…from the News Brief vault…


Needle Exchange and HIV Prevention
Laboratory Medicine, April 1995
A needle-exchange program at the New Haven Department of Health in New Haven, Conn., has experienced a decline in the number of returned needles containing human immunodeficiency virus (HIV).
According to a study in the journal AIDS (1994;8:567-574), the rate of HIV-infected needles from intravenous drug use has decreased 33% since the beginning of the legal needle-exchange program in November 1990.
The study population included an average of 250 participants per month. A total of 49,405 needles were distributed and tracked for circulation patterns; 2,813 of these needles were tested for HIV.
The program tracks and exchanges used needles for new ones on a one-for-one basis per client, with a maximum of 10 needles per visit. Used needles are given to Yale researchers, who collect baseline data on participants and then test needles for HIV proviral DNA by polymerase chain reaction. A positive test indicates the needle was used by at least one HIV-infected user.
Edward H. Kaplan, PhD, principal investigator for the study at the Yale University Schools of Management and Medicine in New Haven, said the program has been effective because frequent exchange of needles decreases needle circulation time and thus decreases opportunities for “needles to share people.” Needles therefore are less likely to become infected and spread HIV.
The study has been criticized as being too limited. David Vlahov, PhD, of the Johns Hopkins University Department of Epidemiology, has suggested that future studies follow up on the individual drug user as the unit of analysis, because the decline in rates of infection could have been caused by shifting demographics in New Haven.
Both researchers agree the study is important because it is the first documented information available on the impact of needle-exchange programs in the United States.
—by Benjamin Ortiz
Red Wine Linked with Antioxidant Activity
Laboratory Medicine, April 1995
Cardiovascular disease would drop 40% and $40 billion could be saved annually if every adult in North America drank just two glasses of wine every day, according to a study and its accompanying editorial published in Clinical Chemistry (1995;41:32-35).
Researchers from the University of Birmingham, UK, and British United Provident Association (BUPA) Research and Clinical Audit, London, UK, conducted the study, which linked red wine with increased antioxidant activity. Antioxidants have been implicated in the prevention of atherosclerosis by their ability to clean up and prevent deposition of cholesterol on artery walls. Specifically, antioxidant compounds known as flavenoids facilitate the absorption of low-density lipoprotein (LDL) cholesterol and relaxation of the smooth muscle, key in the defense against atherosclerosis.
Mean antioxidant activity increased by 18% in nine test subjects who consumed 300 mL of red wine. Comparison with consumption of white wine, fruit juices, and vitamin C showed the high antioxidant capacity of red wine.
Red wine has a high level of flavenoids, a 20-fold concentration over white wine. One antioxidant compound, resveratrol, is unique to red wine. According to Sharon Allaway, BUPA researcher, tentative evidence also shows that red wine more than other forms of alcohol promotes high-density lipoprotein (HDL), a protective factor against heart disease.
The findings may unlock the secrets of the “French paradox”—that the French consume foods high in fat yet have a lower rate of heart disease than the British or North Americans.
According to Allaway, the evidence helps explain why those who consume moderate amounts of red wine have lower mortality rates from heart disease. But, Allaway said, “It would be foolhardy on our part to jump from our studies to recommendations on dietary behavior.”
—by Benjamin Ortiz

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