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July 23, 2003

More Highlights From IAS 2003

The year's largest AIDS conference has ended, but the world of HIV medicine has only begun to take in all the research presented there. Here are some more of the top stories from the 2nd International AIDS Society Conference on HIV Pathogenesis and Treatment:

    Trizivir-Only Regimens Should Be Avoided as First-Line Therapy
    There may remain a small number of people for whom a triple nucleoside (NRTI) regimen like Trizivir (AZT + 3TC + abacavir) is appropriate, Brian Boyle, M.D., reports. But given the regimen's high failure rate when compared to the efavirenz (Sustiva)-containing arms of the major ACTG 5095 study, he says, doctors should think long and hard before using Trizivir or any other triple-NRTI combination alone.

    Efavirenz or Nevirapine: Which Is Better?
    In a comparison of efavirenz and nevirapine (Viramune)-containing regimens, researchers found that both are effective and well tolerated. Generally speaking, they are equally potent for the first year. After that? There's data showing that efavirenz remains potent; such long-term research hasn't yet been done on nevirapine. Andrew T. Pavia, M.D., reports.

    Is There Still Hope for Treatment Interruptions?
    Gerald Pierone, Jr., M.D., provides thorough explanations of the pros and cons of structured treatment interruptions in his summary of a debate between experts at the conference.

    Tenofovir and d4T Go Head to Head
    Cal Cohen, M.D., reports on the most recent results from the pivotal trial of tenofovir (Viread) + 3TC (lamviudine, Epivir) + efavirenz vs. d4T (stavudine, Zerit) + 3TC + efavirenz. He writes: "The tenofovir arm has been influential in establishing an attractive outcome not just for response rates, but for safety as well, since the tenofovir arm had few side effects, and a notably low rate of lipodystrophy, as seen at week 96."

    Should Haart Regimens Be Changed Before Heart Problems Develop?
    Gerald Pierone, Jr., M.D., reports on a debate between HIV experts over the extent to which treatment regimens should be altered because of the risk of heart problems. "Based on the metabolic changes we are seeing now," he writes, "we justifiably can predict higher rates of vascular complications in the future. This means that prevention efforts, as well as strategies for early diagnosis and treatment, should be put into place now."

    Drug-Resistant HIV Spreads Through Europe
    Nearly one out of every 10 Europeans newly infected with HIV has a drug-resistant strain of the virus, according to results of a large study.

    Avoid Mother-Child HIV Transmission by Treating the Baby, Instead of the Mom?
    Giving breastfeeding infants a daily dose of antiretroviral therapy could significantly lower their risk of contracting HIV from their HIV-positive mothers through breast milk.

    The Body's IAS 2003 page is the place to be for full highlights of the conference, including links to Webcasts and audio/video straight from Paris!

How I Learned to Stop Worrying and Love the HAART

For four years, Jennifer McGaugh avoided starting her HIV treatment. Whenever her CD4 count dropped below her personal "too low" line, she'd just lower the line further. Then a pair of epiphanies helped her realize that she didn't need to be afraid of starting HAART.

Older Men Who Have Sex With Men: A Very High-Risk Group

Data from a recent study suggest that the HIV epidemic among older men who have sex with men (MSM) -- those who are 50 years and older -- is at a very high level: 13 percent. The highest prevalence rates were found among older black MSM (30 percent) and moderate drug users (35 percent).

T-20 Supply Will Be Greater Than First Thought

The supply of T-20 (enfuvirtide, Fuzeon) is expected to be 50 percent greater by the end of this year than the drug's manufacturer, Roche, originally expected.

You (And Your Meds) Are What You Eat

How much you eat can sometimes be crucial to the amount of medication that stays in your body. For example, the amount of nelfinavir (Viracept) that stays in the body is three to five times greater when it's taken with a meal than when it's not. Pharmacist Patrick Clay Click has more.

Hepatitis C and Smoking, Alcohol Don't Mix

As if you needed another reason to cut down on the Marlboros and tequila shots: A study last year found that people with hepatitis C should avoid smoking cigarettes and drinking alcohol because both habits can further damage their livers.

AIDS Diagnoses Rapidly Increasing in Washington, D.C.

According to updated 2001 data, Washington, D.C. has a higher AIDS incidence rate than Baltimore, San Francisco and New York, according to research findings scheduled to be presented on July 28 at the National HIV Prevention Conference in Atlanta.

U.S. Will Help Pay for Generic Drugs Overseas

The United States plans to purchase low-cost generic antiretroviral drugs as part of President George W. Bush's $15 billion global AIDS initiative, U.S. officials have announced.

The Changes an HIV Diagnosis Brings

"My granny used to say, 'The only thing that's constant is change.' I never understood that statement until I became an adult. It became even clearer after learning I was infected with HIV." Deneen Robinson, an African-American woman and an HIV educator, has been living with HIV for 11 years.

AIDS-Related Cancer Overview

Although there's been a dramatic drop over the past few years in the number of HIVers who develop cancer, it's still a concern for many people with HIV. Dr. Jeffrey Schouten talks about the latest research on some of the most common AIDS-related cancers, including Kaposi's sarcoma and lymphoma.

Web Highlights

A Selection of the Top HIV/AIDS Stories From Across the Internet:

Prevalence of Unsafe Sexual Behavior Among HIV-Infected Individuals: The Swiss HIV Cohort Study
HIV-positive people with undetectable viral loads are no more likely to have unsafe sex than other people with HIV, the study finds
From Journal of Acquired Immune Deficiency Syndromes (August 1, 2003)

A Desperate Global Scavenger Hunt to Keep AIDS Patients Alive
Thousands of HIVers in the developing world now get drugs through programs that recycle them, through informal physician networks that donate unused drugs or through the black market
From The New York Times (free registration required) (July 22, 2003)

Women Have Larger Increase in CD4 Cell Count After Six Months of HAART
Women's immune systems appear to react more strongly to HAART than men's, at least at first
From (July 22, 2003)

So Many Questions with Zackie Achmat
The renowned South African treatment activist talks about the government report his organization recently leaked; the report said that if HIV drugs were offered to all South Africans who needed it, it could save more than 1.7 million lives by 2010
From Sunday Times, Johannesburg (July 20, 2003)

Formula Feed Is "Medicine to Prevent HIV"
Researchers recommend that formula feeding for babies of HIV-positive women in developing counties be treated as though the formula is a medicine -- which means it should be supplied continuously and adequately paid for by the government
From (July 18, 2003)

Kaletra: Could Upping the Dose Overcome Resistance?
A 67 percent increase in the lopinavir/ritonavir dose was found to be far more effective than increasing only the ritonavir
From (July 18, 2003)

Advancing HIV Prevention: New CDC Strategies for a Changing Epidemic
An analysis of the new HIV prevention and testing strategy launched by the U.S. Centers for Disease Control
From PRN Notebook (June 2003)

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