(West Palm Beach, Florida)  A list containing the names and addresses
of 6,500 people people with HIV/AIDS has been emailed to 800 people in
West Palm Beach, Florida.

The highly confidential list was accidentally attached to an email sent
by health department statistician John W. Nolan, the Palm Beach Post
reports.

The recipients of the email were all county health department employees
the paper reports.

Nolan is responsible for compiling data on HIV/AIDS cases for West Palm
Beach.

4,500 people on the list have AIDS, the others were listed as
HIV-positive.

Health department spokesman Tim O'Connor confirmed the error. It is not
known if all the people on the HIV list have been informed of their
status.

The largest AIDS advocacy in the region expressed concern about the
error.

Tony Plakas, the executive director of COMPASS told the Palm Beach Post
that if the list were to fall into the wrong hands and made public it
devastating effects on the lives of people with AIDS or who are HIV
positive.

"My first reaction is shock and fear," Plankas told the Post.

 "I wish we could say that the stigma attached to HIV/AIDS has faded
and disclosing that someone is affected would be the same as any other
communicable disease, but that is not the case," said Plakas, a former
HIV specialist for the Centers for Disease Control and Prevention's
national AIDS Clearinghouse.

O'Connor said the health department has launched a "full and major
investigation".

The state health department reports that one of every 173 people in
Palm Beach County has AIDS or is HIV positive; 6,555 of the county's
1.13 million residents are now living with HIV/AIDS.

_____________________

Researchers at Johns Hopkins have concluded that sudden, temporary
spikes in the amount of HIV in the body, commonly called "blips,"
generally do not mean the virus is developing resistance to AIDS drugs
and gaining strength in numbers.

"These results should provide relief to hundreds of thousands of
HIV-positive patients in the United States currently taking drug
therapy, called highly active anti-retroviral therapy, or HAART, and
reassure them that their medications have not failed," said senior
study author and infectious disease specialist Robert Siliciano, a
professor at the School of Medicine and a Howard Hughes Medical
Institute investigator. "Physicians and patients now have a much better
idea of when to worry about these blips and when not to worry."

Because HIV mutates rapidly, physicians and patients have worried that
even small, temporary increases in the amount of virus could indicate
the virus had mutated to evade anti-viral drugs being taken.

Instead, the Johns Hopkins team has shown that these so-called blips
are mathematical artifacts, or variations, that stem from the test used
to gauge the amount of virus in the body, a measurement known as viral
load.

According to the findings, to be published in the Journal of the
American Medical Association online Feb. 16, unless the blip is higher
than 200 copies per milliliter of blood, or persists upon repeated
testing, it does not signal that the virus has mutated, or changed
form.

True drug resistance requires changes in therapy that can be very
difficult for the patient, Siliciano said. Different combinations of
medications can have toxic side effects, such as lipid abnormalities
and diabetes, and can be considerably harder to tolerate than the
originally prescribed drug cocktail. Today's anti-HIV drug treatments
quickly suppress the virus to nearly undetectable levels, but blips are
a frequent problem. Earlier studies suggested that blips occur in 11
percent to 46 percent of patients, while the Johns Hopkins study, which
used intensive sampling, found blips in 90 percent of patients.

To see whether or when blips mean possible mutation, the Johns Hopkins
team conducted a detailed genetic analysis of multiple blood samples
from 10 HIV-positive patients, taking samples every two to three days
for a period of three months between June 2003 and February 2004. All
patients had their infection under long-term control, on HAART, and
with viral loads of less than 50 copies per milliliter for at least six
months. In total, 36 blood samples were taken from each patient.

Statistical analysis of the results showed that blips occurred in nine
of the 10 patients with a median viral load of 79 copies per
milliliter. The duration of the blips was typically less than three
days, and blips were not related to any demographic factors, such as
gender or age, nor to any clinical factors, such as illness,
vaccination or differences in antiretroviral drug regimens.

For every blip, the researchers conducted genetic tests on the samples
before, during and shortly after the blip, to uncover any mutations in
the virus. Measures of viral load were confirmed by using two
independent laboratories to test each sample.

No new mutations were found in an analysis of nearly 1,000 viral clones
for mutations in HIV's two key enzymes that are blocked by drug
therapy, protease and reverse transcriptase. The authors also found
that blips were not, again, detected when blood samples were assayed
twice in independent laboratories.

"The lack of any consistency among the tests performed on blood samples
confirms that there is no danger from these blips in viral load," said
study lead author and infectious disease specialist Richard Nettles, an
assistant professor. "These blips can be attributed to random
statistical artifact inherent in measurements of very low amounts of
virus."

Siliciano warns that drug resistance is a growing problem in AIDS
therapy as the virus can mutate faster than medical research can
develop new drugs. When HIV becomes resistant to one drug, it may also
become resistant to other drugs in the same class. With only four
classes of HAART drugs - for a total of 20 drugs - the number of
available combinations is limited for people who have developed drug
resistance.

Funding for this study, conducted solely at Johns Hopkins, was provided
by the National Institutes of Health, the Doris Duke Charitable
Foundation and the Howard Hughes Medical Institute. Other researchers
who took part in this study were Tara Kieffer, Patty Kwon, Daphne
Monie, Yefei Han, Teresa Parsons, Joseph Cofrancesco Jr., Joel Gallant,
Thomas Quinn, Brooks Jackson, Charles Flexner, Kathryn Carson, Stuart
Ray and Deborah Persaud.

Currently, there are more than 40 million people in the world living
with HIV, including an estimated 950,000 in the United States and
23,000 in Maryland. Nearly half of all HIV-infected patients in the
United States develop resistance to one or more classes of treatment
medications.

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