Posts Tagged test results

HIV Prevention in a Pill?

Yesterday an FDA advisory panel recommended approval of Truvada for pre-exposure phylaxis (PrEP) of HIV.  While many in the HIV and AIDS medical and research community support the move, many others fear that it will reduce the use of condoms, which are critical for HIV prevention.  The question is: Will those in high risk categories, those who engage in risky sexual behaviors or use intraveneous drugs, actually adhere to a medical prevention protocol, especially if they are already having difficulty consistently using condoms?  While I think it’s possible that there are those in committed relationships with someone who is HIV positive who may be able to tolerate the serious side effects, the majority of those at risk for contracting HIV may not be able to stick with the regimen.

Studies have shown that getting tested and realizing that you are positive reduces the risk you will pass it on.  Just the awareness that someone is putting someone else in danger may deter people from risky behavior.  But getting tested and the use of a preventive medication requires that people actually care about their role in the spread of HIV.  The continued large number of new cases every year, which is approximately 50,000 according to the Centers for Disease Control, and the 21% increase in new cases in young men aged 13-29 is fueled by the 34% increase in cases among young gay and bisexual men.  It would be great if this could be another tool in the HIV prevention toolbox that doesn’t make people feel safe skipping the condom.  Let’s hope that the right message on this “HIV Prevention Pill” gets out and it helps to stem the tide of new HIV infections and unnecessary disease.

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Medical Marijuana Users Not Protected From Employer Drug Testing

Even for the states that have legalized marijuana for medical use under the Medical Use of Marijuana Act (MUMA), people who are taking advantage of the law are still at risk from their employers.  The act is intended to protect medical users from arrest but the protection does not extend to private businesses.  In at least 2 separate instances employees who were using marijuana for medical purposes were required to submit to drug tests for their employment and were subsequently fired.  Even though both of these people informed their employers about their medical use of marijuana and had supporting evidence from their doctors, the companies still followed through with their corporate policies.

For people suffering from chronic pain or undergoing cancer treatment, marijuana can make a huge difference.  The talk show host, Montel Williams, has suffered with Multiple Sclerosis for years and found relief from constant neurological pain with marijuana.  He says that it improved his health and well being.  He supports this as a treatment so much that he is opening a medical marijuana dispensary in Sacramento, CA that he claims will be professional with a focus on patient care.  It’s truly sad that these sufferers are punished when they have found a treatment that works for them and enables them to function well enough to go back to work.  True medical use of marijuana does not provide an exemption for employers concerned with sticking stringently to the rules but it should.  Their lack of compassion in our “Drug Free” world is cruel and unacceptable.

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Drug Testing for Welfare Recipients on the Rise

Kansas is one of the most recent states to try to pass laws requiring welfare recipients to submit to drug testingAlthough there are many opponents who claim that this will cost the state too much money to test all of these people, in the long run this will help to ensure that the money is going to the children and welfare dependents who need food and shelter.  Too many drug users are on welfare and using the state’s money to purchase drugs.  From any perspective this is not the intention of welfare and makes most taxpayers (including me!) angry.  In fact, many of the welfare recipients who were asked about the drug testing bill now headed to the Governer of Kansas support the concept.  They have seen friends and relatives using welfare funds inappropriately.

The unfortunate side effect of passing laws such as this, and so far 30 states have proposed bills like this, but none have successfully been enacted, is that this doesn’t provide a support system for drug addicts.  The bills address different aspects of the problem, from receipt of welfare benefits, to applying for welfare, to receipt of food stamps.  Those who test positive may be referred for treatment but the treatment isn’t necessarily covered and then there is the question about how they will support themselves while undergoing treatment, if they actually take that step.  What about false positives?  Is there any recourse for those who receive an incorrect result?  Another worry is that some who really need financial aid, and may use it properl,y won’t even apply if they have to be tested.  Some states are even proposing that welfare applicants pay $15-$25 for the test themselves.  Perhaps lawmakers will address these issues later but are hoping that this will be a deterent allowing money to be spent on the things it was meant to provide as a stop gap measure for those temporarily out of work: food and housing.  This is a good idea, but needs to be part of a bigger picture and an overhaul of the entire system to help people who need it and then get then back on their feet and back to work.

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Drug Testing Companies Are Getting More Effective

If you were hoping that your heroin use was tough to catch, you could be in trouble.  In October of last year the US Department of Transportation (DOT) changed their regulations for drug testing, lowering the cutoff levels for amphetamines and cocaine and adding the urine test for the heroin marker to its list of required tests.  The addition of the test for heroin creates complications for employers who need to test their drivers to ensure safer highways.  Heroin metabolizes quickly to 6-AM and then to morphine.  Previously a test for heroin was only conducted after a positive result for morphine. 

Testing laboratories, such as Quest Diagnostics, have updated their arsenal of tests to include an oral fluid test that can accurately reveal five times more heroin use in the general US workforce than previously believed.  The oral fluid test is much easier to administer, making observation simpler, and oral fluid is more difficult to tamper with.   According to the Quest Diagnostics Drug Testing Index™ oral fluid testing with more than 320,000 oral-fluid samples from the general U.S. workforce from January to June 2010, detected a marker for heroin use at a rate of 0.04% compared to the 0.008% positivity rate for urine testing.  If you are a professional driver up for drug testing, it’s time to get clean!

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Research Offers Hope for HIV Cure

Could bone marrow transplants be the answer to HIV?  We continue to hope and researchers continue to work on finding the cure for HIV.  The HIV epidemic continues in the United States prompting President Obama’s recent strategy on fighting it.  56,000 people become infected in the US every year and over 1.1 million Americans are living with the disease.  Attempts to provide clean needles and condoms are just not cutting it. Without the motivation and inspiration of dedicated researchers and bold attempts to find solutions the epidemic will continue.  Naysayers who point out that new research hasn’t found the cure aren’t looking at it from the right angle.

In Berlin last year, scientists transplanted a patient with HIV-resistant bone marrow and claim that he is now cured of HIV.  Doctors in Texas will attempt a similar procedure by using donated umbilical cord blood that has been screened for the HIV-resistant gene.  Due to the great risk of a bone marrow transplant this isn’t a solution for those with only HIV, but could be effective for those with leukemia that will die without the transplant.  HIV tests to let those with the disease know so that they are less likely to spread the disease is one of the strategies identified in the National HIV Strategy, as well as calling on all parts of our society, including the scientific and medical community, to participate in reducing the spread and caring for those who are infected.  This new study can invigorate  the research to continue the search for a cure and motivate the scientific community.   Let’s applaud their efforts, not point out that they haven’t gone far enough.

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One Step Closer in the Fight Against HIV/AIDS

Only months after President Barack Obama addressed the nation stressing a stronger focus on HIV prevention and improved treatment, significant progress is continuing to be made by researchers.  It looks like the research community is taking his words seriously!  A recent study published in Science has found the specific genes that some HIV infected people have that allows their immune systems to maintain low levels of HIV.  These individuals, called “Controllers”, never develop AIDS.  1,500 of them volunteered for the study providing valuable information that will eventually lead to treatments for controlling the HIV infection.  Small variants in the protein HLA-B alert the immune system that there is an infection.  Those who don’t have these controlling genes eventually suffer with AIDS.

HIV infection is still a huge problem in the United States where the number of new cases continues to rise every year despite attempts to halt it’s spread.  The primary focus has been on condom use and those infected frequently don’t receive proper treatment.  President Obama has laid out a National HIV Strategy to reduce the incidence of the disease, increase access to care and reduce HIV-related health disparities.  President and Mrs. Obama were tested for HIV while visiting Kenya in 2006 to encourage men and women there to be tested to prevent spreading the disease.  This is also a large piece of the US strategy because research shows that people who have received positive results and know that they are HIV positive are less likely to engage in the risky behaviors which spread the infection.  Right now, this is the best defense we have but we need to keep pushing the envelope on research and prevention options.  If you think that you are at risk and/or engaging in risky behavior, get tested and stop the virus with you!

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OTC Genetic Tests Not Ready for Prime Time

According to MedPageToday, Walgreens has decided to hold off on selling Over-the-Counter Home Genetic Tests.  Walgreens received an email from the FDA asking them to wait because they consider this test a medical device and it is therefore subject to regulation.  A majority of physicians are still not comfortable with allowing these types of tests to be used at home and they continue to recommend that their patients obtain testing at reliable testing facilities where strict protocols are maintained.  The OTC tests that Walgreens was planning to offer allowed results for such conditions as pre-pregnancy, prostate cancer, diabetes and cystic fibrosis.

These tests provide information on an individual’s risk of developing numerous diseases within their lifetime as compared to a sample of other people.  The information obtained from a Genetic Predisposition DNA test can be used to change your diet and lifestyle and possibly avoid some of these serious disorders. The results aren’t a guarantee because the environment plays such a large factor in our health.  Still, the ability to take preventive action can be critical.

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