HIV/AIDS Newsroom: November 16, 2000
Roche Calls for Potency Guidelines to Help HIV Drug Prescribing
11/04/00; Vol. 356, No. 9241, P. 1581; Jack, David
Hoffmann-La Roche has asked other pharmaceutical companies to agree on a standard method to assess drug potency in vitro. Roche's proposal for makers of protease inhibitors (PIs) was sparked by confusion among doctors over the relative potencies of the drugs. Roche has invited the other drug firms to participate in an initial "Standardization Forum" before April 2001, to help establish some guidelines. In the past year, PIs have gone through many changes -- such as "boosting" their action with ritonavir -- that have forced some firms to re-evaluate the predicted potency of the drugs in in vitro models. Julio Montaner of the British Columbia Center for Excellence in HIV/AIDS says he supports Roche's move, noting that "at present, there is no doubt that the potency data . . . is very confusing and not in the interests of those living with HIV."
The U.S. Food and Drug Administration (FDA) has approved a combination drug for the treatment of HIV, but the agency has warned that about 5 percent of patients trying the pill could undergo a severe, possibly fatal if untreated, allergic reaction. Called Trizivir, Glaxo Wellcome's combination of AZT, 3TC, and Ziagen (abacavir) reduces the number of pills needed in an HIV regimen from four to two. Trizivir will reach the market in December, according to Glaxo, at a price of $26.60 per day. The FDA's warning stems from the fact that about 5 percent of people taking Ziagen experience serious allergic reactions, so patients trying the new drug combination also have that same risk.
Younger Kids Trying It Now, Often Ignorant of Disease Risks
USA Today (www.usatoday.com)
11/16/00; P. 1D; Peterson, Karen S.
A growing number of young teenagers are engaging in oral sex, many of whom have never had sexual intercourse and say they believe in abstinence. However, these teens' belief that oral sex "is not really sex" could put them at risk for sexually transmitted diseases, which can be contracted through the act. An upcoming study on teen sexuality from the Alan Guttmacher Institute features scattered, anecdotal evidence from healthcare providers about increases in oral herpes and gonorrhea in the pharynx of young people. Also, a recent online sex survey from Twist magazine -- including more than 10,000 female respondents, 5,700 of whom were 14 or younger -- found that while 80 percent of the girls said they were virgins, 25 percent reported having had oral sex. Robert Blum, head of the division of general pediatrics and adolescent health at the University of Minnesota-Twin Cities, suggests that part of the problem "is that we define sexual behavior in a very narrow way. And we talk about abstinence, but we are never clear what we are abstaining from." Other factors that may be contributing to an increase in young people having oral sex include early maturation, the media, the belief that oral sex is without threat of disease, and the fact that it provides instant gratification.
A new report indicates that a small variation in the RANTES gene seems to increase susceptibility to HIV, although it slows progression to AIDS after infection. The researchers, led by Dr. David H. McDermott from the National Institute of Allergy and Infectious Diseases, investigated changes known as single nucleotide polymorphisms (SNPs) in RANTES among HIV-infected and HIV-resistant individuals. The authors found that one SNP showed up more frequently in HIV-positive than HIV-resistant participants, a change which boosted RANTES' activity and was linked to a much greater risk of infection. However, according to the report in the online edition of the journal AIDS (2000;14:2671-2678), the subjects with this particular SNP who contracted HIV took about 40 percent longer to progress to AIDS -- possibly because the SNP may stimulate overproduction of the RANTES immune system molecule, which then causes an inflammatory response that increases the space between cells and facilitates HIV's entry.
A New Hampshire man who is infected with HIV has filed a human rights complaint after a doctor refused to conduct a bladder examination on him at the physician's office. According to the complaint filed with the New Hampshire Commission for Human Rights, even though the man was already at the office and had disrobed, the doctor said he would not perform the exam because he was concerned about his office's sterilization procedures and the possible risk of infection for future patients. The doctor then offered to perform the exam at a hospital, which he said could better sterilize the equipment.
Thousands of inmates in New York state prisons are being given priority for flu shots because they have conditions, such as HIV or tuberculosis, that could result in serious complications if they contract influenza. New York's AARP has said it will not object if residents of nursing homes are also among the first recipients of the vaccine. According to prison officials, any remaining doses of the hard-to-obtain vaccine will be given to the state health department.
A new study in the American Journal of Epidemiology (2000;152:913-922) suggests that when HIV seroprevalence drops, the protective effect of the small subnetworks of seronegative individuals who may help limit infectious outbreaks and prevent saturation could be weakened. Researchers from the National Development and Research Institutes in New York studied 767 injection drug users between 1991 and 1993, and the participants supplied the names of up to 10 people with whom they had injected drugs or had sex with in the past month. The study revealed a large connected component with 230 members, 45 percent of whom were infected with HIV; 91 smaller components with 228 members; and 309 individuals unrelated to the others. Based on their findings, the authors theorize that primary infection outbreaks were limited to the connected subcomponents of seronegatives, and they compared the protective effect of the small groups of seronegative individuals to a sociostructural kind of herd immunity.
On December 1, World AIDS Day, singer Ricky Martin will host an MTV documentary about AIDS, describing the experiences of six AIDS patients around the world. An MTV poll last year found that over one-quarter of viewers in 11 nations knew nothing about HIV and 10 percent said they were not concerned about AIDS because they thought there was a cure. Martin said he hopes the "Staying Alive" broadcast, which has a potential audience of almost 330 million households, will increase global awareness about AIDS and encourage people to practice safe sex.
Health officials in Scotland have launched a 3 million pound program to reduce teen pregnancy in the country. Health Minister Susan Deacon said the project aims to reduce pregnancies by 20 percent for 13- to 15-year-olds. Deacon also noted that cases of chlamydia have soared in the past five years, but many young people said they were not aware of the sexually transmitted disease (STD). The Healthy Respect program will involve 12 separate projects throughout Lothian, including a sexual health training program for parents. Another project will try to reduce STDs among homosexual or bisexual individuals. Pro-life groups oppose the new program, but Deacon defended its value at Newbattle High School, noting that "if we provide young people with a space in which they can discuss relationships than they are more likely to delay embarking on sexual relationships."
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.