Antifungal Drug Shows Promise Fighting HIV in the Lab

The topical antifungal agent Ciclopirox eradicates HIV by promoting infected cells to effectively commit suicide, and it does not lead to viral rebound after the therapy is stopped, according to U.S. News and World Report. Reporting their findings in PLOS ONE, researchers studied how, in a laboratory setting, Ciclopirox affected HIV-infected H9 cells and peripheral blood mononuclear cells infected with clinical HIV isolates.

One of the reasons HIV manages to endure in the body even in the face of antiretroviral (ARV) therapy is because the virus blocks cells’ natural mechanism for instigating their own demise in the event they are damaged or infected. The scientists found that Ciclopirox fought the virus by inhibiting the expression of certain HIV genes and also interfering with the cells’ mitochondria, undoing HIV’s inhibition of the suicide mechanism.

Uninfected cells were not affected by the treatment. Also, once Ciclopirox was terminated, the virus did not rebound as it would after stopping ordinary ARVs.

Because Ciclopirox is already approved by the Food and Drug Administration as an antifungal, the process of moving into human trials for an HIV-fighting capacity should be much more efficient. There is a possibility the drug may prove useful as a topical application to reduce the risk of sexual transmission of the virus.

Newly Found HIV Replication Pathway May Lead to New Drugs

The discovery of a new HIV replication route may eventually lead to advancements in antiretroviral (ARV) therapy and attempts to eradicate the virus. Publishing their findings in the Journal of Virology, researchers investigated the phenomenon that more than 90 percent of HIV fails to integrate its DNA into human cells, leaving unintegrated viral DNA in the cell. (Integration is a key component of the HIV lifecycle; integrase inhibitors attack the virus at this juncture.) In the past, researchers have assumed that these stranded viruses could not copy themselves.

But as the scientists discovered, some of this unintegrated virus is able to skip the integration process and still reproduce itself, producing new viruses that can in turn infect other cells.

“Although this is not the virus’s main method for replicating, having this option available can help HIV survive,” the study’s lead researcher, David N. Levy, PhD, associate professor of basic science and craniofacial biology at the New York University College of Dentistry, said in a release. “These new findings suggest one mechanism by which HIV may be surviving in the face of antiviral drugs, and suggests new avenues for research into eliminating infection.”

Levy’s team also discovered that these unintegrated viruses can survive in human cells for weeks, providing themselves a kind of cover against ARVs and other natural immune responses.

HIV-Positive Airman in Kansas Gets Military High Court Appeal

The highest court for the U.S. armed forces has agreed to hear the appeal of a Kansas airman convicted of assault for exposing multiple sex partners to HIV at swinger parties in Wichita, his attorney said Friday.

David Gutierrez was a sergeant serving at McConnell Air Force base in Kansas when he was sentenced in 2011 to eight years in prison and stripped of his rank in an aggravated assault case. Prosecutors told the trial judge that a stiff sentence would send a message that the military values the integrity of its service members, saying Gutierrez played Russian roulette with his sexual partners' lives.

The defense on appeal has won a rare opportunity to present before the U.S. Court of Appeals for the Armed Forces an argument that his attorney says could set a far-reaching precedent across the military.

"It will set the table for the entire military services as to what kind of evidence is necessary to find that someone can cause grievous bodily injury after testing positive for HIV," said Kevin McDermott, one of his defense attorneys.

In addition to the HIV issue, the military appeals court agreed Tuesday to decide whether the evidence was sufficient to find Gutierrez committed adultery. The defense contends Gutierrez can't be guilty of adultery because his wife participated with her husband in the "swinger's lifestyle."

The appeals court, essentially the military equivalent of the U.S. Supreme Court, takes fewer than 5 percent of petitions submitted to it, McDermott said.

A military judge in Wichita found Gutierrez guilty in January 2011 on seven of eight counts of aggravated assault and of violating his commander's order to notify partners about his HIV status and use condoms. The judge also convicted Gutierrez of indecent acts for having sex in front of others and of eight counts of adultery.

Prosecutors did not immediately respond to an email Friday seeking comment.

The Air Force Court of Criminal Appeals affirmed the conviction in March 2013, and the defense appealed to the U.S. Court of Appeals for the Armed Forces.

In its petition, the defense argued that the evidence was not sufficient to prove Gutierrez was HIV positive. The test used has since been recalled by the Food and Drug Administration because it was susceptible to false reactions.

His attorneys also said that even if Gutierrez had HIV, his medical records showed his viral load was so low during that time that he had a "zero chance" of infecting anyone through oral sex and a 1 in 10,000 to 1 in 100,000 chance of infecting a partner through unprotected intercourse.

"If the court agrees with us and determines David was not infected to the point that he could have caused grievous bodily injury to others, this would gut substantially 90 percent of the case against David," McDermott said.

The case has not yet been set for oral arguments and no decision is expected until the summer of 2014.

NYC Requires Families of People With HIV on Support to Work

The city’s agency assisting low-income people with HIV and AIDS is looking for help in paying for its clients’ ­costs of living — from the family members and other people who live with them.

This month, the city HIV/AIDS Services Administration (HASA) issued a rule requiring all household members living with people receiving benefits from the agency to sign up to participate in a work program. The city projects the move will save about $3 million in the coming year.

In July 2013, more than 30,000 New Yorkers living with HIV or AIDS were receiving HASA benefits. Those with families were entitled to extra benefits, such as increased rental assistance or more food stamps. In all, 11,400 household members get such aid. VOCAL-NY, an advocacy group that works with people with HIV/AIDS, estimates that between 10 to 20 percent of these are of working age and were not required to participate in any work program — until now.

If someone living in the household refuses to work or participate in a training program, an HIV/AIDS client may see cuts in his or her aid. But those who work for pay can expect to be penalized too: As noted in a City Council analysis earlier this year, when the family member is already working, “cases will be re-calculated to reflect the additional income.” Benefits, such as rental assistance, could be decreased as a result. HASA clients currently get between $300 and $1,500 a month in rent subsidies.

In addition, some people with HIV/AIDS may no longer be entitled to what the agency calls “intensive case management,” which often includes home care and mental health and substance abuse treatment.

A spokesperson for HRA indicated the administration is  bringing its HIV/AIDS Services program in compliance with longstanding state rules, and that it would be in each family’s best interest to encourage adult members capable of working to do so.

Terri Smith-Caronia, a Housing Works’ vice president, said that the new rule could damage relationships among family members whose benefits are cut. “They are cash- strapped, looking for nickels and dimes,” she said. “The only way to save money is to kick people out. You keep your savings by disrupting households.”

“Our issue is the punitive aspect of the policy,” said Jason Walker, a VOCAL-NY community organizer and coordinator of the New York HIV/AIDS Housing Advocacy Network. “A HASA client would be penalized because of what someone else [in the household] may or may not be doing.”

In March, Human Resources Administration (HRA) Commissioner Robert Doar said that HASA, a division of HRA, would be reaching out soon to clients whose children are now adults and require them, when appropriate, to take part in the agency’s employment programs.

In July, City Council Speaker Christine Quinn and Annabel Palma, chair of the Council’s general welfare committee, expressed concern that the new rule might result in “improper reductions” of benefits.

While the council asked HASA to explain how clients will be assessed and how exemptions will be determined, the agency hasn’t offered any clarification. Palma’s office said it would wait to see how the rule is affecting HASA clients before taking further action.

Affected household members will be given the opportunity to present evidence of barriers to employment such as physical or mental health issues, according to HRA. The evidence will then be evaluated according to state guidelines on a case-by-case basis.

HIV and Hepatitis a Fear on Olympia Playgrounds

An alarming number of hypodermic needles and drug paraphernalia showing up in Olympia playgrounds and parks have parents concerned. A poke puts their children at risk for HIV or Hepatitis.

“It’s a horrible risk you shouldn’t have to face when you ride a bike or play in the playground,” said Jessica Archer, a parent.

One of Archer’s young sons recently had a close call while riding his bike.

“He crashed and he was just a couple inches from a dirty needle, a couple inches,” she said.

Area pediatricians are seeing an increased number of patients saying they were poked by syringes.

“Used needles in a park often mean drug use so there’s blood, there’s all sorts of concerns of a needle poke,” said Dr. Sara Murdoch of Pediatrics Olympia.

Dr. Murdoch has seen a spike in incidents the last few months, including two patients in one day who both tested negative for HIV and Hepatitis. While there’s a low chance of infection, Dr. Murdoch says the ordeal is agonizing for parents.

“The exposure, the waiting and the not knowing,” said Dr. Murdoch.

“Our community is being put at risk by people right now and it’s not ok,” said Archer.

Complaints at places like Bigelow Park have promoted action by the city. Park Rangers have upped patrols and have started a tracking system.

Since Mid-August, 207 hypodermic needles and 107 drug paraphernalia items have been picked up from outdoor areas and safely discarded.

City park officials have also formed a partnership with Olympia Police called the “Downtown Response Team” to fight the problem.

“It could be anyone’s kid and we shouldn’t have to be on high alert for syringes, we just shouldn’t,” said Archer.

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.