Reducing HIV Cases

November 29th, 2008 healthwiki HIV-Aids 0

Universal and annual voluntary testing followed by immediate antiretroviral therapy treatment (irrespective of clinical stage or CD4 count) can reduce new HIV cases by 95 percent within 10 years, according to new findings based on a mathematical model developed by a group of HIV specialists in WHO. The findings were published in The Lancet to stimulate discussion, debate and further research.

Authors of the study also report that the universal voluntary testing followed by immediate ART could have additional public health benefits, including reducing the incidence of tuberculosis and the transmission of HIV from mother to child. Additionally, the model suggests that there could be a significant reduction of HIV-related morbidity and mortality in resource-limited countries with generalised HIV epidemics.

The current WHO policy on treatment involves voluntary testing and clinical and/or immunological evaluation (e.g. Cd4 count) to determine eligibility for treatment with antiretrovirals.

The authors emphasise the theoretical nature of the exercise based on data and raise a number of concerns regarding feasibility, including the protection of individual rights, drug resistance, toxicity and financing challenges.

WHO-recommended preventive interventions need to be maintained and expanded. This includes male circumcision, partner reduction, correct and consistent use of condoms, and interventions targeting most-at-risk populations, also known as “combination prevention.”

WHO will convene a meeting early next year bringing together ethicists, funders, human rights advocates, clinicians, prevention experts and AIDS programme managers to discuss this and other issues related to the wider use of antiretroviral therapy for HIV prevention.

Thought of World AIDS Day

November 29th, 2008 healthwiki HIV-Aids 0

Around 40 million people worldwide are HIV positive, 95% of them live in developing countries.

In 2004, approximately five million people were newly infected with the virus. HIV/AIDS has killed more than 20 million people worldwide. 3.1 million people died of AIDS-related causes in 2004.

The Global Fund To Fight AIDS, Tuberculosis and Malaria (GFATM) was created in 2001 to provide major financial resources in the fight against three diseases. These diseases kill over 6 million people each year and the numbers are growing.

As of mid-2007, the Global Fund Board approved more than US$ 7.7 billion for programmes in 136 countries. Together with the efforts of many implementing partners, Global Fund-supported programmes have already saved 1.8 million lives. Till mid 2008, the Global Fund committed US$ 11.3 billion in 136 countries to support aggressive interventions against all three diseases.

The Global Fund announced its approval of nearly $3 billion in Round 8 funding to improve access to HIV treatment and prevention and help reduce deaths from TB and malaria by 50% by 2015. The Global Fund’s board approved 94 grants worth $2.75 billion over two years, representing the group’s largest funding round to date (Global Fund release, 11/10).

The decision was made in New Delhi, during the Global Fund Board Meeting. The Board decision was rendered particularly difficult because the unusually large average size of the proposals meant that there was not enough money to pay the full cost of the proposals recommended for approval by the Technical Review Panel (TRP).

As of mid 2008, Global Fund supported programmes are estimated to have averted more than 2.5 million deaths by providing AIDS treatment (ARV) for 1.75 million people, anti-tuberculosis treatment (DOTS) for 3.9 million people, and by distributing 59 million insecticide-treated bed nets for the prevention of malaria worldwide.

Round 8 funding support now brings the Global Fund’s overall portfolio to US$ 14.4 billion in 140 countries. “This is the highest amount of new financing approved by the Global Fund ever. These new resources will significantly help the world in achieving global targets such as universal access to AIDS treatment and prevention, and cutting the number of deaths from tuberculosis and malaria by half by 2015,” said Rajat Gupta, Chair of the Global Fund Board.

He added that 38% of the resources will be used for HIV/AIDS programmes, 11% for TB programmes and 51% for malaria programmes. Around 90% of the approved grants will be distributed to low-income countries, 77% of which are in Africa and the Middle East. The remaining funds will be dispersed to countries in Asia, Central Asia, Eastern Europe, Western Pacific, the Caribbean and Latin America.

Michel Kazatchkine, Executive Director of the Global Fund, said the “increased demand” for funding “requires a renewed resource mobilisation effort.” He added that the Global Fund has a “fantastic message to bring back to the rich nations of the world: programmes to fight these three diseases save lives, reduce disease burdens and strengthen health systems” (Global Fund release, 11/10).

There is abundant evidence that science-based HIV prevention is effective, especially when backed by high-level political leadership, a national AIDS programme, strong community involvement together with adequate funding. Components of successful prevention efforts include clear and accurate communication about HIV/AIDS and methods to prevent infection, HIV counselling and testing, and treatment.

Gap analysis reveals that vast majority of people living with HIV/AIDS in the developing world do not have access to the treatment, as a result of limited health care infrastructures and the high cost of many medications. It has been estimated that a total of US$7-10 billion a year is needed from all sources to address the HIV/AIDS epidemic in low and middle-income countries. Allocation of around US$5.4 billion stands as great commitment of Global Fund to fight AIDS.

Fight For The People with HIV/AIDS

November 29th, 2008 healthwiki HIV-Aids 0

For many of us, December 1 will be just like any other day. But millions of people living with HIV/AIDS around the world will be looking towards us to stand up beside them, call for action and help stop their sufferings. Each year on December 1 the world celebrates World AIDS Day.

Yet, thousands of people in the country infected with the virus face social discrimination and stigma from different fonts. According to Human Rights Watch, “People living with HIV/AIDS and those thought to be infected have been imprisoned, assaulted and even murdered.”

The stigma of AIDS has taken many lives before the disease itself killed them. But the reasons behind the suicides and extent of this have rarely come to our knowledge. Society’s limited understanding of this disease is causing innocent people to pay a terrible price.

Increasingly across the world, there are voices questioning in one angle. They question the narrow approach to a single disease, especially the huge financing for AIDS over all else in basic health care. Our approach to this disease needs to change for the sake of our people, our brothers and our sisters who are fighting against odds.

Social factors like discrimination, stigmatisation and rejection have pushed people living with HIV to become desperate and feel hopeless, to the extent of giving up their life. They face discrimination and lack of support not only from the society but also from his/her own family. “I have actually seen how lack of support and stigma really makes to lose hope. How can we live if nobody is willing to listen to our problems?” said one of the victims in a rehabilitation centre in the city.

They are also being confined from friends, scared for losing their jobs. This made them to live in phobia and their condition become worse as they need proper and adequate treatment that could provide them with better life.

Most of these people are not getting proper medical and nursing care as stigma is attached so strongly to this illness that even some well educated people refuse to serve them. Many are afraid of consulting the doctors as they did not wish other people to know about their predicament.

According to the experts, with the existing treatment, people with HIV can lead a normal life like the others particularly if they receive good support from their family members, especially their parents.

The situation is aggravated by the fact that major percentage of the HIV positive individuals are injectable drug users (IDUs), who are marginalised by society and criminalised by the law. HIV/AIDS has already been concentrated epidemic among the IDUs. They must be taken under rehabilitation to stop the spread of this threat.

Conditions of women living with HIV/AIDS are dismal. Women are blamed for carrying the infection, even though they may have got the virus from their partners (in most cases husbands). Instances have been reported, where husbands abandon their ailing wives and children to find another wife. Due to the fear of social and family desertion, women are hesitant to disclose their HIV/AIDS status. Also, disclosure may lead to loss of job and reputations. This fear and dithering will make women an easy target of violence and abuse.

Dr Md Rajib Hossain…

Some Breast Cancers May Naturally Regress

November 26th, 2008 healthwiki Women's Health 0

Researchers who tracked breast cancer rates in Norwegian women proposed the controversial notion on Monday that some tumors found with mammograms might otherwise naturally disappear on their own if left undetected.

But leading cancer experts expressed doubt about the findings and urged women to continue to get regular mammograms, saying this screening technique unquestionably saves lives by finding breast cancer early on when it is most treatable.

Dr. Per-Henrik Zahl of the Norwegian Institute of Public Health in Oslo and Norwegian and U.S. colleagues examined invasive breast cancer rates among nearly 120,000 women age 50 to 64 who had a mammogram — an X-ray of the breast used to find evidence of cancer — every two years over a six-year period.

They compared the number of breast cancers detected with another group of about 110,000 Norwegian women of the same age and similar backgrounds who were screened just once at the end of the six-year period.

The researchers said they expected to find no differences in breast cancer rates but instead found 22 percent more invasive breast tumors in the group who had mammograms every two years.

Mammography and breast self-examination for tumors are standard methods used for early detection of breast cancer, the leading cause of cancer deaths among women worldwide.

The American Cancer Society estimated that about 465,000 women die of breast cancer globally each year, and 1.3 million new cases are diagnosed.

The researchers acknowledged many doctors might be skeptical of the idea but they cited 32 reported cases of a breast cancer regressing, a small number for such a common disease.

Blood Tests May Show Inherited Diseases in Fetuses

November 26th, 2008 healthwiki Diabetes 0

Doctors may soon be able to diagnose inherited diseases such as cystic fibrosis, thalassaemia and sickle cell anemia in fetuses by simply testing a blood sample taken from the mother.

Until now, prenatal diagnoses of such disorders have been possible only through invasive procedures like amniocentesis, which carry a risk of fetal miscarriage.

Amniocentesis is the extraction of a small amount of fluid from the sac surrounding a developing fetus.

But scientists in Hong Kong and Thailand may have found a way to diagnose in fetuses such “monogenic” diseases, which are caused by a single error in a single gene in the human DNA.

This is only possible because fetal DNA circulates in maternal blood, a discovery Lo and his colleagues made several years ago.

Many scientists have since been trying to find the best way to differentiate fetal DNA from maternal DNA, before they can even get down to looking for any anomalies in the fetal DNA. But these efforts have not met with much success.

In an article published in the Proceedings of the National Academy of Sciences, Lo and his colleagues said they had devised a counting system that could “bring non-invasive prenatal diagnosis of monogenic diseases closer to reality.”

Using highly precise digital blood testing technology, both mutant and normal DNA sequences are counted in maternal plasma and that is then used to calculate the number of mutant genes inherited by the fetus and to determine the probability of the fetus developing any monogenic disease.

Lo, however, noted that the accuracy of this method would depend on the concentration of fetal DNA in maternal blood.

Thalassaemia is a blood related genetic disease that can result in reduced fertility or even infertility. Early treatment can improve the quality of life of patients.

Cystic fibrosis affects the respiratory, digestive and reproductive systems and can lead to fatal lung infections.