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THURSDAY, Oct. 11 (HealthDay News) -- Preliminary research suggests that potent AIDS drugs might stop the brain damage that afflicts many people infected with HIV.
The findings are based upon measurements of a brain protein, not extensive cognitive testing, so it's not clear exactly what they mean for thinking processes in patients. Still, the research is promising, said study author Dr. Asa Mellgren, a researcher with the Clinic of Infectious Diseases SAS and Sahlgrenska Academy in Sweden. The finding is published in the Oct. 9 issue of Neurology.
"In a few patients followed for 10 years, we did not see signs that HIV will do any more damage as long as the patient stays on an effective [drug] treatment," Mellgren said.
While it doesn't get a lot of attention, it's not uncommon for AIDS patients to develop brain damage and lose their ability to think clearly, explained Dr. Stuart Lipton, a neurologist with the Burnham Institute for Medical Research and the University of California at San Diego.
In fact, AIDS is the leading cause of dementia in people under the age of 40, Lipton said.
The good news is that the brain damage seems to have become less severe over the past decade, thanks to a new generation of powerful AIDS drugs. "We see a lot more cases of what we call minimal cognitive impairment," Lipton said, causing people to have trouble concentrating.
"It's not this raging dementia anymore," he said. "But it keeps you from working and doing your daily activities, so it's still a problem."
In the new study, researchers examined levels of a protein in 53 HIV patients who began treatment with drugs known as highly active antiretrovirals. This so-called "cocktail" of drugs is considered the best treatment for HIV.
Using spinal taps before and after the men and the women began treatment, the researchers found that levels of the so-called "neurofilament light protein" went down. Levels of the protein are considered to be an indicator of disease that causes the brain to degenerate.
Of the patients, 21 had high levels of the protein at the beginning of the study, suggesting they may have had brain damage. But the levels in about half of them dropped to normal levels after they took AIDS drugs for three months. After one year, only four people still had high levels of the protein.
"It is now possible to measure if the patients have signs of brain damage due to HIV by making a spinal tap, and it is also possible to monitor the changes of this marker during [treatment]," Mellgren said.
It is important to find markers that can indicate what's going on in the brain, said Lipton. However, cognitive tests are still needed to understand fully how a patient is doing, he said.
The study authors acknowledged that future research needs to include more extensive cognitive testing.
More information
Learn more about HIV from the U.S. Centers for Disease Control and Prevention.
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FRIDAY, Sept. 7 (HealthDay News) -- One in four women carries the bacterium Group B streptococcus, the most common cause of life-threatening infections in newborns. Yet most women don't know it.
That same germ can wreak havoc on a newborn child, with infection during birth possibly leading to blindness, deafness, retardation, physical disability and, in the worst cases, death.
There's a simple test that can determine whether a pregnant woman carries GBS, and an effective antibiotic therapy for protecting her child during delivery. Yet, approximately one of every 100 to 200 babies whose mothers carry GBS will become infected and need treatment, according to the U.S. Centers for Disease Control and Prevention.
"It can kill and maim, and 90 percent of it is preventable," said Dr. James A. McGregor, visiting professor of clinical obstetrics and gynecology at the University of Southern California Keck School of Medicine in Los Angeles. "How often in life do you get the chance to prevent 90 percent of something awful?"
As a result, doctors are urging women to make sure they are tested for presence of the bacterium -- and that they make sure steps are taken during delivery to protect their baby.
With a swab of a woman's rectum and vagina, doctors can determine whether she carries GBS.
Both the U.S. Centers for Disease Control and Prevention and the Society of Obstetricians and Gynaecologists of Canada have guidelines that recommend that doctors screen every pregnant woman for GBS. The screening should take place between the 35th and 37th week of pregnancy. If a woman hasn't received a GBS screening by then, she should ask her doctor about it, according to the guidelines.
If a woman tests positive for GBS, she should be given intravenous antibiotics for at least four hours before she delivers, the guidelines say.
Doctors believe that babies who are infected take the bacterium into their bodies by ingesting GBS-containing amniotic or vaginal fluids during labor and delivery, according to the March of Dimes.
"We can't make a normal bacteria that's just living there go away by antibiotics," said Dr. Carol Baker, a professor of pediatrics, microbiology and immunology at the Baylor University College of Medicine, and head of the section for infectious diseases in the college's Department of Pediatrics. "But what we can do, if they are carrying the Group B strep, we give them antibiotic during labor.
"It fills the fluid around the baby, the amniotic fluid, with antibiotic," Baker said. "The baby is in an antibiotic bath, as it were." The antibiotic also floods the mother's blood and the birth canal.
"We can't make it [the germ] go completely away, but we can get the number really, really low -- enough so that the baby won't get a life-threatening infection," she said.
There's a one-in-100 chance that a GBS carrier's baby will become sick from infection with the bacterium. The risk rises to 4 percent under certain circumstances, including preterm delivery, prolonged rupture of the membranes, or fever during labor, according to the March of Dimes.
About 5 percent of babies infected with Group B strep die. Most who survive develop normally, but among those who develop meningitis as a result of GBS, up to 50 percent suffer lasting neurologic damage that can include cerebral palsy, sight and hearing loss, mental retardation, learning disabilities and seizures.
McGregor said that now that screening guidelines are in place, researchers want to eliminate the small number of infections that continue to occur. They are trying to figure out how to better improve the testing, making it quicker and more accurate. They're also looking at ways to make sure mothers get a sufficient dose of antibiotics, even if their labor appears to be a quick one, he said.
"Many hospitals used to have antibiotics on the ward that they could administer," McGregor said. "Now the request has to go to the pharmacy, and that can take an hour the mother might not have."
A potential vaccine that could be given to all women of childbearing years is another option.
"There's increasingly a clearly felt imperative to make a vaccine for Group B strep available for pregnant women," McGregor said.
There are a couple of candidate vaccines that have been identified, but research on them has ground to a halt, because no drug company is interested in pursuing them, he said. In effect, the Group B strep vaccine has become an "orphan" of medical science.
"We need to change our policies about 'orphan' vaccines and 'orphan' therapies," providing incentives and encouragement for research, McGregor said.
Finally, McGregor and Baker believe doctors need to better explain the GBS test at the time it is administered, so women with the bacterium understand that they need antibiotics and know to ask for them.
"If you say, 'I am group B strep positive, I need my antibiotics,' people will be responsive to you," Baker said. "We need to explain the test to the woman. Then she can really help advocate for the right thing being done in a timely fashion."
More information
To learn more, visit Group B Strep International
.
WEDNESDAY, June 13 (HealthDay News) -- If you're a male Nazca booby, being a good husband and father may not be enough to convince your mate to stand by you, says a Wake Forest University study.
It found that female Nazca boobys -- long-lived seabirds that live in the Galapagos Islands -- often switch mates after a few seasons of successfully raising chicks. This may be because the male starts to look a bit ragged from the demands of parenthood, so the female dumps him for a fresher-looking male, explained study co-author and doctoral student Terri Maness.
Since there are significantly more males than females in the colony Maness studied, it's also easy for a female to find a new mate.
"Our study population has 50 percent more males than females, creating the opportunity for females to trade a current mate, which may be worn out from recent breeding effort, for a 'refreshed' non-breeding male," Maness said in a prepared statement.
For this study, she analyzed 14 years of data on 950 males and 700 males. During that time, most of the females ditched old mates for new ones.
"This study really predicts that the probability of divorce increases with the birds' success at breeding and raising a chick, because the effort required may tire out the male and, consequently, his mate may reject him," Maness said.
But there is good news for a spurned male. After he's recovered from the rigors of parenthood and looks presentable again, he may be selected by another female.
The study appears in the June 13 issue of the Proceedings of the Royal Society B: Biological Sciences.
More information
The American Association for Marriage and Family Therapy offers advice on how to prepare for marriage
.