An AIDS Cure in Two Years? Prostratin Could Make It Possible

Scientists researching a cure for HIV have projected that a cure could be available in 18 to 24 months. The researchers were working on two natural compounds––prostatin and bryostatin––that they reproduced in the laboratory for medical purposes. Prostratin comes from the bark of the Samoan mamala tree. Paul Cox, an ethnobotanist and director of the Institute of Ethnomedicine in Wyoming, heard of the bark from a Samoan healer. Paul Wender, a chemist from California’s Stanford University, found in experiments with prostratin that it flushed out the virus from cells where it was hiding. Drugs are able to kill the virus when it is in the open, but not when it is hiding in cells. When patients stopped taking their medication, the virus resurfaced and quickly multiplied. 

Wender was able to recreate the drug and design new variants and has made it 100 times more powerful than that obtained from the tree. The AIDS Research Alliance (ARA), a Los Angeles nonprofit dedicated to finding a cure for AIDS, is developing prostratin. Dr. Stephen Brown, medical director of ARA, stated that the organization was two thirds of the way through necessary experiments before the drug would be ready for market. Researchers had performed initial tests on animals and now were conducting tests on blood from AIDS patients who had been on immunosuppressive therapy. Bryostatin, a compound that comes from a sea creature called bryozoa, also has healing qualities. It was discovered by Robert Pettit, a University of Arizona chemistry professor. Wender created bryostatin variants 1,000 times more powerful at flushing HIV from cells than prostratin. However, additional work is necessary before it could be considered a successful drug candidate. The National Institutes of Health is helping to fund Wender’s research. The study was presented before the 246th American Chemical Society National Meeting, September 8–12, in Indianapolis, Ind.

Maine Confronts Aging Population with HIV/AIDS

The US Senate Aging Committee heard testimony on September 18, the sixth annual National HIV/AIDS and Aging Awareness Day, from five witnesses testifying about the challenges facing aging HIV-infected people. Witnesses noted that states with large aging HIV-infected populations experienced greater impact than other states. According to Kenneth Miller, executive director of Maine’s Down East AIDS Network, older HIV-infected people who lived in rural areas faced complicated health issues, including lack of access to medical care and mental health treatment.

Miller stated that older, rural patients also isolated themselves because of stigma against those who were gay and had HIV. Other difficulties specific to rural HIV-infected people included transportation to physician’s appointments and lack of access to social support networks. Miller recommended ways to improve the system of care, including awareness and outreach. He advised that this population was vulnerable to depression and might not have access to mental health screening and care.

Although treatment advances had extended life expectancy for HIV patients, Sen. Susan Collins (R-Maine) cautioned older Americans not to stereotype HIV as a young person’s disease. Older Americans also were vulnerable to HIV and should “exercise the same kind of care” if they were engaging in high-risk behaviors.

Meeting NoVa Health Needs: Northern Virginia's Gay Men's Health Collaborative Building a Brand That's Part Health Resource, Part Social Club

Gay Men's Health Collaborative (GMHC) hoped to become a driving force in providing resources and services to Northern Virginia’s lesbian, gay, bisexual, and transgender (LGBT) community, thus filling the void left by the closure this summer of another organization that once provided those services. Based in Inova Fairfax Hospital in Falls Church, Va., GMHC provides intervention and prevention services as well as hosting and supporting social opportunities. According to James Leslie, an HIV-health educator and gay men's health coordinator at Inova Fairfax Hospital, social opportunities for LGBT people outside of bars was sparse, especially for gay, bisexual, and transgender (GBT) men, whose rates of HIV infection were high.

GMHC’s dual approach would facilitate programs that focused on HIV prevention and health as well as building self-esteem and support their mental and emotional well-being. It will hold bi-weekly HIV and STD testing on the second and fourth Tuesdays of the month at several Northern Virginia locations. Social events, meant to provide GBT men an opportunity to make friends and build support systems, would focus on no-alcohol activities, including bowling, movie and game nights, and a visit to a local waterpark. "We want to have a space for people outside the city that's not a bar," said Leslie.

A grant from the Virginia Department of Health and private donations will fund GMHC's activities; Leslie hoped the Department of Health would renew the grant as long as he could show the need for such prevention and support services.

Costs Spike for 2nd- and 3rd-Line ARVs and Late Treatment

The National AIDS Treatment Advocacy Project has reported on the increase in cost to treat HIV-infected individuals on second- and third-line antretrovirals (ARVs). Researchers calculated costs after reviewing data from 2007 to 2011 in the MarketScan Commercial Claims and Encounters Database and from the MarketScan Lab Database, which covered 2007 to 2010. The researchers followed 9,931 individuals in the first group, whose treatment moved from first- to third-line therapy, and 486 individuals on ARVs in the second group who provided data on CD4 counts.

The researchers adjusted for factors such as AIDS diagnosis, sex, age, region of the country, and type of health insurance. Results showed that the average cost for total care of HIV-infected individuals on first-line therapy was $28,861, cost for second-line therapy was $35,805, and for third-line, $40,804. Also, the average cost to treat a patient who started treatment with more than 350 CD4 cells was $2,526 per month. Treatment for individuals who started with 100–350 CD4 cells was $2,378 per month, and for individuals with fewer than 100 CD4 cells, the price increased to $4,860 per month.

The full report, “Burden of Illness in a US Commercially Insured HIV Population: Treatment Patterns and Costs,” was presented at the 53rd ICAAC Interscience Conference on Antimicrobial Agents and Chemotherapy, September 10–13, 2013, Denver. Abstract H–662.

Kenya Sees Drop in HIV Prevalence

Preliminary Kenya AIDS Indicator Survey (KAIS) results showed that Kenya’s overall HIV prevalence dropped from 7.2 percent in 2007 to 5.6 percent in 2012. Peter Cherutich, head of prevention for Kenya’s National AIDS and Sexually Transmitted Infections Control Program, attributed the prevalence decrease to more HIV-infected people receiving antiretroviral therapy (ART). Early ART could reduce heterosexual HIV transmission by as much as 96 percent, according to recent studies.

Officials feared that these gains would not be sustainable unless Kenya reduced its reliance on donor funding. At present, more than 70 percent of HIV-infected Kenyans with a CD4 count of 350 or lower were on ART. The HIV virus was undetectable for 80 percent of those, which meant there was low risk of transmitting the virus.

Allan Ragi, executive director of the Kenya AIDS NGO Consortium, attributed Kenya’s progress to the fact that government, donors, civil society, and HIV-infected people had worked together at all levels to put in place effective policies, messages, and interventions. Other HIV prevention efforts included mother-to-child prevention, medical male circumcision, and counseling and testing programs.

KAIS reported that approximately 1.2 million Kenyans had HIV, and HIV prevalence varied by gender and region. Overall prevalence among women was 6.9 percent, compared to 4.4 percent overall prevalence among men and 0.9 percent overall prevalence among children. The survey indicated “substantial” drops in the Coast, Nairobi, and Rift Valley regions, but recorded an overall prevalence increase in Nyanza region from 14.9 percent prevalence in 2007 to 15.1 percent in 2012. 

Can't Hardly Wait: Federally Funded Abstinence-Only Education Finds its Way to New Mexico

The New Mexico Department of Health (DOH) and New Mexico State University (NMSU) quietly began to accept federal funding for abstinence-only education programs in fall 2012, six years after DOH rejected a federal grant for abstinence-only education in public schools. According to DOH Spokesperson Kenny Vigil, the state had accepted more than $470,000 in federal abstinence-only funds, to which the state added in-kind contributions of more than $350,000. Vigil stated that the funding offered New Mexico another sex education option. New Mexico reported the highest teen pregnancy rate and highest chlamydia and gonorrhea rates in the country, and DOH stated that 30 percent of students under 15 reported they had had sex.

According to the Sexuality Information and Education Council of the United States (SIECUS), DOH used the money to fund a community-based curriculum called “Sex Can Wait” in Chavez, Cibola, Curry, Doña Ana, Eddy, Lea, and Luna counties. SIECUS advocated for comprehensive sex education for teens and tracked abstinence-only federal dollars. However, Vigil stated that DOH had piloted the “Sex Can Wait” program, developed in 1994 by Dr. Michael Young, and would offer the curriculum in Curry County middle school after-school programs.

The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics both opposed abstinence-only education, and a 2007 US Department of Health and Human Services study confirmed that students who took abstinence-only courses were likely to have their first sex at the same age and to have as many partners as students who did not receive abstinence-based sex education. Critics noted that abstinence-based education failed to teach teens about birth control and contraception.

Santa Fe Public Schools refused abstinence-only funding and partnered with Planned Parenthood to provide comprehensive sex education for public school students in grades 7–9.

$5M Funding for Project Aimed at Eliminating HIV/AIDS

British Columbia Center of Excellence in HIV/AIDS (BC-CfE) at St. Paul’s Hospital in Vancouver, Canada, has received $5 million in funding for a project to develop an improved HIV drug-resistance test, real-time drug resistance surveillance, and better ways of personalizing HIV treatment.

The new individualized test, which is based on DNA sequencing technology, can detect drug-resistant strains. Also, using the patient’s DNA, two types of tests—viral and human genomic—will enable doctors to determine the best antiretroviral drugs to reduce the virus in the patient’s blood and minimize adverse reactions, thus preventing non-adherence.

The researchers also will develop a new early warning system to monitor and map drug resistance and indicate geographic or population “hotspots” where resistance is highest and transmission risk greatest.

The test at the BC-CfE labs will be available for all Canadian HIV patients through their doctors, and the researchers plan to share the technology with labs globally.

Genome BC, Genome Canada, Genome Quebec, the Canadian Institutes of Health Research, ViiV Health care and the St. Paul’s Hospital Foundation are funding the project.