Category: metabolic disease

Lancet issue on the state of global health

The Lancet has devoted an entire issue to various aspects of global health. The issue is available free for download.

An edited extract from the executive summary follows:

The Global Burden of Disease Study 2010 (GBD 2010) is the largest ever systematic effort to describe the global distribution and causes of a wide array of major diseases, injuries, and health risk factors.

The results show that infectious diseases, maternal and child illness, and malnutrition now cause fewer deaths and less illness than they did twenty years ago. As a result, fewer children are dying every year, but more young and middle-aged adults are dying and suffering from disease and injury.

Thus non-communicable diseases, such as cancer and heart disease, become the dominant causes of death and disability worldwide.

Since 1970, men and women worldwide have gained slightly more than ten years of life expectancy overall, but they spend more years living with injury and illness.


Invitation to apply for research funds

We have entered a new round of invitation to apply for research funds. We are particularly interested in providing initial funding in projects that may allow young researchers to obtain preliminary results as a prelude to acquire further funds from larger funding bodies.

We invite applications from researchers in the East and West Midland, the North East and North West Regions on projects relating to sexually transmitted diseases and HIV. All projects will be initially screened by the Scientific Committee of STIRF and those considered suitable will be sent for peer review by experts in the field. We encourage applications for

The following fields of research will be considerd in relation to STIs and HIV

  • Epidemiology of HIV and other sexually transmitted diseases
  • Health care delivery including views of clients
  • Issues relating to deprived or marginalised communities.
  • Pathophysiology of diseases and syndromes
  • Inter-relationship between diseases
  • Treatment modalities
  • Complications of treatment and co-morbidities

Applications should not exceed £50,000 in the first year. Depending on satisfactory reports a further £25,000 may be available for the second year. Joint funding with other grant giving bodies will be considered.

Further information and guidance on how to apply can be found on

How to Apply for Research funds


CROI 2012 Review web cast

Register now for web-cast education on the most important topics covered by CROI (Conference on Retroviruses and Opportunistic Infections) in February 2012. The web-cast will cover the following topics

  1. Review the latest data on anti-retroviral medication.
  2. Describe studies using HCV protease inhibitors in HIV infected patients.
  3. Describe the latest data on treatment of TB and opportunistic infections in HIV patients.
The target audience are

  • Physicians
  • Physician Assistants Nurses
  • Nurse Practitioners
  • Other health care professionals caring for people with HIV

Registration deadline is May 1.

Central obesity is a risk for HIV-associated cognitive impairment

Because effective antiviral therapy can suppress HIV replication and prolong the life of HIV-infected patients to that approaching non-infected individuals long term complications of antiviral therapy acquire particular importance. Among these are neuro-cognitive disorders.

Neurocognitive impairment, ranging from mild deficits to severe dementia, occurs in about half of HIV-infected individuals. A recent study by McCutchan et al has suggested that increased waist circumference was associated with increased prevalence of neuroognitive impairment in a subgroup of HIV-infected patients followed up in the CNS HIV AntiRetroviral Therapy Effects Research (CHARTER) study. They found that central obesity, but not more generalized increases in body mass (BMI), was associated with a higher prevalence of neurocognitive impairment (NCI) in HIV+ persons. Diabetes appeared to be associated with NCI only in older patients.

These findings are similar to those reported in the non-infected populations with central obesity – known as metabolic syndrome. the mechanisms for these findings are unclear. However as central obesity and metabolic syndrome appear to be common in HIV-infected patients receiving antiviral therapy these findings may have important implication for patients.The authors concluded that avoidance of antiretroviral drugs that induce central obesity might protect from or help to reverse neurocognitive impairment in HIV-infected persons.

Research on the long term metabolic effects of anti-retroviral treatment, which has focused on the mechanisms for increased incidence of cardiovascular disease seen in patients on treatment should be widened to include neurocognitive impairment and its relations to central fat accumulation.

Vitamin D deficiency and cardiovascular disease: more information needed

Vitamin D deficiency is common in the general population. It has been linked with hypertension, myocardial infarction, and stroke, as well as other cardiovascular-related diseases, such as diabetes, congestive heart failure, peripheral vascular disease, atherosclerosis, and endothelial dysfunction.

Yet a recent publication in The Annals of Internal Medicine  has highlighted the conflicting nature of the information available, as it relates to increased cardiovascular disease, and has called for proper prospective randomised studies.

Vitamin D deficiency, along with cardiovascular disease, diabetes and some malignancies are more commonly seen in HIV infected patients compared to age-matched controls. While the mechanism for the vitamin D deficiency in HIV infection is still unclear, this deficiency has been shown to be associated with an increased prevalence of type 2 diabetes mellitus.

In a cross sectional study of their HIV cohort in Pennsylvania, USA, Guaraldi and colleagues showed an almost doubling (OR 1.85 CI 1.03-3.3) of diabetes mellitus in those with vitamin D levels below 20 ng/ml compared to those with normal levels. The authors controlled for vitamin D supplementation, sex, age, body mass index (BMI), and hepatitis C, all of which are known to effect glucose metabolism.

We urgently need prospective studies to confirm these findings and to answer the question if vitamin D supplementation will prevent these putative complications of vitamin D deficiency.