Researchers describe 1st 'functional cure' of HIV in baby

Standard tests can no longer detect any traces of the AIDS-causing virus even though the child has discontinued HIV medication.

"We believe this is the first well-documented case of a [functional] cure," said study lead author Dr. Deborah Persaud, associate professor of pediatrics in the division of infectious diseases at Johns Hopkins Children's Center in Baltimore. The finding was presented Sunday at the Conference on Retroviruses and Opportunistic Infections, in Atlanta.

The child was not part of a study but, instead, the beneficiary of an unexpected and partly unplanned sequence of events that -- once confirmed and replicated in a formal study -- might help more children who are born with HIV or who at risk of contracting HIV from their mother eradicate the virus from their body.

Normally, mothers infected with HIV take antiretroviral drugs that can almost eliminate the odds of the virus being transferred to the baby.

If a mother doesn't know her HIV status or hasn't been treated for other reasons, the baby is given "prophylactic" drugs at birth while awaiting the results of tests to determine his or her HIV status. This can take four to six weeks to complete. If the tests are positive, the baby starts HIV drug treatment.

The mother of the baby born in Mississippi didn't know she was HIV-positive until the time of delivery.

But in this case, both the initial and confirmatory tests on the baby were able to be completed within one day, allowing the baby to be started on HIV drug treatment within the first 30 hours of life.

"Most of our kids don't get picked up that early," Persaud explained.

As expected, the baby's "viral load" -- detectable levels of HIV -- decreased progressively until it was no longer detectable at 29 days of age.

Theoretically, this child (doctors aren't disclosing the gender) would have taken the medications for the rest of his or her life, said the researchers, who included doctors from the University of Massachusetts Medical School and the University of Mississippi Medical Center.

Instead, the child stayed on the regimen for only 18 months before dropping out of the medical system and discontinuing the drugs.

Ten months after stopping treatment, however, the child was again seen by doctors who were surprised to find no HIV virus or HIV antibodies with standard tests.

Ultrasensitive tests did detect infinitesimal traces of viral DNA and RNA in the blood. But the virus was not replicating -- a highly unusual occurrence given that drugs were no longer being administered, the researchers said.

No one is absolutely sure why this child achieved a "functional" cure -- meaning the virus is in remission even without medications. But investigators believe that giving antiviral treatment so early in life meant the virus had no time to create viral "reservoirs" where dormant HIV cells can linger for years before becoming active again.

"For us this is a very exciting finding," said Persaud. "By treating a baby very early [we may be able to] prevent viral reservoirs or cells that stay around for a lifetime of an infected person."

But Dr. Michael Horberg, chair of the HIV Medicine Association and director of HIV/AIDS at Kaiser Permanente, stressed that this was a "functional cure and not a cure in the most classic sense of the word."

"If we take adults off HIV medications, they almost certainly within a short time period would have levels of virus back to where they were before they were taking medication," he said.

Only one instance of a "sterilizing cure" -- when there are absolutely no traces of HIV in the body -- has been documented. This occurred in the so-called "Berlin patient," an American man living in Germany who received a bone marrow transplant for leukemia. The transplanted cells came from a donor who had a rare genetic mutation that increases immunity against the most common form of HIV. This patient has remained HIV-free after discontinuing drug therapy.

And Persaud said she is not advocating that the Mississippi case become the standard of care. "This is a single case and we don't really know what are all of the factors [involved]," she said.

But the case does "pave the way now for us to immediately start clinical studies to see if we can replicate these findings in more infants," Persaud said. Those trials are ready to move forward.

At the last follow-up, the child born in Mississippi was "doing well and was healthy," she added.

Horberg said the findings in the baby were "encouraging" but "time will tell" if such a strategy can keep the virus under control for long periods of time without medication.

He emphasized that there are ways to prevent a baby from becoming infected in the first place.

"This again shows the importance of testing pregnant mothers and getting them into care and on [drug] treatment such that we wouldn't even need to worry about it at this point," he said. "What's encouraging, though, if it does come to this point, we might have some good treatment options."

The research presented Sunday was funded by the U.S. National Institutes of Health and the American Foundation for AIDS Research

More information

Learn more about mother-to-child transmission of HIV at aids.gov.

Health News Copyright © 2013 HealthDay. All rights reserved.

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If You Eat the Mediterranean Way, Can You Drop Your Heart Meds?

Italian olive oil image credit: Wikipedia

Earlier this week, results from a massive study on the benefits of the Mediterranean diet were published in the New England Journal of Medicine. The study–which lasted five years and included 7,500 participants ages 55-80–was a triumph for the Med diet, but there are a few important caveats to consider.

As you’ve likely heard, the Mediterranean diet is high in olive oil, fish, nuts, wine and vegetables – it’s not a low-fat diet by any means, but the fats mostly come from monounsaturated sources (olive oil and nuts).

Participants in this study who ate the Med way consumed about 200 calories more per day than the participants who ate a low-fat diet heavy on bread, potatoes, pasta, rice, fruits, vegetables and fish and light on baked goods, nuts, oils and red meat.

Despite the additional calories, results showed that participants eating the Med way had a 30 percent lower risk of major cardiovascular problems compared to those who were told to follow a low-fat diet.  Doctors tracked heart attacks, strokes and heart-related deaths over the course of the study; there were 96 in the Mediterranean-olive oil group, 83 in the Mediterranean-nut group and 109 in the low-fat group.

Why is this study different and important?

For years the Med way of eating has been touted as healthier than low-fat diets, but those claims lacked clinical evidence. Until this study, evidence for the Med diet came from observational studies of health outcomes (such as the Seven Countries Study). In the latest study, participants were not only tracked for years, but were given periodic blood tests to ensure people were eating enough nuts and olive oil to make a difference.  The blood tests added a clinical evaluation layer that other studies didn’t have.

Does this study tell us that we can eat the Med way instead of taking cardiovascular medications?

No, it does not. In fact, most of the participants in this study assigned to eating the Med diet were already taking prescription medications for cholesterol and blood pressure, and researchers did not alter those prescriptions in any way. Also worth noting, half of the participants had diabetes.

Does this study show that the Med diet prevents all forms of heart disease?

No, but it does show a general decrease in heart-disease outcomes (heart attacks and strokes) in people eating the Med way. When the results are looked at per individual, strokes were the only heart disease outcome to show a significant decrease due to diet. Overall death rates were not affected by diet at all.

If people want to begin a diet closer to the Med way, what does this study say they should focus on most?

Extra virgin olive oil and nuts–specifically walnuts, hazelnuts and almonds. In the study, the two Mediterranean diet groups were supplemented with either four tablespoons a day of extra virgin olive oil or a fistful of nuts. Of these two groups, the Med way-nut group showed the greatest benefits, but both groups did well compared to the third, low-fat group.

Why “extra virgin” olive oil?

While it’s not entirely clear why, or if, extra virgin olive oil is better than other forms of olive oil with respect to heart health, it is less processed and richer in oleic acid than less expensive olive oils. Oleic acid is a monounsaturated fatty acid that previous research has suggested may be a key to improving heart health.

Sources:

The New England Journal of Medicine

AP News 

The Mayo Clinic

Related on Forbes…

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For Tampa doctor, Mediterranean diet news is mom's wisdom

The latest news about the benefits of the Mediterranean diet came as no surprise to Dr. Carmela Sebastian, a Tampa resident and senior medical director for Florida Blue.

"I'm so glad that the world is finally agreeing with what my parents have been saying for years," said the 50-year-old internal medicine specialist, whose family is Italian. Sebastian, who has a healthy living website and is a frequent TV guest on wellness topics, devotes part of her upcoming book to the Mediterranean diet. Sex and Spaghetti Sauce: My Italian Mother's Recipe for Getting Healthy and Getting Busy in Your 50s and Beyond is due out in mid March.

The New England Journal of Medicine recently reported that the first major trial to evaluate the Mediterranean diet's effect on heart disease risk was stopped early, so overwhelming were the findings. The study of more than 7,000 people in Spain at risk of heart disease found the diet lowered the risk of heart attack, stroke and death from heart disease by 30 percent.

The diet — mostly fresh vegetables and fruit, legumes, nuts, fish several times a week, a glass of wine a day and up to a quarter cup a day of olive oil —is based on what people in Mediterranean countries have eaten for centuries. Study participants were counseled to avoid such known diet downers as prepackaged baked goods, sugary sodas, French fries and red meat.

If a quarter cup of olive oil a day sounds excessive to you, I should tell you that I was raised on the stuff. Meats, vegetables, rice and beans, the soft boiled eggs I ate every morning as a child — all of it was doused in a swirl of oil from my Puerto Rican mother's decorative cruet, a fixture on the table.

I caught up with Sebastian by phone this week to talk about the new research and how to apply it to everyday living.

What's so magical about the way people in the Mediterranean traditionally ate?

It's the food itself that's powerful and the portion sizes, which are smaller than what most Americans eat. It's not giant plates of spaghetti or Alfredo sauce on pasta. Italians in Italy don't eat like that. It's a small amount of pasta, usually with a light, vegetable and olive oil based sauce. It's a different way of eating that's also a lifestyle.

In the study, the comparison group was put on a low fat diet, but hardly anyone followed it. What do you think happened?

People will only stick to a meal plan that can work with their lifestyle. It is incredibly difficult to maintain a low fat diet. That's what is so good about this study. It proved that whatever diet or meal plan you choose, it has to fit with the way you really eat. It was easy for the Spaniards to live life on the Mediterranean diet. The foods were familiar and commonly eaten there.

People in the study didn't lose weight yet they lowered their heart disease risk.

Right, and they weren't encouraged to restrict calories or to exercise. That wasn't the point of the study. The idea was to find out the metabolic consequences of what we eat and its impact on heart disease and stroke. The food worked because it worked on a cellular level.

So what's the take home message?

That whole, fresh foods really are medicine and if we want to live a healthier life, we need to think about that. My Italian aunt is 95 years old. She has always eaten the Mediterranean way. Her brain is sharp and her skin is amazing.

How does the diet work in your life?

We live it. Tonight we are having lean, grilled pork chops, sweet potatoes and spinach sautéed in olive oil. We eat dinner out maybe once a week.

Have you converted anyone to this way of living?

My mother-in-law came to stay with us for a while when she was recuperating from surgery. She was in bad shape, obese, could hardly walk because of peripheral artery disease and was on 10 medications a day. I prepared all of her meals in the Mediterranean way. My husband, who's a personal trainer, got her up and walking around the neighborhood, eventually walking 2 miles a day. In the six weeks she was with us she lost 20 pounds and was down to just five pills a day. Now, I have to say, when she went back to her own home and her own cooking, she regressed, unfortunately.

For Tampa doctor, Mediterranean diet news is mom's wisdom 02/27/13 [Last modified: Wednesday, February 27, 2013 11:42pm]

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History is full of warnings about fiscal austerity

A Mediterranean diet, the New England Journal of Medicine reported Monday, can lengthen one’s life span. So inhabitants of southern Europe can look forward to long lives – of anxiety and privation.

Already mired in a depression comparable to that of the 1930s, Spain, Greece and Portugal are going to see things grow worse this year, according to an annual economic forecast released by the European Commission on Friday. Unemployment rates in both Spain and Greece – where a quarter of the populations are unemployed and the share of jobless young people exceeds 50 percent – will rise to 27 percent.

At least the leaders in power in 1930 had an excuse when the economy began to collapse. Then, there was genuine bewilderment among economists and governmental chieftains across the political spectrum about how to induce a recovery. From British Laborite Ramsay MacDonald to the German centrist Heinrich Bruning to American conservative Herbert Hoover, leaders cut spending to bring their budgets into balance.

These austerity policies proved an unmitigated disaster. By reducing government spending while business and consumer spending were tanking, these heads of government constricted all economic activity. In turn, unemployment continued to soar.

Frustrated with the inability of mainstream political parties to stop the collapse, voters in some nations turned to extremes – most notably, of course, in Germany.

Unlike their predecessors, today’s leaders have models on how to revive depressed economies. The example of Franklin Roosevelt, whose public investments in jobs and defense turned the U.S. economy around, and the writings of John Maynard Keynes, who demonstrated that the solution to depression is boosting demand, are plain for all to see. Seeing isn’t believing, however, when ideology dims the eye.

Today, in the spirit of the Bourbon kings who reclaimed power in post-Napoleonic France, having learned nothing during their exile, many European leaders are repeating the mistakes that their predecessors made in the ’30s: demanding that governments reduce spending even as their private-sector economies limp along.

Only this time around, the miracle of the euro has greatly the reduced the autonomy of many continental nations while giving their creditor, Germany, control over their destinies. German Chancellor Angela Merkel is imposing austerity budgets on other nations, even Spain, which had a string of balanced budgets before the 2008 collapse.

The economies of Mediterranean nations, the Merkelites complain, lag behind the productivity rates of their northern European neighbors. But boosting productivity – a goal that everyone embraces – requires more, not less, public investment in worker training, education, new industries and unemployment support.

The relationship between austerity and heightened productivity, whose existence Merkel continually proclaims, is real enough – but in Europe’s current economy, that relationship is inverse.

As in the 1930s, despair about the economic options before them has driven many voters to bizarre extremes. A quarter of Italian voters cast ballots this week for the anti-austerity xenophobic party of a professional comedian. In Spain, a movement for Catalonian separatism is growing.

More ominously, in Greece, an avowedly racist, fascist party involved in numerous instances of violence has won a bloc of seats in parliament. You might think Merkel would be cognizant of the links between economic hopelessness and the rise of fascism – but if she is, it hasn’t affected her austerity economics by so much as a pfennig.

The euro zone isn’t the only part of Europe where austerity is turning out to be a disaster. Britain is the one European nation that, since Prime Minister David Cameron’s conservatives came to power in 2010, has deliberately opted for punishing austerity to bring its budget into balance.

As a result, the British economy has slowed to a crawl, and its budget remains in the red. Last week, Moody’s stripped Britain of its AAA credit rating. In anti-Keynesian theory, austerity economics are supposed to protect one’s triple-A rating, not endanger it.

So much for anti-Keynesian theory.

The United States isn’t immune to Europe’s madness. The sequester slated to begin taking effect Friday is a particularly mindless form of an already stupid policy, poised to inflict a kind of blindfolded austerity at a time when unemployment remains high.

Republican opponents of government spending, not to mention tea party activists, like to think of themselves as true-blue Americans while disparaging the Democrats as Euro-socialists. But it’s the Republicans who are embracing Europe’s failed economics while Democrats attempt to adhere to the American success story of the New Deal.

Republicans might want to bone up on American history; it contains all kinds of valuable lessons.

Harold Meyerson is editor-at-large of The American Prospect. He wrote this for The Washington Post.

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Mediterranean Diet Decoded: What’s On The Menu For Mediterranean Dieters

Health experts are frequently touting the benefits of the “Mediterranean diet,” and with good reason: People prone to this way of eating tend to have better heart health, better brain health and greater longevity overall. A large, randomized Spanish study published online today provides solid evidence that the diet can seriously reduce heart attacks, stroke and death, even among high-risk groups like smokers and diabetics.

But though the term “Mediterranean diet” is tossed around frequently these days, it generally comes with little explanation. Something about fish, something about wine, something about nuts. Add olive oil and stir. Have further questions? Consult elsewhere.

Unlike commercial diet plans or those geared around some half-credible hook (the blood type diet, for instance), the Mediterranean diet actually doesn’t include an extensive set of rules. This is because no one “created” the Mediterranean diet; people in the region simply ate that way, organically, and at some point researchers began to take note of their good health.

With no creator to lay down laws and no publisher screaming for simplification, the Mediterranean diet is refreshingly flexible—more about guidelines than maxims; more eating a certain way that eat-this-not-that. The most important of these is to avoid processed snacks and junk food, focusing instead on fresh fruit, fresh vegetables, good fats and whole grains. Dairy and meat are to be limited; red wine is encouraged.

Here’s a look at what Mediterranean dieters in the new Spanish study ate. While not the only way to follow a Mediterranean diet, it provides an excellent general blueprint.

Recommended foods: 

Extra virgin olive oil: At least 4 tablespoons per day (this is including any oil used in cooking, salad dressings, etcetera).

Fresh fruit: At least three servings per day.

Vegetables: At least two servings per day.

Nuts: At least three servings per week are recommended. Study participants were given one serving of nuts daily, composed of walnuts (15 grams), almonds (7.5 grams) and hazelnuts (7.5 grams).

Seafood: At least three servings per week, especially of fatty fish like anchovies, salmon and sardines.

Legumes: At least three servings per week. This includes beans, peas and lentils.

Wine: At least 7 glasses per week, for those inclined to it; the researchers don’t recommend anybody take up drinking alcohol if they don’t already.

Sofrito: At least two servings per week. Sofrito is a sauce made of tomato and onion, often with garlic and other simmered herbs.

Foods to be limited: White meat. Dairy.

Discouraged: Red meat. Soda. Commercial bakery goods. Processed meats.

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Reading through Glasses

Are you finding it hard reading through at normal length? Would you ruin your vision to create things into focus? If that's the case, you'll need reading through glasses. People above age forty may need single-vision reading through glasses.

The primary two kinds of frames are full frames and also the more compact Franklin glasses. The entire frames possess the entire lens made according to the reading through prescription, the more compact Franklin glasses sit lower lower around the nose and appear like half-eyes.

New consumers frequently think that the price of the frames may be the actual price of the glasses. Sadly, the main reason you'll need the eyeglasses to start with, would be the contacts used. Contacts are an essential aspect to the price of eyeglasses, because they include a variety of options for example antireflective coating, or sun-protection.

Reading through glasses are for individuals who'd be carefully searching at objects for any very long time. Nonetheless they won't be the same as computer glasses, that are different in design. These glasses is going to be fuzzy by trying searching across an area through them.

The half eyes are for individuals who require to see and idolize discuss things, say, for instance, if you're a consultant who must connect to people in addition to read simultaneously.

Prior to deciding on reading through glasses, you have to visit an ophthalmologist or perhaps an eye doctor. Eye specialists are physician concentrating in dealing with eye problems. Opticians examine the attention, identify problems and prescribe glasses. They aren't medically qualified. They provides you with a prescription having a number, against which you'll get the glasses made. A watch examination by an ophthalmologist may be beneficial as it may identify as well as eliminate other eye problems.

Today there's an array of reading through glasses to select from. Some are even collapsible to suit in small, handy, attractive cases. The frames on offer are : intriguing and flattering. You will get these in stainless steal, silver or gold rimmed or perhaps trendy plastic, in a number of shapes and colours. If you're searching for something exclusive, choose hand crafted frames. Add-ons like magnifiers to see tiny print, or perhaps dim light can also be found.

There really is a superb variety to select from. Many eyeglass producers have started to the final outcome that they'll satisfy most the consumers having a straightforward thermoplastic lens. This is actually the result because reading through glasses also have low plus energy, together with exactly the same correction in every eye. This leaves many consumers pleased with terrific eyeglasses in an amazing value.

Make sure to select a reputed maker for spectacles are costly. The greater they're made, the more they'll last and also the more well-suited they'll be for your needs. So far as looks go, today that old adage 'Guys don't make passes at women who put on glasses' just does not affect this manner accessory any longer!

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Reading through Glasses: Does Quality Matter?

Reading through glasses come in most shapes, dimensions and costs. Based on your taste, budget and requires, you'll find glasses that are ideal for you. Some are optical quality, although some could be bought out of the box in the local pharmacy. Are they not all alike? Will it matter in which you have them? The reply is yes, it will matter in which you have them, with no, they are not every alike.

The latest fashions change, and designs of glasses change to maintain. Even just in similar-searching items, you'll find wide variances in construction of contacts, hinges and frames. The types of materials accustomed to result in the glasses could make the main difference from a pair that can last for per week along with a pair that can last for years. What in the event you search for?

First, the contacts ought to be of optical quality. Lower quality plastic contacts might have bubbles or waves within the lens, which makes it harder (or impossible!) to see close-up. The greater option is an aspheric lens, that is lighter, thinner and flatter than the usual conventional lens, to supply crisp, distortion-free reading through.

Second, think about the hinges. Standard hinges often expand, creating a loose fit with time. When the hinges are created with springs, they stand an improved chance of bouncing back from heavy use and handling. The spring also enables for any much more comfortable fit each time, given that they better comply with your mind.

Third, browse the frames. Could they be made from cheap plastic and colored alloys or could they be made from optical-quality zyls and solid metals? Cheap plastics may show scratches and put on than higher quality frames. And affordable materials often peel, flake and show how old they are before their time.

To locate your perfect reading through glasses, consider not just the design and style, but what they are made from too. Pharmacies often sell the less costly kinds of reading through glasses, while trustworthy opticians carry premium glasses. Solid construction rich in-quality materials might help ensure that you'll be reading through in comfort for several years in the future.

Suzanne Hughes is really a style and design expert at http://world wide web.readinstyle.com/ Visit her online boutique to determine a high choice of designer reading through glasses that are certain to please your vision for several years in the future.

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