Patients with four-class drug-resistant HIV have a high burden of disease and “worrying” rate of malignancies, according to findings published in Open Forum Infectious Diseases.

Around 25% develop a clinical event or death within 4 years, researchers from Italy reported.

“Because of the high burden of disease in people living with HIV (PLWH) with 4-class drug-resistant (4DR) virus, close prevention and monitoring interventions are highly recommended, especially in people with a history of clinical events and low CD4+/CD8+ ratio,” the researchers wrote. “In PLWH with 4DR virus, efforts to favor access to drugs with new mechanisms of action are also urgently needed in order to achieve undetectable HIV-RNA load, preserve immune system, prevent clinical progression and ultimately improve quality of life.”

The researchers examined patient data from 148 PLWH with documented resistance to four drugs — nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs) and integrase strand transfer inhibitor (INSTI) — via the PRESTIGO Registry. They analyzed the incidence of death, various clinical events and the burden of disease, which they defined as the occurrence of new events, including AIDS or non-AIDS-defining events or death.

Among the 148 patients, 38 patients experienced 62 new events or died (incidence rate [IR] = 9.12/100 person-years of follow-up [PYFU]; 95% CI, 6.85-11.39). The new events included 12 deaths, 18 AIDS-defining events and 32 non-AIDS-defining events. Cumulative death incidence across 4 years was 6% (95% CI, 3%-13%). The risk for death or new clinical events was higher among PLWH with pervious clinical events (adjusted HR = 2.67; 95% CI, 1.07-6.67).

The authors said the study’s major limitations included the absence of a control group.

“Although, clinical records were carefully monitored, we cannot exclude a potential underestimation of clinical events, especially of non-AIDS-related events and mortality for which a link with the national death registry is not available in Italy,” the researchers wrote. “Another issue is related to the recent establishment of the PRESTIGIO Registry: Recorded people are those who survived a previous potentially fatal event and, for this reason, we might have underestimated the true incidences of AIDS-, non-AIDS-related events and death.”

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A drug used to treat type 2 diabetes could offer a simple and cheap solution to reduce dangerous side effects of steroid treatment, new research from Queen Mary University of London suggests.

The phase 2 clinical trial, funded by Barts Charity, looked at the effects of the diabetes drug metformin on patients currently receiving high doses of glucocorticoids, a type of steroids used to treat chronic inflammatory diseases.

The researchers analysed results from over 50 non-diabetic patients on glucocorticoid treatment from Barts Health NHS Trust and found that patients treated with metformin showed improved clinical outcomes. This included a 30 percent reduction in the rate of infections and lower hospital admissions, in comparison to the placebo group.

They also observed that treatment with metformin strengthened the intended anti-inflammatory effects of glucocorticoids and had beneficial results on several cardiovascular, metabolic and bone markers over the 12-week trial period.

The study is published today in the journal The Lancet Diabetes & Endocrinology, funded as part of a wider £25m commitment by Barts Charity to support innovative medical research at Barts and the London School of Medicine and Dentistry at Queen Mary.

Since the discovery of their therapeutic effects in the 1950s glucocorticoids, such as prednisolone, have revolutionized treatment of patients with chronic inflammatory disease. Now glucocorticoids are used to treat a range of conditions where the immune system is overactive, including rheumatoid arthritis, asthma, inflammatory diseases, and in cancer therapy.

However, prolonged use of these medicines at high doses can lead to serious metabolic side effects such as weight gain, high sugar levels, loss of bone and muscle mass, and increased risk of infection and thrombosis.

Long-term, these features can lead to Cushing’s syndrome, a potentially fatal disorder which also exists in patients where the body makes too much of the stress hormone cortisol.

Several biological medicines have been developed as alternatives to steroids but these drugs are expensive and can present their own adverse effects.

Previous research from Professor Márta Korbonits and colleagues found that steroids are able to influence a key metabolic protein, called AMP-kinase or AMPK. Other experimental studies have suggested that metformin acts, at least partly, via the AMPK protein and in the opposite way to steroids. Based on this evidence, the researchers reasoned that the diabetes drug held the potential to reverse the unwanted side effects of steroids.

Professor Márta Korbonits, Professor of Endocrinology at Barts and the London School of Medicine and Dentistry at Queen Mary, said: “Our findings are strikingly positive and suggest that a simple and immediately available intervention, treatment with the diabetes drug metformin, can improve the clinical status of patients on glucocorticoid treatment, even if they do not have diabetes. The results could have a huge impact on the large number of patients on long-term glucocorticoids, improving treatment-related complications and their cardiovascular prognosis.

“Whilst developed countries may be increasing the use of biologics or other steroid-sparing agents, in many other parts of the world there’s still a heavy reliance on glucocorticoids. Therefore, doctors and patients have been waiting for a safe, cheap and effective treatment that can prevent the major metabolic complications of these medicines, but does not affect, or could even improve, their anti-inflammatory properties. Our results suggest metformin has the potential to help these patients.”

Fiona Miller Smith, Chief Executive of Barts Charity, said: “At Barts Charity we are funding research to pioneer improvements in healthcare that not only enhance the lives of patients in our hospitals and local community but can also have an impact worldwide.

“Steroids are used to treat a vast range of conditions, from cancer to rheumatoid arthritis, and a large number of over 60s need to take these drugs to manage chronic conditions that could otherwise become extremely debilitating. The promising findings of this study show how funding innovative research can help us rethink long-standing problems facing patients and healthcare professionals, and in this case, even deliver new, simple and cost-effective treatment options for the NHS.”

It is estimated that around three percent of the general adult population and up to 11 percent of over 80s are currently prescribed long-term steroid treatment for chronic inflammatory disease.

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(Reuters Health) – The AbbVie drug elagolix, already used to treat the pain of endometriosis, can significantly reduce the chances of heavy menstrual bleeding caused by uterine fibroids, according to the results of two studies reported in The New England Journal of Medicine.

Uterine fibroids are non-cancerous growths in the uterus that can cause problems such as pain, pressure, heavy periods and infertility in as many as half the women who have them. They are very common, particularly among African American women.

The elagolix treatment, if approved by the U.S. Food and Drug Administration, could give women a new option for dealing with the bleeding. Current treatment sometimes involves injections given monthly or every three months. Elagolix is a pill whose effects appear and fade much more rapidly and predictably. The new studies did not directly compare the two treatments.

“This does provide a different approach and many women may prefer that,” lead study author Dr. William Schlaff of Thomas Jefferson University in Philadelphia told Reuters Health in a telephone interview. “We know it’s effective for at least six months. If that can be prolonged, it could act as a bridge to get to menopause, where hormone levels drop naturally.”

“But if you’re 32 years old (with a fibroid bleeding problem) this may not be a bridge you want to use for 20 years,” he said. Such women may want to consider a hysterectomy or some other option.

The two new studies – which were identical – followed a total of 790 women with a menstrual blood loss of more than 80 milliliters (about 2.7 ounces) per month.

At the six-month mark, among women getting placebo treatment, 8.7% in one study and 10% in the other saw their monthly blood loss reduced by at least 50%.

When the women were given elagolix alone, the success rates were 84.1% in one study and 77% in the other.

The treatment suppresses ovarian sex hormones, increasing the odds of osteoporosis. So in some women, doctors also gave hormone therapy to compensate.

With that hormonal “add-back therapy,” monthly flow was still reduced by at least 50% in 68.5% of women in one study and in 76.5% in the other.

Add-back therapy alleviated decreases in bone mineral density caused by elagolix but it also increased the number of hot flushes in both trials, and in one trial, it increased the likelihood of spotting between periods, the researchers found.

Most side effects of the drug “were considered by the investigators to be mild or moderate in severity,” they reported.

The studies, known as Elaris UF-1 and Elaris UF-2, were financed by AbbVie, which sells the drug under the brand name Orilissa.

The 300-milligram twice-daily elagolix treatment would cost more than $47,000 per year, according to prices on goodrx.com. In contrast, monthly leuprolide injections, which are an established treatment, costs roughly $7,000 per year.

Compared with placebo recipients, elagolix recipients with add-back therapy also had higher levels of the oxygen-carrying protein hemoglobin in their blood and were more likely to have their periods cease altogether.

They also tended to score higher on quality of life questionnaires.

Schlaff, who chairs the department of obstetrics and gynecology at Thomas Jefferson, predicted that if the drug is approved for fibroid bleeding, it will change the way women are treated.

“A lot of women want to use oral medication” instead of periodic injections, he said. “Women are going to say, ‘I don’t want to commit to a 1- or 3-month dose.’ Or they may want to start with one and move to another.”

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The National Institutes of Health said Tuesday that researchers have found a new drug that can reduce liver fat and prevent progression of liver fibrosis in people with HIV.

Non-alcoholic fatty liver disease is a growing cause of serious liver problems in HIV-positive people with 25 percent of HIV-positive people impacted, according to a report released earlier this year.

The National Institute of Allergy and Infectious Diseases and the National Cancer Institute, both part of the NIH, conducted the new study with researchers from Massachusetts General Hospital in Boston.

The injectable hormone tesamorelin reduces liver fat in HIV-positive people, the NIH researchers and MGH colleagues reported, adding the drug also prevents liver fibrosis and scarring.

“Many people living with HIV have overcome significant obstacles to live longer, healthier lives, though many still experience liver disease,” NIAID Director Anthony Fauci said in an NIH press release. “It is encouraging that tesamorelin, a drug already approved to treat other complications of HIV, may be effective in addressing non-alcoholic fatty liver disease.”

The ectopic fat accumulates in the liver causing NAFLD, and the visceral fat increases cardiovascular and type 2 diabetes risk. Grinspoon originally developed testamorelin with his colleagues to burn excess abdominal fat in people living with HIV by triggering production of growth hormone.

“People with HIV who develop significant deposits of visceral fat have disturbed production of growth hormone (GH),” Grinspoon, “who first identified the phenomenon,” explained in statement. “GH oxidizes or ‘burns,’ visceral fat.”

Researchers studied 61 men and women with HIV and NAFLD to find out if tesarmorelin could also reduce liver fat and other signs of NAFLD.

In the study, “for more than one in three subjects given the drug (35 percent), liver fat was reduced to below the threshold for NAFLD,” compared with 4 percent who had a placebo, the agency said.

The drug also slowed fibrosis progression with just two people given the drug having advanced fibrosis compared to nine given a placebo.

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There’s an infamous Australian advertisement that has a grim reaper tossing a bowling ball down an alley in the direction of scared white families who serve as pins. “At first only gays and IV drug users were being killed by AIDS,” the cryptic voice narrates the scene. “But now, we know every one of us could be devastated by it.” Created in 1987, the commercial was indicative of the general sentiment toward the autoimmune disease at time, which was outright fear.

Thirty-two years later it’s no wonder that when celebrities like Johnathan Van Ness share with the world that they have HIV, it’s considered another form of bravely “coming out.” Since the 1980s, there has been a stigma about HIV/AIDS that Sarah Hall’s play, As Much As I Can, hopes to tackle.

“At its core, it’s a love letter,” Sarah tells Teen Vogue about the award-winning play that recently showed at NYC’s Public Theater to a sold-out audience. “It is intended to make sure that these men feel seen, feel heard, and feel loved. It’s also an opportunity for the audience to be active participants in the story and to help us create change.”

Unlike past portrayals of the sexually transmitted disease (i.e. Rent or Falsetto), this immersive play has a majority Black cast and revolves around three gay men who are coming to terms with their sexuality while also dealing with the prevalence of HIV in their community. Interspersed with a church scene, drag show performance, and barbershop talk, the play hopes to make the topic of preventative care, transmission, and treatment approachable.

“The biggest misnomer about HIV/AIDS today is that the disease isn’t an issue anymore because of medication,” says Emil Wilbekin, founder of Native Son, an advocacy and networking group for professional black gay men. “Unfortunately, Black gay men suffer the highest rates of infection in the United States today. The CDC reports that by 2020, one in two Black men who have sex with men will be HIV positive — that is half of our population.”

Emil, who has HIV and has been a huge proponent of dismembering the stigma, believes the best way people can help is by showing up. “The best way that people outside of the LGBTQI+ community can support those living with HIV/AIDS is to be compassionate, empathetic, and supportive,” he says. “Being human and loving goes a long way.”

Currently, Blacks/African Americans account for a higher proportion of new HIV diagnoses and people living with HIV, compared to other races/ethnicities — 43 percent of all new diagnosis to be exact. HIV is preventable with medications like PrEP, but Sarah believes the numbers and common misnomers about HIV have not highlighted the urgency of support needed in the Black, gay community.

“There are also so many misconceptions about why Black queer men are facing these infection rates and the statistics don’t communicate the whole story,” she says. “Black queer men are not able to access the standard of care that is available to treat and prevent HIV in the way that they should.”

“We need to change that on an institutional level. Equally as importantly we need to develop an extremely strong support system around these men because they deserve it and because it makes a big impact on the treatment and prevention of HIV.”

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Preventing HIV just got cheaper for many New York residents.

The state Department of Financial Services has directed health care insurance plans to cover the full cost of pre-exposure prophylaxis, or PrEP, which can prevent HIV infection during sex or shared needle use.

PrEP involves taking the pill Truvada daily and seeing a doctor for testing every three months. It can lower the chances of infection from sex by more than 90 percent and from shared needle use by more than 70 percent, said Emma Corbett, vice president of marketing, communications and engagement for Planned Parenthood Mohawk Hudson, which offers PrEP.

The new policy means that people at risk for HIV infection covered by state-regulated health plans won’t face copayments, co-insurance or deductibles to receive the care. And that removes one of the biggest barriers that keeps people from using PrEP, Corbett said.

“Whether or not you can afford your medication is often a reason patients decide not to seek care or discontinue existing care,” she said in an email. “We’re encouraged by this action and are grateful that the governor has taken steps to ensure there is adequate insurance coverage for medications like PrEP because financial barriers hinder access for patients that are taking preventative steps to protect themselves.”

Copayments for people in employer-sponsored, health exchange and individual market plans tend to average around $60 a month for Truvada, said Steve Wood, director of insurance programs for ACR Health, which offers PrEP. And many plans have deductibles that must be met before drug coverage begins, he said. Truvada costs $2,000 for a 30-day supply, he said.

“If you can get if for free, … that’s great,” he said. “That opens it up for tons and tons of people.”

But money isn’t the only reason everyone at high risk isn’t on PrEP or isn’t using PrEP in a way to provide maximum protection, Wood said.

“I think without support and without a good consistent medical provider or some good social supports, I’m not sure how compliant people are with it,” he said. “It’s a difficult medicine to take. It has side effects that you’re going to have to live through for a couple weeks or a couple months. And it’s an everyday pill.”

But it’s worth it for those who stick with the regimen, he said.

“The reality is PrEP is going to save your life. It’s going to keep you from becoming infected with HIV,” Wood said.

Wood said he doesn’t know how many good candidates for PrEP actually choose to go on it in the first place. He did say the two most compliant groups seem to be injection drug users — who are used to taking a drug every day — and gay men over age 50 who, he speculated, remember all the deaths during the AIDS epidemic.

But HIV is not an issue of a particular group or two.

“The impact of HIV is felt by all communities and people of all backgrounds,” Corbett said in her email. “The disease does not know race or gender or sexual orientation. Especially in a time where so many Americans are struggling with addiction and other elevated risk behaviors, it is important to be proactive and PrEP is an effective tool for staying HIV-free.”

But Corbett reminded patients that PrEP does not prevent other sexually-transmitted diseases, and they should still use external or internal condoms during sex.

Gov. Andrew Cuomo announced in 2014 a campaign to end AIDS in New York by the end of 2020. This new policy is in line with that initiative.

At the same time, the state announced the new rules for PrEP coverage — that insurers must now issue member ID cards making it clear whether the plan is subject to state regulations and consumer protections. And the financial services department is putting out consumer information to help transgender New Yorkers understand and access their coverage for gender-affirming care.

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A popular diabetes drug sometimes taken to slow aging may diminish some of the expected health benefits of aerobic exercise in healthy older adults, according to a new report.

The drug, metformin, can blunt certain physical changes from exercise that normally help people to age well.

The results raise questions about the relationship of pills and physical activity in healthy aging and also whether we know enough about how drugs and exercise interact. The results are particularly disconcerting given that healthy, active people may be considering taking the drug to slow aging.

Metformin currently is the most-prescribed medication globally for people with Type 2 diabetes. It allows them to improve their blood-sugar control and insulin sensitivity, in large part by reducing the amount of sugar released by the liver into the blood. In people with diabetes, the benefits can clearly outweigh the risks.

But in recent years, scientists, physicians and plenty of other people entering middle age have become intrigued by the idea that it might also change how healthy people age.

Unsurprisingly, some researchers have speculated that combining metformin and exercise might lead to even greater anti-aging benefits than either approach alone. But little has been known about just how and whether metformin and exercise might work together deep inside our bodies and cells.

So, for the study published in Aging Cell, researchers at the Oklahoma Medical Research Foundation, Colorado State University and the University of Illinois decided to ask 53 sedentary but otherwise healthy men and women in their early 60s to sweat and swallow metformin.

It turned out, to no one’s surprise, that most of the volunteers had better aerobic fitness and blood-sugar control than before, as well as improved insulin sensitivity. But overall, the men and women taking metformin gained less fitness, upping their endurance by about half as much as those taking a placebo. Many of those taking the drug also showed slighter, if any, improvements in insulin sensitivity. (Hardly anyone’s weight changed much, in either group.)

The scientists next looked microscopically inside their volunteers’ muscles and found telling discrepancies between the two groups. The muscle cells of the exercisers on placebo teemed with active mitochondria, which are the cells’ powerhouses. Mitochondria transform oxygen and sugar into cellular fuel in a process referred to as mitochondrial respiration. Higher respiration generally means better cellular health.

In the muscle cells from the men and women on placebo, mitochondrial respiration rose by about 25%, compared to levels at the study’s start. But not so in the muscle cells from the metformin group, which showed little if any upswing.

In effect, metformin road-blocked the normal exercise-related gains in muscle-cell mitochondrial respiration, says Benjamin Miller, a principal investigator in the aging and metabolism research program at the Oklahoma Medical Research Foundation, who oversaw the study.

These results do not mean that people should stop or avoid using metformin, Miller cautions, even to brake aging. But the findings “do give us reason to think a bit more cautiously” about mixing metformin and exercise in healthy people, Miller says.

“There was not an additive effect” from combining them, he says. Instead, metformin and exercise “did not seem to play together very well.”

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A popular diabetes drug sometimes taken to slow ageing may diminish some of the expected health benefits of aerobic exercise in healthy older adults, according to a new report. The drug, metformin, can blunt certain physical changes from exercise that normally help people to age well.

The results raise questions about the relationship of pills and physical activity in healthy ageing and also whether we know enough about how drugs and exercise interact. The results are particularly disconcerting given that healthy, active people may be considering taking the drug to slow ageing.

Metformin currently is the most-prescribed medication globally for people with type 2 diabetes. It allows people with type 2 diabetes to improve their blood-sugar control and insulin sensitivity, in large part by reducing the amount of sugar released by the liver into the blood. In people with diabetes, the benefits can clearly outweigh the risks.

But in recent years, scientists, physicians and plenty of other people entering middle age have become intrigued by the idea that it might also change how healthy people age. Worms and rodents given metformin typically outlive their unmedicated labmates. These animal studies suggest the drug not only reduces blood sugar, it also reduces inflammation and produces other cellular effects that alter aging.

Exercise also influences ageing, of course. Animal and human studies show, for example, that regular activity raises people’s aerobic fitness and increases their insulin sensitivity, both of which are linked with longer, healthier life spans.

Greater anti-ageing benefits

Unsurprisingly, some researchers have speculated that combining metformin and exercise might lead to even greater anti-ageing benefits than either approach alone. But little has been known about just how and whether metformin and exercise might work together deep inside our bodies and cells.

So, for the new study, which was published in Aging Cell, researchers at the Oklahoma Medical Research Foundation, Colorado State University and the University of Illinois decided to ask healthy people to sweat and swallow metformin. They began by recruiting 53 sedentary but otherwise healthy men and women in their early 60s. Most had risk factors for type 2 diabetes, such as a family history, but were not diabetic.

The researchers measured the volunteers’ current aerobic fitness, blood-sugar levels, insulin sensitivity and body mass. They also took tiny leg-muscle biopsies and randomly assigned the volunteers to start taking either metformin or a placebo. All of the volunteers then began a supervised exercise programme, visiting the lab three times a week to jog on a treadmill or pedal a bike for 45 minutes, a routine that lasted for four months.

Afterwards, the researchers repeated all of the measurements from the study’s start and compared the two groups.

It turned out, to no one’s surprise, that most of the volunteers now had better aerobic fitness and blood-sugar control than before, as well as improved insulin sensitivity. Each of these physiological changes would be expected to improve how well the volunteers aged.

But there were notable disparities between the two groups.

Overall, the men and women taking metformin gained less fitness, upping their endurance by about half as much as those swallowing the placebo. Many of those taking the drug also showed slighter, if any, improvements in insulin sensitivity. (Hardly anyone’s weight changed much, in either group.)

The scientists next looked microscopically inside their volunteers’ muscles and found telling discrepancies between the two groups. The muscle cells of the exercisers on placebo teemed with active mitochondria, which are the cells’ powerhouses. Mitochondria transform oxygen and sugar into cellular fuel in a process referred to as mitochondrial respiration. Higher respiration generally means better cellular health.

In the muscle cells from the men and women on placebo, mitochondrial respiration rose by about 25 per cent, compared to levels at the study’s start. But not so in the muscle cells from the metformin group, which showed little if any upswing in mitochondrial respiration.

Road-blocked

In effect, metformin had road-blocked the normal exercise-related gains in muscle-cell mitochondrial respiration, says Benjamin Miller, a principal investigator in the ageing and metabolism research programme at the Oklahoma Medical Research Foundation, who oversaw the study.

Without these souped-up mitochondria, the exercisers on metformin seemed less able to improve their fitness or insulin sensitivity than the other volunteers.

These results do not mean that people should stop or avoid using metformin, Miller cautions, even to brake ageing. The study followed only a small group of people for a relatively short period of time and examined a mere fraction of the voluminous bodily effects of exercise and metformin. It also did not include people taking metformin without exercise.

But the findings “do give us reason to think a bit more cautiously” about mixing metformin and exercise in healthy people, Miller says. “There was not an additive effect” from combining them, he says. Instead, metformin and exercise “did not seem to play together very well”.

More research is needed, though, to understand how metformin affects mitochondria, exercise and ageing, he says. More broadly, the results raise questions about how exercise might respond to other medicines. “Doctors are very cognisant of drug-drug interactions,” he says. “It’s time we consider drug-and-exercise interactions, too.” – New York Times

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Zimbabwe has become the first country in the Sub-Saharan Africa region to complete the successful enrolment of participants who are taking part in the ongoing large-scale HIV vaccine efficacy trials which are currently underway on four continents, covering 12 countries with about 12 669 study participants on board.

Zimbabwe has 500 participants  in the HIV Vaccine Trials Network (HVTN) 705 also known as “lmbokodo” and the Antibody Mediated Prevention (AMP) studies which seek to find a lasting solution to a safe and effective HIV vaccine.

Speaking to The Herald at the weekend, HIV vaccine researcher at the University of Zimbabwe College of Health and Clinical Trials Research Centre, Dr Stranix Chibanda said the country finished its participants enrolment in June and they now await to monitor them as part of the research.

“The 705 study has just finished enrolling participants and now we continue to follow them up monitoring their health and checking how the immune system will react to vaccines.

“This will take a couple of years but I think in the next few years we will be able to roll out one of the vaccines for the benefit of our children today,” said Dr Chibanda.

Dr Chibanda added that while the HIV vaccine trial remained an ongoing process, Zimbabwe had shown its preparedness to take the vaccines aboard once they pass the due process.

“We are still doing the trials and not even in the next five years can we say we will be done. Maybe in 10 years, but I have noticed that the country is ready to take the vaccines once they are approved and licensed by the Medicines Control Authority of Zimbabwe.

“However, the end of this enrolment phase facilitates the collection and analysis of trial specific data enabling researchers to answer research questions. It is in this vein that I want to applaud all those who volunteered to participate in these trials and they are commended for their selfless contribution towards this noble effort to move closer to a world without Aids,” she said.

The AMP studies is now fully enrolled with 4 625 participants from communities in the USA, Brazil, Peru, Tanzania, Botswana, South Africa, Kenya, Malawi, Mozambique and Zimbabwe.

The AMP studies are the most advanced human clinical studies to test wether a broadly neutralising antibody (bNAb) called VRCO1 which is given intravenously can prevent HIV acquisition in people.

The trials also seek to help to establish the concentrations of bNAb’s required for protection and to characterise any “breakthrough”  HIV infection to understand if it was sensitive or resistant to VRCO1.

The studies also could also clarify what level of neutralisation a vaccine or antibody-based method of HIV prevention needs to achieve or maintain to promote sustained protection.

HVTN705 or “Imbokodo”, meaning the rock in Zulu, was derived from a popular African proverb “Wathint’ abafazi, Wathint’ Imbokodo! meaning “You strike the women, you strike the rock!” in recognition of the strength women show in the face of challenges.

This vaccine is being administered in women in Africa with 2 637 healthy HIV negative women aged 18-35 years drawn from Zimbabwe and the neighbouring countries helping in moving ahead with the trials.

The vaccine regimen being tested in Imbokodo is based on “mosaic” immunogens — vaccine components designed to induce immune responses against a wide range of global HIV strains.

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A stroke is a “brain attack.” It can happen to anyone at any time. It occurs when blood flow to an area of the brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. When brain cells die during a stroke, abilities controlled by that area of the brain, such as memory and muscle control, are lost. How a person is affected by their stroke depends on where the stroke occurs in the brain and how much the brain is damaged.

For example, someone who had a small stroke may only have minor problems, such as temporary weakness of an arm or leg. People who have larger strokes may be permanently paralyzed on one side of their body or lose their ability to speak. Some people recover completely from strokes, but more than two-thirds of survivors will have some type of disability.

Recovery:

Recovery time after a stroke is different for everyone. It can take weeks, months or even years. Stroke rehabilitation can include working with speech, physical and occupational therapists. Speech therapy helps people who have problems producing or understanding speech. Physical therapy uses exercises to help patients relearn movement and coordination skills they may have lost because of the stroke.

Occupational therapy focuses on improving daily activities, such as eating, drinking, dressing, bathing, reading and writing. Therapy and medicine may help with depression or other mental health conditions following a stroke.

New research:

Dr. S. Tom Carmichael, chair of neurology at Geffen School of Medicine at the University of California, Los Angeles, talked about a potential new drug to help with stroke recovery, “The mice made about 30 to 50% enhanced recovery called maraviroc. And the thing that is an advantage there is that we know in humans with movement or motor recovery that if you get a 10% improvement in motor function, that actually translates to a meaningful change in your interaction to the community.

“That’s what’s known as a minimal clinically important difference, or MCID. It’s about 10% in humans. And so the mouse recovery was far better than that, and it allows us some hope that it was a meaningful thing we hit in the mouse.”

Carmichael said maraviroc worked in mouse trials. Human trials are beginning now. The maraviroc trial will be run at UCLA, Yale and Burke Rehabilitation Institute. Since the drug is already approved by the Food and Drug Administration for safety in HIV patients., the trial is already in phase two.

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