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Its no cure, but it could mark a distinctive victory in the fight against HIV. A 17-member advisory panel for the Food and Drug Administration has endorsed an over-the-counter HIV test that would allow consumers to test themselves for the AIDS-causing virus in the privacy of their own homes in just 20 minutes. While the test is not perfect, the advisory panel has deemed that the benefits of accustomed in-home testing outweigh potential risks, and have recommended the FDA approve the test for over-the-counter sales.

Made by Bethlehem, Penn.,-based Orasure, the test uses an oral swab to return an HIV diagnosis in a matter of minutes. It is already available for use in clinical settings, and while its not quite as accurate as actual lab diagnostics it could help curb the spread of HIV by allowing for discrete, more accustomed testing. HIV and AIDS are largely spread via sexual contact from one partner to the other by those who do not realize they are infected with the virus.

If the advisory panel is right, the impact could be distinctive. Estimates indicate that roughly 240,000 people among the 1.2 million HIV carriers in the U.S. are unaware they are infected. Thats a full one-fifth. Education and other means of prevention have held the rate of new infections more or less steady at about 50,000 per year over the past 20 years in the U.S. The test has shown to be accurate in positively identifying HIV in trials 93 percent of the time. That means if everyone was testing regularly, Orasures test would still miss roughly 3,800 cases. But it would correctly diagnose 45,000 infected individuals. The FDA estimates that overall, the test could prevent 4,000 new cases each year.

Other at-home HIV tests can be purchased over the counter, but they still rely on consumers to take a blood sample and send it in to a lab for testing. Making HIV testing easy will encourage it as a accustomed practice, authorities hope, while also adding a layer of discretion and privacy around a sensitive topic. A survey showed that 84 percent of gay and bisexual men would test themselves more regularly if they could do so in their own home with an over-the-counter test (men who engage in sexual contact with other men are generally considered at higher risk for acquiring HIV).

The endorsement by the panel, however, does not spell approval for Orasures at-home 20-minute test. It still has to pass top-level FDA approval, a process that will take the panels findings into account. A final decision is expected later this year. The clinical version of the test reportedly retails to doctors for $17.50, but theres no word on what consumer pricing might be.

[R&D]

In a milestone announcement, today the FDA approved the use of Truvada, the first drug to be used for HIV prevention in the 30-plus year battle against the virus. To be used as part of safe sex practices and continued testing, the drug, which was first approved in 2004, has already shown promise in preventing infection, with some figures placing protection rates as high as 90 percent.

Still, some concerns have been raised about the drug, not least among them the potential for mutation of the virus--there are theories that the preventative drug will encourage the virus to become stronger. To help curb that possibility, the FDA says "Truvadas manufacturer, Gilead Sciences, Inc., is required to collect viral isolates from individuals who acquire HIV while taking Truvada and to evaluate these isolates for the presence of resistance." In other words, Truvada will, you know, watch the situation closely.

The drug may also come with a hefty pricetag of $13,900 for a years worth of pills, but right now, its the only drug of its kind, and so that might be expected. Most FDA regulations focus on general safe sex practices--condoms, that kind of thing--to prevent infection, but this is the first medicine approved to stop contraction of the virus. Well bring you more on this as it develops--this is a huge deal for U.S. treatment of HIV.

[FDA]

Viruses are skillful mutants, changing their structures or outer proteins to evade the shifting natural defenses of their targets. (This is why you have to get a flu shot every year.) Now researchers in France report using one of the most proficient mutants, HIV, to fight another intractable disease: Cancer.

Researchers at the French National Center for Scientific Research set out to study molecules that could improve the effectiveness of cancer drugs. As they explain in their paper, this process often involves screening for the desired trait using bacteria, but sometimes a molecule that works on a bacterium doesnt work the same way on a human cell. It would be better to start out with a human cell and screen new compounds right there. To speed the process of finding these new compounds, the team worked with HIV, taking advantage of its replication machinery and proclivity for mutating.

As HIV replicates, it creates slightly new versions of itself over successive generations - this allows it to readily resist most of the drug cocktails and anti-viral treatments developed to fight it. But it could also allow HIV to serve as a sort of molecule factory, creating new iterations of compounds that work in slightly different ways.

The CNRS team modified the genome of HIV by inserting a human gene for a protein called deoxycytidine kinase (dCK). This protein is found in all cells and is important for activating anti-cancer drugs. Researchers would like to make a more potent form of dCK that would allow cancer drugs to work more effectively, which could in turn require less of them, causing fewer side effects and less toxicity.

The team multiplied this mutant HIV through several generations, yielding an entire library of mutant dCK proteins, about 80 in all. Ultimately, they found a variant that induces tumor cells to die. With just 1/300th the dose of cancer-killing drugs, this one-two protein punch is just as effective at stopping tumor growth.

This is notable for a few reasons - first, the mutated protein was shown to work in human cell cultures, eliminating several middle steps with bacteria or animals. Second, it suggests theres a way to make cancer drugs work more effectively simply by beefing up the bodys internal chemistry. And finally, it suggests a new therapeutic use for one of humanitys strongest adversaries - HIV-derived protein factories could pump out generations upon generations of new molecules and drug compounds to help alleviate a wide range of illnesses. The French teams paper appears in the journal PLoS Genetics.

[via ScienceDaily]

Yale researchers developing a new technique for vaccination against genital herpes have succeeded, but their research may have implications far beyond what they set out to accomplish. Employing a two-part immune-system-boosting strategy known as "prime and pull," the researchers have effectively coaxed the bodys own antibodies into setting up a defensive blockade in tissues that formerly were not conducive to such immune responses. In doing so, they may have found a mechanism that is effective in preventing not only herpes, but other sexually transmitted infections as well--infections like the AIDS-causing HIV-1.

Vaccines generally work by boosting the bodies own inherent immune responses to certain pathogens, but for certain kinds of infections this kind of vaccination has proven difficult. This has to do with the bodys so-called "memory" T cells. These antibodies deploy when a foreign pathogen is found within the body, and when they do battle with a given pathogen they do what any good soldier would do: They learn from their adversary. These memory T cells can "remember" how to defeat a certain kind of infection, allowing them to mount increasingly stronger immune responses to fight certain pathogens the body has seen before.

But though these memory T cells circulate throughout the body, certain tissues dont readily harbor them. As such, these tissues are more susceptible to certain kinds of infections, and they are in some places you really dont want to see infected--places like the central nervous system, the intestines, some regions of the respiratory system, and critical for the Yale researchers purposes, some tissues in the female genital tract.

That makes these regions susceptible to infection--unless T cells can be coaxed into taking up residence there. The Yale teams "prime and pull" method is focused on exactly that. Working with mice, the researchers found a way to "prime" T cells to fight a certain kind of infection (in this case, genital herpes) through conventional vaccination that causes a system-wide immune response. Then, via a topical application of chemokines--chemical agents that initiate movement in immune cells--they were able to "pull" these T cells into tissues where they normally dont take up residence, like those peripheral tissues in the vagina that are usually susceptible to infection from various sexually transmitted infections.

These primed T cells effectively took up residence in these tissues where they are usually restricted and have shown to increase immunity toward genital herpes by putting up a wall between the herpes simplex virus (HSV) and the cells they infect. Thats good for HSV vaccination, but the implications may be far greater. The "prime and pull" technique could potentially be used to combat any infectious agent that enters the body through any specific tissue--agents like the human immunodeficiency virus (HIV) that causes AIDS. Thats not to say that this is a cure by any means, but it opens the door to a possible HIV inhibitor.

In fact, prime and pull could go even further. "The prime and pull may not be restricted to fighting infections," lead researcher Akiko Iwasaki told PopSci via email. "One can imagine prime and pulling T cells into solid tumors to facilitate T cell based tumor killing."

Potential treatments to help stymie both cancer and HIV; not bad for a single vaccine study.

[YaleNews]

You can look at AIDS and HIV statistics as numbers in a table, but that doesnt quite tell the story of how one of the deadliest diseases of our time spreads. Here in the United States, infection rates are intimately tied to race, education, geography, and more.

So reveals a new interactive map from researchers at Emory University and the data-mappers MapLarge. Three years ago, they teamed up to create AIDSVu, an incredibly granular look at HIV and AIDS diagnoses, updated yearly based on data from the Centers for Disease Control and local health agencies. Today they released an even more detailed version, which gives a sense of HIV and AIDS infection rates in the U.S. (and the context behind them) better than digits possibly could.

The darker the colors you see here, the higher the rate of AIDS and HIV diagnoses in that county. The lightest tan color you see (in Northwest Montana, for example) on the maps indicate a rate between 0 and 40 per 100,000 people, while the deepest reds indicate a rate of 384 or more diagnoses per 100,000 people (parts of Florida and the South). The white areas contain rates not shown because the population is too small or the diagnosis rate too low to get accurate stats while still protecting privacy. The gray states, only North and South Dakota in this case, had rates so low and a population so sparse they held their data back entirely, says Patrick Sullivan, an Emory University epidemiologist who worked on gathering the data and organizing the maps.

But the most revealing feature of the AIDSVu map is the option to do a side-by-side comparison of diagnosis rates with other statistics, like race, poverty, and education. The idea is to discover "what new kinds of data should we be putting up, how can we combine them, mash them up in ways that would be impactful," Sullivan says.

Isolating the map for only African Americans is just one jarring view to come out of those side-by-side comparisons. Theres a trend similar to the overall rates map, but the rates are even more sharply divided into certain regions of the country.

One the most depressing national statistics is the rate of people with health insurance compared with HIV/ AIDS diagnoses. The map on the right shows the percentage of people with health insurance, by county. The darker the red, the higher the percentage of people with health insurance. You can see its pretty close to an inversion of the diagnoses map--meaning the people most likely to face a diagnosis are often the ones left without health insurance.

The map also lets you focus on individual cities. Here, for example, is New York City, which shows a dense rate of cases in Manhattan, lowering slightly into the outer boroughs.

Compare that to poverty rates in NYC, and youll see some major overlap.

Compare the diagnosis rates in Los Angeles to the the median income (the darker the green, the higher the income) and you see the same trend.

Thats the case for most of the country: more urban, densely populated areas are generally more affected by HIV and AIDS. (The map doesnt offer reasons for this, but its a confluence of factors, like access to testing and treatment, Sullivan says.) But in the South, the rates have reached out to rural areas as well. Head even closer to the equator, to the very tip of Florida, and the map actually falls short of visualizing the severity of the disease. The region is dark red, meaning it has a rate of 384 or more diagnoses per 100,000 people. But some counties here have reached a rate of considerably more than 1,000 diagnoses per 100,000 people.

Sullivan says the hope is for both individuals and organizations to use the map as a resource. Individuals can search for the nearest testing center (and filter for more options) using the map. Health organizations can use the map to determine where the disease has hit hardest, and use that info to channel finite resources for the most effect. It could be working: Sullivan says organizations have used it to set up telemedicine systems in areas of Alabama where theres just one infectious disease doctor or HIV specialist per 70,000 people.

You can check out the map here, and in honor of National HIV Testing Day, find a place to get yourself tested.

[AIDSVu]