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[afro-nets] World AIDS Day 2011: EDCTP-funded research towards prevention and treatment of HIV/AIDS


  • From: "Daniela Pereira" <Pereira@edctp.org>
  • Date: Thu, 1 Dec 2011 12:29:17 +0000

World AIDS Day â 1 December 2011
EDCTP-funded research towards prevention and treatment of HIV/AIDS

Every year, World AIDS Day provides an opportunity to raise awareness of the HIV-epidemic and report on global efforts to alleviate the burden of this infection. Recent reports showed a decrease in the number of deaths from AIDS-related illness and new HIV infections. Despite this important progress sub-Saharan Africa still remains the region most affected by HIV. In 2010, 68% of all HIV-infected people were living in sub-Saharan Africa. This burden is aggravated by the HIV and TB co-disease, the leading cause of deaths. 82% of HIV-positive TB cases also live in this region. The European and Developing Countries Clinical Trials Partnership (EDCTP) expresses its commitment to greater access to information, prevention and treatment of HIV/AIDS towards Getting to Zero. To date, EDCTP has committed â114.6M in 26 clinical trials on HIV/AIDS.

EDCTP funds clinical trials on the three main poverty-related diseases of HIV/AIDS, tuberculosis and malaria. The current portfolio of projects includes studies on prevention of HIV transmission from mother-to-child (MTCT); strengthening of long-term clinical and laboratory research capacity for future HIV vaccine and microbicides trials; phases I and II vaccine trials; HIV/AIDS treatment trials; and studies evaluating HIV resistance to anti-retroviral treatment.

HIV treatment studies: evaluation of second-line therapy
EDCTP is funding the Eastern and Southern Africa Research Network for Evaluation of Second Line Therapy in HIV infection (EARNEST) phase III clinical trial. This is the largest ongoing trial in this area and compares several boosted protease inhibitor-containing second line regimens for patients failing first line therapy. It is conducted in 14 clinical trial centres in five African countries: Uganda, Kenya, Zambia, Malawi and Zimbabwe. The critical question to answer is which ARVs to prescribe to patients failing first-line therapy in resource-limited settings. The outcome of this clinical trial will provide knowledge relevant to national control programmes and to policy makers and is expected to contribute to the national treatment guidelines and the worldwide public health approach to ART rollout.

Uncovering neglected HIV high-risk groups: fishing communities in Malawi and Uganda
EDCTP is funding a study on fisher folk communities, identified as one of the high-risk groups for HIV infection in Uganda and Malawi. This project will generate important information on how best to prevent the spread of HIV/AIDS throughout these communities that are characterised by high personal mobility. The study team assessed the social and behavioural patterns in the fishing communities and the prevailing awareness of HIV. This work is of particular importance to long-term HIV prevention research, especially the large scale clinical trials necessary for AIDS vaccine development.

Developing an infant vaccine against mother-to-child transmission of HIV through breast milk
The PedVacc studies are examining the safety of a new type of HIV vaccine in infants, MVA.HIVA. The vaccine carrier modified vaccinia virus Ankara (MVA) is a weakened virus previously used as a smallpox vaccine. Small pieces of HIV genes have been added to this, but the vaccine does not contain the whole HIV virus, and cannot cause HIV infection or AIDS. MVA.HIVA is one component that could form part of a more complex future vaccine. Volunteer recruitment was successfully completed in The Gambia and Kenya. Immunological analyses are currently ongoing.

Successful drug combination to reduce mother-to-child transmission of HIV during breast feeding
The Kesho Bora study, which completed in November 2010, contributed to the revision of the WHO guidelines on prevention of mother-to-child transmission of HIV. The study was a randomized controlled trial in antiretroviral (ARV)-naÃve pregnant woman infected with HIV-1 and was conducted in five sites in Africa. It showed that giving a triple antiretroviral therapy (ART) to pregnant woman or breastfeeding mothers reduces the risk of HIV transmission to infants by 43% compared to the recommended standard regimen of zidovudine and single-dose nevirapine prophylaxis at that time. WHO now recommends providing combination ART to all pregnant women with CD4 count at or below 350 cells per ÎL and to provide ARV prophylaxis (either to the mother or to the child) for the entire duration of breastfeeding if the mother is not already on ART.

Fighting HIV and TB co-infection related deaths
One of the EDCTP funded projects addressing HIV-TB co-infection is the RAFA project (Rifampicin or early ARV For West Africa project). It evaluates whether aggressive early management of tuberculosis (TB) in HIV-infected patients can reduce the high levels of mortality due to the HIV/TB co-infection by the early administration of high doses of Rifampicin (anti-tuberculosis drug). This is to be compared to other standard TB drugs and a follow up initiation of HIV antiretroviral (ARV) standard treatment after two months. Patient recruitment has started in Benin and Guinea. Additionally, this project is using innovative ideas to improve the capacity and functionality of the West African research facilities powered by solar energy.

More information:

* EARNEST project website<http://earnest.cineca.org/>
* Project profile Uganda and Malawi Fisher folk Study<http://www.edctp.org/Project-Profiles.245.0.html?&no_cache=1&tx_viprojects_pi1%5Baction%5D=show_project&tx_viprojects_pi1%5Bid%5D=92>
Project profile Development of an infant vaccine against mother-to-child transmission of HIV-1 through breastmilk<http://www.edctp.org/Project-Profiles.245.0.html?&no_cache=1&tx_viprojects_pi1%5Baction%5D=show_project&tx_viprojects_pi1%5Bid%5D=47>
* Project profile Kesho Bora - âA Better Futureâ<http://www.edctp.org/Project-Profiles.245.0.html?&no_cache=1&tx_viprojects_pi1%5Baction%5D=show_project&tx_viprojects_pi1%5Bid%5D=60>
* World AIDS Day 2011<http://www.worldaidsday.org/> website
* World AIDS Campaign<http://www.worldaidscampaign.org/> website