News and Notes

| AIDS Deaths Decline | Triple Cocktail Effective | Protease Inhibitors for Kids
| Amino Acids Effective? | Causes of Dementia Probed | Treatment Info on The Web |

AIDS Deaths Decline For First Time in Over 16 Years

On February 27, officials at the Centers for Disease Control and Prevention (CDC) made the by-now famous announcement that, for the first time since the epidemic began in 1981, AIDS deaths declined substantially during the first half of 1996 -- by 12% nationwide compared with the previous year. The CDC reported that new AIDS cases dropped by 6% over the same period. These favorable figures were attributed to effective drug combinations, better access to care, improved financing of AIDS treatments and better prevention efforts.

"This is all certainly good news," said Dr. Anthony Fauci of the National Institutes of Health. "But no one should figure the worst is over and that the epidemic is ending, because the easiest way to make the epidemic far worse is to assume there's no more danger." But the news isn't all good. Death rates varied along ethnic, regional, and gender lines. Deaths were down 21% among whites, 10% among Latinos, and only 2% among Blacks. In the West, deaths dipped 16%; in the Northeast, 15%; 11% in the Midwest; and 8% in the South. Deaths from AIDS among women actually rose by 3%. While the overall decline in the death rate is welcome news, it is important to realize that 22,000 people still died from AIDS during the first half of last year -- as many as died in the first five years of the epidemic. The CDC's announcement follows by a month that of New York City, which in January reported a 30% drop in AIDS deaths.

Fed Study Finds Triple Drug Cocktail Effective

Good news continues to roll in. In late February, federal researchers stopped one of the largest AIDS studies ever mounted when midpoint analysis showed that triple-drug therapyinvolving protease inhibitors halved the rate of death and illness compared with a two-drug regimen. The $5 million study, conducted by the National Institute of Allergy and Infectious Diseases and involving nearly 1,200 patients, is the first to demonstrate a definite medical benefit from three-drug cocktails that include a protease inhibitor. The trial was stopped midway by a watchdog committee which found the data among the three-drug group to be so good that to continue the trial would be unethical. Earlier studies of triple-drug combos have shown decreases in the viral load, but this is the first to show clear-cut results in terms of health and reduced mortality.

FDA Rules That Protease Inhibitors Are for Kids

Despite the lack of conclusive studies about their effectiveness in children, the first protease inhibitors for use by kids were approved under an emergency policy by the Food and Drug Administration (FDA) on March 14. Two members of the new class of HIV-fighting drugs are now available to youngsters: nelfinavir, sold by Agouron Pharmaceuticals under the brand name Viracept; and Abbott Laboratories' ritonavir, which has the brand name Norvir. Nefinavir was the first protease inhibitor to be approved by the FDA simultaneously for both children and adults. Abbott Laboratories submitted dose and safety data from a trial of 51 children in January to receive the expanded labeling. Since FDA approval of drugs for adults means it is also legal for doctors to prescribe them to kids, many HIV-positive children are already being treated with protease inhibitors -- as many as one-third of the children treated at major medical centers, says Dr. Paul A. Krogstad, a pediatrician specializing in childhood AIDS cases at the University of California at Los Angeles. About 10,000 of the nation's approximately 500,000 AIDS cases have been among children and teenagers; almost half of these are still living and thus in need of the most effective medications available.

Geneticist Couple Claims Amino Acid May Improve Survival

Scientists at Stanford University have found that high levels of a common amino acid found in every cell of the human body can dramatically improve survival for people whose immune systems are damaged by HIV. A 204-subject study led by Lenore and Leonard Herzenberg, a husband-and-wife team of geneticists, found that 80% of those patients who maintained normal levels of the amino acid glutathione survived during the three-year-long study despite immune systems that were dangerously depleted. Most study participants whose glutathione levels were abnormally low died during the trial, even though their immune systems were not as damaged. Glutathione plays an essential role in cell division, fighting infection and preventing damage to the body caused by oxidation. The Herzenbergs reported their findings at the February meeting of the American Association of Immunologists, held in San Francisco. They also reported on a small study showing that the related compound N-acetylcisteine, or NAC, successfully increases the amount of glutathione in HIV-infected people. NAC is widely available in Europe to treat bronchitis; in the United States, it is used to treat overdoses of acetaminophen, the pain-relieving drug widely sold as Tylenol. The Herzenbergs have been studying the effects of NAC on HIV disease since 1989.

Mysteries of AIDS Dementia Penetrated by San Francisco Researchers

A San Francisco research team has discovered that certain types of blood cells that often harbor particles of HIV -- the roaming scavenger cells known as macrophages -- can actually cause neurons in the brain to self-destruct, possibly causing AIDS dementia complex. While studying the properties of certain types of macrophages, the researchers found that even when HIV was removed from them, their virus-free fluid still contained molecular "factors" that apparently caused genes within the brain's neurons to begin the process of "apoptosis," a kind of mass cell suicide.

The researchers believe that if increased numbers of macrophages are a signal that the relatively slow process of apoptosis is starting, then regular blood tests could be a useful diagnostic tool for detecting dementia long before its devastating effects take hold. Led by Dr. Lynn Pulliam, chief of microbiology at the Veterans Affairs Medical Center in San Francisco, the team has been studying a variety of neurological diseases for years; its findings on AIDS dementia were published in the journal The Lancet in March. AIDS dementia complex affects about one-third of HIV-infected adults and one-half of children with AIDS. There is no approved treatment for the condition, but new antiviral combinations may help slow development of dementia by lowering viral burdens.

Searching for HIV Treatment Info? Try Surfing The Net

The latest information on HIV treatment research, furnished and kept up-to-date by the nation's leading AIDS researchers, has now hit the net. On March 13, AIDS specialists at the University of California San Francisco launched a website -- http://hivinsite.ucsf.edu -- containing research and treatment topics edited and updated by scientists, physicians, and other AIDS workers. "Reliable, timely information is essential to developing effective responses to the HIV epidemic," said Dr. Paul Volberding, director of the AIDS program at San Francisco General Hospital and a leading AIDS expert. Dr. Volberding said the site's primary audience will be professionals in the medical, behavioral, and social fields, but added "we know that patients will be looking at this as well." Among the site's features are sections on medical information, prevention, education, and social issues, including a state-by-state list of AIDS-related resources and research projects. But unlike many other HIV-specific sites, the UCSF site does not have chat rooms. According to Nicole Mandel, the site's managing editor, seven full-time staff members will contact 500 research programs once a month to keep the content current. According to Mandel, the site is already generating fan mail.

Back to the May 97 Issue of Body Positive Magazine.