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CONVEGNO: “Curare l’AIDS in Africa – Il contributo di Pisa a DREAM”


PISA – 28 GIUGNO 2004


"Curare l’AIDS in Africa – Il contributo di Pisa a DREAM"

Il 28 giugno alle ore 16,30 l’Università di Pisa e l’Azienda Ospedaliera Pisana organizzano un convegno dal titolo: "Curare l’AIDS in Africa – Il contributo di Pisa a DREAM".

Il convegno è l’occasione per dare avvio al programma dell’Università e dell’Ospedale di Pisa di sostegno a DREAM in Africa, che prevede l’invio di studenti e specializzandi della Facoltà di Medicina di Pisa nelle zone dove si realizza DREAM, la formazione di personale sanitario africano sia in Africa che a Pisa, cure specialistiche in Italia per i malati che ne avessero bisogno.

Al convegno partecipano il rettore dell’Università, il Direttore Generale dell’Azienda Ospedaliera Pisana, il Sindaco, le organizzazioni di volontariato presenti nel territorio.

Per la Comunità di Sant’Egidio sono presenti don Matteo Zuppi e il prof. Leonardo Palombi.


An assay based on detection of HIV antigen p24 may be more sensitive than existing tests, U.S. researchers said on Monday.

New HIV assay sensitive to 2 copies/mL

WASHINGTON (Reuters) – An assay based on detection of HIV antigen p24 may be more sensitive than existing tests, U.S. researchers said on Monday.


The test may be useful for screening donated blood and monitoring patients, the developers at the University of Maryland’s Institute of Human Virology said.

They said it is 25 times more sensitive than the best technology currently available. "This new ultra-sensitive testing method, known as Real-Time Immuno-PCR, will allow us to detect HIV earlier and at much lower levels," said Dr. Niel Constantine, who helped develop the test.

Writing in the July issue of the American Journal of Clinical Pathology, Dr. Constantine’s team said the new test detects the viral protein p24, rather than antibodies or viral nucleic acids.

"Each virus particle contains about 3,000 molecules of p24 as compared with only two copies of nucleic acid, so there’s a greater amount of target to detect," Dr. Constantine said.

"It’s an advance over current methods in that we can detect down to the equivalent of two copies of RNA as compared with current methods which have been validated to only 50 copies," his colleague, Janet Barletta, added in a statement.

"We have submitted a patent for this test for the prion protein," Dr. Constantine added in a telephone interview. He believes it could be used to screen blood for Creutzfeldt Jakob disease or HIV.

"If you could save 4 to 5 infected units a year, it would be important to do that," Dr. Constantine said. "You could further protect the blood supply."

It should also be useful for monitoring a patient’s response to HIV treatment.

The research team is also developing a low-cost, battery-operated version of the test that could be used in developing countries.


Bush to add Vietnam to global AIDS initiative

Bush to add Vietnam to global AIDS initiative

WASHINGTON 2004-06-23  (Reuters) – President George W. Bush will include Vietnam in his $15 billion plan to combat global AIDS, passing over harder hit India and China in expanding the initiative to Asia, U.S. officials said.


In a speech on HIV/AIDS on Wednesday, Bush will designate Vietnam 1 of 15 "focus countries" eligible to share in the $15 billion, only a fraction of which has actually been disbursed so far.

"The president will announce tomorrow that the 15th country will be Vietnam," a senior U.S. official said.

Once designated, the United States can sharply increase funding to nongovernmental organizations that provide AIDS services in Vietnam.

Bush will also free up $500 million in funds already appropriated to provide more immediate relief to combat AIDS.

The choice of Vietnam is controversial. The 14 other focus countries are in Africa and the Caribbean, and some activists want to keep the resources for countries most in need.

Officials said they chose Vietnam because they believe they could have a bigger impact there than in China or India, where the disease has spread more broadly to the general population.

"We need to address some of these brush-fire countries before they get out of control," one congressional aide said of the rationale for adding Vietnam to the list.

Some religious conservatives, an important political base for the Republican president, may object to aiding a former foe that is Communist run. The State Department has criticized Vietnam for the arbitrary imprisonment of people for peaceful expression of religious and political views.

In his 2003 State of the Union address, Bush pledged $15 billion to help combat HIV/AIDS, effectively tripling U.S. spending over 5 years, but some AIDS activists have accused him of not living up to his commitment.

Congress approved $2.4 billion for this year and is expected to provide about $2.8 billion in fiscal 2005. AIDS groups lobbied for $3 billion a year.

These groups welcomed the program’s expansion to Asia, but complained that Bush’s proposed budget would cut assistance by almost two thirds to the U.N.-backed Global Fund to Fight AIDS, tuberculosis and malaria, threatening its operations in Africa.

"The original vision of the Fund is being completely undermined by the Bush administration," said David Bryden, spokesman for the Global AIDS Alliance.

White House officials denied that Bush was backing away from his commitment to support the fund.

Last month, the Bush administration opened a new front in the battle to get cheap AIDS drugs to the poorest countries that need them, saying it will consider approving and providing cheap, multiple-dose generics. AIDS groups have accused the government of catering to big pharmaceutical companies that make the brand-name drugs under lucrative patents.

Vietnam has about 130,000 people living with AIDS, the U.S. official said. The government has d


Low CD4 count should not preclude HAART

Low CD4 count should not preclude HAART
Source : J Acquir Immune Defic Syndr 2004;36:702-713

NEW YORK (Reuters Health) – A long-term analysis of the evolution of CD4+ T cell counts in HIV patients on highly active antiretroviral therapy (HAART) suggests immune recovery is possible even in patients with low baseline CD4 levels.


In the June 1st issue of the Journal of the Acquired Immunodeficiency Syndrome, Dr. Felipe Garcia and colleagues at the University of Barcelona in Spain report on the influence of baseline CD4+ T cell count, viral load, and age on immunologic outcome in 861 naïve patients with HIV infection treated with at least three highly active antiretroviral drugs.

The investigators classified patients into quartiles according to baseline CD4+ T cell count. For each patient, they analyzed baseline and "last" CD4+ T cell count, using a linear regression model to account for the fact that individual patients had varying intervals between their first and last measurements.

After a median follow-up of 173 weeks, the relative risk of having a last determination of CD4+ T counts less than 200 cells per microliter was 1.0 for patients counts of 350-499 cells per microliter, 0.92 for patients with 200-349 cells per microliter, and 0.79 for patients with less than 200 cells per microliter at baseline.

On the other hand, the relative risks of having a CD4+ T cell count above 500 cells per microliter at the final determination were 0.32, 0.69, and 0.94, respectively, for patients with baseline counts of less than 200, 200-349, and 350-499 cells per microliter.

"The increase in CD4+ T cells from baseline…was maintained for up to 4years of follow-up," the authors said. "This increase seemed to slow down after approximately 3 years [and] plateau after 4-5 years…even in patients who achieved and maintained viral suppression."

The investigators found no significant differences among the three higher baseline-count groups in the proportion of patients who progressed to AIDS or died. Similarly, baseline age above or below 40 years had no significant effect on progression to AIDS or death.

The authors note that CD4+ T cell counts in their patients never returned to normal. Still, they conclude their findings suggest there is no "point of no return" in CD4+ T cell counts, beneath which HAART should not be initiated.

"Long-term immune recovery is possible regardless of baseline CD4+ T cell count," the researchers conclude. "However, patients who start therapy with a CD4+ T cell count below 200 cells per microliter have poorer immunologic outcome[s]."



OraSure gets HIV-2 test approval in US

OraSure gets HIV-2 test approval in US

CHICAGO (Reuters) – U.S. regulators approved OraSure Technologies Inc.’s saliva test for detecting HIV-2, the company said on Wednesday.


OraSure had received approval in March for a saliva test of HIV-1 that gives quick results. With the latest U.S. Food and Drug Administration approval, OraSure said it plans to market a combined test for use in physicians’ offices and public health clinics as a rapid means of detecting HIV-1 and HIV-2.

Wade King, an analyst with Wells Fargo, noted that the test, which works within 20 minutes and produces results the same day, cuts out laboratory fees, which usually make up about one third of the total cost of testing for the virus.


Southern Africa seen in “death spiral” on AIDS, food shortages

Southern Africa seen in "death spiral" on AIDS, food shortages

JOHANNESBURG (Reuters) – Southern Africa is in a death spiral as AIDS exacerbates food shortages and government and social networks teeter close to collapse, the head of the U.N. World Food Programme (WFP) said on Tuesday.


"If a 747 aircraft crashed every hour, there’d be an international outcry. That’s the death toll we’re facing but there is inadequate collective outrage," WFP Executive Director James Morris said at the end of a tour in the region, the worst hit worldwide by the global AIDS epidemic.

"The end result is that people are dying on a horrific scale and its victims are not getting the help they need."

Morris, U.N. Secretary General Kofi Annan’s special envoy for Humanitarian Needs in Southern Africa, said there were some signs of progress in food production, with Zambia enjoying a surplus and governments implementing emergency programmes.

But he said he was concerned about politically troubled Zimbabwe, which announced in May it no longer needed emergency food aid amid surprise projections of a bumper maize harvest of 2.3 million tonnes – despite earlier international estimates of a shortfall of up to 900,000 tonnes.

"We will do our best to be prepared in the event that their expectations don’t materialise. We hope they do," he said.

Southern Africa has the world’s highest rates of infection of HIV, the virus that causes AIDS, with an average of one quarter of adults in the region infected.

In tiny Swaziland, a startling 38 percent of adults are believed to be HIV positive, while South Africa alone has more than five million people infected.

"What is happening in Southern Africa absolutely represents the most serious humanitarian crisis in the world today," Morris said.


Morris said "help is on the way" for the region’s food crisis – which at its height in mid-2002 saw an estimated 14 million people in need of help – but that the crisis was becoming chronic as countries struggle to implement programmes and produce food with a weakened infrastructure.

Overall, he said there was good progress in food production despite total crop forecasts slightly below last year’s levels.

Zambia, thanks to good weather and programmes to deliver seeds, tools and fertiliser to farmers, was the best performer. The WFP had bought a total of some 160,000 tonnes of food over the last two years from Zambia, which in 2002 saw as many as three million people needing food aid, Morris said.

Zimbabwe, where President Robert Mugabe’s government is accused of political repression and economic mismanagement, remains a question mark. The WFP helped to feed some 6.5 million Zimbabweans in 2003, but has seen that number drop to just 640,000 this month as the government withdraws cooperation.

Zimbabwe effectively blocked the WFP from finishing a crop assessment there this year, and has since publicly charged the world food