HIV/AIDS Newsroom: January 26, 2001
Clinical Tests Are Suspended on Promising AIDS Drug
Wall Street Journal (www.wsj.com)
01/26/01 P. B2
Pfizer revealed that it has halted late-stage human trials of capravirine, a potential blockbuster AIDS medicine, after a year-long trial of the medication in dogs showed that very high doses of the drug caused inflamed blood vessels, or vasculitis. Pfizer said that the Food and Drug Administration is helping the company to create further safety tests in animals. The firm noted that none of the 650 human patients in six clinical trials of capravirine had any indications of vasculitis. Most patients will end their capravirine regimen in favor of other treatments, but those who are doing well with the drug and have failed other therapies will remain on the drug; both groups will be monitored by Pfizer scientists.
White House press secretary Ari Fleischer reported that as some of the special offices the Clinton administration established are due to expire at some point, President Bush is currently reviewing the statuses of both the Office of National AIDS Policy and the Office on the President's Initiative for One America. Fleischer noted that these offices perform "important missions."
Md. to Take Over Count of City's HIV Patients: Health Commissioner Beilenson Says His Office Has Done Inadequate Job
Baltimore Sun (www.sunspot.net)
01/25/01 P. 3B; Garland, Greg
At a public hearing on HIV, Baltimore's health commissioner, Peter Beilenson, announced that he would turn over the responsibility of keeping count of the city's HIV cases to state health officials. "I'm not confident we're doing it adequately," Beilenson said Wednesday. Last October the Maryland AIDS Administration issued a report that was critical of the Baltimore Health Department's HIV/AIDS monitoring. According to the study, cases of AIDS and exposure to HIV are being underreported in the city, and that could affect federal funding. Beilenson noted that although no federal funds have been lost yet, that could occur if the situation is not remedied. Beilenson said the state will take over counting and reporting HIV/AIDS patients in the city for 18 months. Meanwhile, the head of the state AIDS administration agency noted that of the 2,111 new HIV cases reported in Maryland in 1999, nearly 60 percent were in Baltimore.
St. Louis Health officials tested hundreds of halfway house residents for tuberculosis (TB) after one resident was reportedly diagnosed with the disease. A spokesman for the Missouri Department of Corrections noted that the tests may not have been necessary, since further testing indicated that the patient has bacterial pneumonia; city health officials are calling for additional tests, however, suggesting that the man may have both pneumonia and TB. Acting health director Hilda Chaski Adams said, "We've asked them to take a second look, and we're going to continue testing," particularly in case the man is infected with a multidrug-resistant strain of TB. Adams noted that the man had symptoms that appeared to indicate TB infection. There have been nine cases of multidrug-resistant TB in St. Louis in the past several years, eight of which were within one extended family.
According to a study by Dr. Grace C. John and colleagues from the University of Washington in Seattle, another way to decrease maternal-infant transmission of HIV-1 is to reduce the infant's exposure to genital secretions or breast milk. The report, published in the January 15th issue of the Journal of Infectious Diseases (2001;183:206-212), notes that because so many developing countries have restricted access to effective antiretroviral drug therapy, intervention alternatives need to be found. The authors investigated the issue among 92 HIV-infected infants and 187 uninfected infants of HIV-seropositive women in Kenya. The researchers discovered that the risk of mother-to-child HIV transmission rose 80 percent with breastfeeding, 130 percent with HIV DNA detection in vaginal secretions during pregnancy, 170 percent with HIV DNA detection in cervical secretions, and 290 percent with mastitis.
A study by Dr. Joep M.A. Lange and colleagues from the Academic Medical Center in Amsterdam, the Netherlands, indicates that HIV-infected patients with chronic hepatitis B virus or hepatitis C virus infection have at least a three times higher risk rate of developing a critical elevation in liver enzymes after starting an antiretroviral program that contains a protease inhibitor, versus patients who do not have hepatitis. According to the report, published in the December 22nd issue of AIDS (2000;14:2895-2902), the researchers felt that the antiretroviral treatment need not be discontinued to reverse the hepatotoxicity because the patient improvement would probably not be altered either way. The authors emphasize that these test results only apply to highly active retroviral therapies containing protease inhibitors and the possibility of potentially fatal mitochondrial toxicity may also exist with a regimen of nucleoside reverse transcriptase inhibitors.
The death rate in Russia has overtaken the birth rate at a ratio of 1.76 to one, prompting Russian officials to announce this week that the nation's population will decline by at least 7.2 percent by 2016, for a loss of about 10 million people. According to a report by the Interfax news agency, Russia's population may drop from 145 million now to less than 135 million over the next 15 years. Since the fall of the Soviet Union 10 years ago, Russia has struggled with soaring rates of alcoholism, drug abuse, and infectious diseases such as tuberculosis and HIV.
Ben Plumley, an official with UNAIDS, said Thursday that Rwanda is very close to finalizing a deal for lower-priced AIDS drugs with GlaxoSmithKline, Bristol-Myers Squibb, Merck, and Boehringer Ingelheim. The prices for their antiretroviral drugs will likely be between 60 percent and 90 percent lower than those charged to the rest of the world, similar to deals already created with Senegal and Uganda, said Plumley. An initiative was created in May 2000 to develop a low-price AIDS drugs system for those countries most in need, but progress has been slow as drug companies insist on safeguards to prevent the low cost drugs from flowing back into Western countries and undercutting the higher prices there.
At a recent convention of the American Society of Hematology in San Francisco, chemists from Vitex -- a Massachusetts drug company -- presented results from the first human trials of a new blood cleansing drug. The researchers developed a drug, called Inactin, that is able to penetrate cell membranes and the protein shells of viruses to release a positively charged assault targeting the negatively charged DNA and RNA nucleus, rendering the molecule unable to function. Red blood cells do not possess a nucleus of DNA and RNA, so they remain unscathed by the Inactin attack. Scientists believe that treatment with Inactin can effectively decrease the amount of contamination from viral or bacterial pathogens at the rate of 10,000 times or more.
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.