Brazil Hands out Nearly Half Billion Condoms

Brazil's government says it handed out nearly a half-billion free condoms last year — a record for the nation's campaign to reduce AIDS and other sexually transmitted diseases.
    Brazil's Health Ministry says it distributed 493 million condoms last year. That's 2 1/2 condoms for every person in Latin America's largest nation. They cost the government about $19 million. The ministry says the Brazilian government buys and distributes more condoms than any other nation. About 90 percent of all condoms used in Brazil are provided by the government.The federal government distributes the condoms, with some going to states and municipalities to be handed out in various programs including in Brazil's schools.

 

via @abcnews.com

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December 2011- Health Observations and Events

December 2011 Health Current Events - Weeks

Event	Date	Nation	Organisation
THIS WEEKNational Aplastic Anemia and MDS Awareness Week	1st Dec - 7th Dec	United States	AA & MDSIF

National Hand Washing Awareness Week                                                4th Dec−10th Dec

December 2011 Health Events - Days

Event	Date	Nation	Organization
World Aids Day	1st Dec	Worldwide	World Aids Day
International Day Of Disabled Persons	3rd Dec	Worldwide	United Nations

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Starting HIV Drugs Earlier May Delay AIDS But Not Death

New research suggests that HIV-infected patients are most likely to stay clear of AIDS longer if they start drug therapy when their immune systems are still relatively strong. However, starting treatment earlier, compared to waiting, didn't affect dying from AIDS. "There wasn't a clear benefit in terms of preventing death" by prescribing the drugs before some guidelines suggest, said Dr. Keith Henry, director of HIV clinical research at Hennepin County Medical Center in Minneapolis and co-author of a commentary accompanying the study, published in the April 19 edition of Annals of Internal Medicine.

The issue of when to begin drug treatment is a hot topic in the field of AIDS/HIV medicine. If physicians wait to begin treatment, patients can delay the expense not to mention the side effects of pricey anti-HIV drugs. But such delays may also give the virus a chance to become more powerful and better able to fend off medications. If they're not treated with drugs, HIV-infected people almost always go on to develop AIDS. So when should doctors turn to the drugs? In the U.S., guidelines suggest that HIV-infected patients take them when the level of CD4 cells an important part of the immune system dips below 0.500 X 109 cells per liter (cells/L).

In Europe, the guideline number is frequently lower meaning a weaker immune system at under 0.350 X 109 cells/L.In the new study, researchers examined how patients did when they began drug therapy with their CD4 cells at a variety of levels. The study authors examined the medical records of almost 21,000 HIV-infected patients who sought treatment in HIV clinics in Europe and through the Veterans Health Administration system in the United States. The researchers found that the death rate was about the same regardless of whether patients began treatment when their CD4 levels dipped under 0.500 X 109 cells/L or if they waited until their immune systems deteriorated more and reached below the level of 0.350 X 109 cells/L.

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Gene Therapy Against HIV Not a Proven Cure

Experts are reacting with cautious optimism to the announcement Monday that researchers reconfigured immune cells so that they became resistant to HIV in six patients infected with the virus. But they say the jury is out on whether the technique might ever spell an end to AIDS. The goal is ultimately a cure or what's called a "functional cure" having the body permanently keep HIV at bay but "we're not there yet," stressed Dr. Michael Kolber, professor of medicine and director of the Comprehensive AIDS Program at the University of Miami Miller School of Medicine.

The trial, reported Feb. 28 at a meeting of HIV specialists in Boston, "was a proof-of-principle that they could go in and do this. They demonstrated that the cells stayed in the patients, but the patients were not cured," said Kolber, who was not involved in the new research. Another expert agreed that the treatment's true potential remains uncertain. "If successful, this probably could have wide application, but going from six patients to an entire epidemic is a ways to go," said Dr. Michael Horberg, director of HIV/AIDS at Kaiser Permanente Health Plan and vice chair of the HIV Medicine Association.

"With other successes we've already had, that makes it more promising and people are starting to have a greater vision as to what's possible." However, as Kolber pointed out, this trial was what's known as a phase I trial, which means it was primarily looking at safety, not effectiveness, although investigators do often report on initial effectiveness results at this stage. The idea came from an isolated case that first made headlines in 2009, involving the so-called "Berlin patient." This man, an American AIDS patient living in Germany, was apparently cured after receiving blood cells from a donor who happened to have a rare, natural immunity to HIV.

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the "Berlin Patient " - German Doctors believe the man have been cured of HIV Infection as a Result of the Treatment with Stem Cell Transplant

The 'Berlin patient' is an HIV-positive man who developed acute myeloid leukaemia, received successful treatment and subsequently experienced a relapse in 2007 that required a transplant of stem cells.

• While the highly lethal technique used on the man known as the "Berlin Patient" would not work for most of the 33 million people with HIV worldwide, scientists say the research shows important progress toward a universal cure.

"Our results strongly suggest that cure of HIV has been achieved in this patient," said the study in the peer-reviewed journal Blood, a publication of the American Society of Hematology.

Before the stem cell transplant the patient received chemotherapy treatment that destroyed most immune cells and total body irradiation, and also received immunosuppressive drugs to prevent rejection of the stem cells.
Antiretroviral therapy was halted on the day of the transplant, and the patient had to receive a second stem cell transplant 13 days after the first one, due to a further relapse of leukaemia.

The patient continued to receive immunosuppressive treatment to prevent rejection for 38 months, and at 5, 24 and 29 months post-transplant colon biopsies were taken to investigate possible graft-versus-host disease in the intestine. At each investigation additional samples were taken to check for signs of HIV infection in the abundant immune cells of the gut wall.

One of the challenges for any approach to curing HIV infection is long-lived immune system cells, which need to be cleared before a patient can be cured. In the case of the Berlin patient CCR5-bearing macrophages could not be detected after 38 months, suggesting that chemotherapy had destroyed these longer-lived cells, and that they had also been replaced by donor cells.

The German researchers and San Francisco-based immunologist Professor Jay Levy believe that the findings point to the importance of suppressing the production of CCR5-bearing cells, either through transplants or gene therapy.

The patient did not resume antiretroviral therapy after the transplant.
Nevertheless HIV remained undetectable by both viral load testing (RNA) and tests for viral DNA within cells, and HIV antibody levels declined to the point that the patient has no antibody reactivity to HIV core antibodies, and only very low levels of antibodies to the HIV envelope proteins.
Seventeen months after the transplant the patient developed a neurological condition, which required a brain biopsy and lumbar puncture to sample the cerebrospinal fluid for diagnostic purposes. HIV was also undetectable in the brain and the CSF.
An additional indication that HIV is not present lies in the fact that the patient’s CD4 cells are vulnerable to infection with virus that targets the CXCR4 receptor. If any virus with this preference was still present, the researchers argue, it would be able to swiftly infect the large population of memory CD4 cells that has emerged.

The `Berlin patient`, Timothy Ray Brown, a US citizen who lives in Berlin, was interviewed this week by German news magazine Stern.
His course of treatment for leukaemia was gruelling and lengthy. Brown suffered two relapses and underwent two stem cell transplants, as well as a serious neurological disorder that flared up when he seemed to be on the road to recovery.

HIV virus on microscope

The neurological problem led to temporary blindness and memory problems. Brown is still undergoing physiotherapy to help restore his coordination and gait, as well as speech therapy.
Friends have noticed a personality change too: he is much more blunt, possibly a disinhibition that is related to the neurological problems.
On being asked if it would have been better to live with HIV than to have beaten it in this way he says “Perhaps. Perhaps it would have been better, but I don’t ask those sorts of questions anymore.”
Timothy Brown is now considering a move from Berlin to Barcelona or San Francisco, and, reports Stern magazine, enjoying a drink and a cigarette.
Stern also interviewed Dr Gero Hütter, who was in charge of Timothy Brown’s treatment. Dr Hütter told Stern that as a scientist he was “in the right place, at the right time” and that “for me it is important to have overthrown the dogma that HIV can never be cured. Something like this is the greatest thing one can achieve in medical research”.

http://aidsmap.com/page/1577949/http://bloodjournal.hematologylibrary.org/cgi/content/short/blood-2010-09-309591v1
http://www.nytimes.com/1998/06/21/magazine/the-berlin-patient.html
http://www.webmd.com/hiv-aids/news/20101215/hiv-aids-cure-faq

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