U.S. Issues New Guidelines for Treating Children With HIV
Experts at the U.S. National Institutes of Health and the Centers for Disease Control and Prevention have revised their guidelines on the prevention and treatment of dangerous infections in children with HIV.
The new guidelines -- which update 2004 recommendations -- stress the importance of using powerful antiretroviral drugs to suppress the virus that causes AIDS, and offer guidance on when medicines might be discontinued once a child's immune system recovers.
"The guidelines will help health-care workers and public health officials who work with children to save lives that might otherwise be lost," Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, said in a joint NIH/CDC news release. "The infections that can accompany HIV are often the major cause of illness and death of HIV-infected children."
Children with HIV have depleted immune systems and are therefore vulnerable to so-called "opportunistic" infections, including tuberculosis and pneumonia. These types of infections remain the leading cause of death for HIV-infected children, the news release stated.
The new guidelines, to be published in the Sept. 4 issue of the CDC's Morbidity and Mortality Report, include:
- a renewed emphasis on the use of antiretroviral drugs to keep HIV at bay,
- advice on managing "immune reconstitution inflammatory syndrome," a potentially dangerous over-activity of the immune system which can occur as formerly impaired immune responses rebound under treatment,
- information on drug interactions for children on HIV medications,
- new advice on the use of antibiotics to fight off a form of pneumonia that often threatens newborns suspected of being HIV-positive,
- updated advice on immunizing HIV-positive children against pathogens such as hepatitis and HPV,
- new recommendations that might allow some well-treated, HIV-infected children with newly robust immune systems to discontinue medicines aimed at preventing opportunistic infections. Formerly, experts advised that people stay on these medicines for life.
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FDA Approves Swine Flu Test for Troops
A swine flu test for military personnel serving overseas has been approved for emergency use by the U.S. Food and Drug Administration.
According to a news release from the agency, the Department of Defense can now send the H1N1 test to its labs so that troops can be screened quickly. The emergency measure allows the use of unapproved medical products during public health emergencies.
"The FDA worked quickly with the Defense Department to authorize the use of this test to better protect our troops. The test will aid in more rapid diagnosis of 2009 H1N1 influenza infections so that deployed troops can quickly begin appropriate medical treatment," Dr. Margaret A. Hamburg, commissioner of Food and Drugs at the FDA, told the wire service.
The test, known as the CDC swH1N1 (swine) Influenza Real-Time RT-PCR, was developed by the U.S. Centers for Disease Control and Prevention.
In June, the World Health Organization declared the H1N1 swine flu a pandemic, the first time it has taken such a measure in four decades. The declaration was made not because the swine flu is particularly dangerous, but because it had become so widespread. To date, there have been 182,166 cases of infection worldwide and 1,799 deaths, according to the latest WHO estimates.
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Spending on Health Care for Seniors Still Rising: Report
Spending to treat the health problems of Americans 65 and older increased by about $2,000 for every senior who used health services between 1996 and 2006, according to the federal Agency for Healthcare Research and Quality.
Reporting in its News and Numbers publication, the agency said that average spending, adjusted for inflation, for seniors rose from $6,989 in 1996 to $9,080 in 2006. The review covered all Americans 65 and older, except for those living in nursing homes and other institutions.
The agency found significant increases in average spending for seniors for the following types of health care:
- Prescription drug purchase -- from $105 to $174 (66 percent).
- Physician office visit -- from $114 to $180 per visit (58 percent).
- Dental visit -- from $187 to $254 per visit (36 percent).
- Daily hospital stay -- from $2,271 to $2,714 per day (20 percent).
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Extreme Obesity Takes Years Off Life: Report
People who are extremely obese -- 80 pounds or more heavier than a normal weight -- die three to 12 years sooner than normal-weight individuals. But people who are just overweight or moderately obese tend to live a normal life span, a new study found, according to USA Today.
The finding mirrors earlier research that found that being slightly overweight may have no impact on life expectancy, but being severely overweight can shorten life spans dramatically, the newspaper said.
According to U.S. health officials, an estimated 66 percent of adult Americans are either overweight or obese. About one-third are obese, meaning they have a body mass index (BMI, a ratio of weight to height) or 30 or more. About 6 percent of people are extremely obese, with a BMI of 40 or greater.
The study, done by economists at RTI International, a non-profit research organization in Research Triangle Park, N.C., analyzed national data on 366,000 people.
Study lead author Eric Finkelstein said being moderately overweight may not shorten life spans because there are many effective treatments to manage the health problems often brought on by excess weight, including high cholesterol, high blood pressure and diabetes, the newspaper reported.
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Circumcision Won't Shield Gay Men From HIV: Study
While circumcision may help protect heterosexual men in Africa from contracting HIV, the virus that causes AIDS, it does not appear effective in doing so for American gay men, according to the largest study yet on the issue.
The finding could affect future recommendations from the U.S. Centers for Disease Control and Prevention, which is considering advocating the routine circumcision of baby boys, to help cut their odds for HIV infection.
Circumcision "is not considered beneficial" for gay men concerned about lowering their risk of becoming infected with HIV, Dr. Peter Kilmarx of the CDC told the Associated Press. He released the study findings at a conference on Tuesday.
The finding are at odds with some studies conducted in Africa, which have suggested that circumcised males may be less prone to HIV infection during heterosexual sex. But circumcision may not offer the same protection when it comes to anal sex, Kilmarx said.
In the study, the CDC team tracked the HIV infection rate of nearly 4,900 men who had anal sex with an HIV-infected partner. The researchers found an HIV infection rate of 3.5 percent -- whether the men were circumcised or not.
The U.S. government is still devising its recommendations on circumcision, which are expected to be released in 2010, the AP said. Already, more than 80 percent of American males are circumcised, one of the highest rates in the world, and Kilmarx acknowledged that the issue is fraught with cultural and religious meaning. "It's seen by many as more than just a medical procedure," he said.
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