【195-196】Study: AIDS Drug Not Linked to Depression, Suicide

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*【195】AS IT IS

US Secretary of State Returns to North Korea for Nuclear Talks

July 03, 2018

Secretary of State Mike Pompeo is traveling to North Korea for the third time this year for nuclear talks with officials in Pyongyang. Here he pictured in the Cabinet Room of the White House, in Washington, DC, on June 21, 2018. / AFP PHOTO / Olivier Douliery

U.S. Secretary of State Mike Pompeo will travel to the North Korean capital of Pyongyang on Thursday.

The top American diplomat is expected to meet with officials there until Saturday. President Donald Trump’s administration announced the trip this week.

A U.S. delegation, led by U.S. Ambassador to the Philippines Sung Kim, met with North Korean officials on Sunday in the truce village of Panmunjom. It marked the first known meeting between U.S. and North Korean officials since Trump met with North Korean leader Kim Jong Un on June 12 in Singapore.

Speaking on national television on Sunday, national security adviser John Bolton spoke about the idea of denuclearization for the North. He said North Korea’s weapons program could largely be ended in a year.

Officials say North Korea still developing weapons

The diplomatic efforts come as American intelligence officials have stated that North Korea is still processing nuclear fuel and expanding its weapons programs.

Bruce Klingner is with the Heritage Foundation, a research group in Washington, D.C. He said satellite images show that North Korea has expanded a nuclear center and a missile production center. He said North Korea is increasing its production of nuclear materials at both secret and known centers.

In this Thursday, May 24, 2018 photo, smoke and debris rise in the air as barracks buildings for guards and tunneling workers at North Korea's nuclear test site are blown up at Punggye-ri, North Hamgyong Province, North Korea. (APTN via AP)

Klingner said the U.S. must learn from past mistakes.

David Schmerler is a researcher at the Monterey Institute of International Studies in California. He told VOA that North Korea appears to be finishing a factory that is known for making parts for solid-fuel missiles.

In other news reports, American intelligence officials have said the North is seeking to mislead the United States about how many weapons it has.

Before Trump and Kim met in Singapore, North Korea destroyed parts of its Punggye-ri nuclear test area. That is where all six of North Korea’s nuclear tests had been carried out.

North Korea invited reporters from several countries -- including the United States, South Korea, China, Russia and Britain -- to record the event.

However, a North Korean research website called 38 North says satellite images show that the headquarters and other building remain in place.

Stephen Noerper is a director with the Korea Society. He told VOA it is still “early in the process.”

“It will be a very long path ahead that will be complicated and will require numerous meetings.”

Noerper added that North Korea has made a commitment to denuclearize before the whole international community. However, there is still no signed agreement on how that will be carried out.

I’m Mario Ritter.

Wayne Lee, Steve Herman reported this story for VOA News. Mario Ritter adapted it for VOA Learning English with additions from Victor Beattie and Zlatica Hoke. Ashley Thompson was the editor.

We want to hear from you. Write to us in the Comments section, and visit our Facebook page.

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Words in This Story

complicated - adj. having many parts or steps

commitment - n. promise to do or give something

*【196】AS IT IS

Study: AIDS Drug Not Linked to Depression, Suicide

July 03, 2018

A newly diagnosed HIV-positive woman receives treatment at the Mildmay Uganda clinic, Kampala, Feb. 27, 2014.

A new study of a popular medicine could ease concerns about its link to depression.

The drug, efavirenz, is used to fight the human immunodeficiency virus, HIV. The virus weakens the body’s natural defenses.

Some researchers once feared that using efavirenz caused patients to become depressed or consider the possibility of suicide. Researchers working in Uganda reported recently that the drug did not cause those negative side effects.

Efavirenz is a low-cost, once-a-day pill used around the world to treat and prevent HIV and the disease AIDS. It is "the treatment of choice" in most of the world, especially in countries that depend on international aid to treat HIV. That information comes from Mark Siedner of the Africa Health Research Institute.

Some studies in the United States and Europe found the drug increased patients' risk of depression or suicide. But other studies did not reach the same finding.

The mixed results led many doctors in the United States to suggest more costly but possibly safer drugs.

Siedner wanted to take another look at the risk of depression, this time in Africa. From 2005 until 2015, he and a team of Ugandan and U.S. doctors followed 694 patients. All of the patients took either efavirenz or another antiretroviral medication. The doctors asked the subjects whether they experienced depression or ideas of suicide.

No difference

A report on the study was published in the Annals of Internal Medicine.

Siedner says he and his team found there was no difference between the two treatments.

He told VOA, "In other words, efavirenz was not associated with a risk of depression. If anything, there seems to be a signal that…potentially it was associated with a decreased risk. But it wasn't a strong enough [signal] for us to say that."

The researchers also noted that 17 of the patients died during the study. But there was not a single death from suicide.

Siedner has two possible explanations for why their findings differed from those in Western countries. He said one possible cause “is that every single ethnic group in the world, of course, is different, and different in many different ways. Different socially, different environmentally, and in this case, they may be different genetically." His team is looking at whether the genes that control the metabolism of the drug have an effect to play in this story.

A second explanation could be the effectiveness of the drug. Because efavirenz is so powerful, it could be keeping people healthier than they expected. As a result, patients might be less likely to report depression or suicidal thoughts.

Anthony Fauci, a leader in AIDS research for over 30 years, praised the new study as important. He heads the U.S. National Institute of Allergy and Infectious Diseases.

He said the study pushes back against "the initial observation of suicidal ideation, and suicide and depression" as caused by efavirenz.

He told VOA, "I think now what you're seeing is that with these conflicting reports, it's likely someone will come in [with] the proposal to do a randomized study and take a look. So the story isn't ended with this paper."

As more research on the safety of efavirenz is done, new and less costly drugs that might replace it are likely in the future. One of them, dolutegravir, might also create a health risk, however. A study in Botswana found dolutegravir was linked to neural tube defect in embryos. That means it might not be safe for pregnant women.

As always, more research is needed to confirm whether this is a common problem or only affected the population in Botswana.

I’m Susan Shand.

This story was reported by Sadie Witkowski of VOA News. Susan Shand adapted it. George Grow was the editor.

Write to us in the Comments Section or on our Facebook page.

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