BBI

Since 1981, AIDS has killed 25 million people. Last year 3 million died, including 800,000 children. At the end of last year, 40 million people worldwide were HIV-positive, including 2.7 million children less than 15 years old. About 5 million new patients were infected last year, translating to 1,500 new infections every day.The prescription of anti-retroviral drugs (zidovudine and lamivadine) to seropositive pregnant women during pregnancy reduces the risk of materno-fetal transmission of HIV from 25% to 8% and to less than 2% if associated measures such as Caesarean delivery and absence of breast feeding also are taken.

But these anti-retroviral (ARV) drugs also can be dangerous for the baby. According to a study by Professor St phane Blanche of Hopital Neckar (Paris), neurologic problems (convulsions and fever) result three times more often with babies born from anti-retroviral treated mothers (11 cases per 1,000). But the French researchers also estimate that the preventive treatment has saved a much greater number of infants. They recommend that the preventive treatment be continued, although under strict surveillance and that mothers must be alerted to this potential risk.

The World Health Organization (WHO; Geneva, Switzerland) announced at this summer's International AIDS Conference in Barcelona, Spain, the development of new simplified guidelines for the use of ARV therapy in settings where there are no highly trained medical or sophisticated laboratories to initiate and supervise treatment.

"For the first time, we now have the chance to apply a simplified easy-to-follow public health approach to AIDS treatment rather than complex individual treatment regimes," said Gro Harlem Bruntland, WHO director-general. "This, combined with the falling costs of medicines, means it should be possible to extend the life-span of those living with HIV in resource-limited settings."

The new guidelines are the result of a year-long process with input from 120 scientists, researchers and clinicians as well as representatives of civil society and people living with HIV/AIDS in more than 60 countries.

Development of the guidelines was supported by a grant from the National Institutes of Health's (Bethesda, Maryland) Office of AIDS Research in the U.S.

Preventing surgical adhesions

Surgical adhesions are a frequent problem especially after abdominal surgery and gynecological procedures. Britannia Pharmaceuticals (Redhill, UK) initiated Phase III trials of a dry powder phospholipid-based product designed to reduce the occurrence of surgical adhesions. The product, called Adsurf (pumactant), contains two naturally occurring phospholipids and is a reformulation of Britannia's lung surfactant, ALEC, which is licensed in Britain for treating respiratory distress syndrome.

Adsurf is administered as a sterile dry powder via aerosol after the surgical procedure and before the incision closure. The company says the powder melts at just below body temperature, coating the internal surface tissues to prevent the formation of adhesions and helping the body's natural mechanism for generating more surfactant.

Simpler confocal microscopy

Leica Mikrosystems (Glattbrugg, Switzerland) has developed a freely programmable device, the Acousto-Optical-Beam Splitter (AOBS) to replace the conventional beam splitter for separating exitation from emission light. This enables the Leica Spectral Confocal Microscope TCS SP2 AOBS to operate right across the visible wavelength range without filters. The AOBS element can adapt instantly from single to multi-chromatic characteristics within the specified spectral range, the company said. Using the new system, four differing fluorescent proteins can readily be distinguished simultaneously without image processing. Leica said that even with a single Argon laser as excitation source, clear separation of fluorescent proteins CFP, YFP and GFP can be obtained.

Gene therapy for sickle-cell anemia

Sickle cell anemia, or drepanocytosis, is a common hereditary disease in Africa and Mediterranean countries, characterized by a hemoglobin anomaly that results in anemia and in thromboses of peripheral arteries. It was one of the first genetic diseases, where the mutation responsible was identified in 1957. A research group at the Hopital Saint-Louis (Paris) has taken a first step in conquering sickle-cell anemia with a successful correction by gene therapy in a mouse model. Their aim is to develop a gene therapy for use in humans.