Health Headlines - October 23

Genetic Variations Affect Progression to AIDS: Study

Variations in two key genes influence how quickly HIV-infected people develop AIDS, says a U.S. study that challenges the long-held belief that viral load -- the amount of HIV in the blood -- is the main factor that determines progression to AIDS.

Variations in the CCR5 and CCL3L1 genes may affect immune system response to HIV and replication of the virus. Other genes may also play a role but more research is required to determine that, Agence France-Presse reported.

CCR5 controls a key receptor on the surface of the CD4 immune cell onto which HIV attaches, while CCL3L1 controls an immune system signaling molecule called a chemokine, which blocks HIV from attaching to the CCR5 receptor, the researchers said.

In this study, the researchers analyzed thousands of HIV-infected patients and healthy people and found that viral load accounted for only nine percent of the difference in how rapidly HIV-infected patients developed AIDS.

"The genetic variations contribute nearly as much to the extent of inter-individual variability in AIDS progression rates as does HIV-1 viral load," team leader Sunil Ahuja of the University of Texas Health Science Center in San Antonio, told AFP.

"Even after accounting for the detrimental effects of a high viral burden, these genetic factors influence the pace of HIV-1 disease progression," said study first author Hemant Kulkarni, assistant professor of medicine at the Health Science Center.

-----

Home Lead Test Kits Unreliable: CPSC

Home lead test kits are unreliable, the U.S. Consumer Product Safety Commission said Monday. The agency evaluated commonly available test kits on a variety of paints and other products containing different levels of lead, finding that many of the tests did not detect lead when it was there (false negatives) and others indicated lead was present when it was not (false positives).

Of the 104 test results, 56 were false negatives and two were false positives. None of the kits consistently detected lead in products if the lead was covered with a non-lead coating.

Based on these findings, the CPSC said consumers should not use home test kits to evaluate whether products may pose a lead hazard. The new findings are consistent with previous evaluations by the agency.

Testing by a qualified laboratory and trained personnel is the only way to accurately assess a product's lead-related risk, the CPSC said.

-----

Homeowners Urged to Get the Lead Out

National Lead Poisoning Prevention Week gets under way Oct. 21, and the theme for this year is "Protect Our Most Valuable Resource -- Our Children."

To make that happen, the week is designed to educate parents and children about the dangers of lead exposure, especially lead-paint hazards in housing. Many states and communities will offer free lead screening, and conduct education and awareness events.

Lead is highly toxic and can cause a range of health problems, from behavioral problems and learning disabilities, to seizures and even death. Children 6 years old and younger are at greatest risk because their bodies are growing quickly, according to the U.S. Environmental Protection Agency.

Lead exposure among young children has been drastically reduced over the last three decades, thanks to federal, state and local laws that banned lead in gasoline and house paint, as well as efforts to reduce or clean up lead in industrial emissions, drinking water, consumer goods, hazardous sites and other sources. In 1978, there were about 13.5 million children in the United States with elevated blood-lead levels. Today, approximately 310,000 children ages 1 to 5 years old have elevated blood-lead levels, the EPA said.

The federal government aims to eliminate childhood lead poisoning by 2010, according to the EPA.

Most lead exposure occurs when people eat lead-paint chips or lead dust. But the EPA estimates that 10 percent to 20 percent of human exposure may come from lead in drinking water.

To learn more about free lead screenings and Lead Poisoning Prevention Week, visit this EPA site. To order the DVD What Your School or Child Care Facility Should Know About Lead in Drinking Water, visit this site.

-----

Guidelines Updated For Use of Anemia Treatment

Updated joint guidelines on the use of erythropoiesis-stimulating agents (ESAs) to treat chemotherapy-related anemia were released Monday by the American Society of Hematology and the American Society of Clinical Oncology.

ESAs are a class of drug that stimulate bone marrow to produce more red blood cells. The update of the guidelines, originally published in 2002, is based on reviews and analyses of published clinical trials. The guidelines outline the clotting risks of ESAs, make recommendations on usage, and discuss disease progression and patient survival.

The updated guidelines:

• Declare epoetin and darbepoetin equally safe and effective.
• Recommend the use of ESAs as a treatment option for cancer patients who become anemic as a result of chemotherapy when their hemoglobin approaches or falls below 10 g/dL, as well as for patients with low-risk myelodysplasia.
• Suggest that when using ESAs, hemoglobin can be raised to a concentration of 12g/dL, at which point the dosage should be titrated to maintain that level. Dose reductions are also recommended when hemoglobin rise exceeds 1 g/dL in any two-week period or when the hemoglobin level exceeds 11g/dL.
• Recommend discontinuing use of an ESA beyond six to eight weeks if a patient hasn't responded to the drug.
• Recommend monitoring the iron levels of patients being treated with ESAs and providing supplements accordingly.
• Caution against using ESAs for cancer patients not receiving chemotherapy, since recent trials have shown increased thromboembolic risks and decreased survival in such cases.

The updated guidelines were posted online Monday by the journals Blood and the Journal of Clinical Oncology, and will appear in upcoming print issues of both.

-----

Drought Forces Georgia Gov. to Declare National Disaster

Georgia governor Sonny Perdue Saturday declared the northern part of his state a natural disaster area, and asked for a similar declaration from President Bush.

The Atlanta Journal-Constitution reports Perdue's emergency measure came a day after state lawyers had argued in federal court that the U.S. Army Corps of Engineers should reduce the amount of water it releases daily to protect endangered animal species. Georgia is suffering through its worst-ever drought.

"The actions of the Army Corps of Engineers and the Fish and Wildlife Service are not only irresponsible, they are downright dangerous," the newspaper quotes Perdue as saying.

Meanwhile, USA Today reports that mandatory water rationing is just around the corner in Georgia. The state's environmental commissioner Carol Couch told the newspaper that industrial and commercial water users will probably have to make "across-the-board reductions" very soon.

The drought has hit much of the Southeast hard this year. In addition to Georgia, it is the worst dry spell ever for North Carolina and Tennessee, second-driest in Alabama and third-driest in Kentucky, USA Today reports.