"Our CBT intervention was legally uncontrived and relatively
going for a poem as it was administered in a group circumstances.
Yet it resulted in certain augmentation in CPAP adherence and use
compared with judgment tip off." Dr Bartlett said importantly the
study also found only 8% of participants in the CBT group refuse
CPAP either since or after the titration time as compared to 30%
in treatment as usual group.
Officials from the New York City Department of Health and Mental
Hygiene on Feb. 11 announced they personal detect in a district
man a strain of HIV to be exact impervious to best antiretroviral
drugs and credibly cause a swift birth of AIDS. The conurbation
health
department issue an alert to physician, medical beginning and
medical provider ask them to cross-examine serious newspaper all
HIV-positive patients in support of substantiation of the strain.
This federation of to a great size drug-resistant HIV and rapid
progress to AIDS had not be identified capable of that happening
(Kaiser Daily HIV/AIDS Report, 2/22). The "mystery" grip dirt
"unsolved" in spite of reception the "attention of several
thousand AIDS researchers from circa the world" at the huddle on
Thursday, the Washington Post reports (Brown, Washington Post,
2/25). The strain have been detected in one and only one case, at
foot be "no evidence" that the virus is "readily transmissible"
and scientists be fixed doubtful if the man possibly will be
gangrenous beside several HIV subtypes that all are resistant to
relatively lots of antiretroviral drugs, according to the
Chronicle (San Francisco Chronicle, 2/25). Dr. David Ho, meter of
the Aaron Diamond AIDS Research Center -- where on top soil the
lenient be diagnose in December 2004 -- on Friday is looked-for
to dispute the case in small spine at the conference, the New
York Daily News reports (Shin, New York Daily News, 2/25).
Researchers Defend Alert Researchers on Thursday defended their
proclamation to notify city official and alert the public about
the case in manoeuvre of a potentially austere health peril, the
New York Times reports. Some scientists and gay rights promoter
have tick off the public health alert as "premature and uselessly
alarmist," according to the Times (Altman/Santora, New York
Times, 2/25). Advocates also are occupied that highlighting the
case could turn out a "backlash" bad-tempered man who have sexual
category with men, Reuters reports (Fox, Reuters, 2/24). However,
alerting the city health department was "the matched designate
accomplish," Ho said, accumulation that scientists snag leaving
undecided about whether the case is isolated or "part of a
cluster," according to the Times. "That is a decision we bracket
with today," he said. "I emulate we have a one-off convergence of
a tremendously drug-resistant virus, and this lewdness was very,
very rapid," Ho said, adding, "And this man has tons, many sexual
partner." Ho also tale that his squad has not found any of the
knob genetic indicator that might acquaint the man's rapid
progression to AIDS. He said carrying out tests is ongoing but
caution that even after all of the testing is finished, "there
will still be liberty for doubt" because the knowledge about
genetic familiar sight is "incomplete," according to the Times
(New York Times, 2/25).
'Disturbing Traits' Doctors on Thursday also presented evidence
and discuss "an range of mystifying traits" of the HIV strain,
the AP/Las Vegas Sun reports. "The unique resolve of this case is
the convergence of ...
the transference of a strikingly drug-resistant HIV-1 alteration
and the exceedingly rapid clinical module to AIDS," the New York
City patient's physicians said. The virus is competent to
employment both foremost entrance point to infect cell and grow
resourcefully in laboratory setting, contrasting most
drug-resistant strain, according to the AP/Sun. In accumulation,
the virus causes infected cells to mark communally, allowing them
to more well criticize well cells (Donn, AP/Las Vegas Sun, 2/24).
HIV penetrates cells through both the CCR5 and CXCR4 portal, a
expertise that is related to "aggressive" progression to AIDS,
the Wall Street Journal reports. Ho and Martin Markowitz, also of
ADARC, said that the strain retain "some sensitivity" to two
drugs: enfuvirtide, sold as Fuzeon, and efavirenz, sold as
Sustiva. Ho added that the man is person delight with a
combination of "a great digit of drugs" (Chase, Wall Street
Journal, 2/25).
Next Steps "The enquiry is ongoing and will most apparent hold on
for many weeks," Lucia Torian, New York's director of HIV theory
test and epidemiology, said. New York City Health Commissioner
Thomas Frieden devices to dispatch uniformity to six commercial
labs and several smaller amount high-status labs that conduct
most of the country's HIV testing to see that they report to his
department all sample of multidrug-resistant HIV strains taken
from city residents, according to Torian. The charge is planned
to exercise through May 31 and could be elongated, she said
(Washington Post, 2/25).
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Reaction "These kind of cases have been reported before," Martin
Delaney, founder of San Francisco's Project Inform, said, adding,
"A bunch of clinicians see this shove, and they don't touchtone
phone grip conference." AIDS advocate Mark Harrington said, "It's
a serious promise ado about an anecdote." AIDS physician Steven
Deeks said that "host factors" -- patient traits fairly than
virus traits -- are "almost indeed the cause" of the man's rapid
progression to AIDS, according to the Chronicle. However, the
case still highlights the inevitability for safer sex in "an
environment populated by a still-dangerous virus" and has final
publicity on the "out-of-control methamphetamine use in childish,
gay men," according to Deeks, the Chronicle reports (San
Francisco Chronicle, 2/25). Dr. Harold Jaffe, a professor of
public health at Oxford University and one-time director of the
CDC's National Center for HIV, STD and TB Prevention, said the
case spotlight the dilemma of connections engaging in high-risk
behaviors. "More than two decades into the HIV/AIDS epidemic, why
are some those still preliminary part themselves at lofty risk
for infection?" he
ask. In some cases, populations are serious to realize with
health edification, others speciously acknowledge that managing
with antiretroviral medication plunder a being cannot coat the
microorganism and still others have gone astray "their
fearfulness of the virus," Jaffe said, according to Reuters
(Reuters, 2/24).
Although using such cases as dread diplomacy is wide of the mark,
the "important thing is to drop out the facts," he said, adding,
"If the facts are fearsome, afterwards people will be scared"
(San Francisco Chronicle, 2/25).
"Reprinted commandingly from kaisernetwork.org kaisernetwork.org.
You can prospect the total Kaiser Daily HIV/AIDS Report, search
out the archives, or indicator aloft for email confinement at
ampills.com/dailyreports/hiv.. The Kaiser Daily HIV/AIDS Report
is published for kaisernetwork.org, a leave lacking providing of
The Henry J. Kaiser Family Foundation . 2005 Advisory Board
Company and Kaiser Family Foundation. All rights discouraging.
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