HIV/AIDS Newsroom: January 19, 2001
Interferon and Ribavirin vs. Interferon Alone in the Re-Treatment of Chronic Hepatitis C Previously Nonresponsive to Interferon
Journal of the American Medical Association (www.jama.com)
01/10/01; Vol. 285, No. 2, P. 193; Cummings, Kristin J.; Lee, Shing M.; West, Emily S.; et al.
Researchers evaluated the safety and efficacy of interferon and ribavirin compared to interferon alone in patients with chronic hepatitis C virus infection. The authors conducted a meta-analysis of 12 trials comparing the two drugs, involving nearly 1,000 patients in all. The examination of the studies revealed that although patients who did not initially respond to single interferon treatments later responded to the combination therapy, the overall effectiveness of the interferon/ribavirin therapy was still low enough -- less than 20 percent in the most responsive subgroups -- for researchers to conclude that better alternatives are needed.
New York's Queens College, which received $4.5 million from medical entrepreneur, Dr. Bernard Salick, to help it establish an AIDS research center, was recently asked to return the donation for having failed to follow through with the final agreement. Salick's 1997 initiative gave the college the start-up money to begin the funding process for the construction of a $30 million molecular and cellular biological HIV research center to be operated and directed by Dr. Luc Montagnier, the co-discoverer of HIV. The now former-college president, Allen L. Sessoms, had been responsible for raising the remaining funds needed for the project, which was to be supported by private and public monies, but failed to come through. Salick, who along with Sessoms, had enticed Dr. Montagnier to leave the Pasteur Institute in Paris, to direct the Queens center, has given college officials 10 days to return the funds with interest.
Back Off a Bit on HIV Drugs, Experts Decide
01/18/01; Fox, Maggie
In a telephone interview, Dr. Anthony Fauci, head of the National Institute of Allergies and Infectious Diseases, said that AIDS experts are being more conservative in their approach to drug therapy. Fauci explained that the approach stems from the realization that HIV cannot be killed outright and that the drugs can have toxic side effects. The official said that new treatment guidelines, ones which suggest not giving HIV-infected individuals potent drug treatments until they truly need them, will be detailed at an annual meeting of HIV experts in Chicago next month.
Massachusetts native John Chittick visited more than 40 countries over the past two years as part of a personal crusade against AIDS. Chittick -- whose travels included extended stays in Brazil, Vietnam, India, and South Africa -- established youth training groups in each nation. He estimates that about 70,000 teens were involved in his safe-sex and community-outreach education programs.
In a study published in the December issue of the Journal of Acquired Immune Deficiency Syndromes (2000;25:398-402), researchers report that structured treatment interruptions to the drug therapy of HIV patients could significantly increase the risk of drug-resistant HIV-1. The structured interruptions have been suggested as a way of building up an HIV-infected individual's natural immune system and increasing the effectiveness of antiretroviral treatments. However, the researchers suggest that in lieu of these structured interruptions, alternative immune stimulants, such as interleukin-2 or a therapeutic vaccine, be used during continued antiretroviral treatment.
New research published in the British Medical Journal (2001;322:81) suggests that an HIV-infected patient developed pancreatitis after receiving hydroxyurea in an antiretroviral regimen that also included didanosine. Researchers from St. Bartholomew's Hospital in London present the case of a 26-year-old man who was treated with stavudine, didanosine, and nevirapine for 1.5 years, at which point his viral load increased and he was given hydroxyurea two times a day. However, the drug was stopped after 42 days, when the patient reported pain in his upper abdomen, and all drugs were stopped three weeks later, after the patient's condition worsened. The researchers suggest that adding hydroxyurea to the original drug regimen could have precipitated didanosine-induced pancreatitis.
A new HIV control project is set to begin later this month in Kenya. The effort, funded by the World Bank, is expected to initially target the grassroots communities and strengthen the activities of the National AIDS Control Council over the course of four years. According to the council's deputy director, Dr. Patrick Orege, 60 percent of the funding will be used for community-based initiatives, while the balance will be distributed among nine ministries for AIDS control efforts.
Kenya is to receive $30 million to help the nation's fight against AIDS. The program, to be operated through World Vision's Hope Initiative, will focus on the treatment of HIV-infected individuals and children orphaned by the disease. World Vision, a nongovernmental organization, will also emphasize HIV prevention, education, and care for those already infected.
In September 2000, the Centers for Disease Control and Prevention drafted a document detailing four major objectives for preventing new HIV infections. According to scientific documents cited in the draft plan, the agency's objective to reduce new HIV infections in the United States by 50 percent within five years could cost up to $1 billion a year; the CDC's prevention budget for fiscal 1999 totaled just $637 million. Dr. Ron Valdiserri, the deputy director of the National Center for HIV/STD/TB Prevention at the CDC, notes, "We at the CDC recognize that these are ambitious goals, and they won't be easily obtained, but we do think it's possible with appropriate focus and resources to reduce new infections in this country by half." Indeed, some experts say the plan is good but could go even further, such as working to eliminate new infections instead of just reducing them. The CDC's first goal for HIV prevention is to reduce the number of new HIV cases in the United States from approximately 40,000 to 20,000 annually by 2005. The second goal calls for the use of voluntary counseling and testing to boost the proportion of HIV-positive Americans who are aware of their infected status, from 70 percent to 95 percent. The third objective seeks to increase the proportion of HIV-infected individuals who are linked to appropriate care, prevention services, and treatment services from 50 percent to 80 percent. The CDC's fourth goal is to reduce HIV transmission and better HIV/AIDS care and support via partnerships with countries that have limited resources.
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.