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[HATIP #22], 23 January 2004
A regular electronic newsletter for health care workers and community-based organisations on HIV treatment in resource-limited settings. It is supported by and produced in collaboration with St Stephen's AIDS Trust and the International HIV/AIDS Alliance.

Its publication is also supported by Positive Action of GlaxoSmithKline, Boehringer Ingelheim and the Access 4 Trust.
   Last updated: 19.10.05
 
A selection of news stories which have appeared since January 1 2004.


Poor drug supply causing treatment problems in South Africa, Nigeria


  • Problems with drug supply of antiretrovirals have come to the surface in both Nigeria and South Africa in the past few weeks as the realities of implementing large-scale treatment access begin to hit home.



Russian health policies and inaction risk 'super-resistant' TB warn MSF

  • Inaction by Russian health authorities could mean that super-resistant strains of tuberculosis (TB) emerge in the country, according to a letter from Medecins sans Frontieres (MSF) published in the January 17th edition of The Lancet.



Value of life-long HAART questioned by study showing that benefits level off after 3 years

  • Taking HAART for over three years doesn’t lead to any additional suppression of HIV or significant gain in CD4 cells according to French research published in the January 2nd edition of the journal AIDS. On the basis of these findings the investigators question the benefits of very long-term use of HAART.


Zambian study shows that dried blood spots can be used to monitor viral load

  • Collection of blood for monitoring of HIV viral load may be achievable using dried blood spots without sacrificing accuracy of measurement, according to a study published in the December 23rd 2003 issue of The Lancet.


HAART reduces HIV infectivity by over 60%, but increase in unsafe sex means stable HIV incidence

  • HAART has reduced the ability of HIV-positive gay men to transmit the virus by 60%, according to a study conducted by the University of California, San Francisco, published in the January 2nd edition of AIDS. However, this has been offset by an increase in the risk behaviour gay men meaning that the number of new infections has remained roughly stable.



Blood concentrations of indinavir too low when dosed with rifampicin even if ritonavir boosted

  • Concentrations of the protease inhibitor indinavir are reduced by over 80% if the first-line anti-TB drug rifampicin is being taken at the same time, even when indinavir is boosted by the addition of a small dose of ritonavir, according to a small Danish study published in the February 1st edition of Clinical Infectious Diseases, which is now available online.



TB management in refugees and prisoners: Botswana's experience

  • Two studies presented at the 1st National HIV and AIDS Conference (NHASORC) last month in Gaborone, Botswana suggest the TB epidemic there could be even worse among two "congregated" populations: refugees and prisoners. In fact, one of the studies reported a two-month incidence of TB in prisoners in Botswana that was 18 times higher and a rate in prison guards that was 7 times higher than that of the general population.



TB diagnostics perform poorly in Botswana study

  • Lab tests that detect antibodies to TB in blood serum do not perform well in Botswana according to a study presented at the 1st National HIV and AIDS (NHASORC) last month in Gaborone. The study looked at several different types of antibody tests and found each lacking.


Clinton Foundation secures cut price CD4 and viral load tests for resource limited countries

  • The Clinton Foundation has secured a deal with five manufacturers of CD4 and viral load tests, which will cut the price for test kits, testing machines, staff training and machine maintenance for resource limited countries, according to a report in the January 14th edition of the Wall Street Journal.



Multi-drug resistant TB: breakdown in counselling often to blame"

  • Although the incidence is still fairly low, there is an increasing rate of resistance to TB drugs in patients in Botswana, and much of this may be the result of premature treatment discontinuation due to inadequate counselling and a widespread belief in Botswana that TB is not fatal, according to two studies presented at the 1st National HIV and AIDS (NHASORC) last month in Gaborone, Botswana.



Review of experience in delivering ARVs in resource-limited settings now available

  • The World Health Organisation has published a detailed review of experience in delivering antiretroviral therapy in resource-limited settings. The guide, produced by the UK Department for International Development Health Systems Resource Centre, aims to increase understanding of the requirements for scaling up therapy.



Travel away from home linked with risky sex and HIV amongst men in Cameroon

  • Investigators in the Cameroon have found an association between overnight travel from home and being HIV-positive. The study, published in the January 1st edition of the Journal of Acquired Immune Deficiency Syndromes, also found that geographic mobility in men was associated with a higher number of one-off sexual encounters and a greater number of sexual partners. However, investigators failed to find as distinct an association between travel and HIV-status in women. The study confirms that the link between mobility and HIV infection is not confined to rural populations, and that it is a critical feature of urban HIV epidemics too.



Injecting drug users more likely to progress to AIDS even if taking HAART

  • HIV-positive injecting drug users are significantly more likely to develop an AIDS defining illness, even when they are taking HAART, than HAART-treated HIV-positive individuals who do not inject drugs, according to research conducted at Johns Hopkins University and published in the January 1st edition of the Journal of Acquired Immune Deficiency Syndromes.




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