AIDS

A new class of anti-AIDS agent is about to enter the marketplace. The drug is a protease inhibitor targeted against a protease molecule crucial to the replication of the HIV virus.

It is often the case that once a person is given a drug for the treatment of an infection, the infectious agent finds a way to mutate, survive and to ultimately resist the effects of the drug. Researchers at the AIDS Institute at the University of California at Los Angeles have found that a significant number of individuals with AIDS who have never been exposed to this drug harbor a viral strain of HIV that is resistant to the drug. Of the samples taken from a group of infected patients, one third appeared to have the protease enzyme mutations resulting in reduced efficacy of the drug.

According to a study designed to estimate the prevalence of HIV by age, the number of young Americans presenting as new AIDS cases continues to escalate, whilst the number of cases of AIDS among people born prior to 1960 is starting to level off.

The study compared the estimated number of new HIV infections among white, African-American and Hispanic Americans per 100,000 individuals during the time periods 1981-1986 and 1987-1992. Philip S. Rosenberg, Ph.D. of the National Cancer Institute, used a statistical method called “back calculation” on the data, and found that for both time periods, the rate of HIV infection increased rapidly among American youth in their late teens, with peaks in the mid to late 20s. Although the number of new infections appears to be declining over time among white men, especially those older than 30, there was no evidence of a similar decline among women or minority groups.

The study is the first to analyze national AIDS data, and consequently provides the clearest picture to date of a startling pattern of unfavorable trends in acquisition of new HIV infections among the young individuals. “The data indicate that targeted efforts in prevention of infection are needed among adolescents and young adults in all racial and ethnic group, and special efforts are needed over a broader range of ages - certainly through the 30s - among minority men and women” Said Rosenberg.

A recent report has shown that multiple genes or gene combinations may influence how long a person with HIV infection remains disease-free.

Sixty eight HIV positive homosexual men who had not developed AIDS after six or more years of infection, and 71 bisexual and homosexual men who had developed AIDS were screened for genes that encode human leukocyte antigen, HLA. The researchers found that the major histocompatability complex (MHC), a cluster of genes that indicate the HLA region, seemed to govern the rate of progression of HIV infection through multiple interacting genes. Few of the genes showed convincing individual relationships, but cumulatively they had a substantial impact.

MHC is important in the body's immune response to foreign substances such as HIV, and it is hoped the new information could help researchers in exploring the mechanisms that promote or retard deterioration of the immune system and in evaluating certain therapeutic approaches.

SEXUALLY TRANSMITTED DISEASES

More than 13 million people get affected by at least one of the 20 or so known sexually transmitted diseases every year. Since symptoms are often absent or misleading, diagnosis can be difficult, and can lead to serious health problems if not treated. Additionally, STDs tend to cause more severe and frequent problems among women than in men.

The most common STDs are infections caused by genital herpes, chlamydia, gonorrhea, human papillomavirus (HPV, genital warts) and the microorgranism that leads to syphilis. However, if left undiagnosed or untreated, STDs can lead to conditions such as pelvic inflammatory disease, the leading gynecologic cause of hospitalization for women. This condition can scar fallopian tubes and result in infertility or life-threatening ectopic pregnancy. HIV/AIDS, is rapidly rising among heterosexual women, and as yet no cure is known for this fatal disease.

STDs as the name implies are transmitted by sexual intercourse and/or other exchange of body fluids. Women are more likely to be infected by a male than a female partner. Additionally, a mother's STD can infect her newborn and lead to blindness, mental retardation, nervous system damage or death of the infant. Birth by cesarean section in order to reduce the risk of infecting the newborn may become necessary.

Abstinence is the only reliable method in preventing spread of STDs. However, sexually active people can take steps to protect themselves and their partners. Monogamy is the safest means since having multiple partners greatly increases the risk of contracting the STD. When correctly used, condoms can also decrease the chance of getting infected. There are no other menas by which the risk of acuiring STD infection can be lowered.

With the exception of herpes and HIV/AIDS, STDs, especially when diagnosed early are usually treatable. Treatments of herpes infection may lessen the frequency and severity of the symptoms, but the condition is incurable. Genital warts can be removed, but may additional treatment if they recur. Since some STDs, such as chlamydia, cause very few or no symptoms in some women, it is important to have routine examinations. Equally, there are some STDs which are relatively symptomless in men, but can cause great discomfort in women. If either partner has a STD, both should be evaluated, and simultaneoul treated.