Preemie survivors have a tougher time later in life
Infants born prematurely are much more likely to die during childhood and, if they survive, are much less likely to have children of their own later on, according to the largest study of premature babies undertaken. This is tough news for Black women, who have a higher rate of premature births. Researchers already knew that premature infants faced many neurological and developmental problems, but the new findings, released Tuesday, show that the range of problems they suffer is even greater than suspected and persist throughout the child’s lifetime. The study, conducted using Norwegian data on people from the cradle to the grave, suggests that, as the percentage of premature infants who make it through their first year continues to grow, because of advances in neonatology, the number of troubled infants and adults also will rise. “Are we improving their survival at the expense of significant problems down the road?” asked the lead author, Dr. Geeta Swamy of the Duke University Medical Center. But the situation probably is worse in the United States because of racial disparities in the care of newborns, Melissa Adams of RTI International in Atlanta and Dr. Wanda Barfield of the federal Centers for Disease Control and Prevention wrote in an editorial accompanying the report in the Journal of the American Medical Association.” This is an important paper because it documents something we have all known in our hearts – that being born premature has enduring implications,” said Dr. William Benitz, chief of the division of neonatal and developmental medicine at Lucile.

AIDS vaccine researchers vow to keep fighting
With AIDS vaccine plans in disarray after trials of the most promising candidate collapsed, the head of the federal agency that oversees AIDS research renewed the government’s commitment to the development of a drug to prevent the disease. “Despite hundreds and hundreds of millions of dollars, the reality in 2008 is that an HIV vaccine clearly remains beyond our grasp,” Dr. Warner C. Greene, a professor at the University of California, San Francisco and co-chairman of the summit, told the attendees. “The HIV vaccine field is clearly at a critical crossroads, and decisions about our future course will affect the lives of billions of individuals in both research-rich and resource-poor settings for years to come, particularly since research stopped a major HIV vaccine trial earlier last year. “We will not discontinue research, period. Not only will we not decrease it, we will in fact try to increase it,” Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said at a summit of top HIV/AIDS researchers in Bethesda, Md. The agency organized the gathering to help scientists regroup after Merck & Co. announced that it had halted tests of a prominent vaccine candidate in September. After 10 years and millions of dollars in development, two clinical trials determined that the drug not only failed to protect people against AIDS – but might actually have increased their risk of infection. That was particularly hard to take for the Black HIV advocates, since Black Americans are twice as likely to get the disease.

…In a related story, researchers are scaling back another HIV vaccine trials.
Trials of National Institutes of Health’s Vaccine Research Center’s HIV vaccine candidate will be scaled down after the recent failure of a Merck HIV vaccine candidate, Bloomberg reports. Merck in September 2007 announced it had stopped a large-scale clinical trial of its experimental HIV vaccine after the drug failed to prevent HIV infection in participants or prove effective in delaying the progression of the virus to AIDS. The vaccine trial also might have put some participants at an increased risk of HIV, researchers said. The vaccine research center trial called PAVE-100 is similar to the Merck vaccine in that both stimulate disease-fighting CD4+ T cells against HIV and both contain the cold virus adenovirus-5. Researchers in the Merck trial found that men who received that vaccine were at an increased risk of contracting HIV if they had a high immunity to the cold virus when they enrolled in the trial. Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, said that the VRC trial will not enroll anyone with a high immunity to the cold virus. According to Bloomberg, this could rule out nine in every 10 potential study participants in Africa. Also, the trial will require that men be circumcised, according to Wayne Koff, senior vice president for research and development at the International AIDS Vaccine Initiative. the Vaccine Research Center initially planned to enroll 8,500 people in the U.S. and Africa in the trial but now plans to enroll only 2,000. In addition, the International AIDS Vaccine Initiative (IAVI on Monday announced plans to pull out of the VRC trial. Koff said the group had planned to enroll 1,000 people in Africa in the new trial but pulled out because it believes that human trials of HIV vaccine should be small and aim to design better potential vaccines than those currently in development. Koff said that there is not a “clear understanding of why” the Merck trial failed.

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