• Number Thirty-Three
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Guggul and Cholesterol

Interest in guggul as a treatment for high cholesterol and high triglycerides has been increasing since the advent of highly active antiretroviral therapy (HAART). Recent research results add to information on guggul found in the Nov/Dec 2000 HIV ReSource Review issue. The active compounds of guggul
(guggulsterones) are potent antagonists of nuclear hormone receptors involved in cholesterol metabolism. In a recent Phase 1 double-blind, randomized, placebo-controlled trial Dr. Szapary and colleagues studied the safety and efficacy of two doses of a standardized guggul extract. Researchers supplied
guggulipid, containing 2.5% guggulsterones, to some of the 103 healthy adults with hyperlipidemia eating a typical Western diet. Study participants took either three daily doses of standard-dose guggulipid (1000 mg), high-dose guggulipid (2000 mg), or  placebo. The eight-week therapy measured low-density lipoprotein cholesterol (LDL), total cholesterol, high-density lipoprotein cholesterol, triglycerides, and very low-density lipoprotein cholesterol. Study participants randomized to placebo experienced a 5% decrease in LDL, while both standard-dose guggulipid and high-dose guggulipid participants had raised
levels of LDL. A few of the participants treated with guggulipid developed a hypersensitivity rash. Guggulipid did not appear to improve levels of serum cholesterol. 

HIV ReSources Web Site Update
8/29/03 

The HIV ReSources Web Site is updated. 

New links are at: 
National HIV Nutrition Guidelines
Nutrition Links And Resources
Information On Mothers and Children

Updated/Reviewed pages include: 
Nutrition & HIV Discussion Archive 1
Nutrition & HIV Discussion Archive-2
Alternative Research Article Abstracts- 1-13
Alternative Research Article Abstracts - 14-26
Alternative Research Article Abstracts - Issues 27-30

Funding Alert 

The National Institute of Child Health and Human Development (NICHD) invites new and experienced basic scientists, epidemiologists, and clinical investigators to submit research grant applications to further understanding of the relationship between nutrition and HIV. Applications are encouraged that address preclinical or clinical, biomedical and/or behavioral research that concentrates on studies of: (1) nutritional factors and HIV transmission; (2) nutritional requirements for optimal growth, development, and maintenance of health; (3) impact of HIV infection on breastfeeding; (4) interactions between
antiretroviral therapies, diet, nutrition and health; (5) nutritional assessment methodologies; and (6) specific functional biomarkers of outcome related to the nutrition/HIV relationship. For additional information on Fund Number 2375 - Funder's Fund ID: PA-03-163 - Title: Nutrition and the Development, Treatment, and Prevention of HIV Disease in Women, Infants, and Children, visit  the web site. 

Subscriber Note: The HIV Nutrition News Update will not be published on September 5, 2003 as we will be in Vancouver for the Association of Nutrition Services Agencies conference. We will resume our regular publication schedule the following week.
 

Cryptosporidiosis Update

As noted in early issues of the HIV ReSource Review HIV-positive people are more susceptible to opportunistic pathogens such as cryptosporidiosis. The pathogen is caused by the protozoan Cryptosporidium parvum and characterized by diarrhea, abdominal cramps, loss of appetite, low-grade fever, nausea and vomiting. According to the Centers for Disease Control and Prevention some 4,000 patients in the United States are infected by cryptosporidiosis. Infected persons may be asymptomatic, experience acute diarrhea, or be ill with persistent diarrhea that may continue for several weeks. Prolonged and life- threatening disease may occur in severely immunocompromised individuals. Cryptosporidiosis has been associated with malnutrition, impaired growth, and death in children in developing countries. Researcher Dr. Rosemary Soave, at the New York Hospital Cornell Medical Center, noted the disease often results in disturbed sleep patterns, decreased quality of life, dehydration, loss of appetite and subsequent wasting. Many cases of human cryptosporidiosis go unrecognized in people living with HIV. 

Persons who wish to take independent action to reduce their risk for waterborne cryptosporidiosis might choose to take precautions similar to those recommended during outbreaks. During outbreaks or in other situations in which a community boil-water advisory is issued, boiling water for a minute or two eliminates the risk for acquiring cryptosporidiosis. Patients hoping to avoid getting cryptosporidiosis from drinking water should remember that ice made from contaminated tap water can be a source of infection. Fountain beverages served in restaurants, bars, theaters, and other public places might also pose a risk because they are made from tap water. To further reduce the risk for cryptosporidiosis, people should avoid swallowing water during swimming. 

Using submicron, personal-use water filters or drinking bottled water might also reduce the risk but consuming bottled water may carry certain risks. Persons who opt for a personal-use filter or bottled water should be aware of the lack of enforceable standards for destruction or removal of oocysts, product cost, and the difficulty of using these products consistently. To further reduce the risk of illness from microbes and decrease cancer risks from chemicals that form during drinking water treatment, the Environmental Protection Agency (EPA) proposed rules requiring drinking water systems to monitor for and increase protection against Cryptosporidium while expanding the monitoring and control of disinfection byproducts. 

As noted in Issue 17 of the HIV ReSource Review, management of cryptosporidia may include the use of nitazoxanide. The Food and Drug Administration recently approved Alinia (nitazoxanide) for the treatment of diarrhea caused by cryptosporidiosis or giardiasis in pediatric patients. Although the safety and effectiveness of Alinia has not been established in immunodeficient patients, as noted in Issue 17, results from several small clinical trials noted signs of clinical improvement in patients taking the substance. 

Successful double-blind controlled studies in pediatric patients with diarrhea caused by Cryptosporidium parvum paved the way for orphan drug approval status. The most frequent adverse events reported in association with Alinia were abdominal pain, diarrhea, vomiting and headache. Romark Laboratories of Tampa, Fla., is the sponsor of the approved New Drug Application (NDA), Alinia for Oral Suspension. 
 

Delivery of this weekly update was delayed due to the recent Northeast blackout.

Coenzyme Q10

A recent article expands on our literature review of Coenzyme Q10 published in the July/Aug 2003 HIV Nutrition Update Newszine. A deficiency of coenzyme Q10 is now associated with a genetic coordination disorder called Cerebellar ataxia. The 135 patient study noted symptoms such as seizures, developmental delay, mental retardation, and pyramidal signs. Download a coenzyme Q10 monograph from the University of Colorado Health Sciences Center (in PDF). Keep in mind that our 13-page literature review of the dietary supplement did not reveal any reliable scientific evidence showing that CoQ10 supplements improve immune function in people with HIV
infection.

Trans Fat

The Food and Drug Administration (FDA) offers information on trans fat to complement a recently published article in the HIV Nutrition Update on omega-3 fats. FDA issued a regulation requiring manufacturers to list trans fatty acids, or trans fat, on the Nutrition Facts panel of foods and some dietary supplements. This gives consumers more information to make healthier food choices that could lower their consumption of trans fat. Scientific reports have confirmed the relationship between trans fat and an increased risk of coronary heart disease.

As noted in Issue 42 of the HIV Nutrition Update, consumption of omega-3 fats, found mainly in fish, is associated with a lower risk of cancer. Read more on this subject at the International Journal of Cancer web site.
 

Food Safety Information

"Food Safety at Temporary Events" is a 14-step guide to limit the risk of food poisoning from outdoor events. For more food safety information, visit the Foodborne Illness Education Information Center's web site. Additional information on food safety is at the Center for Food Safety and Applied Nutrition web site and the Center for Science in the Public Interest (CSPI) web site. 

View "Food Service Safety Facts: Hand Hygiene in Retail and Food Service Establishments" (2003) and for consumer hand washing advice, visit the FDA web site . 

Food Safety and Inspection Service (FSIS) Safety and Security Guidelines for the Transportation and Distribution of Meat, Poultry and Egg Products is now available on the Food Security and Emergency Preparedness web site. For materials in Spanish, visit  this FSIS web site. 

HIV ReSources Web Site Update 
August 8, 2003
The HIV ReSources Web Site is updated. 

New pages: 
Issue 43 HIV Nutrition Update
Early Nutrition Intervention For HIV/AIDS

New links are at: 
Conference Information
Newsletters And Magazines
HIV Nutrition Update Preview Links
Miscellaneous Information Links

Updated/Reviewed pages include: 
HIV Nutrition News Update Mailing List Information
HIV Nutrition News Update Mailing List Archive Issue One
HIV Nutrition News Update Mailing List Archive Issue Two

Food Recalls

Flowers Foods recalled On Broad Street Bakery, Cobblestone Mill, Country Farms, Flowers, And Winn-Dixie brand bakery products because they may contain small pieces of metal mesh screen. The products were distributed in numerous U.S. states. 

Howard Beef Processors, doing business as Ellison Farms, is voluntarily recalling approximately 194,700 pounds of frozen ground beef products that may be contaminated with E. coli O157:H7. The products were produced on various days between May 30 and June 11, 2003 and distributed to consumers nationwide. Some of the recalled products were also exported to Mexico. The products subject to recall bear the establishment code "EST. 8934" inside the USDA mark of inspection. Media with questions about the recall may contact Alan Sheldon, company media representative, at 507/825-5486. Consumers with questions about the recall may contact Diane Hamersma, company customer service representative, at 800/582-5284. 

Consumers with other food safety questions can phone the toll-free USDA Meat and Poultry Hotline at 800/535-4555. The hotline is available in English and Spanish and can be reached from 10 a.m. to 4 p.m. (Eastern Time), Monday through Friday. Recorded food safety messages are available 24 hours a day. 
 

Conference Update

Don't forget about the September 2003 ANSA conference! For further information, visit the ANSA web site. 

* A public meeting sponsored by the USDA's Office of the Under Secretary for Food Safety and the Food and Drug Administration (FDA) was held on September 16, 2003 in College Park, MD. The public meeting provided information and sought public comments on agenda items for the Codex Alimentarius Committee on Nutrition and Foods for Special
Dietary Uses (CCNFSDU - held Nov. 3-7, 2003 in Bonn, Germany). 

Codex develops food standards, guidelines and codes of practice in order to protect the health of consumers, ensure fair food trade practices and promote coordination of food standards work undertaken by international governmental and non- governmental organizations. Contact the FSIS Docket Room, Docket #03-024N, U.S. Department of Agriculture, Food Safety and Inspection Service, Room 102, Cotton Annex, 300 12th Street, SW, Washington, DC 20250-3700 or visit the web site for the documents. 

* The National Osteoporosis Foundation sponsored three regional clinical meetings for healthcare professionals on the prevention, diagnosis and management of osteoporosis and low bone mass. Meeting locations and dates were in: Washington, DC, Clearwater, FL, and Scottsdale, AZ. For more information visit the web site . 

* The 13th International Symposium on HIV & Emerging Infectious Diseases was held in Toulon, France on June 3-5, 2004. For additional information on upcoming conferences visit the conference web site. 

Food Recall

Land O' Lakes is voluntarily recalling a limited quantity of LAND O LAKES® Salted Stick Butter because the product may contain small fragments of metal. The product was distributed in numerous states within the U.S.A. and sold in retail grocery stores between June 11, 2003, and July 26, 2003. Telephone Land O' Lakes toll-free hotline at 800/328-4155 or visit their web site for more information. 

HIV Nutrition Update - Newszine Issue 43

The July/Aug HIV Nutrition Update Newszine issue has been mailed to subscribers. 

Rachel Stern, MS, RD, CNS and Sharon Ann Meyer, AS, AA, DTR, co-authored the feature article in this issue. The article on coenzyme Q10 is another expansion of a literature review completed by members of the Macronutrients, Micronutrients, and Non-Essential Dietary Supplements subgroup of the National HIV Nutrition Guidelines Working Group. Other subjects covered by the national group are in the April 1st Clinical Infectious Diseases supplement. The issue also includes these columns: 

* Program Spotlight - Comprehensive Care Clinics in VT; 
* Nutrition Forum - questions and answers on liver health; 
* Resources - leads to resources for clinicians and clients; 
* Med Watch - PEGIntron. 
 

NUMEDX Hepatitis Journal

NUMEDX was an integrated healthcare communication company that enlightened and empowered health care providers, patients, and their caregivers. NUMEDX journals were dedicated to HIV/AIDS and all forms of hepatitis. NUMEDX is no longer in business.

Food Recall
Lisy Corporation has recalled all ORALE brand Ground Cumin, Item 141-A 1.5 oz pack size, because it has the potential to be contaminated with Salmonella, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. For additional information visit  the FDA web site .
 

Selenium And Heart Diesase

A recently published article on selenium is based on a session at the 11th International Symposium on Trace Elements in Man and Animals and compliments our feature article in the HIV Nutrition Update March/April 2003 issue. Researchers note that selenoprotein P contains most of the selenium in plasma and may protect against oxidative injury and transport selenium from the liver to peripheral tissues. (1) Another article investigates whether dietary selenium affects plasma homocysteine concentrations. (2) 

As noted in the Update Central column in the Nov/Dec 2002 HIV Nutrition Update issue, elevated plasma homocysteine levels are associated with poor cognition and dementia and an increased risk of heart disease. Since HIV-positive people on HAART already have an increased risk of heart disease due to medication regimens, it may be prudent to check homocysteine levels.

References
1. Burk RF, Hill KE, Motley AK. Selenoprotein Metabolism and Function: Evidence for More than One Function for Selenoprotein. J Nutr 2003; 133:1517S-1520S. 
2. Davis CD, Uthus EO. Does Dietary Selenium Affect Plasma Homocysteine Concentrations in Humans? J Nutr;2003;133: 2392. 

Conference Announcements

A free Hepatitis C Educational Training Session sponsored by the National AIDS Treatment Advocacy Project (NATAP) and the Baltimore City Health Department was held on August 7, 2003 - 08/07/2003 in Baltimore, MD. For more information on other sessions telephone 888/26-NATAP. 

A training program, Practical Management of HIV: Focusing on the Recent Learning Objectives of the AAHIVM Core Curriculum was held on November 1, 2003 in Orlando, FL. The program was sponsored by the University of South Florida College of Medicine, Florida/Caribbean AIDS Education and Training Center (AETC), and the American Academy of HIV Medicine (AAHIVM). For more information on other conferences, visit the web site. 

Dietary Guidelines And Heart Disease

Feature articles in HIV ReSource Review Issue 22 and Issue 23 note that consumption of trans fatty acids increase the risk of heart disease and new rules affecting labeling of trans- fatty acids would be likely in the future. Recently the White House Office of Management and Budget urged the Departments of Health and Human Services (HHS) and Agriculture (USDA) to revise the Nation's "Dietary Guidelines" to include information that omega-3 fatty acids may reduce the risk of heart disease but trans-fatty acids may increase the risk. Improving dietary habits could save thousands of lives. Read a copy of the letter sent to HHS and USDA. For additional information on omega-3 fatty acids, review HIV Nutrition Update Issue 42. 

For additional information on trans- fatty acids please visit: 
* HHS to Require Food Labels to Include Trans Fat Contents
* What Every Consumer Should Know about Trans Fatty Acids
* Questions and Answers about Trans Fat Nutrition Labeling

Food Recall

J. R. Simplot recalled frozen hash browns distributed nationwide and in Japan because they may contain plastic fragments. 

Metformin Recall

The Food and Drug Administration has announced that ChemSource recalled Metformin HCI distributed in West Virginia and Canada due to cross-contamination with Etodolac. For more information from the FDA on Metformin visit the FDA web site. 
 

Frozen Beef
Last week the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) reported that Stampede Meat, Inc. is voluntarily recalling approximately 739,000 pounds of frozen beef products, mostly vacuum packaged steaks, that may be contaminated with E. coli O157:H7. Consumers should return the recalled products to the point of purchase and cook similar (tenderized) products to an internal temperature of 160 degrees as measured with a food thermometer. 

The products subject to recall were produced between March 17 and March 22, 2003, and bear the establishment code "EST. 19113" inside the USDA mark of inspection. The products were distributed in the U.S. and Canada to restaurants, institutions and retail stores nationwide and through door-to-door sales to consumers. 

E. coli O157:H7 is a potentially deadly bacteria that can cause bloody diarrhea and dehydration. The very young, seniors and persons with compromised immune systems are the most susceptible to foodborne illness. 

Consumers and media with questions about the recall may contact Bill Asleson, company executive manager, at 800/353-0933. Consumers with other food safety questions can phone the toll-free USDA Meat and Poultry Hotline at
800/535-4555. The hotline is available in English and Spanish and can be reached from 10 a.m. to 4 p.m. (Eastern Time), Monday through Friday. Recorded food safety messages are available 24 hours a day. 

Smoked Whitefish Salad

Blue and White Food has recalled Sabra Smoked Whitefish Salad distributed in New York, New Jersey and Connecticut because it may be contaminated with Listeria monoctyogenes.

Helpful HIV/AIDS Resources

Centers for Disease Control and Prevention (CDC) Web Site "HIV at Work" addresses questions on HIV and AIDS in the workplace. It offers valuable resources such as the HIV/AIDS Resource Guide, which contains fact sheets and other resources to help labor leaders. 

Nutrition Interventions in the HIV+ Community

HIV CareLink offers "Nutrition Interventions in the HIV+ Community" by Aimee Bert-Moreno, RD, LD/N,  published by the Florida/Caribbean AIDS Education and Training Center. The document is in the HIV Care Link Newsletter, volume 4, issue 1, dated January 15, 2003.
 

National HIV Testing Day

Today is National HIV Testing Day and the Kaiser Family Foundation has prepared a new fact sheet titled “HIV Testing in the United States” that provides an overview of the major issues relating to HIV testing. The fact sheet, along with other materials about HIV/AIDS, is available at their web site.

Computer Virus Warning From AEGIS

As many of you, HIV ReSources deletes numerous copies of so-called spam email laden with viruses. We are passing on this important message from AEGIS to keep you updated on the latest computer virus. Please keep your anti-virus software up-to-date to avoid infection. 

W32 / Sobig .  E@mm is spreading fast.  NOTE: Spaces have been inserted to prevent a false positive.  W32 / Sobig . E@mm is a mass-mailing worm that sends itself to all the email addresses that it finds in files with the following extensions: .wab      .dbx      .htm      .html      .eml      .txt 

The email falsely purports that Yahoo sent it (support@yahoo.com). 

Email Routine Details - The email message has the following characteristics: 
From: support@yahoo.com (NOTE: W32 . Sobig .  E@mm spoofs this field. It could be any address.) 

Subject: The subject line will be one of the following:      Re: Application      Re: Movie      Re: Movies      Re: Submitted 
Re: ScRe:ensaver      Re: Documents      Re: Re: Application ref 003644      Re: Re: Document      Your application 
Application.pif      Applications.pif      movie.pif      Screensaver.scr      submited.pif      new document.pif      Re:
document.pif      004448554.pif      Referer.pif 

Attachment: The attachment name will be one of the following:      your_details.zip (contains details.pif)      application.zip
(contains application.pif)      document.zip (contains document.pif)      screensaver.zip (contains sky.world.scr)      movie.zip
(contains Movie.pif) 

NOTE: The worm de-activates on July 14, 2003, and therefore, the last day on which the worm will spread is July 13, 2003.

Symantec Security Response has created a tool to remove W32 . Sobig . E@mm.  It can be downloaded from their web site.
----------------------------------- 
AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Bridgestone/Firestone, iMetrikus, the John Lloyd Foundation, the National Library of Medicine, and users like you. Make a donation today.

HIV ReSources Web Site Update

The HIV ReSources Web Site is updated.
June 27, 2003

New links are at: 
General Health Information
In Memoriam Chester D. Myers, Ph.D.
Free Music Downloads
Homepage Del VIH ReSources

Subscriber Note: The HIV Nutrition News Update will not be published on July 4, 2003. We will resume our regular publication schedule the following week. 
 

Tim Brewi Memorial 

Tim Brewi's memorial and celebration of his life was held on Saturday, June 21st at 10:30 AM at Griffith Park in the Berlin Forest near the Observatory. View information about Tim and the memorial. 

Conferences

The 15th Annual Conference of the Australasian Society for HIV Medicine (ASHM) was held on October 22-25, 2003 at Cairns Convention Centre in Cairns, Queensland, Australia. The conference is the major forum for the presentation of HIV and hepatitis research in Australia. 

The 4th Canadian HIV/AIDS Skills Building Symposium was held on November 20-23, 2003 in Calgary, Canada. For information on other conferences visit the web site . 

More On Marijuana

An editorial comparing cannabis to tobacco adds to the information we published in HIV ReSource Review Issue 23 and Issue 24. Citing the American Public Health Association's friend-of-the-court brief, a federal appeals court ruled that physicians recommending marijuana to their patients can not be prosecuted. (1) In the US, a San Diego Task Force recently issued guidelines for the use of medical marijuana. 
 

KNOW HIV/AIDS Campaign

National HIV Testing Day is June 27th and both Viacom and the Henry J. Kaiser Family Foundation support this day through the KNOW HIV/AIDS Campaign. As noted at the Henry J. Kaiser Family Foundation web site, numerous activities are taking place this month including HIV testing material airing on television along with Public Service Announcements to run across television, radio and outdoor media outlets. Several popular TV series will air episodes with HIV/AIDS themes directing audiences to resources that provide information about where to get tested in their local areas. For further information including television programming information visit the Henry J. Kaiser Family Foundation or the KNOW HIV/AIDS web site or telephone their toll-free number at 1/866/344-KNOW (5669). 

FSIS Food Recall

ConAgra Poultry Company voluntarily recalled fresh chicken that might have contained glass. ConAgra Poultry Company discovered the problem and contacted FSIS to initiate a product recall. "Because of the potential hazard, I urge consumers who have purchased these products not to eat them but to return them to the place of purchase," said Dr. Garry L. McKee, FSIS administrator. The products recalled were: 

* 3.5-4 lb. bags of "Country Pride FRESH CHICKEN" bearing a sell-by date of "6-20-03," "6-21-03," or "6-22-03." Each bag also had an establishment code of "P-177" inside the USDA seal of inspection. The products were produced on
June 10 and distributed to retail stores in Florida, Georgia, New York, North Carolina and South Carolina. 

* 40 lb. cases of "FRESH YOUNG CHICKEN 8 PC WOFT / 20 HD" bearing a product code of "019434" and an establishment code "P-1279" inside the USDA seal of inspection. The products were produced on June 10 and distributed to institutions in Florida, Georgia, New York, North Carolina and South Carolina. 

* 40 lb. cases of "COUNTRY PRIDE FRESH YOUNG CHICKEN WHOLE WINGS AND LIVERS" bearing a product code of "019553" and an establishment code "P-6638" inside the USDA seal of inspection. The products were produced on June 9-10 and distributed to institutions in Florida, Georgia, New York, North Carolina and South Carolina. 

Consumers with questions about recalls may contact the consumer hotline at 800/414-7500. 

Consumers with other food safety questions can phone the toll-free USDA Meat and Poultry Hotline at 800/535-4555.  The hotline is available in English and Spanish and can be reached from 10 a.m. to 4 p.m. (Eastern Time), Monday through Friday.  Recorded food safety messages are available 24 hours a day. 

NOTE: Access news releases and other information at the FSIS Web site. 
 

FDA Medication and Supplement Update

From MedWatch - The FDA Safety Information and Adverse Event Reporting Program: 

The Food and Drug Administration (FDA) announced that its continuing investigation of counterfeit Lipitor turned up additional counterfeit quantities of the cholesterol-lowering pharmaceutical product. Two additional lots of 10 mg tablets in 90-tablet bottles, coded 20842V and 16092V, and one lot of 20 mg tablets in 90-tablet bottles, coded D270481, were involved. The labeling on each of these bottles states, "Repackaged by: MED-PRO, INC., Lexington, NE 68850." Read the 2003 MedWatch safety summary, including the updated June 3 FDA Talk Paper.

Best Life "Viga" tablets were recalled because they contained unlabeled prescription drug sildenafil.

HIV Nutrition Update Issue 42

The May/June HIV Nutrition Update Newszine issue is now available. In the feature article, Kimberly Dong, MS, RD discusses the use of omega-3 fatty acids and relates information on their use to treat metabolic complications associated with lipodystrophy. Investigators at the Tufts University School of Medicine, Department of Community Health, Nutrition/Infectious Disease Unit are seeking study participants. Visit the following web sites, which have information on omega-3 fatty acids that complement the article: 

1) Fish Oil Consumption and Reduction of Arterial Disease
2) Biomarkers of Fat and Fatty Acid Intake
3) Acute-on-chronic effects of fatty acids on intestinal triacylglycerol-rich lipoprotein metabolism

The issue also includes an article by Richard A. Freiberg, D.O.M., D.Ac., A.P., Board Certified Diplomat on herbal formulas for HIV/AIDS used in Traditional Chinese Medicine. 

Additional columns include: 
* Program Spotlight column on the HIV Outpatient Program of the Medical Center of Louisiana at New Orleans; 
* Herbal Update column with clinical trial information; 
* Book Review on Micronutrients and HIV Infection; 
* Med Watch column on TriCor (Fenofibrate). 

HIV ReSources Web Site Update

The HIV ReSources Web Site is updated.
June 6, 2003

New pages: 
Issue 42 HIV Nutrition Update

New links: 
Information on HIV and AIDS
HIV Nutrition Update Preview Links
Information On Transmission of HIV And AIDS
 

Recalls and Warnings

Orecchiette Salad: The New York State Agriculture Commissioner recently issued a warning on Orecchiette Salad due to Listeria contamination. 

Smoked Catfish: Hope African Food recalled Catfish. 

Ready-to-eat Salad: Fresh Express recalled Hearts of Romaine due to possible Listeria monocytogenes contamination. 

Oral Contraceptives and Licorice: The German National Chemists Association warns women taking oral contraceptives to avoid eating too much licorice. Consumption should be limited to 10 grams a day as too much licorice can contribute to fluid retention (edema). People at high-risk of edema include those with diabetes, heart disease or high blood pressure. Caution is also advised because large amounts of licorice may deplete the body of minerals such as potassium, zinc and magnesium. 

Lipitor: Albers Medical Distributors, Inc., has recalled three lots of 90-count bottles of counterfeit Lipitor. Read the MedWatch 2003 safety alert, including links to the FDA Talk Paper and the company press release. 

HIV Incidence

Approximately 850,000 to 950,000 Americans are now HIV-positive. Most of the newly diagnosed people were tested after they started to notice symptoms. One route to HIV that has received little attention is unprotected oral sex. 

More people can now be tested before symptoms develop with new diagnostic testing methods. The Food and Drug Administration (FDA) recently approved MedMira's three-minute HIV antibody testing kit, which previously received distribution approval in Canada and China. According to MedMira President and CEO Stephen Sham, Reveal is the best rapid HIV test to date. Reveal is designed to detect HIV-1 antibodies within three minutes and will be distributed to health-care providers in the United States. It is hoped that the new test will assist in decreasing HIV transmission by reporting test results earlier than other diagnostic tests. View MedMira Rapid HIV Test Instructions. 

Vaccines designed to prevent HIV infection are another possible way to decrease transmissio. News from the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) notes that studies are underway on a promising new vaccine. The vaccine is directed at the three most globally important HIV subtypes A, B and C, which cause about 90 percent of all HIV infections. Healthy, HIV-negative volunteers were needed to take part in HIV vaccine trials at the NIH in Bethesda, MD at the time of this publication. For more information about the trial, call toll-free 866/833-LIFE (5433) (TTY, toll-free, 866/411-1010). Visit the Clinical Trials web site to see if volunteers are still needed 

HIV Progression 

Another test to predict how soon an HIV-positive person will progress to AIDS has been developed. In addition to measuring levels of CD4 T-cells or the level of HIV in the blood, the new diagnostic test looks for an HIV protein called p24 antigen. (1) Heat-denatured p24 antigen test is cheaper, easier to store and transport and as good as CD4 count and viral load in predicting clinical disease progression. Preliminary studies of immune system status in long-term asymptomatic HIV-positive children identified new markers of HIV disease that could also be used to monitor disease progression. (2) 

References
1. Sterling TR, Hoover DR, Astemborski J, Vlahov D, Bartlett JG, Schupbach J. Heat-Denatured Human Immunodeficiency Virus Type 1 Protein 24 Antigen: Prognostic Value in Adults with Early-Stage Disease. Journal of Infectious Diseases 2002;186:1181-1185. 
2. Resino S, Correa R, Bellón JM, Muñoz-Fernández MA. Preserved Immune System In Long-Term Asymptomatic Vertically HIV-1 Infected Children. Clinical & Experimental Immunology 2003;132(1):105-112. 

Food Insecurity 

Food insecurity is highly prevalent in the United States. Messer and Ross note some 23.3 million Americans use the community-based emergency food system. (1) Their recent article in Nutrition in Clinical Care discusses clinical approaches to food-insecure people and offers measurement tools to define and document hunger and food insecurity in the U.S. 

Positive people can get the nutrition care and support they need through community kitchens such as those listed at the Association of Nutrition Services Agencies (ANSA) web site. Numerous materials and resources are available through ANSA. Also, "Living Well with HIV/AIDS" is a useful manual for health care workers, patients and their families. The 97-page guide was jointly published by the World Health Organization and Food and Agriculture Organization. Read the dietary suggestions and practical solutions for people living with HIV/AIDS worldwide. 

References
Messer E, Ross EM. Talking to Patients About Food Insecurity. Nutrition in Clinical Care 2002;5(4):168. 

Conferences

The Association of Nutrition Services Agencies ANSA Conference 03 " Celebrating 10 years of excellence!" was held on September 4-7, 2003 at the Coast Plaza Hotel & Suites at Stanley Park in Vancouver, B.C. For additional information on future conferences visit ANSA's web site. 

The North American AIDS Treatment Action Forum  (NATAF) was held December 11-14, 2003 in Phoenix, AZ. View additional conference information via the National Minority AIDS Council Internet web site. Click on "Conferences" and select "NATAF". 

Medical Management of AIDS: A Comprehensive Review of HIV Management was held on December 11-12, 2003 at the University of California San Francisco, School of Medicine. For information on future conferences and learning opportunities, access the web site. 
 

Bone Health

We mentioned that Forteo (teriparatide) was being investigated as a treatment for osteoporosis in the Sept/Oct 2002 HIV Nutrition Update (Issue 38). At that time, Teriparatide was not commercially available in the U.S. The FDA has now approved the synthetic human parathyroid hormone (initially used as a test to help diagnose problems of the parathyroid gland) for use as a bone-building treatment. For additional information visit the Foreto web site.

Speaking of building bone, investigators believe mineral-rich water may offer an important supplementary contribution to total calcium and magnesium intake for people who don't like dairy products. (1) A matched case control study of water consumers (240 men and 424 women) revealed that mineral water can contribute up to one-fourth of total daily calcium intake. People consuming mineral water had a significantly higher calcium intake than those drinking low-mineral content water or tap water. Dietary magnesium, provided by mineral water, contributed from 6% to 17% of total daily magnesium intake. 

As noted in our patient education handout "Building Healthy Bones" several vitamins play a role in bone metabolism. Along with calcium, magnesium, vitamin C, and vitamin D, both vitamin K and vitamin B12 may play a role in bone health. (2, 3) Low dietary vitamin K intake is associated with an increased risk of hip fracture in both men and women. Vitamin K can increase bone mineral density and reduce the incidence of fractures in people with osteoporosis. (2) Results from the Framingham Heart Study note that although no significant association was found between dietary vitamin K intake and bone mineral density in men, low dietary vitamin K intake was associated with low bone mineral density in women. (4) A study of plasma vitamin B-12 status in association with bone mineral content and bone mineral density in 194 frail elderly people suggests that vitamin B-12 status is associated with bone health. (3) Osteoporosis occurred more often among women whose vitamin B-12 status was marginal or deficient. 

Visit TheBody for additional information on the latest research of bone disorders among HIV-positive women. For more on bone health view the HIV Nutrition News Update Archive 2 and  Archive 3. 

References
1. Galan P, Arnaud MJ, Czernichow S, Delabroise AM, et al. Contribution Of Mineral Waters To Dietary Calcium And Magnesium Intake In A French Adult Population. J Am Diet Assoc. 2002;102(11):1658-62. 
2. Weber P. Vitamin K and bone health. Nutrition 2001;17(10):880-7. 
3. Dhonukshe-Rutten RAM, Lips M, de Jong N, et al. Vitamin B-12 Status Is Associated with Bone Mineral Content and Bone Mineral Density in Frail Elderly Women but Not in Men. J Nutr 2003;133:801-807. 
4. Booth SL, Broe KE, Gagnon DR, Tucker KL, et al. Vitamin K Intake And Bone Mineral Density In Women And Men. Am J Clin Nutr 2003;77(2):512-516.

USDA Food Safety And Inspection Service Recall

The USDA Food Safety And Inspection Service (FSIS) noted that Blue Ridge Farms, Inc., a Park Forest, IL., firm, voluntarily recalled approximately 400 pounds of ready-to-eat chicken salad that might have been contaminated with Listeria monocytogenes. The products subject to recall were 5-lb. tubs of "Blue Ridge Farms Made Fresh Daily Cajun Chicken Salad," packed in individual cartons and distributed to retail stores in Alabama, Colorado, Illinois, Minnesota and Texas. For further information on food recalls visit the FSIS web site.

Subscriber Note: The HIV Nutrition News Update will not be published during the week of May 11, 2003. We will resume our regular publication schedule the following week.