HIV Cures Come At A Price

Also published on Bilerico.com

Today, amfAR grantee Dr. Timothy Henrich announced two HIV-positive patients who have undetectable levels of HIV after undergoing stem-cell transplants at the 7th annual International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur, Malaysia.

Money (Photo credit: 401(K) 2013)

We’ve had some excellent news about the curing of HIV-infected people in the past year. But it comes at a price.

It’s important to note that the individuals involved received intensive care and went through extreme discomfort in order to eradicate the virus from their bodies. It’s not something that we’ll be able to replicate for the general population anytime soon.

And I think we need to remember that people are still dying of HIV-related causes every day- thousands of people. And new infections aren’t really slowing down- even in the First World where there is convenient access to safe sex supplies. There’s still a disconnect. There’s still ignorance and apathy out there.

It’s still good news however.

From amFAR:

The patients had been on long-term antiretroviral therapy for HIV when they developed lymphoma. To treat the cancer, the patients underwent reduced intensity chemotherapy followed by stem-cell transplants. Since the transplants, Dr. Henrich has been unable to find any evidence of HIV infection.

Dr. Henrich was awarded a grant through the amfAR Research Consortium on HIV Eradication (ARCHE) after presenting preliminary findings on these patients at the International AIDS Conference last July. With support from amfAR, he conducted a clinical study in which his research team withdrew the patients’ antiretroviral therapy and performed several sophisticated assays looking for signs of viral rebound in blood and other tissues. One patient has been off treatment with no detectable virus for approximately 15 weeks, and the second patient for seven weeks, with similar results. However, it is too soon to draw any definitive long-term conclusions.

It is also unclear how long viral rebound might take in a patient whose viral reservoirs have been dramatically depleted, but not eradicated. According to amfAR/ARCHE grantee Dr.Robert Siciliano of Johns Hopkins University, it may take over a year. Previously a patient in a study by the National Institutes of Health had gone 50 days after treatment withdrawal without viral rebound. Dr. Henrich’s patients are at or beyond this threshold, and more definitive answers will emerge as these patients continue to be closely monitored.

“These findings clearly provide important new information that might well alter the current thinking about HIV and gene therapy,” said amfAR CEO Kevin Robert Frost. “While stem-cell transplantation is not a viable option for people with HIV on a broad scale because of its costs and complexity, these new cases could lead us to new approaches to treating, and ultimately even eradicating, HIV.”

The first person to be cured of HIV, Timothy Brown (“the Berlin patient”), also underwent a stem-cell transplant to treat his leukemia. These new cases differ significantly, however, in that the stem-cell donors lacked the genetic mutation (CCR5 delta32) that renders a person virtually resistant to HIV infection. Nor did Dr. Henrich’s patients undergo the intensive chemotherapy or total body irradiation that preceded Timothy Brown’s stem-cell transplant.

“Dr. Henrich is charting new territory in HIV eradication research,” said amfAR Vice President and Director of Research Dr. Rowena Johnston. “Whatever the outcome, we will have learned more about what it will take to cure HIV. We believe amfAR’s continued investments in HIV cure-based research are beginning to show real results and will ultimately lead us to a cure in our lifetime.”

I still can’t help but think we’ve not done our best in response to this epidemic- especially in the last decade. I wonder if, as a community, we settled for simply not dying as a substitute for true health.

If so, what does that say about our self-esteem, self-care and community spirit? Have we lost interest in each other beyond the obvious?

That’s a heavy price to pay.

No Trace of HIV After Stem-Cell Transplants, Researchers Say (news.health.com)
Two patients clear of HIV after stem-cell transplants (irishtimes.com)
Stem-cell therapy wipes out HIV in two patients (thestar.com)

ONE Singular Sensation…

Jun13 by D Gregory Smith

If you run out of condoms this Pride weekend, you have no excuse.

ONE ® Condoms has provided Montana Pride 2012 with 4,000 “Pride Mix” Condoms:

Watch for the condom buckets!

Study: Simple Changes To Dating Sites Could Lower STD’s, HIV

Aug24 by D Gregory Smith

Simple Changes to Dating Websites Could Decrease Spread of HIV and Sexually Transmitted Diseases

A study released today recommends eight ways to reduce transmission of HIV and other sexually transmitted diseases (STDs) among men who meet male sex partners online.

Owners of popular dating and “hook-up” websites and users of those websites, along with HIV and STD program directors, agreed that a few simple measures could have a major impact on the spread of sexually transmitted diseases.

Among the online measures supported by a majority of those surveyed:

• Including “safe sex” as a profile option and allowing users to search for partners by such characteristics
• Providing directories of STD testing locations
• Sending automatic reminders to get an HIV/STD test at regular intervals chosen by users
• Having chat-rooms and other areas for HIV+ men looking for other HIV+ men
• Providing e-cards to notify partners of a potential exposure to STDs
• Posting videos that show men discussing safe sex, HIV status, and related issues
• Providing access to sexual health experts

“Finding sex and love online is here to stay,” said Dan Wohlfeiler, one of the study’s authors working with the California HIV/STD Prevention Training Center for this project. “This shows how we can work with the website owners to turn the internet into a force for the health of their users.”

In California, gay and bisexual men who were diagnosed with syphilis or gonorrhea most frequently reported the Internet as where they met sex partners.

More than 3000 users, 82 state and local HIV and STD Program directors and 18 owners of dating and “hook-up “ websites completed the survey.

Jen Hecht, Education Director at STOP AIDS Project and co-author, said “Since all three groups agree these strategies are important, can be done, and would be used, we need to be getting them online now.”

The study also found a number of strategies with less support. Website owners expressed skepticism about health department staff going online to notify users that they might have been exposed to an STD. In contrast, a majority of HIV and STD prevention directors and users thought this strategy was important. The authors are planning follow-up meetings with owners to further understand their concerns.“We have rising rates of STDs among gay and bisexual men and turning that around means everyone needs to take responsibility for their sexual health,” said Bill Smith, Executive Director of the National Coalition of STD Directors (NCSD). “This study shows how public health professionals, as well the users and owners of sex seeking websites, can band together to make a real difference in securing the sexual health of gay men.”

The study, entitled “How Can We Improve HIV and STD Prevention Online for MSM” funded by amfAR, the Foundation for AIDS Research, was co-authored by H. Fisher Raymond and Willi McFarland at the San Francisco Department of Public Health. The results have been posted today at http://www.stopaids.org/online.

Gonorrhea: Not So Easy To Kill Anymore

Jul8 by D Gregory Smith

Not anymore. . .

Think if you get the clap, you can just go get a shot or take a pill to be cured?

Not so fast, bucko. There’s now another reason to protect yourself:

Today, the Centers for Disease Control and Prevention (CDC) outlined laboratory trends from 2000-2010 that show growing resistance of gonorrhea to antimicrobials. Gonorrhea, a sexually transmitted disease (STD), is a major cause of pelvic inflammatory disease, ectopic pregnancy, and infertility and can facilitate HIV transmission. (Press release, National Coalition of STD Directors)

Yep. Gonorrhea. It used to be a serious disease, before antibiotics made it easy to treat. Now that we’ve been taking antibiotics for everything, resistance is setting in and we’re running out of effective drugs to cure it.

…cephalosporin antibiotics are the last line of defense for treating the disease, as the bacteria has developed resistance to all other antibiotics. The highest level of resistance to cephalosporins, regardless of sexual partner, was found in the Western region of the United States, particularly Hawaii and California, as well as in men who have sex with men in all regions.

“This new data outlines what state and local health departments have been seeing on the ground—that highly untreatable gonorrhea is near,” stated William Smith, Executive Director of the National Coalition of STD Directors. “There are currently no new drugs in development for this infection. If this last class of drugs fails we will have no definitive treatment options for gonorrhea. We call on researchers, government, and partners in industry to make the development of new, effective drug treatments for gonorrhea a public health priority,” continued Smith.

This is a big deal.

It’s important for sexually active persons to be screened for all STD/STI’s at least every six months, or more often if you have many sexual partners and/or have had unprotected sex- and that includes oral- gonorrhea can easily infect the throat. And, remember, any STD/STI increases the risk of contracting/spreading HIV. From the CDC:

Untreated gonorrhea can cause serious and permanent health problems in both women and men.

In women, gonorrhea is a common cause of pelvic inflammatory disease (PID). About 750,000 women each year in the United States develop PID. The symptoms may be quite mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses (pus-filled “pockets” that are hard to cure) and long-lasting, chronic pelvic pain. PID can damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy. Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube.

In men, gonorrhea can cause epididymitis, a painful condition of the ducts attached to the testicles that may lead to infertility if left untreated.

Gonorrhea can spread to the blood or joints. This condition can be life threatening. In addition, people with gonorrhea can more easily contract HIV, the virus that causes AIDS. HIV-infected people with gonorrhea can transmit HIV more easily to someone else than if they did not have gonorrhea. (emphasis mine)

We’ve taken the cure for granted for too long. So- be careful out there.

Full article here.