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EPIDEMICS
In mice, a step towards a vaccine for HIV
by Staff Writers
Paris (AFP) Nov 30, 2011

HIV spreading in Europe, but AIDS cases declining: study
Stockholm (AFP) Nov 30, 2011 - HIV infections continued to rise in Europe in 2010, but thanks to treatment the number of cases of full-blown AIDS has dramatically declined in recent years, according to a report published Wednesday.

"The new data raises concern about the continuing transmission of HIV in Europe," the World Health Organisation's Europe office and the European Centre for Disease Prevention and Control (ECDC) said in their joint report, published a day before World AIDS Day.

Last year, 27,116 new cases of HIV infections were reported in the European Union and European Economic Area, which is an increase of around four percent from 2009, according to the report, which stressed that statistics from Austria and Liechtenstein had not been accessible.

"In contrast, the steady decrease of AIDS cases continued in 2010 with 4,666 reported cases in the EU/EEA region," it said, pointing out that this was a drop of almost 50 percent from 2004 and stressing the importance of early HIV detection for reining in the AIDS epidemic.

According to a United Nations report published last week, a record 34 million people worldwide lived with HIV last year, while improved treatment has meant that the number of AIDS-linked deaths has steadily dropped from a peak of 2.2 million in 2005 to 1.8 million last year.

According to that report, about half of those eligible for treatment are now receiving it, something that saved the lives of 700,000 people in 2010.

"We need to demonstrate the political courage to focus on key populations most affected by HIV and to address the issue of late diagnosis of HIV infection which often leads to delayed treatment and higher rates of AIDS-related morbidity and mortality," ECDC chief Marc Sprenger said in a statement issued by the Stockholm-based EU agency.

ECDC and WHO researchers noted that "HIV epidemics are remarkably distinct in individual countries but overall, HIV continues to disproportionately affect certain key populations."

According to the report, HIV in Europe is still mainly transmitted through sex between men, while in cases of heterosexual contact, about one third of the reported cases originates with people from countries facing general epidemics of the virus.

People who inject drugs and people who are not aware that they carry the disease make up the biggest threat of transmission, according to the report.

The head of WHO Europe, Zsuzsanna Jakab, stressed the importance of creating "tailored responses" to HIV epidemics for different areas, since the characteristics can differ significantly.

Sprenger agreed, insisting that "only the knowledge of the characteristics of the epidemic in specific regions allows for effective responses" against the spread of the disease.


Tests on lab mice have opened up a new path towards a vaccine against HIV, one of the most frustrating quests in the 30-year history of AIDS, scientists reported on Wednesday.

Genetically modified mice fought back the human immunodeficiency virus (HIV) after they had been injected with genes to make antibodies, the first line of defence in the immune system, the report said in the journal Nature.

First identified in 1981, AIDS has claimed at least 25 million lives, although the annual toll is falling sharply from the peak of the pandemic in response to drug treatment.

But AIDS campaigners say the pandemic will only be crushed once a vaccine emerges. So far, in clinical trials, only one candidate formula has had even a modest effect, providing a shield of only 31 percent against the risk of HIV infection.

This has prompted researchers to return to the drawing board, to look for "broadly neutralising antibodies" -- Y-shaped proteins that are the immune system's foot soldiers -- among the tiny number of people with an innate ability to resist HIV.

So far, this trawl has turned up around 20 so-called "bNAbs," but there are big unknowns as to how they work and, if so, whether they can be made into a deliverable vaccine.

Delving into this, a team led by David Baltimore at the California Institute of Technology (Caltech) says it has developed a way to deliver bNAb-making genes to lab mice.

The rodents were engineered to carry human cells that allow HIV to penetrate and reproduce.

The approach, called Vectored ImmunoProphylaxis, or VIP, entails using a harmless virus as a "Trojan horse" in which they tucked the genes able to turn out specific bNAbs.

They then injected the virus into the leg muscles of the mice, where it holed up in cells, enabling the bNAb genes to produce antibodies in response to HIV.

The mice were first challenged with just one nanogram of AIDS virus -- enough to infect most non-treated mice that received it -- but the dose was eventually cranked up to 125 nanograms without problems. There were no signs of any side effects.

"VIP has a similar effect to a vaccine but without ever calling on the immune system to do any of the work," said Alejandro Balazs, lead author of the study, in a press release issued by Caltech.

"Normally, you put an antigen or killed bacteria or something into the body, and the immune system figures out how to make an antibody against it. We've taken that whole part out of the equation."

The team stressed that the jump from mice to humans is large.

"We're not promising that we've actually solved the human problem," said Baltimore. "But the evidence for prevention in these mice is very clear."

He added the team was drawing up plans to cautiously test the method in small-scale human clinical trials.

Baltimore co-won the 1975 Nobel Prize for Medicine at the age of 37 for his work on reverse transcriptase, a key enzyme in the reproduction of retroviruses -- the family that includes HIV.

In an email exchange with AFP, he said VIP was "like gene therapy, but distinct."

Gene therapy entails slotting a gene into the patient's DNA that corrects a flawed, disease-causing counterpart.

Hopes for this field of research were clouded by several reverses, notably the death of a young volunteer, Jesse Gelsinger, in 1999.

The tragedy raised doubts about where genes should be inserted in the genome and about the safety of the virus that delivered them.

Baltimore explained that VIP used a small, harmless vector, an adeno-associated virus (AAV), which took up residence in the muscle cells but did not slot genes into the mouse's DNA code.

"It's not an 'insertion' but a free plasmid-like element that will exist in muscle cells," he said.

Publication of the study coincided with the eve of World AIDS Day.

The number of people living with HIV currently stands at about 34 million, according to the latest UN figures.

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UN hails AIDS response, says concerned about funding
Geneva (AFP) Nov 30, 2011 - HIV infections fell and treatment soared following an unprecedented response to the AIDS epidemic over the last decade, the UN said on Wednesday, while sounding the alarm over declining funds.

New infections dropped by more than a quarter between 2001 and 2009 across 33 countries, a report published ahead of World AIDS Day on Thursday said.

More than 6.6 million received antiretroviral therapy in low and middle income countries last year compared to just 400,000 recorded in 2003.

In their update the World Health Organisation, UNICEF and UNAIDS hailed the "extraordinary" achievements in the battle against the disease.

The WHO and UNAIDS, the agency spearheading the international campaign, have adopted bold targets to achieve zero new infections and zero AIDS-related deaths by 2015.

"What would have been viewed as wildly unrealistic only a few years ago is now a very real possibility," said the report.

"Nevertheless, financial pressures on both domestic and foreign assistance budgets are threatening the impressive progress to date.

"Recent data indicating that HIV funding is declining is a deeply troubling trend that must be reversed for the international community to meet its commitments on HIV."

An estimated 34 million people are living with HIV, according to UNAIDS estimates released earlier this month, but the number of AIDS-linked deaths is steadily dropping from a peak of 2.2 million seen in 2005 to 1.8 million last year.

Globally about half of adults eligible for treatment are now receiving it, with the most dramatic improvement in access seen in sub-Saharan Africa, which recorded a 20 percent jump in people undergoing treatment between 2009 and 2010.

Wednesday's Global HIV/AIDS Response Progress Report said that from 2005 to 2010 the number of children receiving antiretroviral therapy increased from 71,500 to 456,000 -- just 23 percent of those in need.

"In 2010 approximately half of adults in need of treatment were receiving antiretroviral treatment while less than a quarter of the two million children who require antiretroviral treatment were recieving it," Leila Pakkala, director of UNICEF Geneva, told a press conference.

"This is a clear sign of the gap that exists and a gap that must be closed through collective and prioritised action."

A further challenge remains in Eastern Europe and Central Asia where the number of people dying from AIDS-related causes increased 1100 percent over the past decade from 7800 in 2001 to 89,500 last year.

New infections were also on the rise in the Middle East and North Africa.

On financing the battle against AIDS, the report said domestic and international HIV funding dropped from $15.9 billion in 2009 to $15 billion last year, "well below the estimated $22-24 billion needed in 2015 for a comprehensive, effective global response to HIV."

UN Secretary General Ban Ki-moon said: "Heading into the fourth decade of AIDS, we are finally in a position to end the epidemic.

"Financing will be critical to success. I urge all concerned to act on the investment framework put forward by UNAIDS and to fully fund the global investment target of up to $24 billion annually."



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