TASK DEFINITION: Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
PROBLEM: Paragraph: At issue are genes called BRCA1 and BRCA2. When they’re mutated, the body can’t repair damaged DNA as well, greatly increasing the chances of breast, ovarian and certain other cancers. Gene testing allows affected women to consider steps to lower their risk, such as when actress Angelina Jolie underwent a preventive mastectomy several years ago. Most cancer isn’t caused by BRCA mutations — they account for 5% to 10% of breast cancers and 15% of ovarian cancers — so the gene tests aren’t for everyone. But mutations cluster in families, and the U.S. Preventive Services Task Force has long recommended that doctors screen women who have relatives with BRCA-related cancers and refer those who might benefit from gene testing to a genetic counselor to help them decide. Tuesday, the task force expanded that advice, telling primary care doctors they should also assess women’s risk if: —they previously were treated for breast or other BRCA-related cancers including ovarian, fallopian tube or peritoneal cancers, and now are considered cancer-free. —their ancestry is prone to BRCA mutations, such as Ashkenazi Jewish women. Why screen breast cancer survivors? After all, they already know there’s a risk of recurrence. Take, for example, someone who had a tumor removed in one breast in their 40s a decade ago, when genetic testing wasn’t as common. Even this many years later, a BRCA test still could reveal if they’re at risk for ovarian cancer — or at higher than usual risk for another tumor in their remaining breast tissue, explained task force member Dr. Carol Mangione of the University of California, Los Angeles. And it could alert their daughters or other relatives to a potential shared risk. “It’s important to test those people now,” Mangione said. “We need to get the word out to primary care doctors to do this assessment and to make the referrals.” Private insurers follow task force recommendations on what preventive care to cover, some at no out-of-pocket cost under rules from former President Barack Obama’s health care law. The recommendations were published in the Journal of the American Medical Association. Cancer groups have similar recommendations for BRCA testing, and increasingly urge that the newly diagnosed be tested, too, because the inherited risk can impact choices about surgery and other treatment. Identifying BRCA mutation carriers “can be lifesaving, and should be a part of routine medical care,” Drs. Susan Domchek of the University of Pennsylvania and Mark Robson of Memorial Sloan Kettering Cancer Center, who weren’t involved with the new guidelines, wrote in an editorial accompanying them. But too few high-risk women ever learn if they harbor BRCA mutations, they wrote. For example, cancer groups have long recommended that all ovarian cancer patients be tested, but several studies have found testing is done in less than a third. Don’t skip the genetic counseling, said the task force’s Mangione. BRCA testing can cause anxiety and sometimes gives confusing results, finding mutations that might not be dangerous — things the counselors are trained to interpret. There’s a shortage of genetic counselors, particularly in rural areas, and she said counseling by phone can work. There’s a wide array of gene tests, some that search just for BRCA mutations and others that test dozens of additional genes at the same time. There’s even a direct-to-consumer kit sold by 23andMe — but Domchek and Robson warned it only detects the three mutations found most in women of Ashkenazi Jewish descent, not dozens of other mutations. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. Claim: Guidelines say more women may need breast cancer gene test.

SOLUTION: More women may benefit from gene testing for hereditary breast or ovarian cancer, especially if they’ve already survived cancer once, an influential health group recommended Tuesday.

PROBLEM: Paragraph: Under the current system, people on a work, study or family visa only pay a £400 surcharge to use the NHS. This is the current level the international health surcharge is set at each year, but the taxes that people who come to work in the UK pay also goes towards things like the NHS. Under the current system, people on a work, study or family visa incur average NHS costs of £625 per year. It’s unclear how the Conservatives have calculated this new figure and we’ve asked them for more information. Claim 1 of 3 Claim: Under the current system, people on a work, study or family visa only pay a £400 surcharge to use the NHS.

SOLUTION: This is the current level the international health surcharge is set at each year, but the taxes that people who come to work in the UK pay also goes towards things like the NHS.

PROBLEM: Paragraph: A still image provided by KPIX TV and taken from the broadcaster's video footage shows Timothy Ray Brown during an interview at his home in San Francisco. Timothy Ray Brown, was a young HIV-positive American living and working in Berlin who had developed leukaemia and suffered a relapse after initial treatment. REUTERS/Courtesy KPIX TV/Handout Dramatic scientific advances since HIV was first discovered 30 years ago this week mean the virus is no longer a death sentence. Thanks to tests that detect HIV early, new antiretroviral AIDS drugs that can control the virus for decades, and a range of ways to stop it being spread, 33.3 million people around the world are learning to live with HIV. People like Vuyiseka Dubula, an HIV-positive AIDS activist and mother in Cape Town, South Africa, can expect relatively normal, full lives. “I’m not thinking about death at all,” she says. “I’m taking my treatment and I’m living my life.”   Nonetheless, on the 30th birthday of HIV, the global scientific community is setting out with renewed vigor to try to kill it. The drive is partly about science, and partly about money. Treating HIV patients with lifelong courses of sophisticated drugs is becoming unaffordable. Caring for HIV patients in developing countries alone already costs around $13 billion a year and that could treble over the next 20 years. In tough economic times, the need to find a cure has become even more urgent, says Francoise Barre Sinoussi, who won a Nobel prize for her work in identifying Human Immunodeficiency Virus (HIV). “We have to think about the long term, including a strategy to find a cure,” she says. “We have to keep on searching until we find one.”   The Berlin patient is proof they could. His case has injected new energy into a field where people for years believed talk of a cure was irresponsible. Timothy Ray Brown was living in Berlin when besides being HIV-positive, he had a relapse of leukemia. He was dying. In 2007, his doctor, Gero Huetter, made a radical suggestion: a bone marrow transplant using cells from a donor with a rare genetic mutation, known as CCR5 delta 32. Scientists had known for a few years that people with this gene mutation had proved resistant to HIV. “We really didn’t know when we started this project what would happen,” Huetter, an oncologist and haematologist who now works at the University of Heidelberg in southern Germany, told Reuters. The treatment could well have finished Brown off. Instead he remains the only human ever to be cured of AIDS. “He has no replicating virus and he isn’t taking any medication. And he will now probably never have any problems with HIV,” says Huetter. Brown has since moved to San Francisco. Most experts say it is inconceivable Brown’s treatment could be a way of curing all patients. The procedure was expensive, complex and risky. To do this in others, exact match donors would have to be found in the tiny proportion of people — most of them of northern European descent — who have the mutation that makes them resistant to the virus. Dr Robert Gallo, of the Institute of Virology at the University of Maryland, puts it bluntly. “It’s not practical and it can kill people,” he said last year. Sinoussi is more expansive. “It’s clearly unrealistic to think that this medically heavy, extremely costly, barely reproducible approach could be replicated and scaled-up ... but from a scientist’s point of view, it has shown at least that a cure is possible,” she says. The International AIDS Society will this month formally add the aim of finding a cure to its HIV strategy of prevention, treatment and care. A group of scientist-activists is also launching a global working group to draw up a scientific plan of attack and persuade governments and research institutions to commit more funds. Money is starting to flow. The U.S. National Institutes of Health is asking for proposals for an $8.5 million collaborative research grant to search for a cure, and the Foundation for AIDS Research, or amfAR, has just announced its first round of four grants to research groups “to develop strategies for eradicating HIV infection.”   Until recently, people in HIV and AIDS circles feared that to direct funds toward the search for a cure risked detracting from the fight to get HIV-positive people treated. Even today, only just over five million of the 12 million or so people who need the drugs actually get them. HIV first surfaced in 1981, when scientists at the U.S. Centers for Disease Control and Prevention discovered it was the cause of acquired immunodeficiency syndrome (AIDS). An article in the CDC’s Morbidity and Mortality Weekly Report of that June referred to “five young men, all active homosexuals” from Los Angeles as the first documented cases. “That was the summer of ‘81. For the world it was the beginning of the era of HIV/AIDS, even though we didn’t know it was HIV then,” says Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, who has made AIDS research his life’s work. In the subsequent three decades, the disease ignorantly branded “the gay plague” has become one of the most vicious pandemics in human history. Transmitted in semen, blood and breast milk, HIV has devastated poorer regions, particularly sub-Saharan Africa, where the vast majority of HIV-positive people live. As more tests and treatment have become available, the number of new infections has been falling. But for every two with HIV who get a chance to start on AIDS drugs, five more join the “newly infected” list. United Nations data show that despite an array of potential prevention measures — from male circumcision to sophisticated vaginal or anal microbicide gels — more than 7,100 new people catch the virus every day. Treatment costs per patient can range from around $150 a year in poor countries, where drugs are available as cheap generics, to more than $20,000 a year in the United States. The overall sums are huge. A recent study as part of a non-governmental campaign called AIDS2031 suggests that low and middle-income countries will need $35 billion a year to properly address the pandemic by 2031. That’s almost three times the current level of around $13 billion a year. Add in the costs of treatment in rich countries and experts estimate the costs of HIV 20 years from now will reach $50 to $60 billion a year. “It’s clear that we have to look at another possible way of managing of the epidemic beyond just treating everyone forever,” says Sharon Lewin, a leading HIV doctor and researcher from Monash University in Melbourne, Australia. In some ways, we have been here before. Early AIDS drugs such as AZT came to market in the late 1980s, but within a decade they were overtaken by powerful cocktail treatments known as HAART, or highly active antiretroviral treatment. HAART had a dramatic effect — rapidly driving the virus out of patients’ blood and prompting some to say a cure was just around the corner. But then scientists discovered HIV could lie low in pools or reservoirs of latent infection that even powerful drugs could not reach. Talk of a cure all but died out. “Scientifically we had no means to say we were on the way to finding a cure,” says Bertrand Audoin, executive director of the Geneva-based International AIDS Society. “Scientists ... don’t want to make any more false promises. They didn’t want to talk about a cure again because it really wasn’t anywhere on the horizon.”   The ultimate goal would allow patients to stop taking AIDS drugs, knocking a hole in a $12 billion-a-year market dominated by Californian drugmaker Gilead and the likes of Pfizer, GlaxoSmithKline and Merck. It’s unlikely to happen anytime soon, but Brown’s case has opened the door to new ideas. “What it proved was that if you make someone’s cells resistant to HIV...then all the last bits of HIV, that hang around for a long time in patients on treatment, did in fact decay and disappear,” says Lewin. Now scientists working on mimicking the effect of the Berlin patient’s transplant have had some success. One experimental technique uses gene therapy to take out certain cells, make them resistant to HIV and then put them back into patients in the hope they will survive and spread. At an HIV conference in Boston earlier this year, American researchers presented data on six patients who had large numbers of white blood cells known as CD4 cells removed, manipulated to knock out the existing CCR5 gene, and then replaced. “It works like scissors and cuts a piece of genetic information out of the DNA, and then closes the gap,” says Huetter. “Then every cell arising from this mother cell has this same mutation.”   Early results showed the mutated cells managed to survive inside the bodies of the patients at low levels, remaining present for more than three months in five. “This was a proof of concept,” says Lewin. Another potential avenue is a small group of patients known as “elite controllers”, who despite being infected with HIV are able to keep it under control simply with their own immune systems. Researchers hope these patients could one day be the clue to developing a successful HIV/AIDS vaccine or functional cure. Scientists are also exploring ways to “wake up” HIV cells and kill them. As discovered in the late 1990s, HIV has a way of getting deep into the immune system itself — into what are known as resting memory T-cells — and going to sleep there. Hidden away, it effectively avoids drugs and the body’s own immune response. “Once it goes to sleep in a cell it can stay there forever, which is really the main reason why we can’t cure HIV with current drugs,” says Lewin. Her team in Melbourne and another group in the United States are about to start the first human trials using a drug called SAHA or vorinostat, made by Merck and currently used in cancer treatment, which has shown promise in being able to wake up dormant HIV. As scientists begin to talk up a cure, the old question of whether that’s the right goal has re-emerged. Seth Berkley, a medical epidemiologist and head of the U.S.-based International AIDS Vaccine Initiative (IAVI) is concerned. An HIV-positive person holds a placard during a programme organized to mark World AIDS Day in Kathmandu December 1, 2010. To match Special Report AIDS/ REUTERS/Deepa Shrestha “From a science point of view, it’s a fabulous thing to do. It’s a great target and a lot of science will be learned. But from a public health point of view, the primary thing you need to do is stop the flow of new infections,” says Berkley. “We need a prevention revolution. That is absolutely critical.”   Vuyiseka Dubula agrees. The South African activist finds talk of a cure for HIV distracting, almost disconcerting. “This research might not yield results soon, and even when it does, access to that cure is still going to be a big issue,” she says. “So in the meantime, while we don’t have the answer on whether HIV can be cured or not, we need to save lives.” Claim: Special Report: An end to AIDS?.

SOLUTION:
For his doctors, Timothy Ray Brown was a shot in the dark. An HIV-positive American who was cured by a unique type of bone marrow transplant, the man known as “the Berlin patient” has become an icon of what scientists hope could be the next phase of the AIDS pandemic: its end.