THE HAWAII ISLAND HIV/AIDS NEWSLETTER
FDA Approves Test to Help Diagnose Main Virus that Causes
The U.S. Food and Drug Administration (FDA) has approved the APTIMA HIV-
1 RNA Qualitative Assay, manufactured by Gen-Probe Incorporated (San
Diego, Calif.). The APTIMA assay, which detects the RNA--the nucleic acid or
genetic material--of the HIV-1 virus, is the first test approved for the detection
of HIV-1 RNA to help diagnose HIV-1 infection. HIV-1 is the main virus that
"This product offers medical diagnostic laboratories the ability to perform a
gene-based test for HIV-1 that, until now, was only available as part of a larger
kit used to screen blood and plasma donors," said Jay Epstein, M.D., director,
Office of Blood Research and Review, Center for Biologics Evaluation and Re-
search (CBER), FDA. "This test also can detect infection with HIV-1 earlier
than HIV antibody tests when used to detect primary HIV-1 infection."
This test has important implications for medical diagnostic use because it
could be a potential alternative to the traditional Western blot test now used
for confirmation of HIV-1 infection when screening tests for HIV-1 antibodies
are positive. In addition, the Western blot can, in some instances, be difficult
to interpret and may not always provide a conclusive result. In such cases, the
APTIMA test may be helpful in HIV-1 diagnosis. The APTIMA test can also be
used in clinical laboratories and public health facilities to detect early HIV-1 in-
fection, before the appearance of antibodies to HIV-1.
The sensitivity of the APTIMA assay is comparable to that of FDA approved
viral load assays that measure the amount of HIV-1 virus circulating in the
blood of patients with established HIV-1 infection to monitor the treatment and
progression of AIDS. Unlike the viral load tests, the APTIMA test has been ap-
proved for the diagnosis of primary HIV-1 infection, as well as for confirming
HIV-1 infection when tests for antibodies to HIV-1 are positive.
CONTINUED ON PAGE 3
CHOICES Hawai’i Island HIV/AIDS Foundation
is a publication of the
Hawaii Island HIV/AIDS Foundation Mission Statement
75-240 Nani-Kailua Dr. Suite 5
Kailua-Kona, HI. 96740 The Hawaii Island HIV/AIDS Foundation is a non-profit or-
Phone: 331.8177 ganization dedicated to assisting those affected by HIV/AIDS
Fax: 331.0762 to maximize their quality of life, and to ending the spread of
E-mail: email@example.com HIV. We also utilize the lessons learned in the HIV epidemic
to care and advocate for others in the fight against related
16-204 Melekahiwa Pl.
Kea’au, HI. 96749
Phone: 982.8800 Vision
FAX: 982.8802 To build a healthier, stronger, and more sustainable commu-
nity that supports all its members with a focus on HIV issues.
Georgie Kennedy/Executive Director
Kate Nawahine/Benefits Specialist Responsiveness: To people with HIV/AIDS and their fami-
Laura Acevedo/Prevention Outreach lies and to the prevention education needs of the community.
Cindy Medeiros/Benefits Specialist Accountability: To our consumers, funding sources, and
Diana Glynn/Housing Coordinator the community at large.
Jeff Seyfried/Prevention Services to PLWH
Curtis Neck/Prevention Integrity: To provide services to the entire commu-
Cyd Hoffeld/Prevention for Women & Teens nity in a humane, loving, non-judgmental manner.
Bob Kraus/Administrative Assistant
Diversity: To embrace the philosophy of
Wing Takakuwa/Treatment Advocate
Teri Hollowell/Benefits Specialist
Collaboration: To establish and maintain partnerships
Gene Smith/Client-Prevention Services-P4P within the community that maximizes resources and de-
Victor Manongdo/Mens Prevention creases duplication of services.
Wes Smith/Director of Finance
Winic Pierce/Administrative Assistant Leadership: To set the highest standards for responsi-
Yvonne Gilbert/Womens Prevention bility to our mission, vision and values, and be recognized as
Pia Wadkins/Accounting Assistant a positive, inspirational role model in our community.
BOARD OF DIRECTORS Advocacy: A collective public voice to speak on be-
Dr. James Stanley/President half of those affected by HIV/AIDS.
Dr. Anne-Marie Muramoto
The articles contained in this publication are meant to
inform and entertain only. They do not constitute an
endorsement. The publication of any name or image
does not necessarily imply anything about that per-
sons condition, health or sexual orientation. The opin-
ions expressed are those of individual authors and do
not necessarily represent official positions of HIHAF
or any other organization mentioned herein. 2
Contributions of articles and other materials for publi-
cation are encouraged and welcomed.
CBER, one of six centers within FDA, is responsible for the regulation of biologically-
derived products, including blood intended for transfusion, blood components and deriva-
tives, vaccines and allergenic extracts, and cell, tissue and gene therapy products. CBER
also regulates AIDS-related diagnostic tests
SUPPORT GROUP MEETING the street from Puna High School.) All
HIV+ people are invited to attend. For
There will be a Support Group meeting on more information or directions contact
December 12 from 4:30 PM to 6:00PM at Jeff at 982-8800
the Neighborhood Place of Puna. (Across
Laughter Proves Good Medi- the experiment. A series of questionnaires ad-
ministered to sufferers of coronary heart dis-
cine for Heart ease by the cardiologists revealed that pa-
tients who had suffered a heart attack failed
Lacking a sense of humor might not just be to find the humor in a situation, such as
bad for your social life, it might also be wearing the same outfit to a party, 40 percent
harming your cardiovascular health. A new more often than their healthy counterparts.
study shows that laughter actually increases "We didn't know whether that was cause and
blood flow in the body, proving right the old effect or just part and parcel of having the
adage that laughter is the best medicine, at disease," Miller says.
least when it comes to the heart.
They decided to investigate the possible
Cardiologist Michael Miller and colleagues at healthy effects of laughter by measuring vas-
the University of Maryland tested blood flow cular dilation after people chuckled at funny
in 20 healthy men and women after they bits or reacted to intense images. In total, the
watched 15-to-30-minute clips of the comedy researchers gathered 160 measurements of
movies Kingpin and There's Something About blood flow in the brachial artery, which con-
Mary and a stressful film, the opening se- nects the shoulder and elbow, from the 10
quence of Saving Private Ryan. The research- men and 10 women. While laughing, 19 of the
ers measured blood flow both before each subjects increased healthy blood flow by an
viewing and one minute after it ended. "We average of 22 percent. And comparing the
wanted to see whether laughter induced a amused and stressful states brought on by
vascular response," Miller explains. film clips, more than 50 percent more blood
flowed when laughing, according to the paper
Prior research inspired the team to conduct published in the current issue of Heart.
3 Continued on page 8
HIV Infects Epithelial And Brain Cells Lacking CD4
HIV is able to infect cells in the female reproductive tract, brain, and colon that lack CD4 receptors, according to a
report in the October 1st Journal of Acquired Immune Deficiency Syndromes.
"HIV can use a mechanism as gp120-independent infection to infect more types of cells than most scientists previ-
ously determined," Dr. Shen Pang told Reuters Health. "Therefore, many pathogenic effects may not only be
caused by the decrease of immune functions, but may also be caused by the infection of cells in some essential or-
Dr. Pang from UCLA Dental Institute and Jonsson Comprehensive Cancer Center, Los Angeles, California and
colleagues used gp120-defective HIV to infect epithelial cells from the female reproductive system, colon, and
glioneuronal cells to clarify the role of gp120 in HIV infection of CD4-negative cells.
HIV infected cell lines from the female reproductive tract, colon, intestine, and brain at rates ranging from 0.3% to
3.1%, the researchers report.
Infection occurred early, as addition of zidovudine during the first 2 hours of exposure inhibited HIV infection,
but it only moderately inhibited infection when added 6 hours after exposure.
Culture medium from the infected cells was able to infect other cells, the results indicate, demonstrating that HIV
can infect epithelial and brain cells and replicate and generate infectious viral progeny.
Results of further experiments suggest that virus could enter epithelial cells from the apical side and that repli-
cated virus could bud out from the basolateral side of the cells.
Viral clones with truncated gp120 showed infection rates similar to those with intact gp120, the researchers write,
"suggesting that the role of gp120 is minimal." Moreover, CXCR4 and CCR5 were not required for HIV infec-
tion of these CD4-negative cells.
"HIV infects CD4-negative cells, and some of these cells are quite susceptible to such infection," Dr. Pang said.
"Many treatments that only focus on the infection of CD4-positive cells are not enough."
"In the future, I want to identify the proteins responsible for HIV gp120-independent infection," Dr. Pang added.
"I believe that identification of these proteins is the key to prevent or eradicate HIV infection of CD4-negative
LIFE COUNSELING NOW AVAILABLE AT THE EAST SIDE HIHAF OFFICE!
Struggling with life issues? Need help with your relationship? Questions about
sexuality or gender identity? Just need someone to talk to? We now have on staff
in East Hawaii a counseling intern enrolled in the Masters program at UH-Hilo.
Laura has two years of counseling experience, and is supervised by a licensed
clinical psychologist. She is especially well versed in the challenges and issues
that are faced by persons who identify as lesbian, gay, bisexual, transgender, or
intersex, and is trained in HIV/AIDS counseling as well. All meetings are private
and confidential. Fifty minute appointments are presently available on Fridays
between 9 am and 3 pm. Call the Keaau office at (808) 982-8800 and leave a
message for Laura, and she will contact you to schedule.
FORM ALL OF US
Free and Anonymous HIV Testing Loca- Volunteers Needed
tions and Dates
Free and anonymous HIV testing and counseling is We need a couple of dedicated volun-
available to the public on a regular, on-going basis. teers to take charge of the Kona-side
The testing is confidential and totally needle free. rummage sales.
Hilo/Kea’au This involves collecting, sorting,
Hawaii Island HIV/AIDS Foundation
moving items during the pre-sale
Shipman Business Park – 16-204
Melekahiwa Place, Suite 1 period and organizing the sale days.
Monday-Thursday, Gene Smith has been doing this up to
8:30am-3:30pm this point and he will still be avail-
able to assist.
Pahoa Family Health Center, Pahoa Village Give a call if you think it’s something
Every 2nd and 4th Tuesday of month,
you might be able to take on.
Hawaii Island HIV/AIDS Foundation –
75-240 Nani Kailua Drive, Suite 5
In the Pines Plaza , Kailua-Kona
Tuesday and Thursday,
West Hawaii Community Health Clinic
Every Friday from
75-240 Nani-Kailua Drive - Suite 5
Ka’u Family Health Center
Na’alehu every 2nd and 4th Wednesday of each
SUBJECT: ANNUAL COST OF TREATING
NEWLY DIAGNOSED HIV+ INDIVIDUALS
Information from a study done at Weill Medical College at Cornell University's Depart-
ment of Public Health in New York state.
NEW YORK (Reuters) - Future treatment for the 40,000 people infected with HIV in the
United States every year will cost $12.1 billion annually, a new study showed on Wednes-
U.S. patients infected with HIV can expect medical bills for current care related to the dis-
ease of $618,900 during their lifetimes, according to the study, which will appear in the
November issue of Medical Care.
Current medical bills for U.S. HIV patients from the beginning of care until death average
$2,100 per month. The projected lifetime HIV-related medical costs were based on life ex-
pectancies of 24.2 years for patients in optimal HIV care.
The study is intended to provide guidance for policy makers and ensure appropriate funds
are allocated for HIV care and prevention, according to its authors.
"If they rely on outdated cost information, treatment programs will be underfunded and
the economic value of HIV prevention will be understated," lead author Dr. Bruce
Schackman, the head of the health policy at Weill Medical College of Cornell Univer-
sity's department of public health, said.
The Centers for Disease Control and Prevention estimates that 250,000 people with HIV
in the United States -- a quarter of the total with the disease -- do not know they are in-
Since combination therapy became available to U.S. HIV patients in 1996, life expectan-
cies have risen, but so have medical bills. Medications now make up more than 70 percent
of the expense of HIV treatment, according to the study.
The $618,000 lifetime HIV medical bill is comparable to the estimated lifetime medical
cost for U.S. women under age 65 with cardiovascular disease, who can also have long life
expectancies with appropriate medical management, the study found.
Laughter Proves Good Medicine for Heart continued from
much as angry memories or mental calcula-
tions. "What that suggests, at the very least, is
that laughter on a regular basis will undo some
In fact, being light-hearted boosted blood flow of the excess stress we face in our everyday
about the same amount as light exercise or lives," Miller notes. "Patients at risk for car-
drugs that lower cholesterol. Drama-induced diovascular disease should loosen up a bit." --
stress, on the other hand, cut that rate by as David Biello
CAN WE TALK DARLING? sional facilitator and would address topics of
interest common to those who participate.
The Westside staff is wondering if there is suf-
ficient interest in the Kailua area to start a If you think this might be of benefit to you,
Support Group for clients and their part- please give Wing or Teri a call at 331-8177 for
ners/friends. more information or to input your suggestions.
The group is to be moderated by a profes- MAHALO
KATE NAWAHINE SAYS,
“GOODBYE” Cindy Mederios will assume Kate’s du-
ties. Dianna Glynn has been hired to
It is with much regret that we announce work as our Housing Coordinator for
that Kate Nawahine will be leaving the Hawaii county.
Hilo staff effective December 28. Kate
is now and has been a cornerstone of
our organization, she will be sorely
missed, and we wish her well.
How To Tell Someone You Have HIV
• Past sexual partners should be told you are
HIV positive so they can be tested.
The most difficult thing you may ever
have to do is tell a loved one you have HIV. Dis- • Local health departments or your health care
closing your HIV status is difficult but some- provider can assist with partner notification and
times necessary. This "how-to" will help you dis- can do it anonymously.
close your HIV status with the least amount of
stress. • Health care providers can give you more ap-
propriate medical care if they know you com-
plete medical history. Disclosing your status to
your health care team is important.
• Be sure you are ready to tell and are able to
Here's How: handle the reactions you may receive.
1. Know why you want to tell the people you are
telling. What do you want from them?
2. Anticipate their reaction. What's the best you
can hope for? What's the worst you will have to
3. Learn as much as you can about HIV.
4. Have articles or printed material to give to the
person to help them understand.
5. Get support. Talk it over with someone you
trust and come up with a plan.
6. Accept the reaction. You can't control the
fears and feelings of others.
7. Be patient. It may take some time for
those you tell to process the information.