AIDS Commemorate

Today, all people in the world commemorate World AIDS Day. HIV has reportedly infected about 33 million people globally, two million of whom are children under 15. There were an estimated two million HIV-related deaths in 2007.

Indonesian government has been urged to change its “ineffective” approach to HIV/AIDS, as the number of people infected by the disease continues to grow each year. The association projects the number of people in Indonesia living with HIV/AIDS to more than double from 120,000 in 2002 to 270,000 this year. These figures are much higher than those reported by the Health Ministry, which put the number of cases at 18,000 as of September, with the death rate at 20 percent.
Chairman of the Association of Indonesian Physicians Concerned about HIV/AIDS, Samsuridjal Djauzi, said here Sunday the government’s current campaigns, which tend to encourage behavioral change, had proved ineffective in curbing the spread of the disease. He urged the government to start developing “biomedical intervention” as a preventive measure. Actions include promoting male circumcision, which he said could reduce the risk of infection by up to 60 percent, and the use of anti-retroviral drugs. Another problem is the lack of coordination among state institutions, including the AIDS commission and the Health Ministry, which resulted in “overlapping” and “inefficient” campaigns. Beside that, he add Institutions needed to change the attitude of the National Narcotics Agency, which still perceives drug users as mere criminals, thus obstructing activists’ attempts to promote the use of sterile needles. It will be a wish that the citizen has their own responsible to keep the health of their life. It is related to style of life. So it is about how we can grow their consideration about this disease.

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Doctors say marrow transplant may have cured AIDS

An American man who suffered from AIDS appears to have been cured of the disease 20 months after receiving a targeted bone marrow transplant normally used to fight leukemia, his doctors said.

While researchers - and the doctors themselves - caution that the case might be no more than a fluke, others say it may inspire a greater interest in gene therapy to fight the disease that claims 2 million lives each year. The virus has infected 33 million people worldwide.

Dr. Gero Huetter said Wedneday his 42-year-old patient, an American living in Berlin who was not identified, had been infected with the AIDS virus for more than a decade. But 20 months after undergoing a transplant of genetically selected bone marrow, he no longer shows signs of carrying the virus.

"We waited every day for a bad reading," Huetter said.

It has not come. Researchers at Berlin's Charite hospital and medical school say tests on his bone marrow, blood and other organ tissues have all been clean.

However, Dr. Andrew Badley, director of the HIV and immunology research lab at the Mayo Clinic in Rochester, Minn., said those tests have probably not been extensive enough.

"A lot more scrutiny from a lot of different biological samples would be required to say it's not present," Badley said.

This isn't the first time marrow transplants have been attempted for treating AIDS or HIV infection. In 1999, an article in the journal Medical Hypotheses reviewed the results of 32 attempts reported between 1982 and 1996. In two cases, HIV was apparently eradicated, the review reported.

Huetter's patient was under treatment at Charite for both AIDS and leukemia, which developed unrelated to HIV.

As Huetter - who is a hematologist, not an HIV specialist - prepared to treat the patient's leukemia with a bone marrow transplant, he recalled that some people carry a genetic mutation that seems to make them resistant to HIV infection. If the mutation, called Delta 32, is inherited from both parents, it prevents HIV from attaching itself to cells by blocking CCR5, a receptor that acts as a kind of gateway.

"I read it in 1996, coincidentally," Huetter told reporters at the medical school. "I remembered it and thought it might work."

Roughly one in 1,000 Europeans and Americans have inherited the mutation from both parents, and Huetter set out to find one such person among donors that matched the patient's marrow type. Out of a pool of 80 suitable donors, the 61st person tested carried the proper mutation.

Before the transplant, the patient endured powerful drugs and radiation to kill off his own infected bone marrow cells and disable his immune system - a treatment fatal to between 20 and 30 percent of recipients.

He was also taken off the potent drugs used to treat his AIDS. Huetter's team feared that the drugs might interfere with the new marrow cells' survival. They risked lowering his defenses in the hopes that the new, mutated cells would reject the virus on their own.

Anthony Fauci, director of the National Institute of Allergy and Infections Diseases in the U.S., said the procedure was too costly and too dangerous to employ as a firstline cure. But he said it could inspire researchers to pursue gene therapy as a means to block or suppress HIV.

"It helps prove the concept that if somehow you can block the expression of CCR5, maybe by gene therapy, you might be able to inhibit the ability of the virus to replicate," Fauci said.

David Roth, a professor of epidemiology and international public health at the London School of Hygiene and Tropical Medicine, said gene therapy as cheap and effective as current drug treatments is in very early stages of development.

"That's a long way down the line because there may be other negative things that go with that mutation that we don't know about."

Even for the patient in Berlin, the lack of a clear understanding of exactly why his AIDS has disappeared means his future is far from certain.

"The virus is wily," Huetter said. "There could always be a resurgence."
taken from: the jakarta post

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