TUESDAY, July 1 (HealthDay News) -- Death rates for HIV-infected people lucky enough to get their hands on antiretroviral medications have decreased dramatically since the introduction of these drugs in 1996, new British research shows.

For most, the five-year, post-diagnosis survival for those infected sexually is now about equal to that of the general population.

Death rates were higher, however, for older individuals, for those who had been infected for a longer time, and for those who had been infected through intravenous drug use.

Dramatic declines in death rates for HIV-infected individuals following the introduction of highly active antiretroviral therapy (HAART) in industrialized nations in the mid-90s have already been documented.

"HIV is now a complex chronic disease," said Dr. Michael Horberg, director of HIV/AIDS at Kaiser Permanente Health Plan in Santa Clara, Calif. "And, if aggressively treated with accepted medications, we should expect to see mortality similar to the general population in that same demographic."

"[This information] will help health policy makers or those who monitor the effectiveness of treatments to forecast the impact of AIDS on health-care needs," said Srikanth Kolluru, an assistant professor of pharmaceutical sciences with the Texas A&M Health Science Center in Kingsville. "One important thing to know is that the composition of HAART regimen will keep changing for a particular patient during his/her course of therapy depending on the development of tolerance to the particular drug. Hence, newer drugs with different mechanisms of action are continuously needed to be added to HAART regimen to maintain the low mortality rate."

The authors of the current study, published in the July 2 issue of the Journal of the American Medical Association, updates existing information, deliberately focusing on people whose seroconversion rates were relatively well-established. Seroconversion refers to the time when antibodies to HIV appear in the blood, usually from one week to several months or more after actual infection.

More than 16,000 individuals in multiple countries were followed for a median of 6.3 years. During the follow-up period, 2,571 individuals with HIV infection died compared with 235 who would be expected to die in an equivalent general population.

The excess mortality rate decreased from 40.8 per 1,000 person-years before the introduction of HAART to 6.1 per 1,000 person-years in the 2004 to 2006 period.

There was essentially no excess mortality in the first five years after seroconversion among individuals who had been infected sexually. However, over the first 10 years, those aged 15 to 24 years old and those 45 years or over at seroconversion did have higher death rates.

The authors calculated an 88 percent reduction in excess mortality in 2000-2001 compared with the period prior to 1996. This was very close to the 87 percent reduction seen in 1997-2001. In 2004-2006, the excess mortality was 94 percent lower than pre-1996 levels.

The study did not take into account adherence to medication or side effects, which can be severe.

"The study doesn't take into account adverse events and medication adherence. And, over a longer time frame, we don't know if there might be an effect from medications accumulating in the body," Horberg said.

"Despite all these side effects [including diarrhea, nausea, vomiting, fat redistribution], HAART therapy still improves the quality of life and life expectancy, which is nearing close to that of uninfected population," Kolluru said. "Prevention is still the best treatment for AIDS, and that has no side effects."

More information

The U.S. Centers for Disease Control and Prevention have more on HIV/AIDS.

MONDAY, June 30 (HealthDay News) -- Genetics and random environmental factors each play a major role in determining both gay and heterosexual behavior, say British and Swedish researchers.

"This study puts cold water on any concerns that we are looking for a single 'gay gene' or a single environmental variable which could be used to 'select out' homosexuality -- the factors which influence sexual orientation are complex. And we are not simply talking about homosexuality here -- heterosexual behavior is also influenced by a mixture of genetic and environmental factors," study co-author Dr. Qazi Rahman, a leading scientist on human sexual orientation, said in a prepared statement.

Environmental factors are specific to an individual and may include biological processes such as different hormone exposure in the womb, the researchers noted.

The researchers studied more than 3,800 same-gender twin pairs, ages 20 to 47, in Sweden. The twins were asked about the total numbers of opposite sex and same sex partners they had ever had.

"Overall, genetics accounted for around 35 percent of the differences between men in homosexual behavior and other individual-specific environmental factors (that is, not societal attitudes, family or parenting which are shared be twins) accounted for around 64 percent. In other words, men become gay or straight because of different developmental pathways, not just one pathway," Rahman said.

Among the female twins, genetics explained about 18 percent of the variation in sexual orientation, non-shared environmental factors 64 percent, and family environment 16 percent.

It's important to note that heredity and shared environment had roughly the same influence in women, while shared environment had virtually no impact on men's sexual behavior, the researchers said.

The study, which was published in the journal Archives of Sexual Behavior, shows that while genetic factors are important, non-shared environmental factors are dominant in determining sexual orientation.

"This study is not without its limitations -- we used a behavioral measure of sexual orientation which might be okay to use for men (men's psychological orientation, sexual behavior, and sexual responses are highly related) but less so for women (who show a clearer separation between these elements of sexuality)," Rahman noted. "Despite this, our study provides the most unbiased estimates presented so far of genetic and non-genetic contributions to sexual orientation."

More information

The American Psychological Association has more about sexual orientation  .

MONDAY, June 30 (HealthDay News) -- Eating an unhealthy diet during pregnancy may raise your child's lifetime risk of obesity and elevated cholesterol and blood sugar levels, British researchers report.

In tests on rats, a Royal Veterinary College team fed one group of females a diet of processed junk food such as donuts, muffins, cookies, chips and sweets during pregnancy and breast-feeding, while another group of females received a healthy diet of regular feed.

The researchers compared the offspring of the two groups of female rats and found those born to mothers fed a junk food diet had higher levels of cholesterol and triglycerides, a type of fat found in the bloodstream. Both increase the risk of heart disease.

The offspring of the junk food-fed mothers also had higher levels of glucose and insulin, both of which increase the risk of type 2 diabetes.

These rats remained fatter through adolescence and into adulthood than the offspring of the mothers who ate a healthier diet during pregnancy and breast-feeding.

The study was published in the current issue of The Journal of Physiology.

"It seems that a mother's diet whilst pregnant and breast-feeding is very important for the long term health of her child," study co-author Dr. Stephanie Bayol said in a prepared statement. "We always say 'you are what you eat.' In fact, it may be true that 'you are what your mother ate.' This does not mean that obesity and poor health is inevitable, and it is important that we take care of ourselves and live a healthy lifestyle. But it does mean that mothers must eat responsibly whilst pregnant."

Even though this study was carried out in rats, the findings are likely applicable to humans, study co-author Professor Neil Stickland added.

"Humans share a number of fundamental biological systems with rats, so there is good reason to assume the effects we see in rats may be repeated in humans. Our research certainly tallies with epidemiological studies linking children's weight to that of their parents," Stickland said in a prepared statement.

More information

The American College of Obstetricians and Gynecologists offers advice about nutrition during pregnancy  .

THURSDAY, June 19 (HealthDay News) -- The herpes drug aciclovir (Zovirax) doesn't reduce the risk of HIV-1 infection in people who have sex with men infected with genital herpes, a U.S. study finds.

Previous research has shown that herpes simplex virus type-2 (HSV-2) infection -- the most common cause of genital herpes -- increases the risk for HIV-1 infection by two- to threefold.

In this new, randomized, placebo-controlled phase III study, Dr. Connie Celum, of the University of Washington in Seattle, and colleagues examined whether aciclovir, an antiviral drug commonly used to help suppress genital herpes, would reduce the risk of HIV-1 infection.

The final analysis included almost 1,400 HIV-negative but HSV-2 positive women in Africa and more than 1,800 American and Peruvian men who have sex with men. Of those participants, almost 1,600 received 400 milligrams of aciclovir and a similar number received a placebo, for 12 to 18 months.

The incidence of HIV-1 infection was 3.9 per 100 person years in the aciclovir group and 3.3 per 100 in the placebo group -- not a significant difference, the researchers reported in the June 21 edition of The Lancet. In the aciclovir group, incidence of genital ulcers was reduced by 47 percent, and incidence of genital ulcers caused by HSV-2 was reduced by 63 percent.

"Our results show that suppressive therapy with standard doses of aciclovir is not effective in reduction of HIV-1 acquisition in HSV-2 seropositive women and MSM (men who have sex with men). Novel strategies are needed to interrupt interactions between HSV-2 and HIV-1," the researchers concluded.

Further research is needed to determine why aciclovir doesn't reduce the risk of HIV infection, they added.

These findings and others raise doubts about whether control of sexually-transmitted infections should be promoted specifically for HIV prevention in HIV-negative populations, Professor Ronald Gray and Professor Maria Weaver, of Johns Hopkins University, wrote in an accompanying editorial.

More information

The National Institute of Allergy and Infectious Diseases has more about HIV/AIDS.