PEPFAR releases report to Congress, an update on drug-resistant TB in India, and more…

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The following “What We’re Reading” selection is a collection of articles, commentary and resources making headlines recently in global health news.

PEPFAR releases 8th annual report to Congress: The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program delivered its 8th annual report to Congress recently. The five-page document outlines the program’s progress as of the end of fiscal year 2011 in various areas including:  supporting 3.9 million people on antiretroviral treatment; testing 9.8 million pregnant women for HIV in the course of the year; providing prevention of mother-to-child transmission services to more than 660,000 HIV-infected pregnant women allowing 200,000 babies to be born HIV-free; and providing care and support for nearly 13 million people, including more than 4.1 million orphans and vulnerable children. The report also stressed the importance of “leading with science” as we respond to the pandemic, smart investments including spurring private-sector engagement, country ownership, and shared responsibility.

TB institute confirms 8 patients resistant to all known TB drugs:  According to this article in the Hindustan Times, eight of the 12 patients originally reported as having what was coined “totally” or “extremely” drug resistant TB (neither term is recognized by the World Health Organization) have received confirmatory sputum sample testing that show resistance to all first- and second-line TB drugs. Since the original diagnoses of the dozen patients, three have died and, according to a city TB officer, of the six patients that remain in Mumbai, five are undergoing treatment for extensively drug-resistant TB, and one is being treated at Hinduja hospital.

Nonprofit TB Vaccine Developers Sign MOU to Accelerate Progress: Aeras announced it will be joining with the Tuberculosis Vaccine Initiative (TBVI) to “enhance and strengthen collaborative efforts to advance the world’s most promising TB vaccine candidates.” The memorandum of understanding between the two organizations will work to address opportunities and challenges in TB vaccine development that were outlined in the strategic blueprint released by advocates in late March, and published in the journal Tuberculosis, just before World TB Day. According to the Aeras press release, the two organizations will advise each other on vaccines in development, work to streamline the process of candidate selection and review, as they work together to achieve the goals outlined in the blueprint.

Cotrimoxazole discontinuation linked to increased malaria: A study has found that HIV-infected adults with CD4 counts greater than 200 who were receiving antiretroviral therapy and live in an area of sub-Saharan Africa that is malaria-endemic that abruptly discontinue use of cotrimoxazole (used to prevent malaria) have an increased incidence of malaria and diarrhea than those who continue to use the drug. “Many countries recommend that people who start antiretroviral therapy (ART) should discontinue cotrimoxazole when their CD4 cell count – a measure of immune strength – goes above 200, but this practice has not been evaluated in sub-Saharan Africa,” according to IRIN Plus News. The study article, entitled “HIV-Infected Ugandan Adults Taking Antiretroviral Therapy With CD4 Counts >200 Cells/μL Who Discontinue Cotrimoxazole Prophylaxis Have Increased Risk of Malaria and Diarrhea,” appeared in the journal Clinical Infectious Diseases.

Stop TB Partnership Working Group on New Drugs launches “Innovate TB” campaign: The Stop TB Partnership has launched a new campaign, and a contest, to encourage and highlight innovations to achieve zero deaths from TB in this generation. To enter the Innovate TB (or InTB) contest, submit a video, photo series with captions, or written account of an innovative tool, procedure or program that aims to decrease TB in the world by visiting the campaign website. The deadline for submissions is May 26.

The Plague of Our Time – HIV/AIDS Epidemic: The New England Journal of Medicine has a new website and documentary highlighting advances made in the 200 year history of the NEJM. The last of the three-part documentary “Getting Better: 200 years of medicine,” is entitled The Plague of Our Time and looks at the collaboration between scientists and activists in the U.S. response to HIV/AIDS. Director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci, HIV Medicine Association Board Member Dr. Judith Currier, and Dr. Paul Farmer from Partners in Health are some of the stars of the film.    

Nurses demand protection from TB infection: This report from IRIN News describes a public demonstration held by nurses from the National TB Hospital in Manzini, Swaziland – a commercial hub. Swaziland has the highest HIV prevalence in the world and 80 percent of those who are infected also have tuberculosis (TB). The nurses claim that the hospitals are not protecting their workers from TB. The article sites a recent study conducted in KwaZulu-Natal, South Africa, that found TB and drug resistant TB incidence to be six or seven times greater among health care workers than among “non health care worker patients.” “There are no national guidelines on TB infection control measures in the country’s health care facilities, and nurses say this makes matters worse,” according to the article.

Antiviral agents and HIV prevention – controversies, conflicts and consensus: In this editorial commentary from the journal AIDS, lead investigator of the HIV Prevention Trials Network (HPTN) 052 trial Dr. Myron Cohen and colleagues address the issue of using antiretroviral therapy as a means of preventing HIV transmission prior to exposure (as pre-exposure prophylaxis or PrEP), after exposure (as post-exposure prophylaxis or PEP), and as treatment of HIV-infected persons for prevention of secondary infection (or treatment as prevention). The article reviews the latest scientific developments in antiretrovirals used to prevent HIV infection, looks at how studies involving stable heterosexual couples can be interpreted for other contexts, the population-level benefits of ART, data on taking ART to scale, and some thoughts on the importance of combination prevention as we make our way forward.

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