The Risk you take #Smoking an Living with #HIV

1)   Smoking increases an HIV patient’s risk of dying.While HIV infection doesn't have a cure until now, with proper treatment, many people with HIV are living longer and more productive lives. The problem is that smoking poses a great threat to these people. In 2012, a large study by researchers from Copenhagen revealed that HIV-positive smokers lost 12.3 years of life compared with non-smoking people with HIV.

2)   Smoking makes it hard to fight HIV-related infections. Because smoking weakens the body’s defenses, it significantly reduces the likelihood of HIV-positive individuals overcoming opportunistic infections associated with their condition.

3)  Smoking makes HIV-positive people more at risk of cancer. There’s a large body of research suggesting that smoking increases the risk of malignancies and cancers among people with HIV or AIDS. One study published in the Journal of the National Cancer Institute in 1999 revealed anal and cervical cancer are more common among HIV-infected people who smoke than those who don’t.

4)  Smoking increases medication-related complications. HIV-infected individuals who smoke are more likely to suffer from treatment-related complications, such as nausea and vomiting, which can affect the quality of their life. This is why, as studies confirmed, many patients who smoke tend to discontinue undergoing treatments.

5)  Smoking increases risk of heart disease among HIV patients. Cigarette smoking – a known factor for heart disease, may be particularly harmful for people with HIV who are receiving prolonged antiretroviral treatment. Studies show that lipodystrophy, a common side effect of the said treatment, is more common among HIV-infected people who smoke.

6)  Smoking increases risk of AIDS Dementia Complex. This is a type of dementia that occurs in advanced stages of AIDS. In 1996, a study published in the Journal of Acquired Immune Deficiency Syndromes and Human Retro-virology found that AIDS Dementia Complex is much more common among HIV-positive smokers.

7)  Smoking is linked to early death among HIV-positive people. Due to the terrible effects of smoking on the body, there’s no surprise that it may actually accelerate the progression of HIV infection to AIDS. In 2006, a study revealed that the mortality rate in HIV-positive women who smoke is 53% higher than non-smoking HIV positive women.

Something that should make you think twice about protecting yourself.

Virulent A3/02 HIV Strain Leads to AIDS Within Five Years

Added by James Fenner on November 29, 2013.
Saved under AIDS, HIV, James Fenner
Tags: HIV

According to a group of Swedish researchers, based at Lund University, a highly virulent strain of HIV is capable of causing acquired immunodeficiency syndrome (AIDS) within just five years. The strain in question, labeled A3/02, was first discovered in 2011 and is considered part of a worrying rise in the number of cases of infection caused by “recombinant” forms of the deadly virus.

Human immunodeficiency virus (HIV) can be divided into two separate types, including HIV type 1 (HIV-1) and HIV type 2 (HIV-2). HIV-1 is the most typical, pathogenic strain of the virus, which can be further broken down into additional subtypes and circulating recombinant forms (CRF).

All in all, there are more than 60 epidemic strains of HIV-1, responsible for infecting people all over the globe. Typically, a specific geographic region is dominated by just one or two of these strains. If an individual becomes infected with two different strains of HIV-1, however, a recombination form of the virus can occur. The significance of this was briefly touched upon by doctoral student Angelica Palm, who studies at Lund University:

“Recombinants seem to be more vigorous and more aggressive than the strains from which they developed.”

The impact of these subtypes and CRFs on disease progression still remains poorly understood. This is where the Swedish researchers sought to delve a little deeper, by assessing the impact that the new CRF strain has on HIV-infected patients.

The Study

The researchers established the subtype/CRF of over 150 HIV-infected participants, hailing from the Republic of Guinea-Bissau – a country situated on the coast of West Africa, and bordered by Senegal and Guinea.

Structure of HIV virus, including the envelope glycoproteins, gp120 and gp41.

The scientists explored a specific region of one of the HIV virus’ genes, called env, which codes for the surface protein gp160. Ultimately, this protein is then broken down by an enzyme to produce two other functionally essential structures, gp120 and gp41. This helped with identification of the specific subtype/CRF for each subject.

The major subtypes discovered from the participants were called CRF02_AG and A3, affecting 53 percent and 29 percent of people, respectively. Interestingly, 13 percent of all subjects tested positive for A3/02, a recombinant form that stems from CRF02_AG and A3.

CRF02_AG and A3 were certainly anticipated, as they are the most common strains of HIV found in Guinea-Bissau. However, the A3/02 recombinant represented a relatively new strain, whose virulence was yet to be truly tested.

Once the HIV strain had been determined, the researchers wanted to identify how particular subtypes and CRFs influenced disease progression. As a consequence, they calculated a series of hazard ratios (HRs), adjusting for age and gender at seroconversion – the point at which the subjects first tested positive for HIV antibodies. The HR values provide an indication of the risk of developing AIDS, as they took into account the time from estimated seroconversion to developing AIDS and AIDS-related death.

HIV A3/02 Recominant Strain Highly Virulent

The researchers established that participants who were infected with the new, highly virulent form of HIV (A3/02) demonstrated an average three-fold increased risk of AIDS and AIDS-related deaths, compared to those people infected with the A3 strain.

People infected with the recombinant A3/02 strain also developed AIDS much quicker. For A3/02 sufferers, the estimated time from seroconversion to AIDS was five years, whereas the estimated time from seroconversion to death was just eight years.

People infected with CRF02_AG and A3, meanwhile, seemed to show slower disease progression and survived a number of years longer, as evidenced:

• CRF02_AG: seroconversion to AIDS was 6.2 years
• CRF02_AG: seroconversion to death was nine years
• A3: seroconversion to AIDS was 7.2 years
• A3: seroconversion to death was 11.3 years

Thus far, this strain of HIV has only been observed in populations of West Africa. Meanwhile, a number of other studies seem to show that recombinant strains of HIV are beginning to gain a foothold across the globe. According to a recent press release, the university suggests this problem is particularly pertinent to the United States and many countries in the European Union, where immigration levels are typically high.

As a consequence, the authors describe the development of a “complex HIV flora,” the likes of which were not evident during the preliminary stages of the epidemic, where only a sparse few non-recombinant viruses were responsible for infection.

The Future

Patrik Medstrand, a Professor of Clinical Virology at Lund University, ruminated over the implications of these new recombinant forms of HIV and the scientific community’s need to study them:

“HIV is an extremely dynamic and variable virus. New subtypes and recombinant forms of HIV-1 have been introduced to our part of the world, and it is highly likely that there are a large number of circulating recombinants of which we know little or nothing. We therefore need to be aware of how the HIV-1 epidemic changes over time.”

Currently over 35 million people are living with HIV across the globe, with over 35 million deaths having been recorded since AIDS first emerged, during the 1980s.

Worldwide prevalence of HIV in adults for 2011 (Image credit: Centers for Disease Control and Prevention)

Palm and her colleagues aim to continue research into the characteristics of different strains of recombinant HIV, and their presence in carriers throughout Europe. The study could also be useful for health authorities, with strain-specific knowledge potentially proving useful for future treatment strategies.

The recent findings were published in the latest issue of the Journal of Infectious Diseases, entitled Faster Progression to AIDS and AIDS-Related Death Among Seroincident Individuals Infected With Recombinant HIV-1 A3/CRF02_AG Compared With Sub-subtype A3.

By James Fenner

Religious Leaders Report on HIV Commitments

Faith-based leadership plays a critical role in reducing stigma related to HIV, but more still needs to be done, according to a report released for World AIDS Day by the Ecumenical Advocacy Alliance. The report, “Together We Must Still Do More” analyzes responses by religious leaders reporting on their fulfillment of a personal commitment to action to respond to HIV.


The report “confirms and validates two of the most important lessons each one of us has individually learnt from our personal experiences and community leadership involvement actions,” says Rev Canon Prof Gideon Byamugisha, International Network of Religious Leaders Living with or Personally Affected by HIV (INERELA+) and Global Working Group on Faith, SSDDIM & HIV (1).


“One is that AIDS (and the stigma that fuels it) cannot stand ground in the face of resolute faith community leadership and congregational involvement in prayer, accurate information sharing, appropriate attitudes and skills building, service provision and in practical advocacy for policy environments that make safe behaviors and practices known, possible, popular and routine,” states Byamugisha.


The second, he says, “is that wherever and whenever the people living with, vulnerable to, at-risk of and affected by HIV have been loved, cared for, supported and involved in HIV policy planning, messaging and communication and in service delivery; the dividends in enhanced HIV prevention, better health outcomes and greater community mobilization and solidarity against the epidemic have been there for all to see.”


The personal commitment to action was a product of a high-level meeting of religious leaders with people living with HIV and representatives of UN, government, and civil society organizations in March 2010. At the summit, some 40 high-level religious leaders signed “Together We Must Do More: My Personal Commitment to Action”. Since then, over 450 religious leaders have joined them. The commitment is unique because it asks signatories to report every 18 months how they have fulfilled their commitment. This is their second report.


The research that this report presents was conducted between June and September 2013, and comprises the findings from an online questionnaire and one-on-one interviews that surveyed a total of 47 religious leaders from five faith traditions(2) and 24 countries (3). Five key findings indicate that:


• While faith-based leadership plays a critical role in stigma reduction related to HIV, more still needs to be done;
• An effective faith-based and society-wide response to HIV is only possible if people living with HIV participate more meaningfully;
• Support for the faith-based response to HIV has the potential to deliver greater results;
• A perceived decrease in attention to HIV is cause for concern; and
• Gaps remain in responding effectively to the root causes of vulnerability to HIV.


“This report makes an important statement about the central role that faith-based leadership can play in challenging stigma towards people living with HIV,” says Raoul Fransen, MPH, Executive Director a.i., Global Network of People Living with HIV (GNP+).


“What is uplifting is the strength of commitment of many religious leaders from diverse backgrounds, who often face difficulties in their quest to overcome entrenched attitudes. To date, a good deal of work has been done to change faith- and society-held beliefs, but there is still much further to go, and complexities continue to be faced by many when discussing HIV, and the issues surrounding it,” he continues. “ It remains crucial for people living with HIV to participate in faith-based forums, in order to keep HIV on the agenda with faith leaders. In addition, this report shows that there are still some issues, such as men who have sex with men (MSM) and other key affected populations, which remain conspicuous by their absence, and presumably very challenging. It is our job to ensure that the voices of those who are most vulnerable to HIV are not swept under the carpet.”


The report notes that while the study represents a small sample, “the results demonstrate a high degree of commitment on the part of those who participated in the study in responding to HIV to the best of their ability, often with odds stacked against them.” Almost 20% of the religious leaders responding to the survey are openly living with HIV.


Byamugisha concludes, “Though a decrease in attention to HIV as well as the gaps that remain in responding effectively to the root causes of vulnerability to HIV are a cause for concern in the report, we are optimistic that continued leadership work and practical community level action from more faith communities and leaders can overcome these remaining challenges. Every time each of us leaders and faith communities do what we can, a societal solidarity momentum is generated that in sum total accomplishes what initially seemed impossible.”


Notes for Editors


(1) SSDDIM stands for Stigma, Shame, Denial, Discrimination, Inaction and Misaction
(2) Buddhist, Christian, Jewish, Muslim and Sikh faith traditions.
(3) Argentina; Bangladesh; Barbados; Cambodia; Canada; Cuba; Germany; Guyana; India; Israel; Malawi; Myanmar; Nigeria; Norway; Papua New Guinea; Rwanda; Sierra Leone; South Africa; Thailand; United Kingdom; United States of America;Vietnam; and Zimbabwe.


 
The full report, Together We Must Still Do More, is available here, as well as at www.hivcommitment.net.


For more information: contact Ruth Foley, rfoley@e-alliance.ch, +41 (0)22 791 6037.
<< back to Overview

The Ecumenical Advocacy Alliance is a broad international network of churches and Christian organizations cooperating in advocacy on food and HIV and AIDS. The Alliance is based in Geneva, Switzerland. For more information, see http://www.e-alliance.ch/

THE STIGMA WE CREATE IN OUR OWN HIV COMMUNITY.

THE STIGMA WE CREATE IN OUR OWN HIV COMMUNITY. 

When you only use perfect looking models in HIV CAMPAIGNS an publications you present an image to those out there that have signs of facial wasting that ...we can't use you in photos because 

you do-not look the perfect HIV MODEL we are looking for. I know i have felt this myself an the way this is going it has gotten worse an i blame from the top to the bottom of those involved in HIV for creating even more stigma..Most will say that's a lie! But i have observed this swing in who we show as the face of HIV well we out here are the "REAL FACE of AIDS" an you cannot shut me up. This issue has affected many out there that are the ones that have been unlucky with BIG PHARMA HIV MEDS SIDE EFFECTS, drug companies don't care they get their money at the cost of our dignity. Why not sue for damages? Why has know one done that because with all other meds they have sued for damages? But anyways BROTHERS an SISTERS with AIDS don't have SHAME an hide your beautiful FACES of AIDS anymore an tell these people who do the campaigns we want more FACES of AIDS in the PHOTO'S! An please stop hiding be brave an show your photos in public look at me im scarred by AIDS an mishapen by AIDS but here i am out front an have shown my photo all over the world in the last week so why don't you do it to ill show your FACES of AIDS on this blog if you would like to come out of the closet? Let me know ok ?

HIV FACTS

What is HIV?

HIV stands for the Human Immunodeficiency Virus. It is a virus which attacks the body’s immune system – the body’s defense against diseases. When someone is described as living with HIV, they have the HIV virus in their body.

What is AIDS?

AIDS stands for Acquired Immune Deficiency Syndrome. A person with HIV is considered to have developed AIDS when the immune system is so weak it can no longer fight off a range of diseases with which it would normally cope.

How is HIV passed on?

HIV can be passed on through infected blood, semen, vaginal fluids, rectal secretions or breast milk.

The most common ways HIV is passed on are:

• Sex without a condom
• Sharing infected needles, syringes or other injecting drug equipment

Is there a cure for HIV?

No, but treatment can keep the virus under control and the immune system healthy. People on HIV treatment can live a healthy, active life – although some may experience side effects from the treatment. If HIV is diagnosed late, treatment is likely to be less effective.

How can I protect myself and others from HIV infection?

Always use a condom when having vaginal or anal sex. You may also want to use a condom or dental dam during oral sex although the risk of transmission of HIV is much lower. You can get free condoms from a sexual health clinic, which you can locate at via the FPA website. Never share needles, syringes or any other injecting equipment.

THOUGHT

When written in Chinese, the word crisis is composed of two characters--one represents danger and the other represents opportunity.
  —John F. Kennedy

Family crises are unavoidable. At times, things are going to break down. This is no reason to give up and abandon ship. These breakdowns are the things, which will strengthen our lives together if we do not lose faith. The Einstein family had a crisis of sorts when their little boy, Albert, did not talk until he was four years old. But what looked like a problem at first did not end up that way in the long run. 

We can expect downhill slides once in a while, and we may even start to feel full of self-pity. With faith that these setbacks are meant to help us grow stronger, we won't waste them and end up having to face them again and again until we do recognize their true purpose.

What setback can I use to grow stronger today?

Please check out "THE LINK UP PROJECT" for WORLD AIDS DAY!

Link Up is an ambitious, five country project which aims to improve the sexual and reproductive health and rights (SRHR) of more than one million young people living with and affected by HIV in Bangladesh, Burundi, Ethiopia, Myanmar and Uganda.

The majority of SRHR/HIV programmes focus on adults living with HIV or on married women of reproductive age. Young people in many countries are often underserved by these programmes, or in the case of young people living with and affected by HIV, not served at all.

Link Up aims to change this. The project recognises that young people remain at the centre of the HIV epidemic and they have the power, through their leadership, to help bring an end to AIDS.  However, they face multiple barriers to contributing to HIV and SRHR policy and programme development processes.

Over a period of three years, the project will:

• provide comprehensive education on SRHR;
• build the skills and knowledge of civil society, ministries of health and governments to deliver improved services which young people feel safe and comfortable accessing;
• promote and protect the needs and rights of young people affected by HIV in their own national contexts;
• gather evidence around what works when integrating sexual and reproductive health and HIV services to inform the development of new services.

Download this two page project overview (available in English and French).

Download this policy briefing which summarises our recommendations for governments, ministries of health, donors, global policymakers and civil society groups.

Our focus

Link Up will distinctively work with young women and men living with and affected by HIV aged 24 years and under, with a particular focus on young women and men living with HIV, sex workers and children who are exploited for sex†,  men who have sex with men and , transgender people, all of whom experience extreme difficulties accessing services due to the high levels of stigma, discrimination, and in some cases, the fear of arrest.

The programme runs from January 2013 to January 2016. Link Up is funded by a grant of $43.8M from the the Government of the Netherlands’ Ministry of Foreign Affairs (Ministerie van Buitenlandse Zaken or BUZA)through its Sexual and Reproductive Health and Rights (SRHR) Fund.

†We refer to sex workers (aged 18-24) where relevant and ‘children exploited for sex’ for those aged below it.

The Link Up partnership

The project draws on the experiences of a consortium of organisations, and the existing strengths of the implementing partners. By ‘linking up’ we will make a significant contribution to the integration of sexual reproductive health and rights interventions.

Some FEAR: AIDS and HIV in TENNESSEE

  Published: November 29, 2013

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The world changed dramatically in 1981. IBM sold its first personal computer loaded with MS DOS software. The space shuttle Columbia made its inaugural flight. MTV brought music videos into living rooms. Just when it appeared technology was making life better for nearly everyone, doctors in San Francisco, Calif. were baffled by an illness that defied all known treatment. That frightening, incurable disease would soon become known as Acquired Immune Deficiency Syndrome, or AIDS.
In the more than three decades since AIDS emerged as a deadly threat, health officials have watched a roller-coaster of public fear and understanding about it. David Reagan, MD, PhD, chief medical officer for the Tennessee Department of Health, said while some shifts have been good, others are troublesome.
“It’s good we have more accurate information about AIDS, including its causes, effects and treatments but it is disturbing that too many people have become complacent about it,” he said.  “When we look at the alarming rate of new cases in some Tennessee counties, we believe there are many who don’t understand how it can change and end lives.”
In 2012, the Tennessee counties with the highest number of new Human Immunodeficiency Virus cases were Shelby with 413 and Davidson with 169. In the other 93 counties combined, there were 341 cases. By the end of 2012, a total of 19,038 Tennesseans were diagnosed with HIV, which can damage the immune system and lead to AIDS.
“While there have been advances in drugs and treatments, there is still no cure for HIV or AIDS,” said TDH State Epidemiologist Tim Jones, MD. “Once you have HIV or AIDS, you can only try to manage it as a chronic disease with costly medicines that may help some people more than others. We encourage people to be tested to know if they are infected, and to avoid the risky behaviors that can lead to HIV infection.”
“All of us need to know our HIV status definitively,” said TDH Commissioner John Dreyzehner, MD, MPH. “It’s not enough to hope we don’t need treatment or that we won’t transmit it to others. We need to know, and it is easier than ever to be tested.”
There are numerous locations across the state offering free or low-cost testing, including Tennessee’s county health department clinics. To find an HIV testing site near you, go to www.cdc.gov/hiv/prevention/index.html.
According to federal statistics, every nine and a half minutes another person in the U.S. is infected with HIV. While many of the early victims were homosexual men, more than one-fourth of new HIV infections today involve heterosexuals. Unprotected sex and injection drug users sharing needles still account for the majority of new cases.
“The distressing number of new HIV/AIDS cases we are seeing tells us there is not enough understanding about prevention,” Reagan said. “Discussing sexual activity may be uneasy for some parents and community leaders, but we need to have those talks to stem the rising tide of new infections. The physical and emotional toll for individuals, along with the economic healthcare costs to our state and nation, are too significant to be ignored. HIV/AIDS affects all of us in one way or another, and we must all work together to ensure fewer people are hurt by it and to assist those who have been infected.”

For more information about HIV and AIDS, go to www.cdc.gov/hiv/.

It is like a Miracle Drink! It is simple.

~MIRACLE DRINK ... KILLS CANCER CELLS TOO.....MUST READ :~

This MIRACLE DRINK has been circulating for a long time long
ago.It is worth your while to take note.

It is like a Miracle Drink! It is simple.

You need one beet root, one carrot and one apple that
combine together to make the JUICE! Wash the above, cut with the skin on into pieces and put them into the juicer and
immediately you drink the juice.

You can add some lime or lemon for more refreshing taste.
This Miracle Drink will be effective for the following ailments:

1. Prevent cancer cells to develop.It will restrain cancer cells to grow.
2. Prevent liver, kidney,pancreas disease and it can cure ulcer
as well.
3. Strengthen the lung, prevent heart attack and high blood
pressure.
4. Strengthen the immune system
5. Good for the eyesight, eliminate red and tired eyes or dry eyes
6. Help to eliminate pain from physical training, muscle ache
7. Detoxify, assist bowel movement, eliminate constipation.Therefore it will make skin healthy & LOOK more radiant.It is God sent for acne problem.
8. Improve bad breath due to indigestion, throat infection,
9.pain
10. Assist Hay Fever Sufferer from Hay Fever attack.

There is absolutely no side effect. Highly nutritious and easily
absorbed.Very effective if you need to loose weight.You will notice your immune system will be improved after 2 week routine.

Please make sure to drink immediately from the juicer for
best effect.

PLEASE SHARE TO YOUR FAMILY AND FRIENDS.

HIV QUOTE

"No one can lead our lives for us. We are responsible for our actions. So people—especially the younger generation---need to be very careful especially where safe sex is concerned."
-- Salman Ahmad

Some do...some don't Disclose #HIV STATUS.

This is a fantastic explanation to know your position.

HIV-optimistic homosexual and bisexual gentlemen who are mindful of their HIV status are a lot less possible to engage in dangerous sexual behaviors than those people who are not informed of their position, according to a new govt report from the Facilities for Disease Control and Avoidance.

Thirty-3 % of HIV-good males who have sex with men but who are unaware of their HIV status engaged in unprotected anal sexual intercourse in 2011 with somebody who did not have HIV.

Comparatively, thirteen percent of HIV-beneficial guys who have sex with males who did know their status engaged in unprotected anal sex with a person who did not have HIV.

“While we continue being anxious about probably raising amounts of sexual hazard, it is encouraging to see that possibility is considerably decrease in individuals who know they have HIV,” Tom Frieden, M.D., M.P.H, director of the CDC, reported in a statement. “HIV testing stays 1 of our most effective tools to reverse the epidemic. All people should know their HIV status.”

The results are particularly pertinent as a report posted past calendar year from the CDC showed that the price of new HIV infections is escalating between youthful homosexual and bisexual adult males.

In accordance to the CDC, men who have sexual intercourse with males make up virtually two-thirds of new HIV infections in the United States. About 50 % of the 1.one million people today dwelling with HIV in the U.S. are guys who have sex with guys.

The new report also demonstrates that much more adult men who have sex with adult men are engaging in unprotected anal intercourse, with 57 percent participating in this variety of intercourse in 2011 in comparison with forty eight % in 2005.

Read More: Article Source

But to some degree i disagree i know plenty who know #HIV status but lie about it or donot disclose it.

Screening new inmates for HIV may not reveal many new undetected cases

Nov. 26, 2013 – More than 90 percent of HIV-infected inmates entering prison in North Carolina had previously tested positive for the virus, according to a study published in the November 27 issue of the Journal of the American Medical Association.

David Wohl, MD

A significant proportion of people with HIV in the United States enter the prison system each year, and many have believed that screening new inmates for HIV would yield many new diagnoses. “We found that was not the case, and that few of the HIV-positive individuals coming into state prison in North Carolina had not previously been diagnosed with HIV,” said Dr. David Wohl, an associate professor of infectious diseases at the University of North Carolina School of Medicine and the lead author of the paper.

Wohl and his team tested 22,134 inmates entering prison between 2008 and 2009 for HIV using excess blood collected for mandatory syphilis testing. Overall, 1.45 percent (320) of these inmates tested HIV-positive. Merging test results with records from the N.C. Department of Health and Human Services revealed that all but 20, or 93.8 percent, of these inmates had a record of a positive HIV test prior to their incarceration.

The relatively low prevalence of undiagnosed HIV among those entering state prison suggests that an emphasis on screening incoming inmates to detect HIV may not be warranted.  “Other at-risk populations with higher levels of undiagnosed HIV infection may constitute a higher priority for screening for HIV than prisoners. Of all new HIV diagnoses in North Carolina in 2008-2009, less than 2 percent were prison entrants,” the authors concluded.

At the time the study was conducted, HIV testing in the North Carolina state prison system was voluntary. In July 2013, the state passed a bill requiring all prisoners to be tested for HIV at entry, every four years during incarceration, and at release.

Study co-authors are Carol Golin, MD, Jeanine May, PhD, and Becky White, MD, of the UNC Sheps Center for Health Services Research and David Rosen, PhD, of the UNC School of Medicine.

The National Institute of Drug Abuse at the National Institutes of Health funded this research.

---

Contact: Lisa Chensvold, 919-843-5719 or lisa_chensvold@med.unc.edu

Supplement Combo Lessens HIV Progression

Early in HIV infection, a combination of multivitamin and selenium supplements slowed the progress of the disease, researchers reported.

In a randomized placebo-controlled clinical trial in Botswana, the combination cut -- by about half -- the risk of reaching the point of needing antiretroviral therapy, according to Marianna Baum, PhD, of Florida International University in Miami, and colleagues.

But multivitamins or selenium alone had no significant effect, Baum and colleagues reported in the Nov. 27 issue of the Journal of the American Medical Association.

The approach has previously been shown to improve mortality among people with HIV, the authors noted, but studies have focused on people with more advanced disease, with important comorbidities such as tuberculosis, or already on antiretroviral therapy.

The Botswana study is the first to study the effect of micro-nutrient supplementation on patients whose plasma CD4-positive T-cell count was greater than 350 per micro-liter and who were not on antiretroviral therapy during the study, Baum and colleagues reported.

One implication of the findings is that "you may not need always to use an HIV medication to achieve at least part of what we try to accomplish with therapy," commented David Wohl, MD, of the University of North Carolina in Chapel Hill, N.C., who was not part of the study.

"What's nice about this study," he told MedPage Today, is that a simple and inexpensive intervention could have "effects that were fairly profound" and that slowed the decline of immune function.

On the other hand, HIV therapy, when it's eventually used, would probably "trump any effect of micronutrients," he said.

• In a randomized study of HIV-infected adults who had not received antiretroviral therapy-naive, 24-month supplementation with a single supplement containing multivitamins and selenium was safe, significantly reducing the risk of immune decline and morbidity.
• Multivitamins alone and selenium supplementation alone were not statistically different from placebo for any endpoint.

In Botswana, Baum and colleagues enrolled 878 people with a median CD4 cell count of 420 cells per microliter and randomly assigned them to one of four study arms: placebo, micronutrients, selenium, or micronutrients plus selenium.

The study medications were taken daily. The micronutrient pills contained thiamine, riboflavin, niacin, B6, B12, folic acid, and vitamins C and E. Those in the selenium arms got 200 mg of the element daily.

The primary endpoint was HIV progression, defined originally as reaching a CD4 cell count of less than 200 per microliter. Because of a change in national guidelines in March 2008, the researchers redefined HIV progression as reaching a CD4 count of less than 250 cells per microliter.

In a Cox regression model, adjusted for a range of factors and taking interactions between the supplements into consideration, only micronutrients plus selenium had a significant effect, Baum and colleagues reported.

After a median follow-up of 24 months, the combination, compared with placebo, had an adjusted hazard ratio for reaching the endpoint of 0.46 (95% CI 0.25-0.85, which was significant (P=0.01).

The absolute event rate, the researchers reported, was 4.79 per 100 person-years among those getting the combination, and 9.22 per 100 person-years among those getting placebo, they reported.

Multivitamins plus selenium also reduced the risk of an important secondary endpoint -- the combination of disease progression, AIDS-defining conditions, or AIDS-related death, whichever occurred earlier. The adjusted HR was 0.56 and was significant (P=0.03).

The authors reported that there was was no effect of supplementation on HIV viral load. Also, reported adverse events were deemed as unlikely to be related to the intervention.

By Michael Smith, North American Correspondent, MedPage Today

Primary source: Journal of the American Medical Association
Source reference: Baum MK, et al "Effect of micronutrient supplementation on disease progression in asymptomatic, antiretroviral-naive, HIV-infected adults in Botswana: A randomized clinical trial" JAMA 2013; 310(20): 2154-2163.

A good #multivitamin may help slow #HIV progression down?

Multivitamins May Help Fight HIV Progression, Study Suggests

But supplements tested only on those who hadn't started medications

November 26, 2013 

By Randy Dotinga
HealthDay Reporter

TUESDAY, Nov. 26, 2013 (HealthDay News) -- New research from Africa suggests that basic multivitamin and selenium supplements might greatly lower the risk that untreated people with the AIDS virus will get sicker over a two-year period.

It's not clear how patients who take the vitamins and mineral might fare over longer periods. And the impact of the study in the United States will be limited because many Americans diagnosed with HIV, the virus that causes AIDS, immediately begin treatment with powerful medications known as anti-retroviral drugs. Those in the African study hadn't yet begun taking drugs to keep the virus at bay.

Still, "it is incredibly useful to find new strategies to delay the progression of HIV disease," said Dr. Jared Baeten, an associate professor of global health at the University of Washington in Seattle who's familiar with the findings. "Not every HIV-infected person is immediately willing, or able, to initiate anti-retroviral therapy. Inexpensive, proven treatments ahead of starting anti-retroviral therapy can fill an important role."

At issue: Do HIV-infected people benefit from nutritional supplements? Previous research has suggested that even well-fed people infected with HIV may not properly process nutrients in food, said study author Marianna Baum, a professor of dietetics and nutrition at Florida International University's Stempel School of Public Health.

The researchers wondered whether the immune system would get a boost if patients who hadn't yet begun anti-retroviral treatment took nutritional supplements. No study had looked at this before, Baum noted.

For the study, published in the Nov. 27 issue of the Journal of the American Medical Association, the researchers divided nearly 900 HIV-infected patients in the African country of Botswana into several groups. Some took a placebo, a sugar pill with no active ingredients. Others took a multivitamin including B, C and E vitamins. Another group took the multivitamin along with supplements of the mineral selenium, and still others took only selenium.

None of the treatments had a noticeable effect except the combination of multivitamin and selenium. After adjusting their statistics so they wouldn't be thrown off by various factors, the researchers reported that those who took the combination were about half as likely to show signs over two years that their infection had progressed toward AIDS as those who took the placebo.

Overall, the risk that the disease would progress over the two years of the study was fairly low: 32 of the 217 who took the placebo suffered progression of the disease, she said, compared to 17 of the 220 who took the vitamin/mineral combination.

Baum didn't have information about the costs of the supplements, but she said they are low. In the United States, supplements that contain many vitamins and minerals can cost just pennies a day.

The supplements appeared to have no side effects, said Baum, who recommends that people newly diagnosed with HIV begin taking multivitamins. They seem to boost the immune system, she said. The selenium supplements, in particular, may provide enough of the mineral that the virus isn't able to hog it, she said.

Baeten cautioned that not just any multivitamin will do. "The results of this study appear to illustrate that it is not just any supplement," he said.

"Only the combination of vitamins plus selenium was effective," Baeten said. "For U.S. patients, this latter point is relevant, as there's a huge variety of supplements available. I would suggest talking with a doctor before taking any supplements."

He added that the study doesn't detract from the crucial importance of anti-retroviral drug treatment.

Researchers next want to see if the supplements help patients already taking anti-retroviral medications, study author Baum said.

More information

For more about HIV and AIDS, see the U.S. National Library of Medicine.

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