If you have trouble reading this e-mail, you can see the online version at: www.thebody.com/topics.html
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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 08, 2011
Fw: Hot Topics at The Body's "Ask the Experts" Forums
Sunday, November 06, 2011
Interview with the Berlin Patient in Houston
We were happy to have Brown speak on September 22 in Houston at two HIV-cure advocacy lectures sponsored by LIVE Consortium for the LGBT community and doctors at Baylor School of Medicine. His speech moved many in the audience to tears as they heard about his struggle and triumph. At the end of the speech, he was made an honorary citizen of Houston by Mayor Annise Parker. Following is a short interview with Brown.
Read more here:
http://outsmartmagazine.com/2011/11/the-%E2%80%98berlin-patient%E2%80%99/
Friday, November 04, 2011
Sexual Dysfunction in HIV
More here: http://www.thebody.com/Forums/AIDS/Nutrition/Q217890.html
Tuesday, November 01, 2011
Cognitive Therapy Gives Boost to 50-Year-Olds With Long-Term HIV
Small sample but very hopeful
Subject: NATAP/Aging Wk: Cognitive therapy in Aging Patients >50
Cognitive Therapy Gives Boost to 50-Year-Olds With Long-Term HIV
2nd International Workshop on HIV and Aging, October 27-28, 2011, Baltimore, Maryland
Mark Mascolini
Mindfulness-based cognitive therapy proved popular and effective in improving quality of life in a randomized trial involving 40 men and women around 50 years old in Barcelona [1]. Whether positive effects of this intensive therapeutic course last more than a few months in people with HIV remains to be seen.
Anxiety and depression rates are high among people with HIV and may increase as HIV-positive people age. Mindfulness-based cognitive therapy--designed for people with depression--combines cognitive therapy with meditation and other practices aimed at cultivating mindfulness. Psychologists variously define mindfulness as focusing complete attention on the present moment or staying aware of thoughts, feelings, and sensations in the present moment--instead of mulling past or future concerns [2].
Carmina Fumaz and colleagues at Badalona's Germans Trias i Pujol University Hospital planned this randomized trial of 20 men and 20 women with HIV infection for at least 15 years and with quality-of-life deficits marked by scores at or above 65 on the Nottingham Health Profile. The researchers excluded people with bipolar disorder, a documented psychotic episode or epileptic episode, or ongoing psychotherapy. They randomized 10 men and 10 women to a control arm involving only assessment and 10 men and 10 women to mindfulness-based cognitive therapy. Fumaz and colleagues evaluated study participants 3 and 6 months after the intervention.
Cognitive therapy involved eight 3-hour weekly classes, a day-long retreat, and an hour or more of "homework" 6 days a week. The goal of these exercises was to encourage people "to appreciate the present moment instead of focusing on worries about [the] future or past."
Everyone invited to participate agreed to join the study. Median age stood at 50 years (interquartile range [IQR] 46 to 52), median HIV duration at 20 years (IQR 16 to 24), and median time on antiretroviral therapy at 16 years (IQR 12 to 18). Median current CD4 count was 527 (IQR 364 to 633), 39 people (98%) had a viral load below 25 copies, and 17 (43%) had a stable partner. These numbers did not differ significantly between the intervention group and the control group. Nor did measures of energy, pain, emotional reactions, sleep, social isolation, and physical mobility on the Nottingham Health Profile. Only 1 person (in the cognitive therapy group) dropped out.
At post-treatment evaluations, all of the just-noted psychosocial variables improved significantly in the intervention group compared with the control group. All 20 people in the cognitive therapy group had a poor energy score before treatment and none did afterwards. Among seven aspects of daily living, four improved significantly in the intervention group compared with the control group: work, relationships at home, interests and hobbies, and ability to take holidays. The positive impact of cognitive therapy did not differ by gender.
Fumaz and colleagues concluded that mindfulness therapy may be a useful strategy in aging people with HIV infection.
At the Aging Workshop, David Clifford (Washington University, St. Louis) noted that this intervention requires a big time commitment and wondered whether recruitment favored selection of people attuned to this type of therapy. Notably, half of the study participants were retired.
Fumaz agreed that this strategy takes time (she did not discuss cost) but said their center now has a waiting list of people who want to try it. Health workers in the hospital are also eager to sign up for mindfulness-based cognitive therapy. Fumaz noted that 200 hospitals in the United States have mindfulness-based cognitive therapy programs.
The researchers plan to monitor study participants to see if the reported benefits persist longer than 1 year. Three-year follow-up of 18 of 22 US patients in a trial of mindfulness-based meditation for anxiety disorders found sustained good responses on Hamilton and Beck Anxiety and Depression scores, the Hamilton pain score, the Mobility Index-Accompanied test, and the Fear Survey [3].
References
1. Fumaz CR, Gonzalez-Garcia M, Munoz-Moreno JA, et al. Improvement of quality of life after the application of mindfulness-based cognitive therapy in subjects aging with HIV infection. 2nd International Workshop on HIV and Aging. October 27-28, 2011. Baltimore, Maryland. Abstract: O_09.
2. Baer RA. Mindfulness training as a clinical intervention: a conceptual and empirical review. Clin Psychol Sci Prac. 2003;10:125-143. http://www.wisebrain.org/papers/MindfulnessPsyTx.pdf.
3. Miller JJ, Fletcher K, Kabat-Zinn J. Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. Gen Hosp Psychiatry. 1995;17:192-200. http://www.ncbi.nlm.nih.gov/pubmed/7649463.
Friday, October 28, 2011
Healthy Eating and Exercise Videos by Nelson Vergel and Mark King
Exercise Video
IDSA: HIV Patients Face Early Anal Cancer Risk
By Ed Susman, Contributing Writer, MedPage Today
Published: October 25, 2011
BOSTON -- Anal intraepithelial neoplasia seems to develop during in the first year of HIV infection, according to the results of a cross-sectional study.Among 82 patients in the study group, 32.4% were diagnosed with high-grade anal intraepithelial neoplasia and 35.4% were diagnosed with low-grade disease, said John Lough, a medical student at Rush Memorial College in Chicago, in his presentation at the annual meeting of the Infectious Diseases Society of America. In addition, 3.7% were observed with atypia and 18% of the group had normal pathology.
Action Points"Intervention with early treatment and possibly vaccination may be able to prevent the future development of anal cancer in this high-risk population," Lough said. He noted that high-grade anal intraepithelial neoplasia is considered a direct precursor of anal cancer.
- Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
- Explain that anal intraepithelial neoplasia seems to develop during the first year of HIV infection, according to the results of a cross-sectional study.
- Note that individuals who had more than one unprotected receptive anal sex partner during the past six months had a 4.53-fold increased risk of developing high-grade anal intraepithelial neoplasia.
Lough and colleagues recruited the 82 men (average age 36 years) from the Options Project, an NIH study of individuals with confirmed, primary HIV infection within the previous year. Nearly 70% of the patients in the cohort were white and about 16% were Hispanic.
About 32% of the men admitted to use of drugs, such as amphetamines, while 30% were tobacco smokers at the time of the study. Additionally, 40% of the patients were on highly active antiretroviral therapy. The median CD4-positive cell count was about 550 cells/mm3.
The patients underwent a comprehensive clinical examination, an external visual examination, and biopsies of visible anal lesions with high-resolution anoscopy. The researchers used logistic regression to find risk factors for the development of high-grade anal intraepithelial neoplasia.
The authors found that patients who had been infected with HIV for longer than six months had 5.91-fold risk of developing high-grade anal intraepithelial neoplasia when compared with patients who had been diagnosed for less than six months (P=0.01).
He said that 22% of the patients diagnosed with HIV infection for less than six months tested positive for high-grade anal intraepithelial neoplasia compared with 51.6% of patients who had been infected for more than six months (P<0.01).
Individuals who had more than one unprotected receptive anal sex partner during the past six months had a 4.53-fold increased risk of developing high-grade anal intraepithelial neoplasia (P=0.06).
"High-grade anal intraepithelial neoplasia likely develops in the later part of early HIV infection," Lough suggested. He said that CD4-positive cells counts were not particularly helpful in determining the lesion grade.
"There is a need to continue to build capacity for screening for anal cancer especially among HIV-infected men who have sex with men," Lough concluded.
Screening patients for anal intraepithelial neoplasia is controversial, commented IDSA session moderator Joel Gallant, MD, from Johns Hopkins University in Baltimore.
"Many of us assume we should be screening for this because of what we know about cervical cancer which is such a similar disease," he told MedPage Today. "We extrapolate from cervical cancer that we should be doing this screening."
But there is currently no evidence that screening can help prevent anal cancer, Gallant said, pointing out that some professional guidelines recommend it while others do not. One problem with anal cancer screening is that high-resolution anoscopy requires special training and equipment that may not be widely available, he added.
Primary source: Infectious Diseases Society of America
Source reference:
Lough J, et al "Prevalence of high-grade anal intraepithelial neoplasia increases further in early HIV infection" IDSA 2011; Abstract 1391.
Friday, October 21, 2011
Tuesday, October 18, 2011
Fw: Hot Topics at The Body's "Ask the Experts" Forums
If you have trouble reading this e-mail, you can see the online version at: www.thebody.com/topics.html
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