See more on www.dcfukit.org.

In a significant step toward an AIDS vaccine, U.S. government scientists have discovered three powerful antibodies, the strongest of which neutralizes 91% of HIV strains, more than any AIDS antibody yet discovered.

Looking closely at the strongest antibody, they have detailed exactly what part of the virus it targets and how it attacks that site.

The atomic structure of a powerful new antibody, called VRC01 (blue and green) shown binding to HIV (grey and red).

The antibodies were discovered in the cells of a 60-year-old African-American gay man, known in the scientific literature as Donor 45, whose body made the antibodies naturally. Researchers screened 25 million of his cells to find 12 that produced the antibodies. Now the trick will be for scientists to develop a vaccine or other methods to make anyone’s body produce them.

That effort “will require work,” said Gary Nabel, director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases, who was a leader of the research. “We’re going to be at this for a while” before any benefit is seen in the clinic, he said.

The research was published Thursday in two papers in the online edition of the journal Science, 10 days before the opening of the large International AIDS Conference in Vienna, where prevention science is expected to take center stage.

More than 33 million people were living with HIV at the end of 2008, and about 2.7 million contracted the virus that year, according to United Nations estimates. Vaccines, which are believed to work by activating the body’s ability to produce antibodies, eliminated or curtailed smallpox, polio and other once-feared viral diseases, so they have been the holy grail of AIDS research.

Last year, following a trial in Thailand, results of the first HIV vaccine to show any efficacy were announced. But that vaccine reduced the chances of infection by only about 30%, and controversy erupted because in one common analysis the results were not statistically significant. That vaccine was not designed to elicit the new antibodies.

The new discovery is the latest in what Wayne Koff, head of research and development at the nonprofit International AIDS Vaccine Initiative, calls a “renaissance” in HIV vaccine research.

Antibodies that are utterly ineffective, or that disable just one or two strains, are common. Until last year, only a handful of “broadly neutralizing antibodies,” those that efficiently disable a large swath of HIV strains, had been discovered, and none of them neutralized more than about 40% of known HIV variants.

But in the last year, thanks to efficient new detection methods, at least a half dozen broadly neutralizing antibodies, including the three latest ones, have been identified in peer-reviewed journals. Most of the new antibodies are also more potent, able to knock out HIV at far lower concentrations than their previously known counterparts.

Dennis Burton of the Scripps Institute in La Jolla, Calif., led a team that discovered two broadly neutralizing antibodies last year; he says his team has identified additional, unpublished ones.

Some of the new antibodies attack different points on the virus, raising hopes that they could work synergistically. In unpublished research, John Mascola, deputy director of the Vaccine Research Center, has shown that one of Dr. Burton’s antibodies neutralizes virtually all the strains that are resistant to the strongest new antibody, called VRC01, and vice versa. Only one strain out of 95 tested was resistant to both antibodies, he said. Dr. Mascola is one of the authors of Thursday’s papers.

In the latest research, the antibody was found to attack a spike on the virus that attaches to cells the virus infects. Because this spike has to attach to a specific molecule on the cell surface, it is one of the few parts of HIV that don’t mutate much.

Scientists tested 32 patients to see which ones had sera—clear fluid in the blood—that neutralized HIV. The sera contained unknown antibodies. Donor 45 had promising sera, so they focused on him.

Researchers say they plan to test the new antibodies, likely blended together in a potent cocktail, in three broad ways.

First, they could be given to people in their raw form, somewhat like a drug, to prevent transmission of the virus. However, they would likely be expensive and persist in the body only for a limited time, perhaps weeks, making that method impractical for all but specialized cases, such as to prevent mother-to-child transmission during childbirth.

The antibody could also be tested in a “microbicide,” a gel that women and receptive partners in gay male pairings could apply before sex to prevent infection.

The antibodies might even be tried as a treatment for people who are already infected. While the antibodies are unlikely to completely suppress HIV on their own, say scientists, they might boost the efficacy of current antiretroviral drugs.

Dr. Nabel said that the Vaccine Research Center has contracted with a company to produce an antibody suitable for use in humans so that testing in people could begin.

The second way to use the new research is to deploy classical vaccine approaches. Traditional vaccines work by using a weakened or dead virus, or a viral fragment, to train the immune system to recognize the invader and produce antibodies. Because the new HIV antibodies are extremely specific, attaching tightly to particular parts of the virus, scientists have to show the immune system an exact replica of the parts of the virus that the antibodies attack. That’s a tall order—for example, it can be hard for such a replica to hold the correct shape—but different teams are trying different ways to achieve this goal.

One potential pitfall: There is evidence that Donor 45’s cells took months or possibly even years to create the powerful antibodies. That means scientists might have to give repeated booster shots or devise other ways to speed up this process.

Finally, there are experimental methods that employ tactics such as gene therapy. Nobel laureate David Baltimore, with funding from the Bill and Melinda Gates Foundation, is working on one such approach.

His team at the California Institute of Technology in Pasadena, Calif., has stitched genes that code for antibodies into a harmless virus, which they then inject into mice. The virus infects mouse cells, turning them into factories that produce the antibodies.

Using one of the old antibodies, Dr. Baltimore said his team was able to protect mice from getting infected when injected with live HIV. Those experiments are not published. Recently, his lab has begun working with Dr. Burton’s antibodies and the strongest antibody from Donor 45. Even if it proves successful, this strategy is years away from the clinic, Dr. Baltimore cautioned.

Write to Mark Schoofs at mark.schoofs@wsj.com

TheBody.com recently hosted a panel discussion – via teleconference – on unprotected sex among gay men. Absolutely fascinating, engaging and illuminating – a must for any and all interested in gay men’s health.

Click here for the audio and a transcript.

The call was moderated by fogcityjohn and included Walt Odets, Rashad Burgess and Jeffrey Parsons.

- Select quotes –

Walt Odets: It’s a natural behavior, and it’s of emotional significance. And I think gay men naturally engage in it. We have liked to feel that it was somehow dispensable — and it’s really not, emotionally. So, again, we haven’t helped men to think about what they are doing. It’s a very narrow range in which HIV is transmitted. Anal sex has the emotional import for gay men that vaginal intercourse has for heterosexuals. And it can’t be dismissed. And we can’t expect that that’s going to done all the time, under any circumstances, with a condom. It’s compelling. It’s emotionally compelling.

Rashad Burgess: We, as Americans, [need to] recognize the value of gay men, in all of our lives, in the many facets of our lives — whether it be the business owners, whether it be folks’ uncles, or family members, other types of family members, the partners that gay men have. Because it is a community that, it’s imperative, understands that their lives — and as a gay man, that our lives, and my life — is worth saving.

Jeffrey Parsons: We do sometimes forget about the group of gay men who are out there — and it’s a large group — who are very happy, very satisfied. They’re not depressed. They’re not lonely. They’re not engaged in risk behaviors. They’re not seroconverting. They’re actually doing very well. And I think — and I can certainly say this as a researcher — that too often we don’t get to focus on that group. We don’t get to actually talk to them and research them and find out: What are they doing to stay safe, and to stay healthy, and to stay well adjusted?

Read more.

By Randy Dotinga

(HealthDay News) — Research in mice suggests that scientists may have a new lead on using gene therapy against the virus that causes AIDS.

The researchers tinkered with human stem cells and then inserted them into mice where they multiplied into immune system cells that provided protection against infection with HIV, according to a study released online July 2 in Nature Biotechnology.

The results are unlike typical research in animals because the mice have been “humanized”: They have human immune systems and resisted a human disease. Still, until research is conducted on humans, there’s no way to know if the treatment will work in people. And it may be years until that happens.

But there are high hopes. “It’s a one-shot treatment if it works,” noted study co-author Paula Cannon, associate professor of molecular microbiology at the University of Southern California.

In gene therapy, doctors try to coax the human body into doing something differently by tweaking its genetic structure. To treat HIV, the virus that causes AIDS, scientists have been experimenting with using gene therapy to boost the immune system.

In the new study, researchers engineered human stem cells — cells that create other cells — to lock a kind of “door” that allows HIV to enter.

The door, a “receptor” on immune cells linked to a gene known as CCR5, is disabled in a very small percentage of people, and those people appear to be virtually immune to HIV.

“That’s like nature telling us how to cure AIDS,” Cannon reasoned. The idea of the experimental treatment is “to engineer a patient’s own cells so they’d be resistant to HIV” in much the same way.

The researchers did this by “cutting” a gene in the stem cells. These genetically manipulated cells did try and repair the injury, Cannon noted, but they didn’t do a good job and HIV’s way in was essentially disabled.

The researchers inserted these tweaked stem cells into the humanized mice and other mice, then tried to infect them with HIV.

According to the scientists, the genetically engineered stem cells went on to create mature immune system cells, such as T-cells, in the humanized mice. After a couple of weeks, these new immune cells appeared to provide protection against HIV. The cells grew greatly in number, offering fewer targets for the virus to attack.

Meanwhile, the virus made its usual successful attack on other mice that had not undergone the procedure.

Rowena Johnston, vice president of research with the Foundation for AIDS Research (amfAR) in New York City, said gene therapy is starting to show “real promise,” and this study reveals a new side of its potential.

“One of the doctrines of gene therapy in the context of HIV has been the assumption that every relevant cell must be transformed,” she said. “This research demonstrates that need not be the case.”

But could this approach work in humans? The answer to that is yet to come, Cannon said.

“We want to make sure that this works, and a good place to start is in a patient population who already have their stem cells taken out,” she said. Cannon and her colleagues would like to test it by piggybacking on a gene therapy treatment in which the stem cells of HIV-positive lymphoma patients are removed, tinkered with and then put back into their bodies.

Cannon doesn’t know how much the gene therapy will cost, but one estimate puts the expense of this type of treatment for HIV at $100,000. But if it allows HIV patients to avoid taking drugs for the rest of their lives, she said, it should be cost-effective over time.

Whatever the case, the treatment isn’t around the bend. Cannon said it could be four years before research in humans can begin. But another treatment that uses a similar strategy on a type of immune cell is already being tested in people.

Read more.

by Jon Lentz

The diagnostic test, developed by Abbott Laboratories Inc, detects the virus more accurately in the weeks immediately following transmission, the company said.

The sooner patients are diagnosed and placed into care, the better the chance there is to stop further spread of the virus, said Abbott’s senior director for research and development of infectious disease diagnostics.

“With this test, we can detect probably at least 90 percent of the so-called acute infections, people in those early stages, in those first few weeks before they develop those antibodies,” Abbott’s Gerald Schochetman told Reuters in an interview.

Abbott’s test would be the first U.S. test that directly identifies HIV while currently-available tests detect the antibodies that combat the virus and show up weeks later.

The test also is the first approved by the FDA for pregnant women, which could allow them to more quickly start treatment to limit transmission of the virus to their fetuses.

The test, called ARCHITECT HIV Ag/Ab Combo assay, has been available in Europe since 2004 and is commonly used in countries such as the United Kingdom and France.

Approximately 18 million people in the United States are tested each year for HIV, which can lead to acquired immune deficiency syndrome, or AIDS, according to the U.S. Centers for Disease Control and Prevention. One in five infected individuals doesn’t know they have the virus.

About 56,000 people in the United States are infected with HIV each year, and more than a million are living with HIV, the CDC has said.

Abbott’s test will cost about the same as a standard HIV blood test and should be available by the end of the year, company spokeswoman Darcy Ross said.

Read more.

In recent years, we have made huge advances in HIV research, prevention and care.  Still, HIV and AIDS remains an epidemic in this country.  That is why my Administration is launching in the coming days a comprehensive National HIV/AIDS Strategy focused on reducing new HIV infections, increasing access to care, and reducing HIV-related health disparities.  But government cannot address this important issue alone.  We need the commitment of businesses, churches and faith groups, philanthropic organizations, the scientific and medical communities, educational institutions and others.  And all of us have a responsibility to reduce our risk and know our status, to continue to support those already affected by this disease, and to fight the stigma and discrimination people still face.  So on this National HIV Testing Day, let us all recommit to do our part to help stop the spread of HIV and AIDS.

Read more on AIDS.gov or visit our Get Tested page.

Getting down to the nitty gritty of vibrator use, the researchers asked men how they used vibrators specifically, offering five options. From most common to least, here’s what men reported:

• 87% said they used a vibrator for anal penetration
• 73% said they held or rubbed the vibrator against their anus
• 62% held or rubbed the vibrator against the testicles
• 59% held or rubbed a vibrator against their penis
• 25% held or rubbed against other body parts

The survey distinguished between committed sexual relationships and casual sex. There wasn’t a significant difference in vibrator use from one kind of relationship to the other, but overall people tended to use vibrators more in relationships than in casual sexual encounters.

Read more.

A study published in the American Journal of Public Health has been getting a lot of press for confirming an old stereotype—which has masked its more troubling implications. The study seems to indicate that gay men are somewhat slimmer than their straight counterparts, while lesbians are heavier than straight women. But the more important finding is a shared and unfortunate quality: gays, lesbians and bisexuals all face greater health risks than straight people of either gender.

The researchers from the Harvard School of Public Health, Harvard Medical School, and John Snow Inc., used a behavioral risk factor survey involving 67,000 Massachusetts residents, aged 18 to 64 and surveyed between 2001 and 2008. Here’s the much-vaunted weight difference that they found: 21 percent of straight men are obese, according to the survey, versus 14 percent of gay men; 26 percent of lesbians, on the other hand, are obese, versus 17 percent of straight women. But we should look at the rest of the study’s rather grimmer findings. The researchers found that gays and lesbians (who formed 2 percent of their sample) and bisexuals (who formed 1 percent) were, they write, “more likely to report activity limitation, tension or worry, smoking, drug use, asthma, lifetime sexual victimization, and HIV testing.”

Unlike previous studies that focused primarily on sexually transmitted diseases and mental health issues in the gay community, this study included measures of general health and chronic illness. And in these areas, things are not good: gay men smoke more, and are less likely to get prostate-specific antigen tests. Lesbians also smoke more, and have increased risk of heart disease. Bisexual men and women have the most troubling health profile, with the least access to health care, increased risk of suicide, and elevated heart disease risk. Overall, the LGBT community is at elevated health risk, a fact that the media focus on weight differences fails to capture.

The study’s lead author, Kerith Conron of Northeastern University and the Harvard School of Public Health, suggested that, “This may mean that we in the public health community need to come up with more tailored messages to reach these groups, just as car dealers do when they want to reach a specific target audience.” The choice of metaphor is perhaps unfortunate, but the idea is sound: a public health agenda that takes seriously the gay community’s specific needs.

Read more.

The number of men who have sex with men being diagnosed with HIV in the last year in Ireland rose by 42 per cent, a report has said.

According to the Health Protection Surveillance Centre, 97 diagnoses were made in 2008, rising to 138 in 2009.

Most of the men (63 per cent) were born in Ireland and are thought to have picked up the infection in the country.

The median age for infection was 35.6 years, and men under the age of 30 accounted for 35 per cent of diagnoses.

The study concluded that “urgent” measures should be targeted at younger men and those recently diagnosed.

Overall, the latest figures showed a slight decline in the total number of new infections.

The total number of new infections was 395, with a newborn baby and four children among these. They are thought to have acquired the infection from their mothers.

There was not enough information on 65 cases, while 30 were in intravenous drug users and 165 were found in heterosexuals.

Of the 307 new HIV cases where geographic origin of the patient is known, 141 were born in Ireland, 96 were born in sub-Saharan Africa, 21 were born in western Europe, 13 were born in central Europe, 15 were born in eastern Europe and 14 were born in South America.

Read more.

A  Health and Human Services committee voted on Friday to maintain the ban against blood donations from men who have sex with men. Under the regulation, any man who has had sex with another man since 1977 cannot donate blood. The ban was instated in 1985, during the height of the AIDS pandemic.

The vote was 9-6.

Representative Mike Quigley (D- Chicago), who led the effort to re-evaluate the blood ban, said of the decision, “By clinging to a 1980s view of the world, we are perpetuating a stereotype.”

A man who has sex with an HIV positive woman, or a woman who has sex with an HIV positive man is required to wait one year after this sexual encounter to donate blood. The regulation for men who have sex with men is a lifelong ban. It is estimated that if this ban were changed to a one year deferral, 89,000 additional pints of blood would be donated each year. The Red Cross currently collects over 15 million pints of blood annually.

“This decision is outrageous, irresponsible and archaic,” said Rea Carey, executive director of the National Gay and Lesbian Task Force. “We expect more out of this advisory committee and this administration than to uphold an unnecessarily discriminatory policy from another era.

“We’ve said it before: The most critical issue is to ensure that the blood supply is safe and abundant, and this means maximizing the potential donor pool and making sure all donors are screened appropriately and assessed based on actual behavioral risk independent of their sexual orientation. The committee’s decision today not only leaves a discriminatory practice in place, it also puts lives at risk.”

While the committee voted against changing the regulations, the group did call the present system “suboptimal” because it permits “some potentially high risk donations while preventing some potentially low risk donations.”

The committee unanimously recommended taking steps toward an eventual policy change that would examine donors’ individual behaviors, rather than characteristics of a general group, but for now, the prohibition remains.

Read more.