Research notes: HIV findings; research conferences

New findings about HIV biology and behavior

Four recent studies involving Brown AIDS researchers provided new insights into the behavior and biology of HIV infection and treatment.

Two studies appeared in the Journal of Acquired Immune Deficiency Syndromes (JAIDS). In the first, the researchers and colleagues in Southern India showed that the use of a diagnostic tool called total lymphocyte count (TLC) was a low-cost means of determining both the risk of infection in a patient and when to begin treatment.

Obtained relatively easily and inexpensively from a blood sample, TLC was proposed as an alternative to testing an HIV-infected person’s CD4 cell count, which is standard practice in the United States and other developed nations, but too costly and not widely available in countries with fewer resources.

The study involved Brown physicians Kenneth Mayer, Charles Carpenter and Timothy Flanigan, and fourth-year medical student Anish Mahajan. Among the other researchers were Indian collaborators from the Y.R.G. Center for AIDS Research and Education. Y.R.G. is one of several medical facilities overseas affiliated with the Brown University AIDS Program. In mid-February, several Y.R.G. physicians visited Brown to discuss the emerging AIDS epidemic in India.

Mayer was also among seven authors of the second JAIDS study. It showed that when compared to their most recent protected sexual encounter, women were more likely to have an unprotected sexual encounter with a steady male partner older than 40 who drank or who used drugs within two hours of the encounter.

“These results strongly suggest that a successful HIV-prevention intervention for women should have an impact on male partners and particularly focus on drug and alcohol use by that partner,” wrote the authors.

In the third study, researchers from several centers spent 18 months following more than 100 HIV-negative men who had sex with other men. They found that previous infection with herpes simplex virus type 2 was associated with a 1.8-fold increased likelihood of acquiring HIV.

Suppression of herpes simplex virus type 2 with antiviral therapy “should be evaluated as an HIV-prevention strategy among men who have sex with men,” concluded the researchers. Mayer was one of the study authors. The work appeared in The Journal of Infectious Diseases.

Mayer was also the lead author of a paper in the journal AIDS. The article reported on the safety and tolerability of a vaginal microbicide gel that was tested in women in Philadelphia and in two South African cities. Microbicides are topical gels designed to prevent vaginal transmission of HIV. Condoms may prevent HIV transmission but women usually cannot get male partners to use them correctly. The compound tested in the study, called PRO 2000 gel, was found to be safe and well tolerated in sexually active HIV-uninfected and sexually abstinent HIV-infected women. Given this finding, PRO 2000 gel should be considered for evaluation in the next stage of trials, which would test the product’s efficacy, said the authors.

“Development and distribution of a safe and effective HIV vaccine will take many years, so there is an urgent need for the development of efficacious, convenient and inexpensive microbicides,” wrote the authors. – Scott J. Turner

Medical specialists gather to explore new Down syndrome test

Jacob Canick, professor of pathology and laboratory medicine, will co-direct a conference in Providence March 28-29 that will introduce a more-precise prenatal test for risk of Down syndrome to medical specialists from across the nation and Canada.

The two-part screening procedure is called the Integrated Test. Conference presenters will include its British creators and other leading prenatal, genetics, obstetric and gynecological experts from Europe, Canada and the United States.

Use of the Integrated Test could reduce the number of pregnant women who eventually require amniocentesis, an invasive procedure used to diagnose Down syndrome.

"The Integrated Test will make prenatal care safer for pregnant women because fewer of them would need to subject themselves to an amniocentesis to get the same high rate of detection," said Canick, who has helped develop several tests and markers for risk of pregnancy complications.

Currently, labs in London, Toronto, New York, Turin and Porto offer the Integrated Test. It combines blood samples taken at two times in pregnancy and a special ultrasound to capture six different pregnancy risk markers. These markers, combined with a woman's age, provide the most accurate risk value for Down Syndrome.

This spring, the Medical School and at Women and Infants will become the first university-related hospital system in the United States to offer the Integrated Test to pregnant patients. Canick also directs the Division of Prenatal and Special Testing at Women and Infants. – Scott J. Turner

‘Frontiers in Environmental History’

Some 240 environmental scholars and activists have participated this week in the Brown-hosted annual conference of the American Society for Environmental History. The four-day event, titled “Frontiers in Environmental History: Mainstreaming the ‘Marginal’,” continues through March 30 on campus and at the Providence Biltmore Hotel.

The conference opened March 26 with a keynote lecture by Pulitzer Prize-winning writer Jared Diamond, author of the acclaimed “Guns, Germs and Steel: The Fates of Human Societies” and a professor of geography at UCLA. Diamond spoke on “What Environmental and Cultural Factors Make Some Societies Especially Fragile?”

“The conference demonstrates the maturing of environmental history as a discipline – especially its increasing emphasis on issues of environmental justice and on adopting a transnational perspective," said coordinator Karl Jacoby, Brown’s Robert J. Carney Assistant Professor of History.

“This has been designed to emphasize the issues of class and race that haven’t been in the mainstream,” added fellow organizer Nancy Jacobs, an assistant professor of history and Africana studies.

The conference includes a series of 60 panel sessions March 27-29 at the Biltmore Hotel and a half-dozen local field trips on March 28. It will close with an international teleconference on “Environmentalism in the Developing World: A Conversation between Providence, South Africa and India” on March 30 at the Watson Institute.

The two-hour teleconference, which begins at 9 a.m., will feature environmental activists and scholars in South Africa and India, according to Jacobs. Brown students, faculty and staff are invited to attend the session.

In conjunction with the ASEH conference, the John Carter Brown Library is hosting a special exhibit, “Plants and Publications from the New World, 1492-1825: A Potpourri of Ethnobotany, Taxonomy and Ecological Concerns,” curated by Anita Been of Madison, Wisc.

For more information on the conference, call 863-1865. For a full schedule of conference events, visit the Web site. For further information on the John Carter Brown Library exhibit, call 863-1262. – Mary Jo Curtis