MUSIC:"Our World" theme
Thisweek on "Our World" ... A better way to treat people with HIV and TB... Health care and the U.S. presidential candidates ... and studying foreststo learn why wildfires are on the rise...
PIERCE:"If you have a tree that kind of is atthe edge of its comfort zone, so to speak, it will be a more sensitive recorderof those environmental stresses."
Thosestories, how rural migrants are clustering near protected environments, andmore. I'm Art Chimes. Welcome to VOA's science and technology magazine,"Our World."
Inmany parts of the world, patients with HIV arrive at a clinic because they're sick with HIV, but because they've come down with tuberculosis.Now some new research is revealing the best way to treat these patients. RoseHoban reports.
Tuberculosisis epidemic in many poor countries that have high rates of HIV. But Dr. SalimAbdul Karim from the University of KwaZulu-Natal in South Africa says there'sno general agreement on how to treat the two diseases when a patient has themtogether.
KARIM:"And if you had to ask 10 medicalpractitioners how you would treat this patient who has these two conditions,you would get ten 10 different answers."
HOBAN:Anti-retroviral drugs used for treating HIVwere created and tested in Western countries where there aren't many peoplewith tuberculosis. As a result, researchers never studied the best way to treatHIV and TB together and the possible interactions among different drugs.
Butin Southern Africa, patients frequently have both diseasessimultaneously, and doctors struggle to treat them. To begin with, Karim saysmedications for tuberculosis and HIV can interact with one another.
KARIM:"The TB drugs induce certain keyenzymes in the liver that result in the antiretroviral drugs being metabolizedmore quickly. And the particular TB drug that does this is called rifampicin.And rifampicin is a key drug in TB, so you cannot exclude it from TBtreatment."
HOBAN:Another problem is that some patientsactually get after taking their TB drugs. Karim says that'sbecause the body's immune system goes into overdrive once it gets some helpfrom medication. The third problem is that patients getting treated for TB andHIV simultaneously end up taking a lot of pills.
KARIM:"And each of these drugs has its ownside effect profile. So we have a lot of concern that when you put patients onanti-retrovirals, that they might then stop taking their TB drugs because ofside effects they're getting from the antiretroviral drugs. It's just theprocess of having to take seven drugs? I mean, handfuls of medication."
HOBAN:Karim and colleagues from ColumbiaUniversity in the United States started a study to determine the best way totreat these patients. They recruited more than 600 people to try different waysof taking the drugs. The trial is still going on.
Butin August, Karim and his colleagues reviewed the preliminary data. They foundthat patients waiting to complete TB treatment getting HIV drugswere 50 percent more likely to die than patients being treated for bothdiseases simultaneously.
KARIM:"We should encourage all patients whohave both tuberculosis and HIV to receive both therapies, both sets of drugs,at the same time. TB therapy, they have to start because they won't die fromHIV, they'll die from the TB. Don't wait for them to finish their TB treatment.Start the antiretroviral drugs."
HOBAN:The study results were announced in a pressrelease, rather than the usual publication in a medical journal. Karim says inthe time it would take to publish these results, 10,000 people in South Africaalone could die from being treated for TB before getting anyanti-retroviral drugs. So he says they've altered their study, and they'reurging doctors who see these patients to get them started on anti-retroviralsbefore completing the six-month course of TB medications. I'm Rose Hoban.
Scientistssay they have identified more than two-dozen genes that are frequently mutatedin people with the most common form of lung cancer. The researchers say thefindings open the possibility of developing individualized therapies to fightthe disease. VOA's Jessica Berman reports.
BERMAN:Genetics researchers at three U.S.institutions have identified 26 genes that are frequently mutated in peoplewith the most common form of lung cancer, adenocarcinoma.
Lungcancer is the number one cancer killer worldwide, accounting for one milliondeaths each year. About 90 percent of those stricken with the disease aresmokers and former smokers.