Tuberculosis, past and present, a research round-up, another microbicide approach and more . . .

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New weapon targets ancient foe: In a Jan. 7 blog post, National Institutes of Health Director Dr. Francis Collins  praises the FDA approval of the new antituberculosis drug Sirturo (known also as bedaquiline). With a brief history of TB, from its traces in Egyptian mummies, to “consumptives” in Victorian England, to the resurgence of tuberculosis around the world, he spells out why the development of more new drugs is critical.

Tuberculosis in New York City – Turning the Tide: This article by Thomas Frieden, now director of the Centers for Disease Control and Prevention, dates back to 1995, when he led New York’s program to control tuberculosis. He recounts here how tuberculosis programs, having become “victims of their own success,” were understaffed and under-resourced by the time the HIV epidemic combined with rising rates of poverty and homelessness, and immigration from countries with high prevalence of the disease joined to bring a resurgence of tuberculosis in the 1980s. With less than half the patients treated for the disease cured in 1989, drug resistance spread — the rate doubling in less than a decade. This article is about how that trend was reversed, with focus on screening, treatment and prevention among those at high risk. “New York City’s experience demonstrates that tuberculosis can be controlled even in populations in which immunosuppression is common and the prevalence of drug-resistant organisms is high,” he writes.

Hospital transmission of XDR-TB: On the other hand, this story, about a study in a South Africa hospital where conditions allowed drug-resistant tuberculosis to spread, gives a look at failures to institute necessary infection control measures today.

Px Wire: A Quarterly Update on HIV Prevention Research: With a spread summing up the elements of AVAC’s “Achieving the End” report, a closer look at PEPFAR’s Blueprint, and a report from AVAC’s Advocacy Partners’ Forum in Johannesburg, this is a quick way to catch up on recent action in HIV prevention.

HIV Trial scrutiny:This article looks at plans for a clinical trial in Africa to determine if antibody therapy can prevent breast milk transmission of HIV. It balances issues about testing treatments in areas where they are unaffordable, with the point that confronting HIV in poor countries was, in itself considered unaffordable once.

First Trial Proposed of a Candidate Microbicide for Women Living with HIV: Women living with HIV could benefit from a microbicide that could help protect them from infection with additional strains of the virus, but could not use those currently in human trials because of the risk of developing resistance to the antiretroviral drugs the current products contain. This article tells of a different approach to developing a microbicide, and why that is encouraging news.

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