HIV

Union Cabinet approves amendments to HIV and AIDS (Prevention and Control) Bill, 2014

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The Union Cabinet under the chairmanship of Prime Minister Narendra Modi has given its approval to introduce official amendments to the HIV and AIDS (Prevention and Control) Bill, 2014 which has been drafted to safeguard the rights of people living with HIV and affected by HIV.

The Bill seeks to address HIV-related discrimination, strengthen the existing programme by bringing in legal accountability and establish formal mechanisms for inquiring into complaints and redressing grievances. The Bill seeks to prevent and control the spread of HIV and AIDS, prohibits discrimination against persons with HIV and AIDS, provides for informed consent and confidentiality with regard to their treatment, places obligations on establishments to safeguard rights of persons living with HIV and create mechanisms for redressing complaints. The Bill also aims to enhance access to health care services by ensuring informed consent and confidentiality for HIV-related testing, treatment and clinical research.

The Bill lists various grounds on which discrimination against HIV positive persons and those living with them is prohibited. These include the denial, termination, discontinuation or unfair treatment with regard to employment, educational establishments, health care services, residing or renting property, standing for public or private office, and provision of insurance (unless based on actuarial studies).  The requirement for HIV testing as a pre-requisite for obtaining employment or accessing health care or education is also prohibited.

Every HIV infected or affected person below the age of 18 years has the right to reside in a shared household and enjoy the facilities of the household. The Bill also prohibits any individual from publishing information or advocating feelings of hatred against HIV positive persons and those living with them. The Bill also provides for Guardianship for minors. A person between the age of 12 to 18 years who has sufficient maturity in understanding and managing the affairs of his HIV or AIDS affected family shall be competent to act as a guardian of another sibling below 18 years of age to be applicable in the matters relating to admission to educational establishments, operating bank accounts, managing property, care and treatment, amongst others.

The Bill requires that “No person shall be compelled to disclose his HIV status except with his informed consent, and if required by a court order”. Establishments keeping records of information of HIV positive persons shall adopt data protection measures. According to the Bill, the central and state governments shall take measures to prevent the spread of HIV or AIDS; provide anti-retroviral therapy and infection management for persons with HIV or AIDS; facilitate their access to welfare schemes especially for women and children; formulate HIV or AIDS education communication programmes that are age appropriate, gender sensitive, and non-stigmatizing; and lay guidelines for the care and treatment of children with HIV or AIDS. Every person in the care and custody of the state shall have right to HIV prevention, testing, treatment and counseling services. The Bill suggest that cases relating to HIV positive persons shall be disposed’ off by the court on a priority basis and duly ensuring the confidentiality.

There are no financial implications of the Bill. Most of the activities are being already undertaken or can be integrated within the existing systems of various Ministries under training, communication and data management, etc. The Bill makes provision for appointment of an ombudsman by state governments to inquire into complaints related to the violation of the Act and penal actions in case of non-compliance. The ombudsman need not be a separate entity, but any existing state government functionary can be deputed or given additional charge.

Source: 1

A new treatment appears to have erased HIV from a patient’s blood

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The first of 50 patients to complete a trial for a new HIV treatment in the UK is showing no signs of the virus in his blood.

The initial signs are very promising, but it’s too soon to say it’s a cure just yet: the HIV may return, doctors warn, and the presence of anti-HIV drugs in the man’s body mean it’s difficult to tell whether traces of the virus are actually gone for good.

That said, the team behind the trial – run by five British universities and the UK’s National Health Service – says we could be on the brink of defeating HIV (human immunodeficiency virus) for real.

“This is one of the first serious attempts at a full cure for HIV,” Mark Samuels, Managing Director of the National Institute for Health Research Office for Clinical Research Infrastructure, told Jonathan Leake at The Sunday Times.

“We are exploring the real possibility of curing HIV. This is a huge challenge and it’s still early days but the progress has been remarkable.”

HIV has long proved very difficult to treat because the disease can hide in dormant cells where the immune system can’t get to it.

This new therapy is the first aimed at destroying HIV in every part of the body, and it works by combining a drug that reactivates these dormant HIV cells with a vaccine designed to help the immune system find and kill them.

The vaccine is given to patients first, boosting the immune system’s ability to detect and combat HIV-infected cells. Then, a drug called Vorinostat is used, activating the dormant HIV cells left over, so the immune system can fight them too.

It’s as though the infected cells suddenly step out from their hiding place, and the newly boosted immune system can then pick them off.

Standard antiretroviral drugs in use today are effective at stopping HIV from reproducing and can keep the virus at bay, but are unable to kill it off altogether.

But the drug combination being used in this trial – which is being tested on 50 HIV patients – could mean we have a more effective treatment on our hands.

The unnamed 44-year-old man who is currently showing no sign of the virus in his blood is the first to finish the trial. In a few months, when the antiretroviral drugs wear off from him and the other participants in the study, we should have a better idea of whether the HIV has truly disappeared.

If the 44-year-old indeed has no traces left of HIV, it would mean he is only the second person to ever be cured of the disease, which affects some 37 million people around the world.

To date the only person considered to have been cured of HIV is American Timothy Ray Brown, who was given a bone marrow transplant from a donor known to be resistant to HIV. The stem cells he was given rebuilt his immune system, eradicating both the HIV and his acute myeloid leukaemia at the same time.

But that kind of treatment is too specific, too costly, and too dangerous to be used widely, which is why this new trial is causing a lot of excitement.

However, nobody’s taking anything for granted yet, including the male patient.

“I took part in the trial to help others as well as myself,” he told The Sunday Times.

“It would be a massive achievement if, after all these years, something is found to cure people of this disease. The fact that I was a part of that would be incredible.”

Source: 1

India, South Africa to begin collaborative research on HIV/AIDS and TB

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The Department of Biotechnology (DBT) in collaboration with Department of Science & Technology, and the Department of Science & Technology, Government of South Africa, and South African Medical Research Council will soon embark on a collaborative research programme on HIV, TB and TB/HIV. The programme would be under the framework of bilateral Science and Technology Cooperation Agreement between the Department of Science and Technology, Ministry of Science and Technology, Governments of India and South Africa.

The thrust areas of the programme would be on development of preventive HIV vaccine by designing immunogens that can elicit potent and broadly neutralizing antibodies; isolation and characterization of neutralizing MAbs effective against clade C HIV-1 viruses for use in combination therapies, passive immunization, and/or for designing preventive vaccines; Creation of cohorts of TB patients with HIV-1 co-infection and formation of national biorepositories (for breath condensates, blood, tissue etc.)to facilitate immunological studies on HIV and TB; and identification of biomarkers and development of novel assays for diagnosis and management of tuberculosis and tuberculosis with HIV co-infection.

The DBT’s initiative in this regard is significant as the human immunodeficiency virus (HIV) and tuberculosis (TB) are the leading causes of death in adults and children in both India and South Africa, and the impact of the converging dual epidemics is one of the major public health challenges of our time. Development of effective biomedical tools and solutions for diagnosis, prevention and treatment of AIDS and tuberculosis is required to address challenges in disease management and control.

Interdisciplinary research in these areas will not only accelerate development of transformational technologies but also help to develop capabilities and solutions for these unconquered diseases. The proposal should be geared towards product development or have clinically useful applications. It should have intra country linkages and a strong collaborative component utilizing complementary expertise of both countries, and addressing regional needs.

Scientists in either country could also submit proposals in case they have an existing product or a proof of concept and they would like to access facilities in either country for a collaborative framework to help facilitate product development in an accelerated manner (e.g. manufacturing, preclinical testing etc.). The programme is aimed to facilitate partnerships between research institutions in India and South Africa. This programme will leverage upon existing scientific capacities, enable technology transfer and catalyze mentorship/training. Thus, this collaboration will synergistically advance discovery efforts towards development of new technologies and products for prevention and management of HIV/AIDS and TB by building scientific leadership capacity, fostering a sustainable environment for translational research and enhancing clinical capability/capacity. In South Africa, this call for proposal is open to researchers residing in South Africa and who are affiliated with a recognized higher educational or research institution such as a university, university of technology or science council. The South African applicant must be in possession of a PhD. Private sector companies are not eligible for this call. In India, the lead Indian applicants should be scientists/faculty members working in regular capacity in universities, academic institutes or national research and development laboratories/institutes. Private sector companies are not eligible for this call.

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HIV therapy cuts mother-to-child transmission during breastfeeding

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For mothers who are infected with human immunodeficiency virus (HIV) but their immune system is in good health, taking a three-drug antiretroviral regimen during breastfeeding period can essentially eliminate HIV transmission by breast milk to their infants, finds a study.

The findings showed that both three-drug maternal antiretroviral therapy and daily infant nevirapine were safe and effective at preventing HIV transmission from mother to child during breastfeeding.

“Maternal antiretroviral therapy safely minimises the threat of HIV transmission through breast milk while preserving the health advantages of breastfeeding, as the high infant survival in this study underscores,” said Anthony S. Fauci, Immunologist and Director of National Institute of Allergy and Infectious Diseases (NIAID) — a US-based research organisation.

Further, the rate of perinatal transmission in those who continued the regimen was found to be very low – 0.3 per cent at six months of age and 0.6 per cent at one year of age.

The longer an HIV-infected mother breastfeeds, the greater the risk for HIV transmission to the infant.

Overall, infant mortality in the study was extremely low, with nearly all babies surviving their first year of life, the researchers said.

In comparison, in the absence of any intervention, rates of HIV transmission from a HIV-infected mother to her child during either pregnancy, labour, delivery or breastfeeding historically have ranged from 15 to 45 per cent, according to World Health Organisation (WHO).

“These findings add to the considerable body of evidence confirming the benefits of antiretroviral therapy for every person living with HIV,” Fauci added.

Infant mortality in resource-limited countries can be high, but following the therapy, nearly 99 percent of babies lived to see their first birthday.

HIV-infected mothers in areas that lack safe, clean water may be encouraged to breastfeed because of the health benefits for the infant and the risk for infants from mixing formula with an unsafe water supply, the study said.

Breastfeeding helps prevent malnutrition, and antibodies from breast milk protect babies against potentially life-threatening diarrheal and respiratory infections.

“HIV-infected mothers in low and middle income countries, who may not have access to alternative feeding methods, can be reassured that breastfeeding is a safe option for their infants,” explained Nahida Chakhtoura from Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) in the US.

For the study, the team enrolled 2,431 pairs of HIV-infected mothers and their HIV-uninfected infants at clinical research sites in India South Africa, Malawi, Tanzania, Uganda, Zambia, and Zimbabwe between June 2011 and October 2014.

 On average, the women were asymptomatic and had relatively high CD4+ cell levels — a marker of good immune system health.

 The first group of women used triple-drug antiretroviral therapy daily doses of nevirapine for the infant until 6 weeks after birth.

 The second group used triple-drug antiretroviral therapy until one week after delivery and daily doses of nevirapine for the infant beginning from the first week after birth and continuing through completion of study follow up.

 Infant nevirapine also offers a safe and effective alternative if the mother has difficulty adhering to or tolerating antiretroviral therapy, the researchers concluded, suggesting lifelong antiretroviral therapy for all pregnant and breastfeeding women living with HIV.

 The results were presented at the 8th International Workshop on HIV Pediatrics in Durban, South Africa, recently.

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Cancer-fighting immunotherapy could treat HIV

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Scientists from the University of California, Los Angeles found that recently discovered potent antibodies can be used to generate a specific type of cell called chimeric antigen receptors (CARs), that can be used to kill cells infected with HIV-1.File Photo: AP
Scientists from the University of California, Los Angeles found that recently discovered potent antibodies can be used to generate a specific type of cell called chimeric antigen receptors (CARs), that can be used to kill cells infected with HIV-1.

A type of immunotherapy that has shown promising results against cancer could also fight HIV, the virus that causes AIDS, a new study has found.

Scientists from the University of California, Los Angeles found that recently discovered potent antibodies can be used to generate a specific type of cell called chimeric antigen receptors (CARs), that can be used to kill cells infected with HIV-1.

CARs are artificially created immune T cells that have been engineered to produce receptors on their surface that are designed to target and kill specific cells containing viruses or tumor proteins.

Chimeric receptors are the focus of ongoing research into how gene immunotherapy can be used to fight cancer. However, they could also be used to create a strong immune response against HIV, said Otto Yang, professor at UCLA.

Although the human body’s immune system does initially respond to and attack HIV, the sheer onslaught of the virus – its ability to hide in different T cells and to rapidly replicate — eventually wears out and destroys the immune system, leaving the body vulnerable to a host of infections and diseases.

Researchers have been looking for ways to strengthen the immune system against HIV, and it now appears CARs could be a weapon in that fight.

“We took new generation antibodies and engineered them as artificial T- cell receptors, to reprogramme killer T cells to kill HIV-infected cells,” said Yang.

“Others have used antibodies against cancer antigens to make artificial T-cell receptors against cancer and shown this to be helpful in cancer treatment,” he said.

 

While the receptors approach has been in use for almost 10 years to fight cancer, this is the first attempt to use the technique to treat HIV since 15 years ago, when experiments proved unsuccessful.

The new research differs because it takes advantage of new antibodies that have been discovered in the past few years.

In the previous trials, researchers had used an early type that was not antibody-based. That approach, however, was abandoned because it was clinically ineffective.

Here the researchers used seven recently discovered .“broadly neutralising antibodies” that have the ability to bind multiple strains of invading viruses, unlike earlier isolated antibodies that tend to bind few strains.

These antibodies were re-engineered as artificial CAR—T cell receptors to have activity against broad strains of HIV.

In lab tests, the researchers found that all seven had varying degrees of ability to direct killer T cells to proliferate, kill and suppress viral replication in response to HIV-infected cells.

The next step is to find strategies to put these receptors into humans.

The research was published in the Journal of Virology.

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