing 97 medicines and vaccines to treat or prevent HIV/AIDS and related conditions, according to a new report released by the Pharmaceutical Research and Manufacturers of America (PhRMA). December 1 marks the 21st anniversary of “World AIDS Day” a global awareness campaign that originated at the 1988 World Summit of Ministers of Health on Programmes for AIDS Prevention.

“We are greatly encouraged by these critically important medicines and vaccines in development to treat and prevent HIV infection,” says PhRMA President and CEO Billy Tauzin. “Pharmaceutical researchers are continuing their efforts to develop new therapies and vaccines to improve and lengthen the lives of HIV-infected patients.”

The report found that the 97 products in development include 23 vaccines and 54 antivirals. These drugs are either in human clinical trials or awaiting approval by the U.S. Food and Drug Administration .

Thirty-one medicines to treat HIV/AIDS have been approved since scientists first identified the virus that causes AIDS more than 20 years ago. The first HIV/AIDS medicine was approved in 1987, just four years after the virus was identified.

Although the U.S. Centers for Disease Control and Prevention (CDC) estimate that more than 1 million Americans were living with HIV infection at the end of 2006, the increased availability and utilization of newer prescription medicines has helped to reduce the U.S. death rate from AIDS substantially in recent years, according to government statistics. In fact, the CDC estimates that since the introduction of highly active anti-retroviral therapy in 1995, the annual number of deaths in the U.S. due to AIDS has dropped by more than 70 percent.

Despite this progress, AIDS remains a devastating and growing health problem in developing countries, particularly in sub-Saharan Africa, China, India and the Russian Federation. According to the Joint United Nations Programme on HIV/AIDS, in 2007 an estimated 33 million people were living with HIV, 2.7 million were newly infected with HIV, and 2 million people died from the disease.

From 2000 to 2007, America’s pharmaceutical research and biotechnology companies contributed more than $9.2 billion to improve health care in the developing world, according to the International Federation of Pharmaceutical Manufacturers & Associations.

The projects they supported included clinics to treat patients with HIV/AIDS, education and prevention programs, initiatives to prevent mother-to-child transmission of HIV, and donations of medicines for AIDS and related diseases. A number of companies also provide AIDS drugs at reduced prices in many countries.

“As a result of HIV/AIDS medicines, a disease that was once a virtual death sentence can now be controlled and treated as if it were a chronic disease,” states Tauzin. “And the new medicines our scientists are working on right now bring hope for even more promising results in the future.”

“While researchers are making exciting progress in the search for new treatments for HIV/AIDS, these efforts are wasted if the medicines that are developed don’t get to the patients who need them,” says PhRMA Senior Vice President Ken Johnson.

Help is available to patients in need through the Partnership for Prescription Assistance (PPA), a program sponsored by America’s pharmaceutical research companies. To date, the PPA has helped more than 6 million patients nationwide. Since its launch in April 2005, the PPA bus tour has visited all 50 states and more than 3,000 cities.

Source: Pharmaceutical Research and Manufacturers of America

A third of adults diagnosed with HIV in the UK last year were diagnosed late, according to figures released today by the Health Protection Agency.

In 2008 there were 7,298 new diagnoses of HIV in the UK with an estimated 32% (2,310) of adults over 15 years being diagnosed at a point after which treatment should already have begun (CD4 cell count <200 per mm3). This results in patients missing out on the benefits that come from early diagnosis, including improved life expectancy.

According to British HIV Association guidelines introduced last year, patients with HIV should now be considered for treatment when their CD4 cell count reaches <350 per mm3 rather than waiting until it falls further to <200 per mm3. If these guidelines were used when interpreting the latest figures, it would mean more than half (55%) of all individuals diagnosed last year would have been diagnosed late.

The number of deaths among HIV-infected people has remained stable over the past decade. However, three quarters of the 525 people with HIV who died in 2008 had been diagnosed at a point after which treatment should have begun according to the latest treatment guidelines (i.e. a CD4 cell count <350 per mm3). This highlights the importance of promoting testing to ensure early diagnosis and enable successful treatment.

The agency’s annual HIV report also shows that the number of people living with HIV in the UK increased to 83,000 in 2008. This number will continue to rise as people with HIV live longer on effective therapy.

Improvements have been made in the number of people testing for HIV - 100,000 more tests were performed at GUM (genitor-urinary medicine) clinics in 2008 than the previous year (950,000 up from 850,000 in 2007). 93% of people attending GUM clinics are now tested for HIV. This has continued to increase steadily since 2004 when 23% of visitors to a GUM clinic were not being tested for the infection.

National HIV testing guidelines recommend wider HIV testing in those areas of the country where the prevalence of diagnosed HIV infection is greater than 2 per 1,000 population aged 15 to 59 years. There are 43 local authorities in England (35 Primary Care Trusts) where the prevalence of HIV is above this threshold. It is in these areas that health professionals should routinely offer HIV testing to all men and women aged 15 to 59 years who are registering in general practice or admitted for medical care.

Dr Valerie Delpech, an expert in HIV from the Health Protection Agency said: “HIV is a serious infection but if diagnosed early, there are very good treatment options. Of concern is that over 22,000 people remain unaware of their infection in the UK and cannot therefore benefit from effective treatment.

“It is encouraging to see the increased numbers of HIV tests being performed in STI clinics. However, we must reduce the number of people presenting late with their infection by increasing awareness of the importance of testing, improving access and de-stigmatising the HIV test.

“We need to continually reinforce the safe sex message - using a condom with all new or casual sexual partners is the surest way to ensure you do not become infected with a serious sexually transmitted infection such as HIV.

“People need to know that testing for HIV and all sexually transmitted infections is both free and confidential at sexual health clinics across the UK. If you have had unprotected sex with a new or casual partner you should go and get tested.

“Medical guidelines published last year have encouraged more widespread testing in areas where there is a high prevalence of diagnosed HIV and we hope this will contribute to improving awareness of the infection in this community and therefore increase testing.”

2008 in numbers

Living with HIV

– An estimated 83,000 people are living with HIV in the UK (both diagnosed and undiagnosed).
– This equates to a rate of 1.3 people per 1,000 population.
– Among the 83,000 HIV infected individuals, 27 per cent (22,400) remain unaware of their infection.

Accessing care

– 61,213 people diagnosed with HIV were accessing care in the UK last year - this represents and eight per cent increase in 2007 (56,433) and more than 3x the number in1999 (20,009).

New diagnoses

– 2008 saw 7,298 new diagnoses of HIV, a similarly high figure to recent years, although a decline on the peak observed in 2005 (7,975).
- 38% (2,760) were among gay men and four out of every five probably acquired their infections in the UK.
- 58% (4,220) were acquired through heterosexual contact - with the majority of cases probably infected abroad. Total diagnoses among heterosexuals have declined from their peak in 2004 (5,020) although those acquired within the UK are increasing from an estimated 740 in 2004 to 1,130 in 2008.
- 170 infections were acquired through injecting drug use.
- 110 were acquired through mother-to-child transmission.

Late diagnoses

– An estimated 32% (2,310/7,218) of adults aged over 15 years were diagnosed with a CD4 cell count <200 per mm3 within three months of diagnosis. The proportion diagnosed with a CD4 cell count <350 per mm3 (the threshold at which treatment should be considered according to 2008 British HIV Association guidelines) was 55% (3,970/ 7,218).

Death

– 525 deaths (387 men and 138 women) were recorded among HIV-infected people in 2008.

* Adjustments have been made to some of the detailed figures provided above to take into account missing information relating to the cases reported

Notes

To view HPA’s annual HIV report - HIV in the United Kingdom: 2009 Report visit the agency’s website at http://www.hpa.org.uk/HPA/Publications/InfectiousDiseases/HIVAndSTIs/

Late diagnosis is defined as having evidence of substantially reduced immunity assessed by a laboratory measure of a CD4 count of <200cells/mm3 or an AIDS diagnosis at the time of an HIV diagnosis. For more information about this visit here.

A high prevalence of HIV is considered to be areas where diagnosed HIV prevalence in the local population exceeds 2 in 1,000.

Source
Health Protection Agency

A rare parasitic disease, which normally only is transmitted by contaminated water, has been shown to be transmitted by gay sex between hiv-positive men. In the industrial world the disease is virtually absent, but from now on that could change. For this observation, Taiwanese researcher Chieng-Ching Hung received a doctorate from the University of Antwerp and the Institute of Tropical Medicine Antwerp.

Amebiasis, an infection with the single-celled amoeba Entamoebia histolytica, normally is very rare. You only catch it in a few developing countries where the amoeba is endemic, and where hygiene is somewhat substandard, leading to contact with contaminated water. It only becomes dangerous when the amoeba invades your intestinal lining and causes a bloody diarrhoea, or when it enters the bloodstream, where it, among other things, causes liver abscesses. All in all amebiasis takes some 70 000 lives a year, worldwide.

For some time now, physicians suspected the disease to be a bit overrepresented among HIV-positive male homosexuals. But it was difficult to come to conclusions from small numbers, and in addition the classical diagnostic test (putting the stool under the microscope) was not really dependable. Hung used modern molecular techniques, pinpointing the amoeba more precisely and, what’s more, showing which amoebas were closely related. In other words: who had got the infection from whom.

In Taiwan, seropositive (hiv-infected) gay men showed to be infected much more often with the amoeba than the healthy population, and also than seropositive heterosexuals. On top of that, Hung found men from different regions nevertheless to be infected by closely related amoebas. The only sensible explanation is that the infection happened through homosexual (oral-anal) contact.

In today’s mobile world this means that those people in turn can transmit the infection to regions where it normally is absent.

In other words: physicians in industrial countries from now on better know who Entamoebia histolytica is, and what it brings about.

Not only amebiasis marches in the wake of hiv; Hung also confirmed in his Taiwanese cohort what is seen elsewhere: tuberculosis and hepatitis B and C are more virulent in combination with hiv, and more often present.

Source: Institute of Tropical Medicine Antwerp