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Shortfalls in laboratory services may limit attainment of worldwide targets for HIV

The researchers analyzed responses to annual surveys sent to WHO offices from 127 countries between 2012 and 2014. Respondents each reported on the capacity and usage of CD4 testing, HIV viral load (VL) testing, and early infant diagnosis in their country. The researchers found that the capacity of available CD4 instruments was sufficient to meet the demand of all people living with HIV/AIDS (PLWHA), irrespective of treatment status, but VL capacity was inadequate to cover needs in most reporting countries. Even when capacity was sufficient, machines were being underutilized; only 13.7% of existing CD4 capacity and only 36.5% of existing VL capacity were utilized across reporting countries in 2013. Habiyambere and colleagues note that the responses were limited to national programs and did not include testing capacity in the private sector, and that incomplete responses or non-response to surveys limit the comprehensiveness of the survey data. However, they note that these findin...
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Very low transmission of HIV within couples receiving both ART, PrEP

Antiretroviral therapy (ART), which by suppressing HIV replication both controls progression of HIV and reduces infectiousness, was provided to the HIV-infected partner. To reduce susceptibility to infection prior to viral suppression in the HIV-infected partner, the HIV-uninfected partners were offered antiretroviral drugs for pre-exposure prophylaxis (PrEP) prior to and during the first 6 months of ART. The researchers followed the couples for an average of about one year per couple. The primary goals of the study were to evaluate implementation of this delivery model, however, part-way through the anticipated delivery period, it became clear that HIV transmission rates were considerably lower than would have been anticipated. In addition to high acceptability and adherence, the dual treatment regimen showed rates of HIV transmission 96% lower than estimated rates of transmission in a simulated cohort of serodiscordant couples. The researchers note that conclusions are limite...
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HIV-infected adults with depression have increased risk for heart attack

With the advent of highly effective antiretroviral therapy and improved survival, people with HIV-infection are living longer and are now at an increased risk for cardiovascular disease (CVD). There is an urgent need to identify novel risk factors and primary prevention approaches for CVD in HIV. Although depression is prevalent in HIV-infected adults and is associated with future CVD in the general population, its association with CVD events has not been examined in the HIV-infected population. Matthew S. Freiberg, M.D., M.Sc., of the Vanderbilt University School of Medicine, Nashville, Tenn., and colleagues conducted a study that included 26,144 HIV-infected veterans without CVD at baseline (1998-2003) participating in the U.S. Department of Veterans Affairs Veterans Aging Cohort Study from April 2003 through December 2009. At study entry, 4,853 veterans (19 percent) with major depressive disorder were identified. The average age of those with MDD was 47 years and for those wi...
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Hitching a ride: Misfiring drugs hit the wrong targets

Sometimes, these side effects can be caused when a drug hits the wrong target, binding to the wrong protein. However, the difficulty of tracking this process means that little research has been carried out. Now, a new study led by scientists at the University of Oxford and published in  Nature Chemistry  has shown how a series of anti-HIV protein i nhibitor drugs can interfere with the processing of a protein known as prelamin A, essential for maintaining the shape of human cells and directly related to ageing. The researchers used mass spectrometry -- a long-established way of identifying molecules by measuring their mass -- to observe directly the drugs' 'hitchhiking' on the wrong protein. Professor Dame Carol Robinson of Oxford's Department of Chemistry, corresponding author on the paper, said: 'The "hitchhiking" of drugs on incorrect targets is a common problem but isn't much studied, as it can be difficult to observe directly. You have to ...
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Concerns over glutathione skin bleaching in the UK

Ophelia Dadzie, a consultant dermatologist at The Hillingdon Hospitals NHS Foundation Trust and Founder and Director of London Ethnic Skin Limited, says that "there is a lack of authoritative public health information in the UK about the efficacy and safety of this practice." Skin bleaching is a cosmetic procedure that involves lightening constitutive skin colour, and one such agent used is glutathione, an antioxidant that can be administered orally or intravenously. Anecdotal evidence suggests that there has been an increase in the use of intravenous glutathione for skin bleaching in the UK. This practice is usually provided by beauty and aesthetic clinics, and in some cases non-medical practitioners administer the treatment. Potential adverse side effects include toxicity of the nervous system, kidney and liver, headaches, and rare, but serious skin conditions such as Stevens Johnson syndrome and toxic epidermal necrolysis. Other potential risks include transmiss...
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Genome-wide Toxoplasma screen reveals mechanisms of parasitic infections

"There's never been a really good way of looking at the function of all genes in any apicomplexan parasite," says Whitehead Fellow Sebastian Lourido. "We've introduced a method to assess the function of the entire genome. This technology can be used to study a variety of topics, from nutrient acquisition and responses to immune pressures to epistasis and genetic interactions. This is an important leap forward in what's possible to investigate in these parasites." The Centers for Diseas e Control and Prevention (CDC) estimates that more than 60 million people in the United States are infected with  T. gondii . Transmission can occur by ingesting oocytes from infected cat feces or by eating undercooked meat containing  Toxoplasma  cysts. After infection, some healthy people experience a month or more of flu-like symptoms, but the disease can cause seizures and potentially fatal encephalitis in the immunocompromised, including patients receiving tran...
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Gonorrhoea: Encouraging decrease in certain antibiotic resistance levels of gonococci across Europe

On an annual basis, countries of the European Union and European Economic Area (EU/EEA) participate in Euro-GASP to test susceptibility of  Neisseria gonorrhoeae  to the antibiotics commonly used for gonorrhoea treatment. In 2014, 23 EU/EEA countries collected and tested more than 2,000 gonococcal isolates and found a significantly lower proportion with cefixime resistance (2%), compared with 2013 when 4.7% of the tested isolates were not susceptible to this drug. The 2014 results continue the trend of decreasing cefixime resistance that started in 2010 (8.7%) but was interrupted by a slight increase in 2013. The ECDC report Gonococca antimicrobial susceptibility surveillance in Europe 2014 [add link] also shows that resistance to the antibiotic azithromycin has colntinued to rise across Europe since 2012 to a level of 8% of tested isolates in 2014. The highest resistance to this recommended drug was seen among isolates taken from men who have sex with men (10%) and m...
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