Link Between Frequent Alcohol Use And Faster HIV Disease Progression

January 12, 2011

HIV disease tends to progress at a faster rate in infected individuals who consume two or more alcoholic drinks a day, according to an important new paper in AIDS Research and Human Retroviruses, a peer-reviewed journal published by Mary Ann Liebert, Inc. The article is available free online.

The article, entitled "Alcohol Use Accelerates HIV Disease Progression," clearly demonstrates that frequent alcohol use, defined as two or more drinks daily, is associated with declining CD4+ cell counts (which indicate a weakened immune system) in individuals with HIV disease who either are or are not receiving antiretroviral therapy (ART). Based on the results of a 30-month prospective study, the authors, Marianna Baum, Carlin Rafie, Sabrina Sales, and Adriana Campa, from Florida International University (Miami), Shenghan Lai, from Johns Hopkins University, and John Bryan Page, from University of Miami, Florida, conclude that alcohol has a direct effect on CD4 cells and that the accelerated decline in CD4+ cell counts in frequent alcohol users is not simply due to poorer adherence to ART in this population.

Another article by Natascha Ching, Karin Nielsen-Saines, Jaime Deville, Lian Wei, Eileen Garratty, and Yvonne Bryson, from the David Geffen School of Medicine at UCLA, Los Angeles, CA, demonstrated that children who were infected with HIV while in utero via maternal-fetal transmission, were subsequently given antiretroviral therapy, and had no detectable HIV in their blood, still produced neutralizing antibodies against HIV, suggesting that low levels of viral replication might still be occurring despite drug therapy. In the article "Autologous Neutralizing Antibody to Human Immunodeficiency Virus-1 and Replication-Competent Virus Recovered from CD4+ T-Cell Reservoirs in Pediatric HIV-1-Infected Patients on HAART," the authors present data to support their conclusion that the children's CD4 T-cells may contain latent HIV reservoirs that formed early in life before antiretroviral therapy was initiated.

"It is important that HIV infected individuals make informed decisions relating to alcohol consumption. This article will help to achieve that goal," says Thomas Hope, PhD, Editor-in-Chief of AIDS Research and Human Retroviruses and Professor of Cell and Molecular Biology at the Feinberg School of Medicine, Northwestern University, Chicago, IL.

Source:
Vicki Cohn
Mary Ann Liebert, Inc./Genetic Engineering News


Teen Users Of Crack And Cocaine At Significant Risk For HIV

January 10, 2011

Teens with a history of crack or cocaine use are significantly more likely to engage in unprotected sex than youth who have never used these drugs, putting themselves at increased risk for HIV, according to a study in the April issue of the Journal of Child and Adolescent Substance Abuse.

Researchers from the Bradley Hasbro Children's Research Center report that teens in psychiatric care who used crack and/or cocaine at least once were six times more likely to use condoms inconsistently, which was defined as "sometimes," "never" or "rarely." The findings suggest that crack cocaine appears to have more of an influence on risky teen behaviors than other factors, like alcohol and marijuana use, which are more routinely incorporated into adolescent HIV prevention interventions.

The study is one of the first to look at the link between crack and cocaine use and HIV risk behaviors in adolescents. Previous research has demonstrated this association in adults.

"Unprotected sex is the most common way that HIV is transmitted among teens, so if we can develop a clearer picture of why some kids engage in high-risk sexual behaviors, we will be better prepared to educate them about safe sex," says lead author Marina Tolou-Shams, PhD, of the Bradley Hasbro Children's Research Center. "Our findings suggest that future HIV prevention interventions should include content specific to crack and cocaine use, just as they do with drugs that are more commonly used by teens, like alcohol and marijuana."

Overall, nearly 280 teens between the ages of 13 and 18 from therapeutic psychiatric day programs took part in the study. Participants exhibited a range of psychiatric diagnoses, including mood disorders, post-traumatic stress disorder and disruptive behavior disorders. More than half of all adolescents were male, and more than three-quarters were Caucasian. Approximately 13 percent of teens in the study reported trying crack or cocaine at least once.

After controlling for known adolescent HIV risk factors, such as gender, race, age and psychiatric status, researchers found that only 47 percent of teens with a history of crack and/or cocaine use said they used condoms "always or almost always." In addition, 15 percent of these adolescents have a history of sexually transmitted diseases (STD), nearly three-quarters reported using alcohol at least once and more than half indicated prior marijuana use.

In comparison, 71 percent of teens who never used crack or cocaine reported using condoms consistently.

Tolou-Shams says it was important to look at the association between crack and cocaine use and HIV risk behavior in adolescents with psychiatric disorders, since previous research has shown that teens in mental health treatment have high rates of risky sexual behavior and are more likely to engage in substance use.

"Our study clearly shows that youth in psychiatric treatment are using other drugs - and not just alcohol or marijuana - at high rates and that a history of drug use should alert clinicians to a wide variety of possible behavioral risks in their young patients," she adds.

The authors recommend that all clinicians who treat adolescents - including pediatricians, social workers and psychologists - routinely discuss their patients' mental health history, lifetime use of all substances and sexual activity, as well as provide appropriate interventions when necessary in order to reduce their HIV risk.

The research is supported by grants from the National Institute of Mental Health and the Lifespan/Tufts/Brown Center for AIDS Research (CFAR).

Tolou-Shams is also an assistant professor of psychiatry at The Warren Alpert Medical School of Brown University. Study co-authors include Larry K. Brown, MD, and Nicholas Tarantino, BS, both from the Bradley Hasbro Children's Research Center and Alpert Medical School, and Sarah W. Feldstein Ewing, PhD, at the University of New Mexico.

Source:
Jessica Collins Grimes
Lifespan


Older People And Those With HIV Are More Vulnerable To Tuberculosis

January 06, 2011

A study by the Barcelona Public Health Agency has revealed those sections of the population that are most vulnerable to tuberculosis. The research, published in the journal Respiratory Research, shows that the highest death rates from this disease are among those aged over 50 or infected with HIV.

"Some patients give up their tuberculosis treatment (which lasts for a minimum of six months), resulting in a danger of them infecting other people, worsening their own state of health or even dying", Joan A. Caylà, lead author of the study and a researcher at the Barcelona Public Health Agency (ASPB), tells SINC.

The study, published in the journal Respiratory Research, identifies the factors linked to people giving up tuberculosis treatment and deaths from the disease. Researchers from the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) analysed a sample of 1,490 people with the illness in Spain between 2006 and 2007.

The results of these studies show that abandoning tuberculosis treatment is usually related to having undergone previous treatment for the disease, being an injecting drug user (IDU), living with a large number of people, and also the doctor's perception that the patient does not have a good understanding of the treatment.

The authors from the ASPB, meanwhile, stress that deaths are associated with failure to understand the treatment, being an IDU, being in directly-observed treatment (DOT), and also being over the age of 50 or being infected with HIV.

One-third of the world population

The World Health Organisation (WHO) declared 24 March as World Tuberculosis Day, to commemorate the day in 1882 when the biomedic Robert Koch announced the discovery of the bacillus that causes the disease. This was the first step towards being able to diagnose and cure it.

Each year, eight million people contract tuberculosis worldwide, and two million die from it. Although tuberculosis is still endemic in Spain and other wealthy countries, there has been a resurgence of tuberculosis infections in some rural areas, and with the increase in HIV and failure to control the disease.

The WHO aims for the tuberculosis prevalence and death rates to have fallen to half their current levels by 2015. Today, around two billion people - one-third of the entire world population - are infected with tuberculosis.

Source: Plataforma SINC


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