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Snuffing Out Smoking In Those With HIV

February 25, 2011

While researchers have done a good job documenting health problems associated with the high prevalence of smoking among Americans who have HIV/AIDS, it's now time to focus on how to get these smokers to kick the habit, Saint Louis University School of Public Health research finds.

Of the 1.1 million Americans living with HIV/AIDS, between 40 and 60 percent are smokers - which is two to three times the rate of smokers in the general population.

Jenine K. Harris, Ph.D., study author and associate professor of community health at Saint Louis University School of Public Health, examined the kinds of research conducted on smoking and HIV/AIDS from 1980 to 2008. Her research was published online ahead of print on May 13 in the American Journal of Public Health.

She found the vast majority of the research - 237 of the 272 published articles - looked at the relationship between smoking and HIV/AIDS. However, fewer than 2 percent of the articles examined the effectiveness of interventions aimed at preventing or reducing smoking among those living with HIV/AIDS.

"The accumulation of nearly two decades of discovery research leaves little doubt that smoking is a widespread problem and a major modifiable risk factor for disease and death in people living with HIV/AIDS," Harris said.

Researchers don't know the best strategy to help those with HIV/AIDS quit or not start smoking. Typically, specialized smoking cessation programs that target certain populations can be effective. However, few studies have examined targeted smoking cessation programs for those who have HIV/AIDS. One study found that a standard smoking cessation program would not help 86 percent of smokers who have HIV/AIDS.

Harris says it's time for researchers to connect the dots between the health problems associated with HIV and smoking and effective ways to help those with HIV quit smoking.

"The delay between discovery of smoking related health outcomes in people living with HIV/AIDS and the delivery of interventions to reduce smoking among this population has serious consequences," Harris said.

To speed the process of finding solutions, she suggested researchers and clinicians in the HIV/AIDS field collaborate with experts in tobacco cessation who understand how targeted population-based programs work. In addition, she suggested that researchers who are examining the link between smoking and HIV/AIDS and those who are looking at effective programs work closer together. The ultimate goal is to look at the evidence of what works to come up with effective programs that curb smoking among those who have HIV/AIDS.

Accredited for 19 years, Saint Louis University School of Public Health remains the only accredited school of public health in Missouri. It is one of 41 fully accredited public health schools in the U.S. and the only accredited Jesuit school in the nation.

Source
Saint Louis University Medical Center


Tags: Smoker, smoking

Older People And Those With HIV Are More Vulnerable To Tuberculosis

February 15, 2011

A study by the Barcelona Public Health Agency has revealed those sections of the population that are most vulnerable to tuberculosis. The research, published in the journal Respiratory Research, shows that the highest death rates from this disease are among those aged over 50 or infected with HIV.

"Some patients give up their tuberculosis treatment (which lasts for a minimum of six months), resulting in a danger of them infecting other people, worsening their own state of health or even dying", Joan A. Caylà, lead author of the study and a researcher at the Barcelona Public Health Agency (ASPB), tells SINC.

The study, published in the journal Respiratory Research, identifies the factors linked to people giving up tuberculosis treatment and deaths from the disease. Researchers from the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) analysed a sample of 1,490 people with the illness in Spain between 2006 and 2007.

The results of these studies show that abandoning tuberculosis treatment is usually related to having undergone previous treatment for the disease, being an injecting drug user (IDU), living with a large number of people, and also the doctor's perception that the patient does not have a good understanding of the treatment.

The authors from the ASPB, meanwhile, stress that deaths are associated with failure to understand the treatment, being an IDU, being in directly-observed treatment (DOT), and also being over the age of 50 or being infected with HIV.

One-third of the world population

The World Health Organisation (WHO) declared 24 March as World Tuberculosis Day, to commemorate the day in 1882 when the biomedic Robert Koch announced the discovery of the bacillus that causes the disease. This was the first step towards being able to diagnose and cure it.

Each year, eight million people contract tuberculosis worldwide, and two million die from it. Although tuberculosis is still endemic in Spain and other wealthy countries, there has been a resurgence of tuberculosis infections in some rural areas, and with the increase in HIV and failure to control the disease.

The WHO aims for the tuberculosis prevalence and death rates to have fallen to half their current levels by 2015. Today, around two billion people - one-third of the entire world population - are infected with tuberculosis.

Source: Plataforma SINC



Tags: Smoker, smoking

Most Men in Long-Term Study of HIV Report Low Use of Illicit Drugs

February 10, 2011

Most older gay and bisexual men enrolled in a long-term study of HIV used recreational drugs infrequently over a 10-year period, report University of Pittsburgh Graduate School of Public Health researchers at the XVIII International AIDS Conference.

The study explored the drug use habits of 1,378 HIV-positive and negative gay and bisexual men, ages 44 to 63, enrolled in the Pitt Men's Study, part of the Multicenter AIDS Cohort Study (MACS), which began in 1983 and is the longest-running National Institutes of Health-funded investigation of HIV/AIDS.

Study researchers surveyed participants about their use of recreational drugs (poppers, crack, cocaine, methamphetamine and ecstasy) between 1998 and 2008. They found that 79 percent of participants reported infrequent drug use, and three subgroups emerged: nearly 6 percent who reported consistently high drug use; more than 7 percent who increased their drug use; and 7 percent who decreased their use of drugs.

"We know that drug use among men who have sex with men contributes to a host of health problems, including HIV infection, but we know very little about how drug use changes as these men age," said Jessica G. Burke, Ph.D., study author and assistant professor, Department of Behavioral and Community Health Sciences, Pitt's Graduate School of Public Health. "Previous studies have linked drug use in gay men to risky sexual behaviors and to higher rates of HIV infection, but most of these studies have focused primarily on specific time-points and on younger men."

According to Dr. Burke, the data will provide needed insights to develop interventions for preventing and treating drug use among gay and bisexual men as they age. Moving forward, she will be combining these results with qualitative data collected through interviews with participants about their experiences with drugs.

"Although a majority of participants reported infrequent drug use, three subgroups of men displayed distinct patterns of use over 10 years of midlife. Understanding more about these subgroups and the factors that lead to drug use will give us a better understanding of how we can address this behavior among similar individuals."

Study co-authors include Sin How Lim, Ph.D., Michael Marshal, Ph.D., Anthony Silvestre, Ph.D., Steven Albert, Ph.D., and Ronald Stall, Ph.D., all of the University of Pittsburgh; and David Ostrow, Ph.D., of the Chicago MACS and David Ostrow and Associates. The study was funded by the National Institutes of Health.

Story Source:

    The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Pittsburgh Schools of the Health Sciences, via EurekAlert!, a service of AAAS.


Tags: Smoker, smoking

Computer Models Could Personalize Medicine To Prevent Pandemics

February 02, 2011

What makes some viral infections fatal and others much less severe is largely a mystery. It is thought that a part of the variability can be attributed to differences in how individuals respond to infection.

Professor Michael Katze, presenting at the Society for General Microbiology's spring meeting in Edinburgh, describes how computer modelling could be a powerful tool to allow treatments to be tailored to individuals. This approach could ultimately prevent future pandemics.

Professor Katze, from the University of Washington in Seattle reveals how 'systems biology' methods could successfully tackle viral infections, such as HIV and hepatitis C virus, for which there is still no effective vaccine or treatment.

"Systems biology is like a Rubik's cube - it's a matrix that integrates computational models, experimental systems and high-throughput data in a variety of combinations to solve the puzzle of virus-host interactions. It provides a powerful new approach to virology, drug discovery and vaccine development," explained Professor Katze.

Computer models of the whole cell can be made and tested by simulating virus-induced changes and monitoring the whole cell response. Comparing the model to real biological examples allows the model to be refined and allows researchers to make further predictions about how different cells respond to different changes.

Improved animal models may help us understand how differences in an individual's genetic make-up affect HIV development. "Determining which host genes affect HIV progression has been relatively slow using the current techniques in isolation," remarked Professor Katze. "Some current studies indicate there is a link between genes that affect how virus particles enter the host cell and disease progression," he continued.

Identifying the molecules produced from these host genes could provide a method to effectively detect disease, predict how individuals respond to infection and even establish how effective a vaccine is. "If this becomes as easy as doing a simple blood test, we will be equipped to provide the most effective treatment to the individual. This will limit the spread of the virus which in turn could help protect the population as a whole and even prevent the next pandemic," suggested Professor Katze.

Source:
Laura Udakis
Society for General Microbiology


Tags: Smoker, smoking


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