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The untold Side of the movie "Dallas Buyers Club"
The movie Dallas Buyers Club brings attention to a little-recognized part of the AIDS activist movement: ....
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Exhorbitant Price New Hepatitis C Drug
Fair Pricing Coalition Condemns Gilead Sciences on the High Price of New Hepatitis C Drug Sovaldi™...
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Six Promising HIV Drugs in the Pipeline (2013-2014)
What new HIV medications do we have to look forward to over the next few years? How will these newer drugs improve upon the older ones? To shed some light on these questions....
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What Can We Look Forward to in HIV Cure Research
TheBodyPRO.com's Nelson Vergel sat down with leading HIV cure research activist Richard Jefferys for an update on current important aspects, and controversies, in HIV cure research....
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What Supplements Can I take with HIV medications?
Is it ok to supplement with Creatine (Cell-Tech), and Protein (Nitro-Tech) along with Glutamine...
Tuesday, November 30, 2010
Fw: Hot Topics at The Body's "Ask the Experts" Forums
Saturday, November 20, 2010
Review of aTalk by Nelson Vergel: “Survivor Wisdom: Advances in Managing Side Effects, Living Well, and Aging with HIV” – New York City, November 9, 2010
http://nybc.wordpress.com/2010/11/17/nelson-vergel-survivor-wisdom/
Tuesday, November 16, 2010
Fw: Hot Topics at The Body's "Ask the Experts" Forums
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Thursday, November 11, 2010
Egrifta Gets Approved for the Treatment of Abdominal Fat Accumulation in HIV- Activists Ask Serono to Price it Affordably
Press Release from Serono:
http://multivu.prnewswire.com/mnr/emdserono/47019/
Here's a link to the full prescribing info via Serono's website:
http://www.emdserono.com/cmg.emdserono_us/en/images/FULL%20PRESCRIBING%20INFORMATION_tcm115_59676.pdf?Version=
A Closer Look at Egrifta, a Newly Approved Treatment for HIV-Associated Belly Fat Gain (Lipohypertrophy)
http://www.thebody.com/content/art59340.html
For physicians interested in learning more about EGRIFTA™ and
the process for prescribing EGRIFTA™, call the AXIS Center
toll-free at 877-714-AXIS (2947).
Egrifta.com will have more information soon about patient assistance and other important issues
Briefing Information for the May 27, 2010 Meeting of the Endocrinologic and Metabolic Drugs Advisory Committee
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/EndocrinologicandMetabolicDrugsAdvisoryCommittee/UCM213260.pdf
LETTER SENT BY ACTIVISTS TO SERONO:
Executive Vice President
Endocrinology
EMD Serono Inc.
Risk of MI May Go Up With Calcium Supplements
MedPage Today
Published: July 29, 2010
Effect of calcium supplements on risk of myocardial infarction and ...
Jul 29, 2010 ... Recently, the Women's Health Initiative reported that calcium and vitamin D had no effect on the risk of coronary heart disease or stroke.41 ...
www.natap.org/2010/newsUpdates/081110_05.htm
Calcium supplements boost heart-attack risk: Meta-analysis
Jul 29, 2010 ... Calcium supplements boost heart-attack risk: Meta-analysis. "Schindler also said that the real risk of MI appeared to be in people who took ...ww.natap.org/2010/newsUpdates/080610_21.htm
Calcium supplementation appears to increase the risk of myocardial infarction, a meta-analysis showed.
Among studies of patients with or at risk for osteoporosis, those who took calcium supplements were about 30% more likely to have an MI than those who did not, Ian Reid, MD, of the University of Auckland in New Zealand, and colleagues reported online in BMJ.
Among randomized controlled trials with patient-level data, the hazard ratio for MI with supplementation was 1.31 (95% CI 1.02 to 1.67). Among those with trial-level data, the relative risk was 1.27 (95% CI 1.01 to 1.59).
"As calcium supplements are widely used, these modest increases in risk of cardiovascular disease might translate into a large burden of disease in the population," the researchers wrote. "A reassessment of the role of calcium supplements in the management of osteoporosis is warranted."
Action Points
* Explain to interested patients that none of the studies included in the meta-analysis was designed to evaluate the cardiovascular risk associated with calcium supplementation.
Commenting on the study, Suzanne Steinbaum, DO, a cardiologist at Lenox Hill Hospital in New York City, said in a prepared statement that "this study helps to remind us that 'one size does not fit all,' even in recommending supplements and preventive care."
"For patients who are at risk for heart disease, with multiple risk factors, or a strong family history, perhaps calcium supplementation should not be considered," she said.
Murray Favus, MD, an endocrinologist at the University of Chicago, said in an e-mail to MedPage Today and ABC News, "I am sufficiently concerned to advise those with high calcium supplement intake to limit calcium supplement use in favor of dietary sources until the risk of supplements can be sorted out."
Reid and his colleagues analyzed data from 11 randomized controlled trials that evaluated the use of calcium supplementation (at least 500 mg/day). They excluded studies that also administered vitamin D, which has been shown to have a cardiac benefit, in order to get a clearer picture of calcium's effect on the heart.
None of the individual studies was designed to assess the risk of cardiovascular events.
All 11 studies -- with a total of 11,921 participants and a mean duration of four years -- had trial level data; five -- with 8,151 total participants and a median follow-up of 3.6 years -- had patient-level data.
Separate pooled analyses of patient-level and trial-level data yielded similar results, with about a 30% increased risk of MI with calcium supplementation.
None of the individual trials found a significantly increased risk, although six had nonsignificant trends in that direction.
In the analysis of patient-level data, calcium supplementation was associated with an increased risk of MI in participants who had a dietary calcium intake above the median of 805 mg/day, but not in those with lower dietary intake (P=0.01 for the interaction).
Previous studies evaluating dietary calcium intake showed a reduced cardiovascular risk with greater consumption. The difference between those results and the findings of the current study suggests "that cardiovascular risks from high calcium intake might be restricted to use of calcium supplements," according to the researchers.
It is possible that calcium supplements elevate cardiovascular risk by increasing serum calcium levels, which have been associated with higher MI rates in observational studies, they noted.
Other possible mechanisms include an increase in vascular calcification or coagulability or altered vascular flow.
"Calcium supplements, given alone, improve bone mineral density, but they are ineffective in reducing the risk of fractures and might even increase risk, they might increase the risk of cardiovascular events, and they do not reduce mortality," John Cleland, MD, of the University of Hull in England, and colleagues wrote in an editorial published with the study.
"[Supplements] seem to be unnecessary in adults with an adequate diet," they added. "Given the uncertain benefits of calcium supplements, any level of risk is unwarranted."
Considering the available evidence, the editorialists wrote, "patients with osteoporosis should generally not be treated with calcium supplements, either alone or combined with vitamin D, unless they are also receiving an effective treatment for osteoporosis for a recognized indication."
The study authors noted that the analysis was limited in that it excluded trials in which calcium supplements were coadministered with vitamin D.
In addition, they noted, only two of the trials had data adjudicated by blinded trial investigators and seven -- which accounted for 15% of the participants -- had incomplete or missing data.
Noting the inherent limitations of a meta-analysis, Stephen Richardson, MD, an endocrinologist at NYU Langone Medical Center in New York City, said in an e-mail that a prospective study is needed to definitively assess the cardiovascular risk with calcium supplementation.
The meta-analysis "may temper our enthusiasm for calcium supplementation in low-risk populations," he said, "but patients with high risk for fractures will continue to take calcium supplements."
The analysis was funded by the Health Research Council of New Zealand and the University of Auckland School of Medicine Foundation. One of the study authors is funded by a career scientist award of the chief scientist office of the Scottish government health directorates. The Health Services Research Unit is funded by the chief scientist office of the Scottish government health directorates.
Reid has received research support from and acted as a consultant for Fonterra. He and three of his co-authors had study drugs for clinical trials of calcium supplementation supplied by Wyeth, Mission Pharmacal, Shire Pharmaceuticals, and Nycomed.
The editorialists reported that they had no conflicts of interest.
This article was developed in collaboration with ABC News.
Primary source: BMJ
Source reference:
Bolland M, et al "Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis" BMJ 2010; DOI: 10.1136/bmj.c3691.
Additional source: BMJ
Source reference:
Cleland J, et al "Calcium supplements in people with osteoporosis" BMJ 2010; DOI: 10.1136/bmj.c3691.
Vitamin D Deficiency in EuroSIDA Linked to All-Cause Mortality and AIDS
Vitamin D Deficiency in EuroSIDA Linked to All-Cause Mortality and AIDS
Tenth International Congress on Drug Therapy in HIV Infection, November 7-11, 2010, Glasgow
Mark Mascolini
Analyzing almost 2000 cohort members, EuroSIDA investigators found a higher risk of a new AIDS diagnosis or death from any cause in people with lower vitamin D levels [1]. These associations held in analyses corrected for an array prognostic factors in people with HIV.
EuroSIDA researchers randomly selected 2000 cohort members older than 16 who had at least 1 month of follow-up and CD4 and viral load measurements within 6 months. A single laboratory measured 25OHD levels in 1985 samples, and the investigators divided them by level into lower, middle, and upper thirds (tertiles). The low tertile (25OHD below 12 ng/mL) included 714 people, the middle tertile (12.1 to 20 ng/mL) included 622, and the high tertile (above 20 ng/mL) included 649.
Median age was similar across tertiles (39.3 T1, 38.1 T2, and 38.0 T3, P = 0.19), as were CD4 count (356 T1, 376 T2, and 360 T3, P = 0.13) and viral load (2.5 log T1, 2.6 log T2, and 2.6 log T3, P = 0.36). Median month of sample collection was February 2002 in T1, November 2001 in T2, and September 1999 in T3 (P < 0.0001). The low tertile had a significantly lower proportion of whites (81.9% T1, 87.8% T2, and 90.6% T3, P < 0.001) and a significantly lower proportion of people infected during sex between men (35.3% T1, 44.4% T2, and 45.9% T3, P = 0.0022).
Multivariate analysis identified several factors independently associated with 25OHD levels in the low tertile, including nonwhite race (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.19 to 2.15, P = 0.0017), each additional 10 years of age (OR 1.12, 95% CI 1.01 to 1.24, P = 0.035), sample collection during spring (when vitamin D levels would be low after scanty winter sun exposure), and living in central or northern Europe rather than sunnier southern Europe. Compared with cohort members infected during sex between men, those infected during heterosexual sex had a 51% higher risk of being in the lowest tertile (OR 1.51, 95% CI 1.18 to 1.92, P = 0.001) and those infected by injecting drugs had a 65% higher risk (OR 1.65, 95% CI 1.26 to 2.15, P = 0.0003).
A multivariate model devised to predict the impact on low D levels on risk of progression to AIDS, non-AIDS disease, or death considered gender, ethnic origin, HIV risk group, region of Europe, HBV and HCV status, prior AIDS, antiretroviral exposure, age, CD4 count, nadir CD4 count, viral load, date of vitamin D sampling, season of sampling, and date of joining EuroSIDA. Compared with people in the low tertile, people in the middle and high tertile had an independently lower risk of death from any cause or new AIDS (but not new non-AIDS diseases) at the following incidence rate ratio (IRR):
New AIDS diagnosis
-- Middle tertile: IRR 0.58, P = 0.0086
-- High tertile: IRR 0.61, P = 0.020
Death from any cause
-- Middle tertile: IRR 0.68, P = 0045
-- High tertile: IRR 0.56, P = 0.0039
During follow-up, 48 people died from an AIDS-related cause and 112 died from non-AIDS causes. Repeating the multivariate analysis according to cause of death, the researchers found that people in the highest tertile had a 40% lower risk of a non-AIDS death than people in the lowest tertile (IRR 0.60, 95% CI 0.37 to 0.098, P = 0.043). But being in the high tertile had no significant impact on AIDS death. In this analysis, being in the middle tertile did not significantly affect the risk of AIDS death or non-AIDS death.
The EuroSIDA investigators noted that their analysis is limited by its observational nature and single vitamin D measurement, but a longitudinal study is under way. They called for "intervention studies on correction of vitamin D deficiency . . . to gain a better understanding of the pathophysioloigcal mechanisms behind these findings."
Reference
1. Viard JP, Souberbielle JC, Kirk O, et al. Vitamin D and clinical disease progression in HIV infection: results from the EuroSIDA study. Tenth International Congress on Drug Therapy in HIV Infection. November 7-11, 2010. Glasgow. Abstract O413.
Wednesday, November 10, 2010
Tuesday, November 09, 2010
Fw: We need you to do something for the cure.
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