Pitt breakthrough may improve HIV treatment

From the Triblive.com

A discovery about how HIV spreads through the human body could help doctors tame the virus in some infected patients, researchers say. Findings at the University of Pittsburgh Graduate School of Public Health show the disease moves slowly in people whose immune cells are low in cholesterol. That suggests HIV patients might live longer if researchers can regulate cholesterol metabolism in those cells, said lead author Giovanna Rappocciolo.

“We think it’s important because it’s a very new approach to the study of the HIV infection. I think it could be significant,” said Rappocciolo, an assistant professor in the Department of Infectious Diseases and Microbiology at Pitt. Her work with department Chairman Charles Rinaldo appears Tuesday in mBio, the journal of the American Society for Microbiology. Funded through the National Institutes of Health, their discovery caps several years of research focused on eight men in the Pittsburgh area.

The men are among 5 percent to 10 percent of the more than 1.1 million people in the United States living with HIV who can stay healthy for seven years — or longer — without conventional therapies, Rappocciolo said. Those patients had low cholesterol levels inside certain cells that spread HIV in the body, Rappocciolo and several Pitt colleagues found. Researchers relied on data assembled over 30 years through the Pitt Men’s Study, part of the NIH-supported Multicenter AIDS Cohort Study spanning four cities.

“Results like ours are the real payoff of the past three decades of meticulous data and specimen collection,” Rinaldo said in a statement. Rappocciolo said their department has received more than $70 million for research related to AIDS, the final stage of the HIV disease that severely inhibits the immune system. Rappocciolo stressed her findings do not mean that HIV patients with low-cholesterol diets are safeguarded.

Read more at triblive.com 

HIV infection increases risk of melanoma

From aidsmap.com

HIV infection is associated with an increased risk of melanoma, according to the results of a meta-analysis published in PLOS ONE. Overall, people living with HIV had a 26% increase in their relative risk of melanoma compared to the general population, the risk increasing by 50% for white-skinned people with HIV. The increased risk was statistically significant in white-skinned people diagnosed with HIV and of borderline statistical significance for all people diagnosed with HIV.

The authors recommend that fair-skinned people living with HIV should be regularly screened for suspicious skin lesions and should also be warned about the dangers of prolonged exposure to the sun.

Melanoma (skin cancer) diagnoses have increased markedly in the UK and many other countries in recent years. There is also evidence suggesting that people living with HIV have a higher risk of developing this skin cancer compared to individuals in the general population. Studies conducted before effective antiretroviral therapy became available in the mid-1990s showed that having HIV increased the relative risk of melanoma by approximately a quarter.

However, it is uncertain whether people living with HIV continue to have an increased risk of melanoma in the era of effective antiretroviral treatment. A team of Australian and UK investigators therefore conducted a systematic review and meta-analysis, looking at the association between HIV and the relative risk of melanoma in the periods before and after potent HIV therapy became available. The investigators’ analysis included cohort studies involving adult patients.

A total of 21 studies met their inclusion criteria. These were conducted between 1999 and 2013. Most (twelve) were conducted in the United States, eight in Europe and one in Australia. Most of the studies reported on cohorts of patients with HIV and those diagnosed with AIDS, but six studies defined their study population as patients with AIDS. The majority of studies (16) were population based, most of the patients being men (76-92%). One study included only men who have sex with men; one study included women only; a single study was restricted to veterans and two studies reported on single-clinic patient cohorts.

Continue reading on aidsmap.com.

Marking a scientific milestone

research pageFrom the Huffington Post
by John-Manuel Andriote
Journalist and author, ‘Victory Deferred: How AIDS Changed Gay Life in America’

Thirty years ago, in an April 23, 1984 press conference in Washington, D.C., the world learned that American microbiologist Robert C. Gallo and his colleagues at the National Cancer Institute had proved that a retrovirus first seen by their counterparts at Institut Pasteur in Paris was the cause of AIDS.

Secretary of Health and Human Services Margaret Heckler also announced that day that the Gallo team had created a blood test to detect antibodies produced by the body to fight infection. With it we finally had the ability to know who was infected, to screen donated blood and to track the spread of the virus.

By the time of the announcement, 4,177 AIDS cases had been reported in the United States across 45 states. New York City alone accounted for more than 1,600 cases. San Francisco, far smaller than the nation’s largest city and the East Coast’s biggest gay mecca, had more than 500 cases. The majority of these cases were among gay men of all skin tones.

Although the HIV test was originally intended to screen the blood supply, it became available to the public in early 1985. After early uncertainty about what, exactly, a positive test meant, it became clear it meant that a microbial time-bomb was ticking inside you, set to explode at some unpredictable time in a nightmare that would eventually lead to your death from the cancers, dementia, brain infections and other horrors that attack a body when HIV has destroyed the immune system.

Continue reading on the Huffington Post.

Combating HIV by zip code

Minority neighborhoods in the U.S. are hit as hard by HIV as gay enclaves

From Healthline.com

HIV rates in some urban American neighborhoods rival those of Haiti and Ethiopia, according to a researcher at Brown University in Providence, R.I.

And while affected communities include big-city gay enclaves, such as New York’s Chelsea district, minority neighborhoods in the Bronx and Harlem make the list, too. The difference is that those in mostly white neighborhoods are more likely to be tested and treated than those in minority neighborhoods.They are also less likely to die of AIDS.

In an era of Internet targeting, Dr. Amy Nunn’s approach of going door-to-door if necessary to reach people with HIV may seem old-fashioned. But in areas with limited access to health care, employment, and education, HIV experts agree that a new model is needed to reach at-risk groups of black and Hispanic Americans.

Of the 50,000 new HIV infections in the U.S. in 2010, gay and bisexual men accounted for two-thirds of them, according to the U.S. Centers for Disease Control and Prevention (CDC). Black men and women are eight times more likely to become infected than whites, based on population size. Of all groups, white men who had sex with men comprised the largest segment of new infections, at 11,200. Black men who had sex with men were second, with 10,600 new infections.

Dr. Nunn, an assistant professor of medicine at Brown, told Healthline that more money must be targeted toward poor and minority neighborhoods. “If this were happening to white people there would be protests,” she said. “It’s so easy to overlook poor people.”

Of the more than 1.1 million people in the U.S. living with HIV, almost 16 percent don’t know they have it, according to the CDC. Powerful antiretroviral medications available to most everyone in the U.S. can suppress viral loads to the point that transmission is unlikely. But they will only work if they are taken regularly.

“We’ve got to get these people into treatment come hell or high water,” Nunn said.

Continue reading on Healthline.com.

Weekly clinic geared toward LGBTQ clients in Pittsburgh

research pageFrom The Pittsburgh Post Gazette… 

The first weekly Community Clinic for lesbian, gay and transgender people will be held Thursday in downtown Pittsburgh. The clinic, with physician Stacy Lane, is the only one targeting LGBTQIA individuals with no age limits or income requirements. It will be held on the eighth floor at 810 Penn Ave. from 2 to 5:30 p.m. During the clinic hours, the Garden of Peace Project will supply testing for sexually transmitted diseases and Project Silk will provide HIV testing.

Charmaine Turner, founder and director of Step Up 2 Step Out, will host a hip-hop dance class at 4 p.m. The Garden of Peace Project and Project Silk, which are the hosts, invite other providers to host their own dance classes or other health-related group activities such as yoga, meditation and self-esteem workshops.

STD prevention is a part of HIV prevention: STD Awareness Month 

A message from Gail Bolan, M.D., Director, Division of STD Prevention, Centers for Disease Control and Prevention (from AIDS.gov)

Gail Bolan, M.D., Director, Division of STD Prevention, Centers for Disease Control and Prevention

Gail Bolan, M.D., Director, Division of STD Prevention, Centers for Disease Control and Prevention

April marks the annual observance of STD Awareness Month. And for this month, I’d like to focus on the link between STD prevention and HIV prevention.

The Centers for Disease Control and Prevention (CDC) has been invested in exploring the intersection of HIV and other STDs. Every year, 20 million new STDs occur including 50,000 new HIV infections. We know that people who have STDs such as gonorrhea, herpes, and syphilis are more likely to get HIV compared to people who do not. In fact, being infected with genital herpes makes you 3 times more likely to get infected with HIV, if exposed. And data collected from several major U.S. cities indicate that nearly 45% of gay and bisexual men with syphilis are also infected with HIV.

So this STD Awareness Month, I encourage the public, health care providers, and community-based organizations to bring a renewed sense of enthusiasm and focus to their STD awareness and prevention efforts. Individuals should know that the same behaviors that put you at risk for acquiring STDs can put you at risk for getting HIV. Physicians should follow recommended screening and treatment guidelines. And community-based organizations should support local STD and HIV prevention efforts.

The link between STDs and HIV is real. By educating yourself on ways to lower your risk, you can take action to protect your health. Not having sex is the most effective way to prevent STDs and HIV, but if you are sexually active, you can lower your risk of STDs and HIV by

  • Choosing one partner and agreeing to be sexually active only with each other. It is still important that you and your partner get tested for STDs and HIV and share your test results with one another.
  • Limiting the number of people you have sex with if you have more than one partner.
  • Using latex condoms or dental dams the right way every time you have sex.

STD and HIV testing is a critical part of preventing the spread of disease. I am urging providers to educate patients on their risk for STDs and HIV, and make taking a sexual history a priority. The behaviors and circumstances that put people at risk for STDs also put them at risk for HIV; take the opportunity to offer HIV testing to all patients who are tested for an STD. With 20% of new HIV cases being detected in STD clinics, it’s clear that a continued merging of STD and HIV prevention efforts is needed. As well, patients diagnosed with HIV at STD clinics have been found to have less-advanced disease.

You can go to the CDC Website to find out more about STD Awareness Month.