More on HIV prevention, diagnosis and treatment

November 30, 2007

World AIDS Day 2007

On December 1st PLoS Medicine is publishing a collection of research articles and commentary, as well as an editorial to mark World AIDS Day 2007.

Like all PLoS Medicine papers they are open access: freely available for anyone to read, download, redistribute and otherwise use, as long as the authorship is properly attributed

Details of the papers can be found below: Please mention PLoS Medicine in your report and use the links below to take your readers straight to the online articles:




IN THE PLoS MEDICINE MAGAZINE SECTION:

CMV retinitis is causing blindness in young people with HIV in the developing world

"We have unequivocally observed that CMV retinitis is causing blindness in a young population in developing countries, even though the full scope of the problem remains to be defined," says an international team of 14 eye doctors, HIV specialists, and medical and humanitarian aid workers in this week's PLoS Medicine.

Cytomegalovirus (CMV), a member of the herpesvirus family, was a familiar cause of blindness and death in patients with advanced AIDS in Western countries prior to the introduction of highly active antiretroviral therapy (HAART). In the era before HAART, about 1/3 of patients with AIDS in the West suffered potentially blinding CMV retinitis.

But in developing countries, CMV retinitis has been neglected, with little data describing the scope of the problem, and no strategy for management of the disease, say David Heiden (California Pacific Medical Center, San Francisco, California), Nathan Ford (Médecins Sans Frontières, Bangkapi, Bangkok, Thailand) and colleagues. CMV is absent from current and pending WHO guidelines for the management of HIV in resource-limited settings, they say, while the WHO's ambitious "Vision 2020" program, which seeks to provide guidance on the use of ophthalmologic resources until the year 2020, fails to mention CMV retinitis.

In order to assess the prevalence of CMV retinitis in HIV-infected patients in developing countries, the authors conducted retinal screening examinations at the primary care level in AIDS clinics in five countries of sub- Saharan Africa and Southeast Asia. They examined 325 HIV-infected patients with weakened immune systems (CD4 counts below 50 cells per micro liter). Twenty percent of patients had CMV retinitis, usually not previously diagnosed, and additional studies found 37% of individual eyes with CMV retinitis were blinded by the infection.

"The stark reality is that conditions favorable to the development of CMV retinitis--patients with low CD4 counts in the absence of HAART--are most common in impoverished rural areas where profound blindness will have a devastating impact on the entire family, and often a fatal outcome for the patient," say the authors.

Successful management of CMV retinitis is a realistic goal, say the authors, and must begin with decentralizing diagnostic capacity to the primary care level. They suggest that all high-risk patients (at minimum all patients with CD4 count below 50) must have properly conducted retinal screening examinations with the pupil fully dilated and using an indirect ophthalmoscope. Treatment with valganciclovir, an oral medication that is effective for both eye and systemic disease, is essential, say the authors. "Valganciclovir, a single-source monopoly product, is prohibitively expensive at present," they say, "but must be made available and affordable."

Citation: Heiden D, Ford N, Wilson D, Rodriguez WR, Margolis T, et al. (2007) Cytomegalovirus retinitis: The neglected disease of the AIDS pandemic. PLoS Med 4 (12): e334.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040334

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-12-heiden.pdf

Related image for press use: http://www.plos.org/press/plme-04-12-heiden.jpg

Caption: Example of CMV Retinitis

CONTACT:

Veronique Terrasse
Communications Officer - Asia
Médecins Sans Frontières
522 Mooban Nakorn Thai 14,
Bangkapi, Bangkok 10240
Thailand
Tel +66 08 15 82 36 40
E-mail: asiainfo@msf.org

David Wilson
Médecins Sans Frontières
Medical Coordinator
522 Mooban Nakorn Thai 14
Ladphrao Road, Soi 101/1
Bangkok 10240, 10240
Thailand
+ 66 8 1987 3241
+ 66 2374 9835
david.wilson.thai@gmail.com

Nathan Ford
Médecins Sans Frontières
Johannesburg
South Africa
nathan.ford@joburg.msf.org




Recent developments and future directions for antibody-based HIV-1 vaccines

In May 2007, the Global HIV Vaccine Enterprise (http://www.hivvaccineenterprise.org/) convened a two-day workshop to discuss humoral immune responses to HIV and approaches to designing vaccines that induce viral neutralizing and other potentially protective antibodies. This week PLoS Medicine publishes a report of the workshop, authored by David Montefiori (Duke University Medical Center) and colleagues. The report is a follow up to the Global HIV Vaccine Enterprise Scientific Strategic P lan, published in PLoS Medicine in 2005 (http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0020025)

Citation: Montefiori D, Sattentau Q, Flores J, Esparza J, Mascola J, et al. (2007) Antibody-based HIV- vaccines: Recent developments and future directions. PLoS Med 4(12): e348.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040348

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-12-montefiori.pdf

CONTACT:

David Montefiori
Duke University Medical Center
Department of Surgery
Department of Experimental Surgery Box 2926 Medical Center
Durham, NC 27710
United States of America
+1 919 684-5278
+1 919 684-4288 (fax)
monte@acpub.duke.edu




HIV Treatment Proceeds as Prevention Research Confounds

In an editorial that introduces the World AIDS Day 2007 issue, The PLoS Medicine Editors call for continued efforts to develop definitive methods of HIV prevention.

Citation: The PLoS Medicine Editors (2007) HIV treatment proceeds as prevention research confounds. PLoS Med 4 (12): e347.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040347

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-12-editors.pdf

CONTACT:

The PLoS Medicine Editors
medicine_editors@plos.org
-end-
About PLoS Medicine

PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit http://www.plosmedicine.org.

About the Public Library of Science

The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit http://www.plos.org.

PLOS

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