News from the Thirteenth Conference on Retroviruses and Opportunistic Infections

The Conference on Retroviruses and Opportunistic Infections (CROI) takes place each February in the United States, and has established a reputation as the leading scientific conference in the HIV field.

This year’s CROI featured a rich selection of research reports relevant to resource-limited settings, including encouraging data from Zambia, South Africa, Uganda and international cohorts on the success and tolerability of ART, important new data on TB treatment, and contradictory findings on the risks and benefits of treatment interruptions.

This edition of HATIP contains links to aidsmap.com reporting from CROI; the next edition will include further reporting and summaries of research focusing on two areas: TB and HIV, and the risk of death in people who begin antiretroviral treatment in resource-limited settings.

News headlines

CROI: rapid response predicts success in HIV/HCV coinfected patients

http://www.aidsmap.com/en/news/BD51C0C3-36BF-47E6-B116-37190B489F8E.asp

Virological response to hepatitis C therapy after four weeks appears to predict who will have a successful response to a full course of treatment in HIV-positive people coinfected with hepatitis C genotypes 1 or 3, according to findings from two studies presented last week at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver.

Bristol Myers Squibb announces voluntary licenses for atazanavir in India and South Africa

http://www.aidsmap.com/en/news/18333DF9-46B6-47E0-879A-42727AD4CED3.asp

Bristol Myers Squibb announced today that it will grant voluntary licenses for manufacture of its new protease inhibitor atazanavir, sold in Europe and North America under the brand name Reyataz, to pharmaceutical companies in India and South Africa for sale in India and Africa.

CROI: Cotrimoxazole prophylaxis reduces adverse birth outcomes in Zambian women with HIV

http://www.aidsmap.com/en/news/5FC7F0F9-3158-4BDA-B677-875B82B3C1D9.asp

Cotrimoxazole prophylaxis significantly improves birth outcomes in women with HIV according to an analysis of a mother-to-child HIV transmission (MTCT) study in Lusaka, Zambia. The serendipitous finding was observed after cotrimoxazole prophylaxis began to be offered routinely in Zambia to HIV-infected women with advanced disease.

CROI: Two studies show single-dose nevirapine prevents HIV transmission in consecutive pregnancies

http://www.aidsmap.com/en/news/077B2D16-12AA-4B3E-A944-E3B0D2B0265A.asp

Women who have used single-dose nevirapine (Viramune) to prevent mother to child transmission (PMTCT) of HIV can use it with equal or greater success during a second delivery, according to studies presented at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver last week.

CROI: Male circumcision reduces risk of transmission of HIV and some STIs to female partners

http://www.aidsmap.com/en/news/D775D204-7155-4CDF-ACB5-8CAA1C6730FA.asp

Male circumcision reduces the risk of HIV transmission to female sexual partners by approximately one-third according to a study presented to the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver on February 8^th. The investigators also found that circumcision reduces the risk of men infecting their female partners with some sexually transmitted infections.

CROI: Risk of new illnesses declines sharply after first two months on treatment in resource-limited settings

http://www.aidsmap.com/en/news/032EA68E-0832-48C3-A7CF-62ECB8B66CE6.asp

People on antiretroviral therapy (ART) in resource-limited settings experience HIV-associated illnesses (HAI) and tuberculosis (TB) at double the rate observed in high-income countries, according to a study reported at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver.

CROI: TB rates skyrocketing in Western Cape township — most infectious cases associated with HIV coinfection

http://www.aidsmap.com/en/news/CE720DF3-2054-4C37-988C-409FE2B6B33E.asp

Infectious smear-positive TB  (tuberculosis) is most commonly found in people with HIV coinfection, which is likely to be responsible for the skyrocketing rates of TB in South Africa according to a survey of TB and HIV prevalence in a peri-urban township south of Cape Town. There was also a high number of smear-negative TB cases, but it was more likely to be found among HIV-negative individuals.

CROI News Feature: Experts divided over the future of treatment interruptions

http://www.aidsmap.com/en/news/54ABE6CE-49F4-4FD6-8BDB-32708873EFCC.asp

Experts at the Thirteenth Conference on Retroviruses and Opportunistic Infections, held this week in Denver, were divided over the future of structured treatment interruptions during a lively panel discussion that followed the presentation of the results of the SMART study, reported separately here along with five other structured treatment interruption studies. Whilst the CD4-guided treatment interruption arm of the Trivacan trial in west Africa was also terminated early due to excess illness in those who interrupted therapy, two other CD4-guided treatment interruption studies - Staccato and ACTG 5170 - appeared to have more positive outcomes, as did two fixed-length treatment interruption trials, Window and PART.

CROI: Greater declines in TB incidence observed with long-term antiretroviral therapy

http://www.aidsmap.com/en/news/9E0101FB-11D2-47C3-A384-4F31995715D2.asp

The incidence of tuberculosis (TB) in people on antiretroviral therapy (ART) continued to decrease over the first three to five years on treatment in a South African study reported this week at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver.

CROI: Capsaicin patch helps relieve neuropathy

http://www.aidsmap.com/en/news/C007D69E-07D3-41E4-8E59-CC14664AF051.asp

A patch containing 8% capsaicin can relieve the pain caused by peripheral neuropathy for up to three months, according to a controlled study presented on Tuesday at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver.

CROI: Tenofovir and kidney toxicity - low rates seen, but some groups may be more vulnerable

http://www.aidsmap.com/en/news/538244AD-0FCD-4FBA-8250-34F45FBF379F.asp

The Thirteenth Conference on Retroviruses and Opportinsitic Infections gathered together five varied studies of kidney toxicity in patients taking tenofovir (Viread) to better establish the frequency of this adverse event.

CROI: Heart attack risk elevated by protease inhibitor treatment but not NNRTIs

http://www.aidsmap.com/en/news/DB1EE740-DA2F-4E0B-B372-85A7FC5DC3C9.asp

The increased risk of heart attack seen in patients taking antiretroviral therapy is caused by protease inhibitors and not non-nucleoside reverse transcriptase inhibitors (NNRTIs), according to an analysis of the D:A:D study presented today at the Thirteenth Conference on Retroviruses and Opportunistic Infections (CROI) in Denver. The study showed that this was partially due to the changes in blood fat levels caused by protease inhibitors.

CROI: Side-effects, especially neuropathy and rash, common but rarely severe in two studies of African patients on antiretroviral therapy

http://www.aidsmap.com/en/news/48A79438-B95F-49B9-90FB-B8D4A246C5DC.asp

Although drug side-effects due to antiretroviral therapy (ART) are relatively common in African patients, they are no more likely to be severe than in patients in industrialised countries, and appear chiefly related to the d4T (stavudine, Zerit) component of first-line treatment rather than to nevirapine (Viramune), according to two large studies presented on Wednesday at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver.

CROI: CD4-guided treatment interruptions unsafe, SMART study concludes

http://www.aidsmap.com/en/news/5CA70DAC-AFEA-4567-8FC7-4CD5C458F10A.asp

Treatment interruptions guided by CD4 cell counts put HIV-positive patients at an increased risk of disease progression, AIDS and death, according to the results of a large international study presented today at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver.

CROI: Antiretroviral therapy reduces the high incidence of TB in South African children with HIV

http://www.aidsmap.com/en/news/9453A62B-64A0-4267-A45F-5AC7A8F72B87.asp

Children with HIV in South Africa have an extremely high incidence of tuberculosis (TB), but antiretroviral therapy (ART) substantially reduces TB (suspected cases) according to a study reported at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver. (The presentation can be viewed or listened to here).

CROI: Abacavir may be safer than nevirapine in Africans, DART sub-study suggests

http://www.aidsmap.com/en/news/AA3B19BA-A37B-499A-ACE0-93CD87F6F699.asp

Abacavir (Ziagen) appears to cause fewer serious adverse drug reactions than nevirapine in African patients taking part in a substudy of the DART trial, investigators reported on Tuesday at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver.

CROI: HIV subtype D causes disease more rapidly than HIV-1 subtype A in Uganda

http://www.aidsmap.com/en/news/FE5EA2A1-67D7-4D6D-9C65-CA45C5F13C08.asp

Ugandans infected with HIV subtype D are more likely to experience rapid disease progression to AIDS or death than those infected with subtype A, according to a study reported at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver. This effect was independent of viral load for the first two years after infection.

CROI: Rapid scale-up of HIV treatment in Zambia

http://www.aidsmap.com/en/news/B67B5B29-EAFE-4563-A98E-539EA9086356.asp

Zambia’s Ministry of Health reported impressive results from its HIV treatment scale-up programme at the Thirteenth Conference on Retroviruses and Opportunistic Infections, held this week in Denver.

CROI: Valaciclovir reduces HIV genital shedding in HIV-positive women

http://www.aidsmap.com/en/news/4797D024-25FE-44A8-B225-5172D98DF4D2.asp

Treating herpes simplex virus-2 (HSV-2) with valaciclovir reduces genital shedding of HIV in women, according to the results of a proof-of-concept study presented to the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver on Monday. This is the first randomised controlled trial to demonstrate a causal relationship between HSV-2 and HIV replication.

CROI: 70% still on first regimen after three years in Khayelitsha, but lactic acidosis a major challenge

http://www.aidsmap.com/en/news/2AF3CBB2-4B24-407C-B905-6354C1E548B7.asp

Lactic acidosis is occurring at an unusually high frequency in South African women receiving d4T-based therapy and is the main reason for toxicity-related treatment switches, a South African research group reported on Monday at the Thirteenth Conference on Retroviruses and Opportunistic Infections, taking place this week in Denver.

CROI: Successful PREP trial in monkeys sparks call for more research

http://www.aidsmap.com/en/news/A9933662-4C06-4968-9146-082EAF42DE33.asp

A successful trial of ‘combination pre-exposure prophylaxis’ (PREP) in monkeys using tenofovir (Viread) and FTC (emtricitabine, Emtriva) has resulted in community advocates calling for more studies to see how the concept might be applied to humans.

CROI: Simplified treatment regimens show promise in HIV-infected children

http://www.aidsmap.com/en/news/87CA1C05-1D3F-4556-B2C4-B1866F4647DF.asp

Two studies presented this morning at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver have shown that simplified HIV drug regimens are safe and effective in HIV-infected children and adolescents.

Palliative care: a basic human right, id21 insights health #8

The global HIV pandemic has raised awareness of the need to provide care for those suffering from incurable diseases. Palliative care aims to maximise the quality of life and relieve the suffering of patients and their families.

The latest issue of 'id21 insights health' is edited by Richard Harding, King's College London, with contributions including: 

• Liliana De Lima, International Association for Hospice and Palliative Care, examines whether the WHO's palliative care strategy is working in Latin America.
• Liz Gwyther, Hospice Palliative Care Association of South Africa, calls for palliative care to be an integral part of every health care professional's role.
• Anne Merriman, Hospice Africa Uganda, on the success story that is Uganda's palliative car service and how it is a model for the rest of Africa.
• Olivia Dix, Diana Princess of Wales Memorial Fund, argues that donors must think and act strategically both together and with existing health systems to support palliative care.
• Suresh Kumar, Neighbourhood Network in Palliative Care (Kerala, India), highlights a remarkable experiment in Kerala where local communities have created the first large scale palliative care programme of its kind in a developing country.

Read the whole issue
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This issue of id21 insights health is free to read online athttp://www.id21.org/insights/insights-h08/index.html or as a PDF filehttp://www.id21.org/insights/insights-h08/pdf.html and in print. For print copies and a free subscription to future issues of 'id21 insights health', please email your full postal address to id21@ids.ac.uk quoting"id21 insights health #8" and stating how many copies you would like to receive (all id21 publications are free of charge). Back issues are also available – see http://www.id21.org/insights/index.html

More about id21
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Visit http://www.id21.org/ for over 2500 policy-relevant research highlights on development issues.

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New publication from the CORE Initiative, in partnership with the International HIV/AIDS Alliance

CBO/FBO Capacity Analysis: A Toolkit for Assessing and Building Capacities for High Quality Responses to HIV/AIDS

Download a PDF or order this publication at:

http://www.aidsalliance.org/sw31738.asp

This publication was developed by the CORE Initiative to enable community and faith based organisations to analyse levels of capacity in different areas of organisational and technical work. It is based on an existing toolkit for NGOs developed by the International HIV/AIDS Alliance (the NGO Capacity Analysis Toolkit) and on a design developed by Geoff Foster, of Family AIDS Caring Trust in Zimbabwe.  It was further developed with contributions from staff at ANCS in Senegal, the Alliance in the Caribbean, CARE Rwanda and Uganda, Thai National AIDS Foundation and various CORE Initiative and Alliance staff.  The toolkit was published in December 2005.

Who is this publication for?

This tool can be used with community organisations to identify capacity-building needs, plan any technical support needed by the organisation and monitor and evaluate the impact of capacity-building support.

How can you help more people get this publication?

Please help us to distribute this publication by passing on the information in this email through your e-mail group or similar forum, on your website, and/or by using the web link below.

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