HIV patients may risk Alzheimer’s
Last Updated: 2004-07-22
PHILADELPHIA (Reuters) – Patients infected with HIV may have a higher risk of Alzheimer’s disease, researchers said on Thursday.
Dr. Cristian Achim of the University of Pittsburgh and colleagues examined the brains of about 160 people infected with HIV and found that two-thirds contained deposits of beta-amyloid protein similar to those seen in Alzheimer’s patients. All the patients had been taking highly active anti-retroviral therapy.
Achim told a news conference his team found "abundant deposits" of the protein in the brains they examined. It was not clear whether the disease or the medications were the cause, he told attendees at the 9th International Conference on Alzheimer’s Disease and Related Disorders.
Achim said the findings would now be tested using brain imaging techniques that can detect the accumulation of beta-amyloid. Alzheimer’s researchers are experimenting with techniques such as positron emission tomography or PET to see if it can help them diagnose Alzheimer’s before symptoms develop.
AIDS mortality higher in women with depression
Source : Am J Public Health 2004;94:1133-1140
Last Updated: 2004-07-21
NEW YORK (Reuters Health) – In HIV-positive women, chronic depressive symptoms appear to increase the risk of AIDS-related death, researchers report in the July issue of the American Journal of Public Health.
Dr. Judith A. Cook of the University of Illinois at Chicago and colleagues note that previous studies have shown an association between depression and immune system suppression and other negative health outcomes. However, the relationship between depression and HIV disease progression is not well understood.
To investigate further, the researchers examined data on 1716 HIV seropositive women who, over a 7.5 year period, paid semi-annual visits to clinics at one of 6 sites.
In all, 147 (9%) died from AIDS-related causes over the course of the study. Other causes, including accidents and non-HIV-related diseases accounted for the deaths of another 147 women.
Women who had chronic depressive symptoms were more than twice as likely to die of AIDS-related causes than were women who had few or no such symptoms. These findings are line with those of another large multi-center study.
Moreover, AIDS mortality was less likely in women who reported mental health service use. Among other factors that reduced mortality were being on a HAART regimen or on non-HAART combination therapy.
Thus, Dr. Cook told Reuters Health, "we now have substantial evidence from two large, multi-site cohorts of HIV-positive women that depression treatment must be part of the best-practice standard of care for women with HIV."
"Antiretroviral treatment alone," she added, "will not address the needs of a significant number of women with HIV." Such therapy, the researchers conclude, "must be augmented by appropriate and sensitive mental health treatment, particularly as HIV disease progresses."
Low-cost alternative for CD4 cell counts found effective
Source : J Acquir Immune Defic Syndr 2004; 36:1006-1010
Last Updated: 2004-07-20
NEW YORK (Reuters Health) – Coulter cytosphere assay is an inexpensive alternative to flow cytometry for measuring CD4 cell counts, a multinational team of researchers from India report.
The need for a "simple reliable and cost-effective immunologic marker" for CD4 assay prompted Dr Pachamuthu Balakrishnan from YRG Care Centre for AIDS Research and Education, Chennai, India, and colleagues to evaluate a manual method commonly used for measuring blood cell counts.
CD4 lymphocyte counts of 122 HIV-positive patients in various disease stages were evaluated using the conventional flow cytometry and the low-cost cytosphere assay using a commercial Coulter manual CD4 kit. In the low-cost method, the blood sample was mixed with monocyte-blocking and CD4-cytosphere reagents and CD4 count carried out manually using a Coulter hemocytometer.
Overall, there was a close correlation of 0.97 between the CD4 counts using flow cytometry and those using the Coulter cytosphere assay, Dr. Balakrishnan and colleagues report in the August issue of Journal of Acquired immune Deficiency Syndromes.
The correlation was most accurate for CD4 counts less than 200 per microliter, with the sensitivity, specificity, positive and negative predictive values being 94.9%, 96.4%, 92.5% and 97.6% respectively. The mean difference in the CD4 cell count between the two methods was only 10 cells per microliter, the researchers note.
Coulter cytosphere assay is cost-effective, requiring only an initial investment of $500 for the microscope and $10 per test as compared to an initial cost of $40,000 and $1000 annual cost for flow cytometry, Dr. Balakrishnan’s team writes.
"The inter- and intrapersonal variability was within acceptable limits and the reproducibility is excellent," Dr. P Balakrishnan told Reuters Health.
As the only requirements are a microscope and a week’s training, the cytosphere assay can be carried out even in primary care settings, he said.
"Hence, the cytosphere assay can be used as an alternate to flow cytometry for estimation of CD4 T-lymphocyte counts, especially in resource-poor settings of developing countries," Dr. Balakrishnan and colleagues conclude.
Source : J Acquir Immune Defic Syndr 2004; 36:1006-1010
Denmark gives $93.8 mln for Tanzanian health sector
Last Updated: 2004-07-20
DAR ES SALAAM (Reuters) – The Tanzanian government on Tuesday received 560 million Danish crowns ($93.8 million) from Denmark to improve the distribution of medicines and to train health workers for the next five years.
Although none of the money will be used in the purchase of drugs, some of it will be used in the distribution of antiretroviral drugs, or medicines used to inhibit the progress of HIV in the body.
The Danish government through its development agency Danida has contributed a total (840 million Kroners) $140 million to the Tanzanian Health Sector Programme Support (HSPS) in the past eight years.
"HSPS does not exclusively earmark funding for (the fight against HIV/AIDS), but will contribute by strengthening key systems necessary for its success, for example, drug delivery, hospital management and quality of district services," health ministry official Mariam Mwaffisi told a news conference.
The government plans to have about 30,000 people on antiretroviral therapy from July this year.
U.S. gives Cambodia $31m for health care, schools
Last Updated: 2004-08-03
PHNOM PENH (Reuters) – The United States pledged $31.5 million to Cambodia on Tuesday to help rebuild the impoverished southeast Asian nation’s health care and education systems after decades of war and unrest.
The vast majority of the grant aid will go to fighting diseases such as HIV/AIDS, officials said, and promoting maternal and child health.
Cambodia has the highest HIV infection rate in Asia, with an estimated 2.6 percent of the population, or 157,000 people, infected. According to the United Nations, it also has among the highest rates for infant mortality in the region.
The remaining $2 million is to be spent on teacher training programmes to try to bolster an education system undermined by poorly paid teachers, endemic corruption and lack of adequate books and resources.
Even though the curtain came down on Cambodia’s civil war in 1998, the legacy of decades of fighting and the Khmer Rouge genocide continues to hamper the country’s development. Nearly two-thirds of government revenue is foreign aid.
Japan has historically been the country’s biggest donor.
U.S. approves Glaxo, Gilead AIDS drug combinations
Last Updated: 2004-08-02
WASHINGTON (Reuters) – The U.S. Food and Drug Administration on Monday said it has approved two once-daily antiretroviral drug combinations made by Glaxosmithkline Plc and by Gilead Sciences Inc. for use in the United States and in developing countries.
Truvada, the Gilead drug, contains emtricitabine and tenofovir.
EPZICOM, the Glaxo drug, contains lamivudine and abacavir.
The fixed-dose combinations are designed to simplify treatment regimens.
Proponents of aggressively treating AIDS around the world consider the combinations vital to fighting the disease in Africa and the Caribbean.
The Bush administration had resisted spending U.S. money on HIV-fighting drug combinations, arguing they had not been proven safe and effective.
Under pressure from AIDS activists and some lawmakers, health officials set up an approval process to certify that the combination drugs met U.S. standards.
HIV, which causes AIDS, has infected 43 million people worldwide and has killed more than 25 million. There is no cure, but combination drug treatments can control the virus and keep patients relatively healthy.