Bill Proposes Mandatory HIV Testing for D.C. Inmates
Vaccine Researchers Find Two New Antibodies
HIV-positives Advised to Get Swine Flu Vaccine
Positively Aware “HIV Basics: What You Should Know” Available Now
In August, Tibotec Therapeutics, along with the U.S. Food and Drug Administration (FDA), issued an important safety update to health care providers regarding severe skin and hypersensitivity reactions.
The warning on the drug label has been augmented to include reports of hypersensitivity reactions, which sometimes occur with hepatic (liver) failure, and fatality due to toxic epidermal necrolysis (TEN), which is a life-threatening skin disorder, usually resulting from medication use and which falls under the symptomology of “rash,” often associated with the non-nucleoside class of HIV drugs, including Intelence, Sustiva, and Viramune.
Severe skin reactions, such as TEN, can be dangerous and even fatal. The rash is usually seen within the first six weeks of treatment. However, allergic reactions can occur at any time.
According to the letter sent to health care providers, “Discontinue Intelence immediately if signs or symptoms of severe skin reactions or hypersensitivity reactions develop (including, but not limited to, severe rash or rash accompanied by fever, general malaise [not feeling well, as with a flu], fatigue, muscle or joint aches, blisters, oral lesions, conjunctivitis, facial edema [water accumulation], hepatitis, and eosinophilia [increased levels of the white blood cell eosinophil, usually a sign of an allergic reaction]).” In addition, the levels of liver transaminases should be monitored. The letter also stated the importance of discontinuing Intelence immediately “in cases where severe rash hypersensitivity reaction is suspected.” It’s always a good idea to consult with your physician first before discontinuing any medication.
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Bill Proposes Mandatory HIV Testing for D.C. Inmates
On August 30, Martin Ricard reported in the Washington Post that District of Columbia Council member Marion Barry has proposed a bill calling for mandatory HIV testing and counseling for all inmates entering a D.C. jail. At present, voluntary testing is available, although inmates can opt out. According to the report, “Barry's bill mandates collecting blood samples from inmates, including those convicted of a sex crime, upon entrance to a D.C. jail. It also calls for providing counseling services after the test.”
Though the bill has been stalled in committee since July, Barry says the alarming rate of HIV infection in the District makes it necessary. The District’s HIV/AIDS Administration reports that at least 3%, or an estimated 15,000 residents, are living with HIV, making it the highest rate known in the country. The agency estimates that thousands more have not been tested and don’t know they are HIV-positive.
According to the Bureau of Justice Statistics, 21 states currently test inmates for HIV when they are admitted to prison. But most states test only with an inmate's consent or upon court order.
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Vaccine Researchers Find Two New Antibodies
Researchers from the Scripps Research Institute announced that they have discovered two powerful HIV antibodies that can now possibly be used to identify a new vulnerability on the virus.
Wayne Koff, senior vice president of research and development at the International AIDS Vaccine Initiative (IAVI) said in a September 3 press release, “The findings themselves are an exciting advance toward the goal of an effective AIDS vaccine because now we’ve got a new, potentially better, target on HIV upon which to focus our efforts for vaccine design.”
According to the release, the two new antibodies, PG9 and PG16, target a region of the viral spike used by HIV to infect cells. Researchers at the IAVI-organized Neutralizing Antibody Consortium (NAC) will now focus on studying the molecular structure of both the antibodies and the targeted region on the HIV spike. The information they gather will then be used to devise immunogens (the active ingredients in vaccines) that will trigger similar antibodies.
While this discovery is very early in the process of vaccine development, it is also encouraging in its potential and impressive in the scope of collaboration between the academics, companies, and countries involved. According to Seth Berkley, president and CEO of IAVI, “The story of the discovery of these two new antibodies demonstrates the challenges of AIDS vaccine research, but also the power of the collaboration that formed to produce this advance. This is what can happen when your have researchers from the global North and South, from academia and industry, from within and outside the HIV field, working together in a framework to speed innovation. I am confident we will continue to move toward solving the AIDS vaccine challenge, one of the greatest scientific and public health challenges of our time.”
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HIV-positives Advised to Get Swine Flu Vaccine
HIV-positive people are being advised to “get vaccinated for the H1N1 virus, commonly called the swine flu, later this fall,” according to a September 3 article by Matthew Baiko for the National AIDS Treatment Advocacy Project (NATAP). However, “San Francisco health officials stress there is no evidence to suggest that people living with HIV are any more susceptible to the swine flu than they would be for the seasonal flu.”
Dr. Susan Fernyak, Director of Communicable Disease Control and Prevention for the San Francisco Health Department, says, "They should think of it as the same as the seasonal flu. Whatever their reaction would be for the seasonal flu should be their reaction for H1N1. If they don't care about the seasonal flu, they shouldn't be up in arms about swine flu.”
According to interim guidelines issued by the Centers for Disease Control and Prevention and updated in June, there is "insufficient data available at this point" to know who has the highest risk for contracting the swine flu, though people who are HIV-positive, particularly those with low CD4-cell counts or AIDS "can experience more severe complications of seasonal influenza and it is possible that HIV-infected adults and adolescents are also at higher risk for [H1N1] virus infection complications."
Although people with immunosuppression due to medications or an HIV infection are at higher risk for contracting the swine flu, they are not considered to be among the groups most at risk, according to health officials, and are being asked to wait until late November or early December to begin the two-dose H1N1 vaccine regimen.
In the meantime, commonly advised precautions such as covering your nose and mouth with a tissue when you cough or sneeze; washing your hands often with soap and water; and staying home when you experience flu-like symptoms can help prevent the spread of any flu, including H1N1.
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Positively Aware “HIV Basics: What You Should Know” Available Now
The September/October issue of Positively Aware is available in print and is now online. This issue focuses on basic information about HIV, drugs used in treatment, nutrition, exercise, and topics relating to disclosure and stigma, finding the right health care provider, and dealing with the financial ramifications of living with HIV. Featured on the cover, and in a profile by Jeff Berry, is Jack Mackenroth of Project Runway fame, talking about his anti-stigma campaign “Living by Design.” This is a great resource for anyone who is newly-diagnosed or their care givers, and for those who may need a “refresher course” on HIV.
Copies are available at most AIDS service organizations, HIV specialist doctors’ offices, at TPAN, or sign up for a subscription, free to HIV-positive folks, at www.positivelyaware.com or by calling 773-989-9400.discuss this news brief in our discussion forum
