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Women with HIV too often unseen: US advocate
by Staff Writers
Washington (AFP) July 25, 2012

Cancer drug flushes out lurking AIDS virus: study
Paris (AFP) July 25, 2012 - Scientists in the United States said Wednesday they had used a cancer drug to flush out the AIDS virus lurking dormant in trial patients' white blood cells -- a tentative step towards a cure.

The ability of the HIV genome, or reproductive code, to hide out in cells and be revived after decades poses a major obstacle in the quest for a cure.

Being able to expose the virus in its hiding place would allow scientists to target the host white blood cells in a killing blitz.

"It is the beginning of work toward a cure for AIDS," David Margolis, co-author of the study published in the journal Nature, told AFP as the International AIDS Conference was under way in Washington.

HIV is a retrovirus, inserting its DNA into the genome of host white blood cells, CD4+T cells in this case, and turning them into virus factories. Sometimes it goes into hiding in some cells even as others keep on producing.

Some 34 million people around the world are living with HIV, which destroys the immune system and has caused about 30 million AIDS-related deaths since the disease first emerged in the early 1980s.

In the latest study, researchers in the United States used the chemotherapy drug vorinostat to revive and so unmask latent HIV in the CD4+T cells of eight trial patients.

The patients were also on antiretroviral drugs, which stops HIV from multiplying but have to be taken for life because they do not kill the virus hidden away in reservoirs.

"After a single dose of the drug, at least for a moment in time, (vorinostat) is flushing the virus out of hiding," Margolis said of the trial results -- the first drug ever shown to do so.

"This is proof of the concept, of the idea that the virus can be specifically targeted in a patient by a drug, and essentially opens up the way for this class of drugs to be studied for use in this way."

The drug targets an enzyme that allows the virus to lie latent.

The researchers cautioned that vorinostat may have some toxic effects and stressed this was merely an early indication of feasibility that had to be explored further.

Exactly what would happen after the virus was unveiled in reservoir cells was also not certain, said Margolis.

"We know that many cells that produce HIV die in the process. We know many cells that produce HIV can be identified and killed by the immune system. As far as we can tell, all the viruses floating around while patients are taking therapy don't get into cells because they are blocked by the therapy," he said.

Without a host cell, the virus would die within a few minutes.

"There is a possibility that this could work. But ... if it is only 99 percent true and one percent of the virus escapes, it won't succeed. That is why we have to be careful about our work and what we claim about it."

In a comment published with the study, HIV researcher Steven Deeks said the research provided "the first evidence that ... a cure might one day be feasible".

But, as is common with early clinical trials, the study raised more questions than answers -- including ethical concerns about giving potentially toxic drugs to HIV-infected people who are otherwise healthy, he said.

"These data from the lab of David Margolis are genuinely exciting for those exploring pathways to achieving a cure for AIDS," Oxford University HIV researcher John Frater told AFP, calling for investment in further research.

HIV immunologist Quentin Sattentau called the findings promising, but said other types of reservoir cells, including in the brain, may not respond to this treatment.

"Thus there is a long way to go before we will know if this can work to completely eradicate HIV from an infected person."

As a black American woman with HIV, Linda Scruggs said Wednesday that she represents a group that is disproportionately affected by the pandemic and must get more involved in advocacy and research.

In the United States, black heterosexual women made up the next largest group of new infections after gay men of all races in 2009, with about 5,400 cases according to data from the US Centers for Disease Control and Prevention.

And worldwide, AIDS remains the top killer of women of reproductive age, said a UNAIDS report released last week, signaling that women of all races are particularly vulnerable to the 30-year-old disease.

Scruggs was first diagnosed with HIV 22 years ago, when she was 25 years old and took a routine blood test related to her pregnancy.

She was 13 weeks along, and recalls her doctors telling her she was HIV positive and could either have the baby and perhaps live three years, or abort the fetus and maybe live for about five years.

Scruggs expressed her pride for the son she decided to have, Isaiah, who recently turned 21 and was born without HIV, as she began her talk to the International AIDS Conference aimed at highlighting the struggles of women.

"We are not asking you. We are telling you. It is time to address the inequality of women globally ... we need to be part of the solution," she told a cheering auditorium at the world's largest meeting on HIV/AIDS.

The political backdrop to the pandemic is inescapable in Washington. The US capital is struggling with its own soaring HIV rates and embroiled in partisan bickering over healthcare reform.

Washington's city-wide prevalence rate of 2.7 percent (nearly 15,000 people) exceeds that of many developing countries.

Among the city's black population, about half the city's residents, the prevalence rate is 4.3 percent. One in 32 black US women can expect a diagnosis of HIV in her lifetime, the CDC has said.

AIDS advocates say President Barack Obama's plan to reform healthcare could help turn the tide on an epidemic that predominantly affects poor and minority communities by extending coverage to more people.

However, Obama's Republican foes say the costs would be too high and as many as 13 state governors are vowing to opt out of a plan to expand Medicaid coverage to the poor.

"This is an epidemic of communities of color," said Daniel Montoya, deputy executive director of the National Minority AIDS Council, saying minorities tend to have less access to healthcare, which can make them more vulnerable.

Nationwide, black women make up 60 percent of new cases among women and face infection rates that are 15 times the rate in white women, according to C. Virginia Fields, president of the National Black Leadership Commission on AIDS.

"We still need to have that national outrage to bring those numbers down," Fields said, referring to remarks in 2007 by Secretary of State Hillary Clinton, who was at that time a presidential candidate.

Reacting to CDC data showing HIV/AIDS as the top cause of death in black women aged 25 to 34, Clinton had said: "If HIV/AIDS were the leading cause of death of white women between the ages of 25 and 34, there would be an outraged outcry in this country."

While many groups are jostling for the spotlight at the conference, which has drawn more than 20,000 experts, policy makers and advocates to the US capital, Scruggs said her appeal should not take away from the need to help gay men, traditionally the focus of efforts to halt the disease.

Instead, it is time for women to take a greater role in research and leadership, and to express the complexities of their lives that may contribute to their high infection rates.

"My life had never been a cup of tea," said Scruggs, who recounted being molested by an uncle and raped multiple times as a young woman. She does not know which event may have infected her with HIV.

"I understood why me. I understood there were things in my life and my past that would get me there," she said.

Her own healing process took root in the 1990s when she was asked to stand in for a speaker and tell her story to a doctors' conference.

Afterwards, she realized talking publicly about her ordeal was helping to free her of a long-held burden.

But she also acknowledged that plenty of stigma remains, and women too often stay silent about their condition.

"We are here and we are a force to be reckoned with. We are changing the game," said Scruggs. "We don't have another 30 years. We don't need another 30 years. We need you to do it now."


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AIDS cure may have two main pathways: experts
Washington (AFP) July 24, 2012
Investigators are looking into two main paths toward a cure for AIDS, based on the stunning stories of a small group of people around the world who have been able to overcome the disease. Despite progress in treating millions of people globally with antiretroviral drugs, experts say a cure is more crucial than ever because the rate of HIV infections is outpacing the world's ability to medica ... read more

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