Inside News

HIV

• Half of HIV-Positive Americans Unaware of Infection or Are Not Receiving Treatment
• Condoms in Federal Prisons Considered
• BMS Issues Warning Regarding Stavudine
• Viracept Price Freeze

TB

• Intermittent TB Therapy Resulting in Rifamycin Resistance

HIV

Half of HIV-Positive Americans Unaware of Infection or Are Not Receiving Treatment

Data from the CDC show that nearly half of all HIV-positive Americans do not know that they are infected or are not receiving treatment for a known infection. The CDC estimates that 850,000 to 950,000 Americans are infected with HIV, with 180,000-240,000 unaware that they are infected. In addition, almost one-third of Americans who know they are HIV-positive are not receiving treatment for their disease. (The New York Times, 2/26/02)

Condoms in Federal Prisons Considered

In order to shift federal HIV/AIDS dollars to those hardest hit by the epidemic, a federal HIV/AIDS task force is considering condom distribution in federal prisons. This comes after an announcement by Scott Evertz (director of the White House Office of National AIDS policy) that there is going to be general shift in how federal HIV/AIDS dollars are spent. While some prison officials fear that condoms in prisons will encourage sexual behavior, other experts concentrate on the HIV epidemic behind bars as a public health issue and view condoms as a necessary part of HIV prevention. (AIDS Law & Policy, 17 (5); 3/15/02)

BMS Issues Warning Regarding Stavudine

Bristol-Myers Squibb has issued a letter to health care providers warning that its antiretroviral drug stavudine (d4T, Zerit) has produced a potentially fatal neuromuscular reaction in some patients. Lactic acidosis is a potential side effect of nucleoside analogues (NRTIs), the class of drug to which stavudine belongs. BMS warns that in these rare cases, conditions mimicking the clinical presentation of Guillain-Barre syndrome (neuromuscular weakness, respiratory problems) have resulted in the death of patients who continue to take stavudine despite lactic acidosis and other warning signs. The letter warns that health care providers should discontinue the use of stavudine by patients who develop muscle weakness. The letter is available at the following Web site. (FDA Web site, 3/29/02; www.fda.gov/medwatch/SAFETY/2002/safety02.htm#zerit)

Viracept Price Freeze

Agouron Pharmaceuticals has decided to freeze the price of its antiretroviral drug nelfinavir (Viracept) for two years. The current wholesale price is $2.02 per tablet and the drug is taken as five tablets twice a day. (AP, 3/17/02)

TB

Intermittent TB Therapy Resulting in Rifamycin Resistance

In a CDC study on rifamycin therapies in TB/HIV co-infected patients, patients with low CD4 counts (<60 cells/mm³) at initiation of TB therapy who received "highly intermittent regimens" (i.e., once- or twice-weekly therapy) tended to develop rifamycin resistance. Although more data is needed to clarify these findings, the CDC is currently recommending treating all TB/HIV co-infected patients whose CD4 count is <100 cells/mm³ with daily TB therapy for the first two months of treatment and then with daily or three times weekly therapy for the continuation of therapy. (MMWR, 3/15/02; www.cdc.gov/mmwr/preview/mmwrhtml/mm5110a5.htm)

Back to the HEPP News April 2002 contents page.