AIDS news: 包括4个艾滋病药的复方药物"Quad", 唾液HIV检测, 艾滋病预防药 : One_a_day therapy pill ("quad" pill), home HIV test (OraQuick), prevention pill (Truvada)

AIDS news: 包括4个艾滋病药的复方药物"Quad", 唾液HIV检测, 艾滋病预防药 : One_a_day therapy pill ("quad" pill), home HIV test (OraQuick), prevention pill (Truvada)
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Making HIV treatment simple: The new ‘quad’ pill

By Charlie Osborne | July 2, 2012

The treatment for HIV patients comes in many guises. Often, this involves a plethora of different drug cocktails; on occasion, trial-and-error combinations or simply a multitude of different pills to take during the day.
Human beings can be notorious for forgetting to take their daily dose. The more complicated the process, the less we’re inclined to follow the guidelines — or able to remember to.
So what if the treatment available became a one-time, single daily experience? Perhaps we wouldn’t forget quite so often, and perhaps it wouldn’t seem like such a chore. This, in turn, can only boost the effectiveness of the treatment plans we’re on.
For scientists in the United States, combining cocktails of drugs into one daily treatment tailored for those with the human immunodeficiency virus (HIV) appears to be safe and effective, according to a new study.
HIV isn’t currently possible to cure. Modern treatment methods include taking different pills at different stages of the day — and if a sufferer forgets, the treatment becomes less effective. Medical breakthroughs are not the sole way to combat illness and disease — what is known as patient compliance is also key, in order to maximize the effectiveness of drugs and procedures.
Paul Sax, clinical director at Brigham and Women’s Hospital, in Boston, Massachusetts, and associate professor at Harvard Medical School, led the recent study with this in mind.
A new “quad pill” that combines four separate drugs into one daily dose was given to 700 HIV sufferers in order to ascertain whether simplifying treatment raised the level of patient compliance — and therefore improving how we tackle HIV.
The team found that the new drug was “safe and effective” although one side effect is the raised risk of kidney problems. Sax said:
“Patient adherence to medication is vital, especially for patients with HIV, where missed doses can quickly lead to the virus becoming resistant to medication.
Our results provide an additional highly potent, well_tolerated treatment option and highlight the simplicity of treatment resulting from combining several antiretrovirals in a single pill.”
The four-in_one pill is the first to include a type of drug called an integrase inhibitor, which prevents the virus from replicating. An HIV specialist at Birmingham Heartland Hospital, Dr Steve Taylor, believes these types of combination treatments are the next step in tackling HIV.
Taylor said:
“Without a doubt the achievement of a one_a_day pill has been a big advance in tackling HIV. We’ve come a long way from people taking up to 40 pills three times a day.”
Combination drugs may increase the options available for treatment, but Taylor warns that 25 percent of those in the UK with HIV remain undiagnosed. We may not be able to control the spread effectively, but at the least, new HIV drug development may make the condition a little easier to live with.
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...Quad是四个药物的复方，研究发现，使用 Quad治疗的患者90%病毒载量下降到目标水平，结果略微胜过标准疗法。Gilead称，它确信该药能在2012年中按计划获得上市批准。Quad是包括4个药的复方药物：试验药物整合酶抑制剂 elvitegravir和增强剂cobicistat，以及2个已上市的老药Emtriva（emtricitabine，恩曲他滨）和Viread（韦瑞德，替诺福韦）。...
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FDA panel backs HIV over-the-counter test kit

By Charlie Osborne, Smart Planet | May 17, 2012

HIV prevention may be improved in the United States due to a new HIV testing kit that a panel at the Food and Drug Administration has recommended for distribution.
A panel at the FDA has recommended the approval of the over-the-counter HIV test, called the OraQuick In-Home HIV Test, and believe it is a safe and effective method that the general public should be able to purchase.
Even though there is a possibility of false results, the FDA’s advisory panel believes that the kit’s potential to help control the spread of the disease — which often goes untested and carried by those who are not aware — it is worth the effort to commercialize and distribute.
The FDA will decide this year if it is to be approved for commercial manufacture, the BBC reports. As 50,000 new cases are reported each year and a number must go untested and potentially causes additional infection, any way to provide detection of the disease — especially in the privacy of a home — may prove of benefit.
To take the test, an individual must swab the outer gum area of their mouth so the oral fluid can be checked for the presence of the HIV virus.The OraQuick In_Home HIV Test is reported to take 20 minutes and is 93 percent accurate for positive results. According to the manufacturer, it is 99.8 percent effective for negative results. If results prove positive, then it is recommended this becomes confirmed with a blood test for higher accuracy.
The panel that has recommended approval of the kit, the Blood Products Advisory Committee, voted unanimously for the test. However, they also suggested that the manufacturer should include “highly visible” warnings on the packaging concerning false results, and that it should also contain a toll-free number for counselling if the test proves positive.
Carl Schmid, deputy director of the AIDS Institute, said:“We are always looking for game changers, and we believe this is one of them.
Not only will it help reduce the number of infections but it will bring more people into care and treatment.”The maker, OraSure, says the home testing kit could be retailed at less than $60 if the FDA approve the panel’s recommendation
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唾液HIV检测新手段

加拿大麦吉尔(McGill)大学健康中心的一项新研究指出，唾液HIV检查时检查艾滋病的一项新手段，具体是什么样的呢?来看看下面的介绍吧：
　　这项研究证实，OraQuick HIV1/2抗体快速检测试剂，可用于检测病人唾液标本中的HIV2抗体。现在它可在现场检测唾液、指血、静脉血、血浆标本中的HIV1及HIV2抗体。只需要20分钟就可以得到检测结果，而且准确性高达100%。
　　这项研究的主要作者Nitika Pai 以450名印度居民进行艾滋病病毒感染的测试。其中32%的人为艾滋病病毒阳性。
　　研究人员进行的OraQuick诊断准确性测试，是利用二种样品进行的，一种取自于唾液，另一种则是指尖采血，检测结果再与传统验血比较。
　　研究人员发现，唾液检测的准确性可达100%，而指尖采血检测准确率为99.7%，其中有一例为伪阳性反应。
　　有少部分受试者表示唾液测试时有些不适，但是66%的受试者表示指尖采血检测更不舒服。
　　虽然口腔OraQuick 测试已经获得美国食品与药物监督管理局核准，但是之前的研究显示，它的准确性并不够。因此在印度进行了这项研究，根据研究结果，口腔测试的效果更为准确。
　　唾液检查艾滋病具体情况就是上面介绍的那样，希望上面的介绍对您有所帮助，如果您还有什么疑问的话请点击咨询我们的在线专家。
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FDA panel recommends new HIV-prevention drug

By Charlie Osborne, Smart Planet | May 12, 2012

A drug hailed as a means to prevent HIV infection has won the approval of a FDA panel, which may result in the clearance of a daily drug designed to battle the growing rate of the viral infection.
It is reported that the Food and Drug Administration advisory panel recommended the drug Truvada, designed for daily intake through a series of votes in a meeting this week.
The drug can be prescribed for otherwise healthy people who are considered at ‘high risk’ of contracting the human immunodeficiency virus — including homo***ual and bi***ual men, and hetero***ual couples who include one HIV-carrying partner.
Truvada has been marketed since 2004 as a treatment for those already carrying the virus. A combination of two older drugs, Emtriva and Viread, it is usually prescribed once an individual is already battling the condition.
The meeting eventually voted to recommend its daily use, but it did highlight a number of concerns. In particular, the potential of the drug lulling people into a false sense of security was raised — and whether it would result in the reduced use of condoms, which is currently one of the best ways to defend against HIV.
The drug’s effectiveness in women was also questioned, as clinical trials have shown a reduced level of protection for the fairer ***. In addition, whether individuals would adhere to the strict use of the drug was debated. One contributor told the panel:
“Truvada needs to be taken every day, 100 percent of the time, and my experience as a registered nurse tells me that won’t happen. In my eight years, not one patient that I’ve cared for has been 100 percent adherent.”
The drug does not offer full protection against the virus, but in a three-year study, the rate of infection was reduced by 75 percent in hetero***ual couples using the drug as a preventative measure.
However, the panel stressed that users must be tested for HIV before the drug is used, as long-term use would only increase resistance to the drug, and make long-term treatment more difficult to achieve.
Over a million Americans are estimated to carry the HIV virus, with hundreds of thousands unaware of their condition. The rate of new infections over the last 15 years is approximately 50,000 per year. Homo***ual and bi***ual men account for almost two-thirds of these cases.
The advisory panel in question cannot enforce its recommendations, but usually the FDA does follow its advice. A final decision is expected in June this year.
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第一个艾滋病预防药 美咨询小组支持Truvada

作者： 吴宁康 | 中央广播电台 – 2012年5月11日 上午7:27

美国抗病毒药物咨询委员会(Antiviral Drugs Advisory Committee)10日呼吁美国当局，通过吉利德科学公司(Gilead Sciences)研发出的药品Truvada，成为第一个「人体免疫缺乏病毒」(HIV)的预防药物。HIV病毒是造成艾滋病(AIDS)的主要病毒。
负责对美国食品和药物管理局(US Food and Drug Administration)提供咨询的抗病毒药物咨询委员会，是以19票对3票，支持指定Truvada成为HIV病毒阴性反应的同性恋男性药品，并以19票对2票、1票弃权，支持指定Truvada成为性伴侣为HIV病毒阳性反应、而本身尚未感染者的药物。
美国食品和药物管理局并不一定要接受抗病毒药物咨询委员的建议，但通常都会接受。而委员会的这项表决支持，可望使Truvada成为第一个被批准用于高风险群病患预防HIV感染的药物。
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治爱滋病新药Truvada 疗效有七成

【***2011年07月21日讯】（***记者郭靖康编译报导）最近有两项新的治爱滋病的研究发现，其中治爱滋病新药“Truvada”，经由美国疾病控制和预防中心（CDC）实验结果，疗效有七成以上。另一项的研究是由比尔和梅林达盖茨基金会资助，华盛顿大学开展的研究，用“Truvada”和“Viread”二种新药共用，疗效也接近七成。这为今后人体感染HIV后发展为爱滋病，药物的治疗带来新曙光。 据《美联社》报导，由CDC开展的研究，共涉及1,200多名博茨瓦纳（Botswana）的男性和女性。其中大约有一半人每天给预Truvada治疗，而另一半人则给安慰剂。分析表明服药组有4人感染了HIV，而对照组则有19人。这意味着Truvada药物降使HIV感染的风险降低78％。 CDC的帕克斯顿（Lynn Paxton）博士负责协调各机构对爱滋病的预防研究，他说：“这是个好消息，这对爱滋病预防来说真是个好日子”。“Truvada”和“Viread”都是由吉利德科学公司（Gilead Sciences）生产的。
第二项研究共有4,700肯亚和乌干达夫妇参与。每对夫妇都有一个HIV感染而另一个没有。未受HIV感染的人有一部分每天给予药物治疗，另一部分给予安慰剂。结果是 用“Truvada”治疗的人中有13名感染了HIV，用“Viread”治疗的有18名感染了HIV，而没有治疗的人中却有47人感染了HIV，得出的结论是药物治疗使HIV感染的风险降低了62％至73％。 该研究的共同主持人、华盛顿大学的研究员贝滕（Jared Baeten）博士说：“从本质上讲，不给那些用安慰剂的人治疗是违反道德的行为。我们的研究结果揭示药物治确实能够预防异性之间的HIV传播。”在这两项研究中，研究人员还给参与者提供谘询和赠送避孕套，这也可能解释了为何整体参与者感染率相对较低之故。
最早的有关爱滋病药物治疗的效果是去年宣布的。这是有关用Truvada治疗秘鲁、厄瓜多尔、巴西、南非、泰国和美国（三藩市和波士顿）的男同性恋者的研究。结果表明药物降低44％的HIV感染风险，而对与那些能坚持严格按治疗方案治疗的男性，药物治疗达到了降低73％甚至更多的HIV感染风险的效果。 基于这些令人鼓舞的结果，专家们真是喜不自禁。CDC建议医生给男同性恋者开Truvada处方。但这良好的发展势头却当头遭到一盆冷水。在今年四月涉及肯亚、坦桑尼亚和南非3,900名妇女研究的中期分析时，却发现Truvada并没有什么预防效果。
科学家们至今仍在寻找为什么四月份的研究Truvada无效而最新的两个研究却有效的原因。帕克斯顿博士说，有一种可能的解释是，在四月份进行的研究中，妇女接受药物治疗的次数比她们应有的次数少。 吉利德科学公司位于加州福斯特，是爱滋病药物的主要生产商。最近联合国卫生官员宣布，该公司已同意让一些药物由其他的药厂生产，从而无形中增加了这些药物在贫穷国家应用的可行性。
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Home / HIV/AIDS Basics / Just Diagnosed with HIV AIDS : Treatment Options : First Steps to Treatment :

First Steps to Treatment

You may feel a little overwhelmed when you first begin treatment for your HIV disease. During your first appointment, your healthcare provider should ask you questions about your medical history, conduct a physical exam, and order various medical tests. This is also a good time to ask all of the questions you may have about living with HIV and various treatment options available to you.

The initial medical tests your provider may order will give a better understanding of how the HIV virus is affecting your immune system. Two of the most important tests will be a CD4 count and a viral load test. You may also take a drug resistance test to determine the best medication options for you. The results of all of these tests will provide a baseline measurement for future tests.

Your provider may also order some other tests:
Complete blood count
Blood chemistry profile (including liver and kidney function tests)
Urinalysis
Tests for other ***ually transmitted diseases (STDs)
Tests for other infections, such as hepatitis, tuberculosis, or toxoplasmosis
An HLA-B*5701 test: Checks to see if you have a sensitivity to a specific HIV medication (abacavir) and should avoid taking it.
Coreceptor tropism assay: Checks to see if a specific type of HIV medication is appropriate for you. This test is usually used only if your body has shown resistance to other medications.
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Classes of HIV/AIDS Antiretroviral Drugs

The antiretroviral medications used to treat HIV/AIDS currently are organized into five major drug classes.
Reverse Transcriptase (RT) Inhibitors interfere with the critical step during the HIV life cycle known as reverse transcription. During this step, the HIV enzyme RT converts HIV RNA to HIV DNA. There are two main types of RT inhibitors.
Nucleoside/nucleotide RT inhibitors are faulty DNA building blocks. When these faulty pieces are incorporated into the HIV DNA (during the process when HIV RNA is converted to HIV DNA), the DNA chain cannot be completed, thereby blocking HIV from replicating in a cell.
Non-nucleoside RT inhibitors bind to RT, interfering with its ability to convert the HIV RNA into HIV DNA.

Protease Inhibitors interfere with the protease enzyme that HIV uses to produce infectious viral particles.
Fusion/Entry Inhibitors interfere with the virus' ability to fuse with the cellular membrane, thereby blocking entry into the host cell.
Integrase Inhibitors block integrase, the enzyme HIV uses to integrate genetic material of the virus into its target host cell.
Multidrug Combination Products combine drugs from more than one class into a single product. To combat virus strains from becoming resistant to specific antiretroviral drugs, healthcare providers recommend that people infected with HIV take a combination of antiretroviral drugs known as highly active antiretroviral therapy (HAART). Developed by NIAID-supported researchers, the HAART strategy combines drugs from at least two different antiretroviral drug classes.

In Development
Another HIV/AIDS drug class known as maturation inhibitors is still in development. If successful, they could potentially prevent HIV from properly assembling and maturing. For example, these treatments could block HIV from forming a protective outer coat or from emerging from human cells.

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China's Center for Disease Control does AIDS testing, gives free med's to those who are HIV+, and talks up prevention. That's good, could be better, and we can help. Us foreigners bring a lot of insights from societies that have lived with AIDS for 30 years, particularly the middle-aged gay men here who've lived the pre-AIDS life, then seen friends get sick and pass---and now NOT die. The stigmatization stuff, too.

Few of us can understand the nitty gritty of the medicine, but we can get a sense of the trends and work this into conversations with our Chinese students and colleagues. Those of us who are ***ually active, and see the dynamics in China's gay bathhouses, and the gay (and straight) *** industry, can also add something through gentle, humorous reminders of what safe *** is.

Though China is a "poster child" in comparison to many other places, there's still some bad news for our community: Chongqing and Chengdu's gay male population may have an HIV infection rate of 20%, a third of the new cases of AIDS in China got infected from gay ***, and most HIV+ individuals in China are not aware they are infected. The government testing centers now require identification- --no more anonymous HIV tests---and the med's provided through government channels may not be state-of-the- art (don't know the details). Curious how affluent, educated HIV+ individuals in the big cities make sure they get good treatment and med's---is there a gray/black market for imported AIDS drugs? Inland, not wealthy individuals rely on the government.

Through multiple channels we can help interested individuals hear about the trends abroad, which might help get them happening in China Here's some from recent articles:

[Intro to posting on ShanghaiLGBT and BGLAD, yahoogroups that many LGBT expats ("foreigners") participate in. From : AIDS news: One-a-day QUAD pill, home HIV test (OraQuick), prevention pill (Truvada) , Thu Jul 5, 2012 10:43 pm (PDT) . Posted by: "rmahoney58" ]