Rapid implementation of the Gene Xpert, ‘the cuts that kill,’ and more…

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The following is a compilation of recent articles and news pieces making headlines in HIV/TB and global health.

HIV transmission via breast milk lower with daily nevirapine:  A recent Medscape article reviews findings from the HPTN 046 trial, which looked at more than 1500 babies breastfed by their HIV-infected mothers while receiving daily nevirapine. The babies on the six-month regimen were less apt to become infected than the infants who received the drug for six or 14 weeks. The trial also did not show an increase in adverse events associated with the longer regimen. The results of this phase III, randomized placebo-controlled study were issued at a late-breaking abstract at the 18th Conference on Retroviruses and Opportunistic Infections in Boston.

U.S. to fund  training of 140,000 African health workers: An article by the Associated Press details a new initative by the President’s Emergency Plan for AIDS Relief (PEPFAR) program to stem brain drain in Africa. Global AIDS Coordinator Eric Goosby announced that the U.S. will fund training for 140,000 African health care workers in a partnership between medical schools in the U.S. and Africa to “transform and dramatically increase” medical education on the African continent. “Some $130 million from [PEPFAR] and the National Institutes of Health will be awarded as grants over five years to medical schools across sub-Saharan Africa to work with partner schools in the United States,” according to the article.

Rapid implementation of the Xpert MTB/RIF diagnostic test: The World Health Organization (WHO) released a technical document outlining operational “how-to’s” and practical considerations when using the Gene Xpert, clarifying how the test can be effectively rolled out. In December the WHO endorsed the test, which can detect TB and drug resistance in less than two hours.  

The cuts that kill:  Joanne Carter, executive director of RESULTS, addressed the potentially devastating cuts to global health programs proposed for fiscal year 2011 by the House of Representatives in a powerful op-ed in the Huffington Post Thursday. A board member of the Global Fund to Fight AIDS, Tuberculosis and Malaria – Carter also combats recent overstatements of fraud at the Global Fund in her piece.

Risk of bone fractures higher among HIV-infected patients:  A new study in Clinical Infectious Diseases examines rates of bone fractures among HIV-infected patients as compared to the general population, and finds higher rates of fracture with the former. The study analyzed nearly 6,000 HIV-positive patients over an eight year period, comparing that with data for persons from the general population over a six year period, and found fracture rates among HIV patients between 1.98 and 3.69 times greater.

Further research critical to eliminating pediatric AIDS: In another op-ed to the Huffington Post, Drs. Nicholas Hellman and Richard Marlink make the case for supporting a robust research agenda focusing on children in order to move closer to an AIDS-free generation even in a challenging economic environment. “Studies in resource-poor settings have revealed that more complex drug regimens can reduce infant HIV infections even further — to nearly the same levels as now seen in the developed world,” the authors argue.

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