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Experts Promote 'Seek, Test, Treat and Retain' Paradigm and Opioid Substitution for Injection Drug Users

An evidence-based approach is needed to help stem rapidly growing HIV/AIDS epidemics in Eastern Europe, Central Asian, and elsewhere associated with injection drug use, according to a new report released at the XVIII International AIDS conference (AIDS 2010) last week in Vienna. The report calls for establishment of coordinated efforts to test and treat drug users and then take steps to retain them in care, and underscores the benefits of methadone maintenance and similar opioid substitution approaches. The report's findings support the demand for science-based national drug policies set forth in the conference's official statement, the Vienna Declaration.

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Biomarkers of Inflammation and Cardiovascular Risk in HIV Positive Children

Children with HIV have higher levels of certain biomarkers of inflammation and endothelial dysfunction compared with healthy children, as well as coagulation abnormalities associated with higher risk of cardiovascular disease, according to 2 recently published studies. These findings, suggested to one study team, suggest that efforts to control cardiovascular risk factors should start early for HIV positive children.

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Large Meta-analysis Finds No Link between Efavirenz (Sustiva) and Birth Defects

A meta-analysis of 16 studies looking at more than 8000 live births to HIV positive mothers found that using efavirenz (Sustiva, also in the Atripla combination pill) during the first trimester of pregnancy was not associated with an increased risk of birth abnormalities, according to a report in the June 19, 2010 issue of AIDS.

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Antiretroviral Therapy for Mother or Infant Reduces HIV Transmission during Breast-feeding

Treating HIV positive mothers with a combination antiretroviral regimen or giving infants nevirapine for 28 days after birth both reduced the risk of mother-to-child HIV transmission during breast-feeding, according to findings from the BAN Study reported in the June 17, 2010 New England Journal of Medicine. But the Mma Bana Study, described in the same issue, found that women with HIV should start antiretroviral therapy (ART) during pregnancy to have the greatest effect in reducing transmission risk.alt

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Management Age-related Conditions Is a Key Aspect of Care for Older People with HIV

Elder people with HIV are often diagnosed late, have more advanced immune suppression, and typically have a variety of co-existing chronic age-related conditions, according to a Spanish study of patients age 70 or older reported in the November 2009 issue of Current HIV Research. Older patients respond well to antiretroviral therapy (ART), however, achieving undetectable viral load and good CD4 cell recovery.

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