INFECCIONES DE TRANSMISIÓN SEXUAL Y EL VIH

Estimados colegas esta información muy interesante sobre ITS y VIH obtenidos de Journal Watch. Saludos Dr. Carlos Erazo STDs Go to Journal Watch  Subscribe  My Alerts STDs for October 18, 2011 SUMMARY AND COMMENT Many Unaware of Their HIV-Positive Status Despite High Rates of Testing October 17, 2011 | Salim S. Abdool Karim, MD, PhD | HIV/AIDS Clinical Care The results illustrate the need for frequent repeat testing and comprehensive prevention efforts. Reviewing: Kranzer K et al. PLoS ONE 2011 Sep 28; 6:e25244 SUMMARY AND COMMENT Hormonal Contraception May Increase Risk for HIV Infection Free! October 7, 2011 | Paul E. Sax, MD | HIV/AIDS Clinical Care Women using hormonal contraception — especially injectable forms — had a twofold increase in the risk for both acquiring and transmitting HIV infection. Reviewing: Heffron R et al. Lancet Infect Dis 2011 Oct 4; SUMMARY AND COMMENT Sperm Washing with Assisted Reproduction — Safe and Effective for HIV-Serodiscordant Couples October 7, 2011 | Carole Gilling-Smith, MD, PhD | HIV/AIDS Clinical Care In a group of studies that involved more than 1700 HIV-serodiscordant couples undergoing sperm washing with assisted reproduction, none of the women or newborns seroconverted to HIV-positive. Reviewing: Vitorino RL et al. Fertil Steril 2011 Apr 95:1684 NEWS IN CONTEXT Oral Tenofovir Dropped from HIV PrEP Trial Free! October 3, 2011 | Raphael J. Landovitz, MD, MSc | HIV/AIDS Clinical Care Evaluation of oral tenofovir/FTC and tenofovir gel will continue as planned. SUMMARY AND COMMENT Can Combined HIV Antigen/Antibody Testing Speed the Detection of New Infections? October 3, 2011 | Abigail Zuger, MD | HIV/AIDS Clinical Care The theory's attractive, but a new test still needs to be validated. Reviewing: Bischof JJ et al. AIDS 2011 Sep 24; 25:1927 SUMMARY AND COMMENT What to Do With Discordant Syphilis Serology Results? October 3, 2011 | Timothy J. Henrich, MD | HIV/AIDS Clinical Care Available evidence supports confirmatory treponemal-specific testing for patients who have an initial positive syphilis immunoassay followed by a negative RPR result. Reviewing: Park IU et al. J Infect Dis 2011 Sep 19; 204:1297 Hoover KW and Radolf JD. J Infect Dis 2011 Nov 1; 204:1295 FEATURE HIV Treatment as Prevention: An Interview with Myron Cohen Free! October 3, 2011 | HIV/AIDS Clinical Care Insights and observations from the principal investigator of the HPTN 052 trial SUMMARY AND COMMENT "HIV-Related" Osteopenia May Antedate HIV Infection September 26, 2011 | Abigail Zuger, MD | HIV/AIDS Clinical Care Low bone-mineral density was more common than expected among HIV-negative men who have sex with men and was correlated with amphetamine and inhalant use. Reviewing: Liu AY et al. PLoS ONE 2011 Aug 29; 6:e23688 FEATURE Common Sense on HIV Testing Free! September 26, 2011 | HIV/AIDS Clinical Care Paul Sax, MD, pleads his case in his blog HIV and ID Observations. Free Full-Text Article Summary and Comment Many Unaware of Their HIV-Positive Status Despite High Rates of Testing The results illustrate the need for frequent repeat testing and comprehensive prevention efforts. HIV counseling and testing (HCT) is an important entry point for accessing HIV treatment and prevention services. Ideally, HCT should be performed at regular intervals, especially for sexually active individuals living in high-prevalence settings. In a recent (2010) cross-sectional study, researchers assessed HCT uptake and HIV prevalence among 1300 individuals (age, >15) randomly selected from a peri-urban community near Cape Town, South Africa. Field workers visited the homes of these individuals up to five times to encourage them to undergo free HCT through a mobile HIV testing service; 88% eventually accepted. Overall, 23% of study participants tested positive for HIV infection. Remarkably, 45% of these cases represented new diagnoses, even though most of the study participants had been tested for HIV before (71% overall; 38% in the previous year). The proportion of study participants with a new HIV diagnosis was 18% among those who had never been tested before and 9% among those who had. This proportion varied by the timing of the most recent test — 5% among those tested within the preceding year, 8% among those tested 1 to 2 years previously, and 20% among those tested >2 years previously. The prevalence of HIV infection was highest (42%) among women aged 25 to 35, whereas the proportion of positive tests that were new diagnoses was significantly higher among men (62%, vs. 37% among women). Comment: The large proportion of individuals with new HIV diagnoses in this community, even among those who had an HIV test in the preceding year, underscores the need for frequent repeat HIV testing — and also indicates high underlying incidence rates. HCT and awareness alone are insufficient to reduce HIV acquisition. — Salim S. Abdool Karim, MD, PhD Published in Journal Watch HIV/AIDS Clinical Care October 17, 2011 Citation(s): Kranzer K et al. High prevalence of self-reported undiagnosed HIV despite high coverage of HIV testing: A cross-sectional population based sero-survey in South Africa. PLoS ONE 2011 Sep 28; 6:e25244. (http://dx.doi.org/10.1371/journal.pone.0025244) Medline abstract (Free)

INFORMACIÓN SOBRE VIH SIDA EN ECUADOR AL 2010

Estimados colegas, en breve se colocaran los datos oficiales relacionados con la epidemia del VIH al 2010.

Saludos

Dr. Carlos Erazo

http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/JC2141_UNAIDS_GLOBAL_FUND.PDF

UNAIDS has the authority and capacity to bring partners
together and create opportunities for us to share information and
reach consensus on key issues. At the Global Fund Implementers
Forum organized by UNAIDS in Dakar, April 2011, we openly
and constructively discussed our experiences of working with the
Global Fund, and, with UNAIDS support, we made sure that the
voice of civil society has been taken into account.

The world can achieve the UNAIDS vision of zero new HIV
infections, zero discrimination and zero AIDS-related deaths.
UNAIDS and the Global Fund have a critical part to play in
achieving this vision. We are stronger together.
Michel Sidibé,
Executive Director, UNAIDS

Characteristics Associated with HIV Infection Among Heterosexuals in Urban Areas with High AIDS Prevalence 24 Cities, United States, 2006--2007

If you have trouble reading this e-mail, please click here.
MMWR Weekly Volume 60, No. 31 August 12, 2011
PDF of this issue Earn CE MMWR Online Subscriptions Contact MMWR CDC Homepage MMWR RSS Feed How to Add MMWR RSS feeds Learn More About RSS	REPORTS Characteristics Associated with HIV Infection Among Heterosexuals in Urban Areas with High AIDS Prevalence 24 Cities, United States, 2006--2007 full text Human Rabies from Exposure to a Vampire Bat in Mexico Louisiana, 2010 full text Progress Toward Poliomyelitis Eradication Nigeria, January 2010--June 2011 full text Notifiable Diseases and Mortality Tables full text Department of Health and Human Services Centers for Disease Control and Prevention

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CONFORMACION DE DISTRITOS PRELIMINARES

Estimados colegas para su conocimiento. 

El Ministerio de Salud Pública en coordinación con el Ministerio de Inclusión Económica y Social , el Ministerio de Educación y SENPLADES ha venido trabajando en la conformación de los Distritos Administrativos, para lo cual se ha contado coon el apoyo de las Direcciones Provinciales de Salud a  nivel nacional, así como de las instancias técnicas de la Planta Central.

Se pone a conocimiento los Distritos Preliminares.

Zona 1   Provincias de Esmeraldas, Carchi, Imbabura, Sucumbios
             

Zona 2  Provincias de Pichincha, Napo, Orellana
            
Zona 3  Provincias de Cotopaxi,Tungurahua,Chimborazo,Pastaza
            

Zona 4  Provincias Manabí, Santo Domingo de los Taschilas
           

Zona 5  Provincias Santa Elena, Guayas, Los Rios, Bolivar, Galápagos
           

Zona 6  Provincias Cañar, Azuay, Morona Santiago
            

Zona 7  Provincias.  El Oro, Loja, Zamora Chinchipe
           

Zona 8  Cantones Guayaquil Samborondon, Duran


Zona 9  Cantón Quito


Saludos

LEY DE PREVENCION Y ASISTENCIA INTEGRAL DEL VIH/SIDA EN EL ECUADOR

http://es.scribd.com/doc/14600158/Ley-de-prevencion-y-asistencia-integral-del-VIH-SIDA-Ecuador

"LEY INTEGRAL SOBRE VIH-SIDA

 

EXPOSICIÓN DE MOTIVOS

 

El Proyecto de Ley Integral sobre VIH-SIDA, que se pone a consideración, constituye una propuesta de abordaje del problema del VIH-SIDA desde una perspectiva de desarrollo humano, que busca superar la fragmentada visión médica o biomédica de esta realidad hasta ahora imperante en el país, yproporcionar respuestas integradas que atiendan tanto la epidemia del VIH como la infección, lo cual implica modificar nuestra forma de percibir el problema y sus implicaciones.

La propuesta es producto de un proceso de creación colectiva, paciente y riguroso, extensamente discutido y validado, que comprometió esfuerzos de instituciones del Estado, organizaciones de la sociedad civil y especialistas de distintas formaciones académicas. Por iniciativa de las ONGs con trabajo en VIH-SIDA, cuya experiencia y constatación práctica de las limitaciones de la normativa vigente les impulsó a determinar la necesidad de generar una nueva legislación, es que ahora se cuenta con un proyecto elaborado participativamente y que incluye una visión integral para el abordaje del tema relacionado con el VIH-SIDA. Sus borradores han sido sometidos al estudio y análisis de diferentes ministerios y en la última fase, a la validación de múltiples actores y actoras en dos talleres en que se aprobaron los textos finales."

New Regimens to Prevent Tuberculosis in Adults with HIV Infection

 http://www.nejm.org/doi/pdf/10.1056/NEJMoa1005136

Background
Treatment of latent tuberculosis in patients infected with the human immunodeficiency
virus (HIV) is efficacious, but few patients around the world receive such treatment.
We evaluated three new regimens for latent tuberculosis that may be more
potent and durable than standard isoniazid treatment.
Methods
We randomly assigned South African adults with HIV infection and a positive tuberculin
skin test who were not taking antiretroviral therapy to receive rifapentine
(900 mg) plus isoniazid (900 mg) weekly for 12 weeks, rifampin (600 mg) plus isoniazid
(900 mg) twice weekly for 12 weeks, isoniazid (300 mg) daily for up to 6 years
(continuous isoniazid), or isoniazid (300 mg) daily for 6 months (control group). The
primary end point was tuberculosis-free survival.
Results
The 1148 patients had a median age of 30 years and a median CD4 cell count of
484 per cubic millimeter. Incidence rates of active tuberculosis or death were 3.1 per
100 person-years in the rifapentine–isoniazid group, 2.9 per 100 person-years in the
rifampin–isoniazid group, and 2.7 per 100 person-years in the continuous-isoniazid
group, as compared with 3.6 per 100 person-years in the control group (P>0.05 for
all comparisons). Serious adverse reactions were more common in the continuousisoniazid
group (18.4 per 100 person-years) than in the other treatment groups (8.7
to 15.4 per 100 person-years). Two of 58 isolates of Mycobacterium tuberculosis (3.4%)
were found to have multidrug resistance.
Conclusions
On the basis of the expected rates of tuberculosis in this population of HIV-infected
adults, all secondary prophylactic regimens were effective. Neither a 3-month course
of intermittent rifapentine or rifampin with isoniazid nor continuous isoniazid was
superior to 6 months of isoniazid. (Funded by the National Institute of Allergy and
Infectious Diseases and others; ClinicalTrials.gov number, NCT00057122.)

CHronIC Care for HIV and nonCommunICable dIseases

Estimados colegas  aqui les envio la información para el cuidado integral de las personas viviendo con VIH , y con enfermedades  crónicas no transmisibles.

Este es el link para bajarse el libro en PDF.

http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/20110526_JC2145_Chronic_care_of_HIV.pdf

Saludos

Carlos Erazo

INFORMACIÓN DISPONIBLE SOBRE VIH - SIDA EN ECUADOR.

HIV/AIDS SURVEILLANCE DATA BASE

COUNTRY AND RECORD SELECTION CRITERIA
HOME		MAPS	HELP

ESTIMADOS COLEGAS ESTE ES EL LINK PARA IDENTIFCIAR LA FUENTE DE LA INFORMACION DISPONIBLE EN EL ECUADOR Y CONOCIDA EN EL MUNDO ENTERO.




 http://hivaidssurveillancedb.org/hivdb/RecordSelPage.aspx

SALUDOS

DR. CARLOS ERAZO


Prevalence, in Percent, of Human Immunodeficiency Virus (HIV) for: Ecuador

  Number of records found = 79.Data Quality = All

Geographic Area	Reference Date	Population SubGroup	Sex	Age	Prev. Rate	Sample Size	Virus Type	Specimen Type	Type of Test	Source ID	Comments
Chone	2001	Homosexuals	M	ALL	0	44	HIV1	BW	ELISA, WB	M0835	Port city.
Colta	1988-1989	Indian urban population	B	ALL	0	94	HIV1	B	ELISA, WB	C0103	Located in Chimborazo Province.
Colta	1988-1989	Indian urban population	B	ALL	0	94	HIV2	B	ELISA, WB	C0103	Located in Chimborazo Province.
De Agosto	1988-1989	Indian urban population	B	ALL	0	17	HIV1	B	ELISA, WB	C0103	Located in Pastaza Province.
De Agosto	1988-1989	Indian urban population	B	ALL	0	17	HIV2	B	ELISA, WB	C0103	Located in Pastaza Province.
Eastern Ecuador	1983	Indians	B	ALL	0	70	HIV	B	ELISA	L0031	Waorani Indians.
Esmeraldas	1988	Volunteers	B	ALL	0	422	HIV	B	ELISA, WB	R0020
Esmeraldas	1988	Homosexuals	M	ALL	0	20	HIV	B	ELISA, WB	R0020
Esmeraldas	1988-1989	Black prostitutes	F	ALL	0	37	HIV2	B	ELISA, WB	C0103	Located in Esmeraldas province.
Esmeraldas	1988-1989	Black prostitutes	F	ALL	0	37	HIV1	B	ELISA, WB	C0103	Located in Esmeraldas Province.
Esmeraldas	1988	Prostitutes	F	ALL	1.56	64	HIV	B	ELISA	R0020
Four cities	2001-2002	Homosexuals	M	ALL	2.82	142	HIV1	BW	ELISA*2, WB	M0886	Men having sex w/ men (MSM). Age 18+. Also, see B0549.
Guayaquil	1999-2001	Homosexuals	M	ALL	27.75	227	HIV1	BW	ELISA*2, WB	M0886	Men having sex w/ men (MSM). Age 18+. Also, see B0549.
Guayaquil	1992	STI pts.	B	ALL	1.28	390	HIV1	B	ELISA, WB	R0148	Attending a STI clinic. Age range 15-45 yrs. Apr. 92.
Guayaquil	1992	STI pts.	B	ALL	1.79	390	HIV1	B	ELISA, WB	B0300
Guayaquil	2000-2001	Prostitutes	F	ALL	2.1	1047	HIV1	BW	ELISA*2, WB	M0886	Recruited from brothels, saunas, massage houses, parks, & streets. Age 18+. Also, see B0598.
Guayaquil	1992	Pregnant women	F	ALL	0.26	390	HIV1	B	ELISA, WB	B0300	Age range 15-45 yrs.
Guayaquil	2001	Homosexuals	M	ALL	24.74	97	HIV1	BW	ELISA, WB	M0835	Port city.
Guayaquil	1992	STI pts.	B	ALL	1.93	1190	HIV1	B	ELISA, WB	R0104	Largest city in Ecuador.
Guayaquil	1993	STI pts.	B	ALL	3.58	1395	HIV1	B	ELISA, WB	R0104	Largest city in Ecuador.
Guayaquil	2006	Homosexuals	M	ALL	19	541	HIV	B	RAPID,WB	G0474	Men having sex with men (MSM). Prevalence approximated from a graph. Feb. - June 06. RAPID test: Determine.
National	1988	Blood donors - volunteer	B	ALL	0	25358	HIV	B	ELISA, WB	L0035	Includes donors from Quito & provincial cities. Sept. 86 - Dec. 88.
National	1986	Blood donors - volunteer	B	ALL	0.03	6524	HIV	B	ELISA, WB	L0035	Includes donors from Quito & provincial cities. Sept. 86 - Dec. 88.
National	1994	Blood donors	B	ALL	0.1	88133	HIV	B	ELISA	S0326	90 % of blood donors were screened.
National	1987	Blood donors - volunteer	B	ALL	0	20282	HIV	B	ELISA, WB	L0035	Includes donors from Quito & provincial cities. Sept. 86 - Dec. 88.
Not specified	1989(?)	Hemophiliacs	B	ALL	0	141	HIV	B	ELISA, WB	R0020
Not specified	1988	Military recruits	B	ALL	0	7187	HIV	B	ELISA, WB	L0035	Group also includes other institutional personel.
Not specified	1999-2002	Prostitutes	F	ALL	1.8	N/A	HIV1	BW	ELISA, WB	C0504	Only the prevalence rate was given. Age 18+. Recruited from brothels, massage parlors, hotels, & streets.
Not specified	1988	Promiscuous individuals	B	ALL	0	91	HIV	B	ELISA, WB	L0035
Not specified	1988	Prostitutes	F	ALL	0	100	HIV	B	ELISA, WB	L0035
Not specified	1989	Blood donors	B	ALL	0.02	28672	HIV	B	UNK	R0043
Not specified	1988	Hemophiliacs	B	ALL	1.75	57	HIV	B	ELISA, WB	L0035
Not specified	2008(?)	Homosexuals	M	ALL	15.1	916	HIV	B	UNK	B0741	Men having sex w/ men (MSM).
Not specified	1988	Homosexuals & bisexuals	M	ALL	57.69	26	HIV	B	ELISA, WB	L0035
Portoviejo	2001	Homosexuals	M	ALL	4.08	98	HIV1	BW	ELISA, WB	M0835	Port city.
Quininde	1988	Prostitutes	F	ALL	0	100	HIV	B	ELISA, WB	R0020
Quito	2000-2001	Prostitutes	F	ALL	0.5	200	HIV1	BW	ELISA*2, WB	M0886	Recruited from brothels, saunas, massage houses, parks, & streets. Age 18+. Also, see B0598.
Quito	1988	Blood donors - volunteer	B	ALL	0	17884	HIV	B	ELISA, WB	R0020	Red Cross blood bank.
Quito	1992	Blood donors	B	ALL	0	N/A	HIV1	B	ELISA, WB	R0093	Only the prevalence rate was given.
Quito	1988-1989	Out-pts.	B	ALL	0	50	HIV2	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1991	STI pts.	B	ALL	1.4	143	HIV1	B	UNK	R0104	Various STI treatment sites.
Quito	1988-1989	Prostitutes	F	ALL	0	94	HIV2	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	2001	Homosexuals	M	ALL	11.11	45	HIV1	BW	ELISA, WB	M0835	Located in Andean region.
Quito	1987	Blood donors - volunteer	B	ALL	0	955	HIV	B	ELISA, WB	R0020	Other blood banks.
Quito	1990	Prostitutes - high SES/income	F	ALL	0	151	HIV1	B	ELISA, WB	R0054	High social economic status. Worked in bars & nightclubs in Mariscal area in the Red Zone of Quito. Oct. - Dec. 90.
Quito	1988-1989	Hospital personnel	B	ALL	0	57	HIV2	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1986	Partners of AIDS pts.	F	ALL	6.25	16	HIV	B	ELISA, WB	R0020
Quito	1988	Homosexuals	M	ALL	28.57	14	HIV	B	ELISA, WB	R0020
Quito	1988-1989	STI pts.	B	ALL	0	159	HIV1	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1988-1989	Prostitutes	F	ALL	0	94	HIV1	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1988-1989	STI pts.	B	ALL	0	159	HIV2	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1988-1989	Hospitalized pts.	B	ALL	0	99	HIV2	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1988-1989	Blood donors	B	ALL	0	396	HIV2	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1988	Blood donors - volunteer	B	ALL	0	1429	HIV	B	ELISA, WB	R0020	Other blood banks.
Quito	1992	STI pts.	B	ALL	0.52	191	HIV1	B	ELISA, WB	R0093	Four STI centers.
Quito	1988-1989	Hospitalized pts.	B	ALL	0	99	HIV1	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1999-2001	Homosexuals	M	ALL	14.45	263	HIV1	BW	ELISA*2, WB	M0886	Men having sex w/ men (MSM). Age 18+. Also, see B0549.
Quito	1991	STI pts.	B	ALL	1.23	163	HIV1	B	ELISA, WB	R0093	Four STI centers. Nov. - Dec. 91.
Quito	1988-1989	Blood donors	B	ALL	0.51	396	HIV1	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1988-1989	Out-pts.	B	ALL	0	50	HIV1	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1988-1989	Hospital personnel	B	ALL	0	57	HIV1	B	ELISA, WB	C0103	Race: White & halfcaste.
Quito	1988	Prisoners	B	ALL	0	662	HIV	B	ELISA, WB	R0020
Quito	1987	Military cadets	B	ALL	0	487	HIV	B	ELISA, WB	R0020
Quito	1987	Blood donors - volunteer	B	ALL	0	16978	HIV	B	ELISA, WB	R0020	Red Cross blood bank.
Quito & Guayaquil	2000-2001	Prostitutes	F	18Y25Y	1.86	590	HIV1	BW	ELISA*2, WB	B0598	Recruited from brothels, saunas, massage houses, parks, & streets.
Quito & Guayaquil	2000-2001	Prostitutes	F	ALL	1.84	1247	HIV1	BW	ELISA*2, WB	B0598	Recruited from brothels, saunas, massage houses, parks, & streets. Age 18+. Breakdown by age is provided & by city in M0886.
Quito & Guayaquil	2000-2001	Prostitutes	F	26Y+	1.69	650	HIV1	BW	ELISA*2, WB	B0598	Recruited from brothels, saunas, massage houses, parks, & streets.
Quito & Guayaquil	1987-1988	Prostitutes	F	ALL	0	369	HIV	B	UNK	R0054
San Cristobal island	1988-1989	General population	B	ALL	0	127	HIV1	B	ELISA, WB	C0103	Located in Galapagos Province.
San Cristobal island	1988-1989	General population	B	ALL	0	127	HIV2	B	ELISA, WB	C0103	Located in Galapagos Province.
Sangolqui	1988-1989	Indian urban population	B	ALL	0	53	HIV1	B	ELISA, WB	C0103
Sangolqui	1988-1989	Indian urban population	B	ALL	0	53	HIV2	B	ELISA, WB	C0103
Six cities	1999-2002	Homosexuals	M	ALL	16.61	632	HIV1	BW	ELISA*2, WB	B0549	Cities: Quito, Guayaquil, & 4 port cities. Breakdown by age is provided.
Six cities	1999-2002	Homosexuals	M	25Y29Y	23.2	125	HIV1	BW	ELISA*2, WB	B0549	Cities: Quito, Guayaquil, & 4 port cities.
Six cities	1999-2002	Homosexuals	M	30Y+	20.4	201	HIV1	BW	ELISA*2, WB	B0549	Cities: Quito, Guayaquil, & 4 port cities.
Six cities	1999-2002	Homosexuals	M	18Y20Y	11.11	126	HIV1	BW	ELISA*2, WB	B0549	Cities: Quito, Guayaquil, & 4 port cities.
Six cities	1999-2002	Homosexuals	M	21Y24Y	11.9	168	HIV1	BW	ELISA*2, WB	B0549	Cities: Quito, Guayaquil, & 4 port cities.
St. Domingo	1987	Prostitutes	F	ALL	0	105	HIV	B	ELISA, WB	R0020
Sucumbios Province	1993	Prostitutes	F	ALL	0	390	HIV1	B	ELISA	B0300	Age range 18-50 yrs.

ANALISIS SITUACIONAL DE LOS SISTEMAS DE MONITOREO Y EVALUACIÓN DE LOS PROGRAMAS NACIONALES DE VIH/sida DE LA SUBREGION ANDINA Bolivia, Colombia, Chile, Ecuador, Perú y Venezuela 2008

ANALISIS SITUACIONAL DE LOS SISTEMAS DE
MONITOREO Y EVALUACIÓN DE LOS PROGRAMAS
NACIONALES DE VIH/sida DE LA SUBREGION
ANDINA 2008
Bolivia, Colombia, Chile, Ecuador, Perú y Venezuela

http://bvs.per.paho.org/SCT/SCT2008-008/SCT2008008.pdf

Reunión de Alto Nivel sobre el Sida de 2011

http://www.unaids.org/es/aboutunaids/unitednationsdeclarationsandgoals/2011highlevelmeetingonaids/

"La respuesta mundial al sida continúa dando frutos: un número sin precedente de personas accede al tratamiento y las tasas de nuevas infecciones por el VIH han descendido en casi un 25%

En el momento en que se cumplen 30 años desde que se registrara el primer caso de sida (5 de junio de 1981), el ONUSIDA calcula que 34 millones de personas [30,9 millones- 36,9 millones] viven con el VIH en todo el mundo y que prácticamente 30 millones [25 millones-33 millones] han fallecido por causas relacionadas con el sida.

NUEVA YORK/Ginebra, 3 de junio de 2011—A finales de 2010, en torno a 6,6 millones de personas recibían terapia antirretrovírica en países de ingresos bajos y medios, lo que supone una cifra casi 22 veces superior a la de 2001, según un nuevo informe presentado hoy por el Programa Conjunto de las Naciones Unidas sobre el VIH/Sida (ONUSIDA), titulado Treinta años de sida: las naciones en un punto clave del camino (en inglés).

En 2010, un número récord de 1,4 millones de personas inició por primera vez el tratamiento antirretrovírico, una cifra muy superior a cualquier año previo. Según el informe, al menos 420.000 niños recibían terapia antirretrovírica a finales de 2010, lo que supone un aumento superior al 50% respecto a los 275.000 que lo hicieron en 2008.
 “El acceso al tratamiento transformará la respuesta al sida en la próxima década. Debemos invertir en acelerar el acceso a la terapia del VIH y en encontrar nuevas opciones de tratamiento”, afirmó Michel Sidibé, director ejecutivo del ONUSIDA. “La terapia antirretrovírica es ahora más que nunca un gran motor para el cambio: no solo impide que las personas mueran, sino que también evita nuevas infecciones por el VIH en hombres, mujeres y niños”.

Esta declaración alude a los resultados del ensayo HPTN052 , publicados el 12 de mayo de 2011, que demostraron que si una persona que vive con el VIH se adhiere a una posología antirretrovírica efectiva, el riesgo de transmitir el virus a su pareja sexual seronegativa se puede reducir en un 96%.
 “Los países deben hacer uso de lo mejor que la ciencia puede ofrecer para evitar nuevas infecciones por el VIH y muertes relacionadas con el sida”, afirmó la Vicesecretaria General de las Naciones Unidas, Asha-Rose Migiro. “Estamos en un momento crucial en la respuesta al sida. El objetivo de alcanzar el acceso universal a la prevención, el tratamiento, la atención y el apoyo relacionados con el VIH para 2015 debe convertirse en una realidad”.

Las iniciativas de prevención del VIH están dando frutos
Según el informe, la tasa mundial de nuevas infecciones por el VIH se redujo en prácticamente un 25% entre 2001 y 2009: en la India, este descenso fue superior al 50%; y en Sudáfrica, al  35%. Ambos países albergan al mayor número de personas que viven con el VIH en sus continentes.
El informe concluye que en la tercera década de la epidemia, las personas estaban comenzando a adoptar comportamientos sexuales más seguros, lo que refleja la repercusión de las iniciativas de prevención y sensibilización. Sin embargo, todavía hay escollos importantes. Los varones jóvenes suelen estar más informados sobre la prevención del VIH que sus coetáneas: las últimas encuestas demográficas y de salud arrojaron que en torno al 74% de éstos sabían que los preservativos eran efectivos para prevenir la infección por el VIH, mientras que entre las jóvenes, esta cifra solo era del 49%.
En los últimos años se han producido avances importantes en la prevención de nuevas infecciones entre niños gracias al aumento del número de mujeres embarazadas seropositivas que ha accedido a la profilaxis antirretrovírica durante el embarazo, el parto y la lactancia. El número de nuevas infecciones por el VIH en niños fue en 2009 un 26% menor que en 2001.
Unos 115 países de ingresos bajos y medios están ofreciendo un tratamiento óptimo a las mujeres embarazadas que viven con el VIH siguiendo las recomendaciones de la Organización Mundial de la Salud. Sin embargo, 31 países todavía utilizan terapias subóptimas en muchos de sus programas. El ONUSIDA insta a todas estas naciones a revisar sus directrices de tratamiento y hacer la transición a los tratamientos óptimos recomendados por la OMS."

"En sida no ha sido erradicado, todavía quedan retos importantes

Según las últimas estimaciones del ONUSIDA, 34 millones de personas [30,9 millones-36,9 millones] vivían con el VIH a finales de 2010, y cerca de 30 millones [25 millones-33 millones] habían muerto por causas relacionadas con el sida desde que se registrara la enfermedad por primera vez hace 30 años.
A pesar de la expansión del acceso a la terapia antirretrovírica, todavía hay un gran déficit de tratamiento. A finales de 2010, nueve millones de personas elegibles para seguir la terapia no podían acceder a ella. El acceso para los niños es aún más limitado que para los adultos: en 2009, solo el 28% de los niños elegibles recibían tratamiento, mientras que para las personas de todas las edades la cobertura era del 36%.
Aunque la tasa de nuevas infecciones por el VIH ha descendido globalmente, el número total de infecciones sigue siendo muy alto, en torno a 7.000 cada día. La reducción global de la tasa de nuevas infecciones oculta las variaciones regionales. Según el informe, África subsahariana y Asia sudoriental fueron las regiones donde el descenso en el número de nuevas infecciones superó la media, mientras que en América Latina y el Caribe fueron más modestos, de apenas un 25%. Por otro lado, esta tasa ha aumentado en Europa oriental, Oriente Medio y África septentrional.
En prácticamente todos los países la prevalencia del VIH en las personas más expuestas al riesgo de infección (hombres que tienen relaciones sexuales con hombres, usuarios de drogas inyectables, profesionales del sexo y sus clientes, y personas transgénero) es mayor que en otra poblaciones. El acceso de estos grupos a la prevención y el tratamiento es generalmente menor debido a la existencia de leyes punitivas y discriminatorias, así como al estigma y la discriminación. Según los datos de abril de 2011, 79 países, territorios y áreas penalizan las relaciones homosexuales consentidas; 116 países, territorios y áreas penalizan algún aspecto del trabajo sexual; y 32 países tienen leyes que permiten la pena de muerte por delitos relacionados con drogas.
Según el informe, las desigualdades de género también siguen siendo un gran obstáculo para responder de manera efectiva al VIH. El virus es la principal causa de muerte de mujeres en edad reproductiva, y más de un cuarto (26%) de todas las nuevas infecciones se dan en mujeres de entre 15 y 24 años.
Se reducen los recursos destinados al sida
Según el informe, las inversiones en la respuesta al VIH en los países de ingresos bajos y medios prácticamente se multiplicaron por 10 entre 2001 y 2009, de USD 1.600 millones a USD 15.900 millones. Sin embargo, los recursos internacionales destinados al VIH se redujeron en 2010. Muchos países de ingresos bajos siguen dependiendo ampliamente de financiación externa. En 56 países, los donantes internacionales cubren, como mínimo, el 70% de los recursos para el VIH.
“Me preocupa que las inversiones internacionales se estén reduciendo en un momento en el que la respuesta al sida está consiguiendo resultados para las personas”, afirmó Sidibé. “Si no invertimos ahora, lo pagaremos con creces en el futuro”.
En 2011, el ONUSIDA y sus asociados propusieron un marco de inversión que concluyó que para 2015 se necesita una inversión de al menos USD 22.000 millones, 6.000 más de los que se dispone actualmente. La repercusión es mayor cuando estas inversiones se destinan a un conjunto de programas prioritarios que se basan en un tipo de epidemia nacional. Se estima que con una inversión de esta magnitud se conseguirán evitar hasta 2020 diez millones de nuevas infecciones por el VIH y 7,4 millones de muertes relacionadas con el sida. El número de nuevas infecciones descendería de unos 2,5 millones en 2009 a en torno a un millón en 2015.
Perspectivas sobre el sida de líderes de todo el mundo
El informe contiene comentarios de 15 líderes de la respuesta mundial al sida, entre otros, el presidente de Sudáfrica, Jacob Zuma; el ex-presidente de los Estados Unidos, Bill Clinton; el ex-presidente de Brasil Luiz Inácio Lula da Silva; el presidente de Malí, Amadou Tounami Touré; y Jean Ping, presidente de la Comisión de la Unión Africana. Estos comentarios versan sobre áreas diversas, como la financiación para el sida, la cooperación Sur-Sur, el liderazgo de los jóvenes, la capacitación de la mujer, las poblaciones más afectadas, el consumo de drogas inyectables, los derechos humanos, el estigma y la discriminación, y la integración de sistemas.
Los jóvenes lideran la revolución de la prevención del VIH
Treinta años de sida: las naciones en un punto clave del camino también incluye un artículo sobre un acto que se celebró recientemente en Robben Island, Sudáfrica, donde el arzobispo Desmond Tutu, copresidente de la Comisión de alto nivel del ONUSIDA sobre la prevención del VIH, pasó el testigo del liderazgo en la respuesta al sida a una nueva generación de jóvenes.
Según el informe, algunos de los mayores avances en la prevención del VIH se han producido entre los jóvenes. Los datos indican que cada vez son más los jóvenes que, en muchos de los países más afectados, están optando por retrasar su iniciación sexual y evitan aquellas conductas sexuales que pueden exponerles a un mayor riesgo de infección."

MAPA DE LA SITUACION DEL VIH-SIDA EN ECUADOR 2010

ESTIMADOS COLEGAS, A LA DERECHA DE SU PANTALLA ENCONTRARAN EL LINK DEL MAPA HACIENDO CLICK SOBRE LA IMAGEN, EN ESTA SE HAN  REFERENCIADO DATOS POR CADA PROVINCIA SOBRE EL MAPA, AL DAR CLICK EN LOS GLOBOS , PODRAN VER LA INFORMACION COLOCADA EN CADA UNA DE LAS PROVINCIAS.

ESTAREMOS HACIENDO USO DE LA TECNOLOGIA DISPONIBLE PARA MANTENERLOS INFORMADOS, COMO FUE NUESTRO COMPROMISO.

SALUDOS.

DR. CARLOS ERAZO

ALGUNOS DATOS INTERESANTES SOBRE EL VIH

LOS CONDONES MASCULINOS SON EFECTIVOS PARA DISMINUIR EL RIESGO DE LA INFECCIÒN DEL VIRUS EN UN 80% A 95% .
LOS CONDONES FEMENINOS SON EFECTIVOS PARA DISMINUIR EOL RIESGO DE LA INFECCIÓN DEL VIRUS EN UN 94% A 97%.

FUENTE: THE SANFORD GUIDE TO HIV/AIDS THERAPY 2010.

SALUDOS

DR. CARLOS ERAZO

HIV Therapy Dramatically Cuts Transmission in Heterosexual Pairs

"By Michael Smith, North American Correspondent, MedPage Today Published: May 12, 2011

Triple-drug therapy dramatically reduced transmission of HIV in heterosexual couples when one partner is infected and the other is not, results of a randomized trial showed.
Treating the infected partner in these discordant couples reduced transmission by 96%, compared with no treatment, according to Myron Cohen, MD, of the University of North Carolina Chapel Hill, and colleagues.
The $73 million trial had been slated to finish in 2015 but was stopped early after those clear-cut results were found by the study's data safety monitoring board during a planned interim review.
A series of mathematical models and observational studies have suggested that treatment of HIV can reduce transmission, and other studies have suggested that anti-HIV drugs might be used as prophylaxis.
But this is the "first, rather dramatic, randomized trial in discordant couples," according to Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, one of the sponsors of the so-called HPTN 052 trial.
It "nails the concept down rather nicely," he said in a telephone media conference.
Outside experts hailed the trial as a giant step forward.

"This study is another milestone in the history of HIV," said John Bartlett, MD, of Johns Hopkins. "The concept of treatment for prevention is proven."

"Patients can take the drugs for their own health and for public health," Bartlett added in an email to ABC News/MedPage Today.

The findings have the potential to transform approaches to the treatment and prevention of HIV," according to Mark Kline, MD, of Baylor College of Medicine in Houston.

Kline noted in an email to ABC News/MedPage Today that a trial in the mid-1990s showed that administering a single anti-HIV drug to pregnant women could prevent mother-to-child transmission of the virus.

That finding had "an immediate and direct impact on public health policies" and led many experts to think that treatment might prevent infection in other settings, he said.

"Now, we have conclusive evidence from a prospective, randomized treatment trial in support of that contention," Kline said.

Indeed, the findings "must serve as a clarion call" for expanded access to treatment, according to Mitchell Warren, executive director of the New York-based AIDS Vaccine Advocacy Coalition.
"We now have evidence from a randomized trial confirming what has been seen in observational settings: (antiretroviral) treatment is prevention," Warren told MedPage Today in an email.
The study, conducted by the HIV Prevention Trials Network, began in April 2005 and enrolled 1,763 couples, 97% of them heterosexual, in nine countries.
All the HIV-infected participants -- 890 men and 873 women -- had relatively intact immune systems, with CD4-positive T-cell counts between 350 and 550 per cubic millimeter and were not eligible at the time for HIV treatment based on their local guidelines.
They were randomly assigned to get immediate treatment or to wait until their CD4 counts fell to 250 or they had an AIDS-defining event.
All told, the review found 39 cases of HIV infection among the previously uninfected partners, and genetic analysis showed that 28 of those came from the infected partner. (Seven did not, and four are still being analyzed.)
But 27 of the linked infections occurred in the deferred treatment group and just one in the immediate therapy arm, a difference that was significant at P<0.0001.
All participants in the deferred treatment arm are now being offered triple-drug therapy regardless of their CD4 count, Cohen told reporters during the telephone media conference.
He said that the original plan for the study was to have homosexual couples included, but very few agreed to take part. For that reason, he said, it would be a "mistake" to assume this finding would apply to men who have sex with men.
Cohen added that the trial shows that even with a relatively intact immune system, transmission can occur. "You can't look at a high CD count and make the assumption that transmission is not going to occur," he said.
HIV transmission risk is linked to the amount of the virus in the blood, the so-called viral load, but many physicians will assume that if the CD4 count is relatively high, they can "let it go," Fauci said. The study investigators are currently analyzing viral load data from the trial, he said.
The treatment regimens used in the trial varied depending on the location of patients, Fauci said, with 11 different antiretroviral drugs employed in various combinations.
The researchers also found that 17 cases of extrapulmonary tuberculosis occurred in the HIV-infected partners in the deferred treatment arm and just three in the immediate treatment arm. The difference was significant at P=0.0013.
There were 23 deaths -- 10 in the immediate treatment group and 13 in the deferred treatment arm -- but the difference was not significant."


LINK:  http://www.medpagetoday.com/HIVAIDS/HIVAIDS/26442?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=188864

Early HIV Treatment Associated with Greatly Reduced Transmission to Partners

Estimados colegas , aqui les dejo el link para poder revisarlo:

http://www.niaid.nih.gov/news/newsreleases/2011/Pages/HPTN052.aspx

Saludos

Dr. Carlos Erazo

A 10-year study on early HIV treatment has been stopped prematurely after a monitoring board found convincing evidence that it "can have a major impact on reducing HIV transmission," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, in an NIH announcement Thursday.
Called HPTN 052, the international study was conducted primarily among some 1800 heterosexual couples. One partner in each couple was uninfected at entry. Infected partners were randomized either to immediate treatment with a three-drug antiretroviral regimen or to deferred treatment (until CD4 counts fell below 250 per cubic millimeter or an AIDS-related event occurred).
There were 28 new infections linked to partners, 27 of which occurred among the deferred-treatment group, giving a relative reduction in transmission of 96%.
Dr. Carlos del Rio of Journal Watch HIV/AIDS Clinical Care commented that the findings "prove once and for all that antiretroviral therapy not only is good for the individual but it is also good for society, as it reduces HIV transmission."

Findings Result from NIH-funded International Study

Men and women infected with HIV reduced the risk of transmitting the virus to their sexual partners by taking oral antiretroviral medicines when their immune systems were relatively healthy, according to findings from a large-scale clinical study sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
The clinical trial, known as HPTN 052, was slated to end in 2015 but the findings are being released early as the result of a scheduled interim review of the study data by an independent data and safety monitoring board (DSMB). The DSMB concluded that it was clear that use of antiretrovirals by HIV-infected individuals with relatively healthier immune systems substantially reduced transmission to their partners. The results are the first from a major randomized clinical trial to indicate that treating an HIV-infected individual can reduce the risk of sexual transmission of HIV to an uninfected partner.
“Previous data about the potential value of antiretrovirals in making HIV-infected individuals less infectious to their sexual partners came largely from observational and epidemiological studies,” said NIAID Director Anthony S. Fauci, M.D. “This new finding convincingly demonstrates that treating the infected individual—and doing so sooner rather than later—can have a major impact on reducing HIV transmission.”
Led by study chair Myron Cohen, M.D., director of the Institute for Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill, HPTN 052 began in April 2005 and enrolled 1,763 couples, all at least 18 years of age. The vast majority of the couples (97 percent) were heterosexual, which precludes any definitive conclusions about effectiveness in men who have sex with men. The study was conducted at 13 sites in Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, the United States and Zimbabwe. The U.S. site collected only limited data because of difficulties enrolling participants into the study. However, data from one serodiscordant couple at the site was included in the DSMB’s analysis. At the time of enrollment, the HIV-infected partners (890 men, 873 women) had CD4+ T-cell levels—a key measure of immune system health—between 350 and 550 cells per cubic millimeter (mm³) within 60 days of entering the study. The HIV-uninfected partners had tested negative for the virus within 14 days of entering the study.
The investigators randomly assigned the couples to either one of two study groups. In the first group, the HIV-infected partner immediately began taking a combination of three antiretroviral drugs. In the second group (the deferred group), the HIV-infected partners began antiretroviral therapy when their CD4 counts fell below 250 cells/mm³ or an AIDS-related event, such as Pneumocystis pneumonia, occurred. Throughout the study, both groups received HIV-related care that included counseling on safe sex practices, free condoms, treatment for sexually transmitted infections, regular HIV testing, and frequent evaluation and treatment for any complications related to HIV infection. Each group received the same amount of care and counseling.
In its review, the DSMB found a total of 39 cases of HIV infection among the previously uninfected partners. Of those, 28 were linked through genetic analysis to the HIV-infected partner as the source of infection. Seven infections were not linked to the HIV-infected partner, and four infections are still undergoing analysis. Of the 28 linked infections, 27 infections occurred among the 877 couples in which the HIV-infected partner did not begin antiretroviral therapy immediately. Only one case of HIV infection occurred among those couples where the HIV-infected partner began immediate antiretroviral therapy. This finding was statistically significant and means that earlier initiation of antiretrovirals led to a 96 percent reduction in HIV transmission to the HIV-uninfected partner. The infections were confirmed by genetic analysis of viruses from both partners.
Additionally, 17 cases of extrapulmonary tuberculosis occurred in the HIV-infected partners in the deferred treatment arm compared with three cases in the immediate treatment arm, a statistically significant difference. There were also 23 deaths during the study. Ten occurred in the immediate treatment group and 13 in the deferred treatment group, a difference that did not reach statistical significance.
The study was designed to evaluate whether antiretroviral use by the HIV-infected individual reduced HIV transmission to the uninfected partner and potentially benefited the HIV-infected individual as well. Additionally, the study was designed to evaluate the optimal time for a person infected with HIV to initiate antiretrovirals in order to reduce HIV-related sickness and death. Based on their analysis, the DSMB recommended that the deferred study arm be discontinued and that the study participants be informed of the trial’s outcome.
“We want to thank the study participants for making such an important contribution in the fight against HIV/AIDS. We think that these results will be important to help improve both HIV treatment and prevention,” said Dr. Cohen.
Study participants are being informed of the results. Individuals who became HIV-infected during the course of the study were referred to local services for appropriate medical care and treatment. HIV-infected participants in the deferred treatment group will be offered antiretroviral therapy.  The study investigators will continue following the study participants for at least one year.
The study was conducted by the HIV Prevention Trials Network, which is largely funded by NIAID with additional funding from the National Institute on Drug Abuse and the National Institute of Mental Health, both part of the NIH. Additional support was provided by the NIAID-funded AIDS Clinical Trials Group. The antiretroviral drugs used in the study were made available by Abbott Laboratories, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline/Viiv Healthcare and Merck & Co., Inc.
The 11 HIV drugs that were used in various combinations included the following:

• atazanavir (300 mg once daily)
• didanosine (400 mg once daily)
• efavirenz (600 mg once daily)
• emtricitabine/tenofovir disoproxil fumarate (200 mg emtricitabine/300 mg tenofovir disoproxil fumarate once daily)
• lamivudine (300 mg once daily)
• lopinavir/ritonavir 800/200 mg once daily (QD) or lopinavir/ritonavir 400/100 mg twice daily (BID)
• nevirapine (200 mg taken once daily for 14 days followed by 200 mg taken twice daily)
• ritonavir (100 mg once daily, used only to boost atazanavir)
• stavudine (weight-dependent dosage)
• tenofovir disoproxil fumarate (300 mg once daily)
• zidovudine/lamivudine (150 mg lamivudine/300 mg zidovudine taken orally twice daily)

In an ongoing international clinical study called Strategic Timing of Antiretroviral Therapy, NIAID is examining the optimal time for asymptomatic HIV-infected individuals to begin antiretrovirals. For additional information about the HPTN 052 study, see the Questions and Answers. Visit the NIAID HIV/AIDS Web portal for more information about NIAID’s HIV/AIDS research.