Peace Corp volunteer forbidden to serve when diagnosed HIV-positive
Study finds that adverse events of antiretroviral therapy differ by race and gender
Suppressing human protein in T-cells reduces HIV’s ability to get in, study shows
Observing clinical symptoms just as good as laboratory tests, says WHO
New Madonna movie looks at AIDS crisis in African country
Peace Corp volunteer forbidden to serve when diagnosed HIV-positive
Peace Corp volunteer Jeremiah Johnson was hit with a double-whammy in January, when he was diagnosed with HIV and then subsequently given a “medical separation” from the volunteer organization, according to Washington Post columnist Stephen Barr.
Johnson was on assignment in Ukraine, teaching English to 6th- through 11th-graders. While there, he learned that he was HIV-positive through a scheduled medical exam. Ukranian law prevents people with HIV from working in the country and Johnson was ordered to return to Washington, D.C. immediately.
But instead of being reassigned to a different location that would allow him to work despite his HIV status, Johnson was left to explain to his family and friends why he had returned home nearly a year ahead of schedule. “It put a dark and depressing spin on my coming home, which I didn’t want,” he said to the Post.
Believing that the Peace Corps’ decision to let him go was in violation of federal anti-discrimination laws, Johnson spoke with an attorney who then referred him to the American Civil Liberties Union (ACLU).
The ACLU has written to Peace Corp director Ronald Tschetter regarding Johnson’s termination, stating that the organization’s policy to “terminate volunteers who are HIV-positive without an individualized assessment as to whether they are able to serve with reasonable accommodation” violates the 1973 Rehabilitation Act.
Though Tschetter has yet to respond, Peace Corps press director Amanda Beck says that he does intend to, and defended the organization by stating that it “does not have a policy of automatically excluding people with HIV.” Beck stated that “the Peace Corps conducts individualized medical examinations of volunteers and applicants who are HIV-positive,” though she could not speak about Johnson’s individual situation because he had not given the organization permission to do so.
Positively Aware will keep you updated on this story as it develops.
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Study finds that adverse events of antiretroviral therapy differ by race and gender
A recent study published in the Journal of Acquired Immune Deficiency Syndromes (JAIDS) found that while the overall rate of adverse events among HIV-positive people starting anti-HIV medication for the first time does not differ significantly among different races and genders, there were significant differences for specific adverse events.
Conducted by Temple University School of Medicine’s Ellen Tedaldi and colleagues, the study compared the frequency and types of adverse events among 1,301 patients initiating antiretroviral therapy, including 701 black participants, 225 Latinos, and 273 women.
Having adjusted for differences in baseline characteristics such as age, HIV transmission risk, hepatitis B or C co-infection, viral load, body mass index, diagnosis of AIDS, and baseline hypertension, cardiovascular effects were still found to be 2.64 times more frequent among the black participants than their white counterparts. Kidney side effects were 3.83 times more frequent.
In addition, black men in the study experienced 2.45 times higher rates of psychiatric-related adverse events than white men, which the researchers attribute to “a constellation of factors that included psychosocial and biologic association,” including undiagnosed mental illness among black men and the known effect that HIV has on the central nervous system.
Women were 2.34 times more likely to experience grade four anemia (considered to be the most serious type), compared with men.
Researchers indicate that their findings “could inform HIV-treating clinicians about particular issues to consider in the selection of antiretroviral regimens for diverse populations.
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Suppressing human protein in T-cells reduces HIV’s ability to get in, study shows
A recent study published in the Proceedings of the National Academy of Sciences found that the ability of HIV to enter and to replicate inside of CD4 cells is significantly reduced when a human protein known as ITK, which is found inside such cells, is suppressed.
The study was conducted by Pamela Schwartzberg and colleagues of Boston University. They used human cells in a laboratory to test two methods of suppressing ITK, one to stop it from functioning and another using a drug to chemically interfere with the protein.
According to the researchers, “suppression of the ITK protein caused many of the pathways that HIV uses to be less active, thereby inhibiting or slowing HIV replication.” While they were not able to block infection altogether, they were able to severely impair it, resulting in “minor effects at multiple stages of [the] HIV lifecycle” which ultimately add up to a “more profound effect.”
Researchers are concerned about the impact that ITK suppression could have on the normal function of CD4 cells, however, neither suppression method was found to interfere “significantly” with CD4 cell survival.
Because it targets a human protein rather than HIV itself, ITK suppression could be helpful in addressing the emergence of drug-resistant virus. Schwartzberg stressed that it would likely be several years before we actually see a drug that suppresses ITK, and that more studies are needed to assess other ways of suppressing the protein.
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Observing clinical symptoms just as good as laboratory tests, says WHO
The World Health Organization (WHO) recently released data from a study which suggests that assessing HIV treatment by observing simple physical signs is on par with treatment based on advanced laboratory analysis.
The study used a computer simulation model to analyze the five-year survival rates of three groups of patients – monitoring either viral load, or CD4 cell count, or clinical observation. Researchers found no statistical difference in the results among the differing groups, with survival rates of 83%, 82%, and 82% respectively (67%, 64% and 64% out to 20 years).
Implications of this study are particularly important for clinicians in countries within Africa and Asia, where resources are scarce and access to costly laboratory testing is limited.
“The results of this study should reassure clinicians in [resource limited countries], who are treating literally millions of people without these laboratory tests, that they are not compromising patient safety,” said Charles Gilks, a co-author of the study and the coordinator of antiretroviral treatment and HIV care at WHO.
While observation of physical symptoms may be as effective as laboratory tests at assessing antiretroviral therapy, researchers stress that it is by no means the preferred method of care where adequate resources are available.
In fact, a separate study published recently in AIDS showed that higher CD4 cell counts in patients taking antiretroviral therapy are not only associated with lower rates of HIV-related illness, but also a lower rate of serious illnesses such as heart, kidney, and liver disease as well as some cancers. Actual CD4 counts, however, cannot be assessed simply by observing, therefore, a more accurate assessment can only be made through laboratory testing.
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New Madonna movie looks at AIDS crisis in African country
Legendary pop star and humanitarian Madonna recently wrote, produced, and narrated a documentary that focuses on the one million children orphaned by the AIDS crisis in Malawi, the birthplace of her adopted son, David.
The film recently premiered at the Tribeca Film Festival in New York, where the pop culture icon spoke about the impact that the venture has had on her family.
“My husband, Guy Ritchie, has seen it many times and he loves it. My daughter, Lourdes, has seen it and wept. I mean, there are children her age suffering so it’s really hard for me. But she’s gone to Africa with me and she’s experienced it,” Madonna said.
She also admitted to feeling a connection to this particular African country, and said that someone living there had actually brought the story to her personally and asked if she could help.
“I couldn’t run away or ignore it.”
The experience of making the film has also deeply affected the megastar. “I realized how silly any of my complaints are…It gave me a perspective and a great sense of appreciation.”
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