4th International Conference on Drug Therapy in HIV Infection

07-November-98

Three key speakers opened the conference, each giving their reports on recent developments in HIV. Dr. Douglas Richman (University of California, San Diego, USA) presented an overview of the status of antiviral therapy today. Dr. Richman felt the faster you treat an individual who has the AIDS virus the sooner the virus will be suppressed to below detectable levels. He also indicated that if a patient's viral load is below the limit of detection (below 50 copies per ml), it does not mean that the virus is absent from the body.

30.6 Million Cases

Dr. Kevin De Cock (Director of the Division of HIV-AIDS Prevention for the CDC) presented material concerning public health issues. Dr. De Cock reported that according to 1997 studies, the highest rate of newly infected persons with AIDS was in the metropolitan group of young African American women. He felt this rise was largely due to inadequate education on transmission of the virus. North American HIV/AIDS cases have now risen to at least 850,000. While this number may be alarming to many, it is only a fraction of the 30.6 million cases world wide. Sub Saharan Africa leads the world in HIV/AIDS with 20.8 million people infected.

Alert!

Glaxo Wellcome representative, Ben Plumley, informed me today that a second death has been attributed to abacavir. This death occurred in a patient from France who re-started abacavir following the development of the typical hypersensitivity reaction. It was reported to me that this patient did so on his own without consulting his physician. Mr. Plumley asked me to convey the message that patients should NOT restart abacavir once it has been discontinued because of the hypersensitivity reaction.

IL2

Immune Therapy led the morning discussions with a presentation from Dr. D. Cooper (Sydney, Australia) who spoke on the benefits of Interleukin 2 (IL2). Dr. Cooper presented information from a study of 120 patients who received intravenous IL2 and who had significant increases in their CD4 counts as a result of this therapy.

The importance of increases in CD4 counts was emphasized by Dr. Autran (Paris, France), who presented information on failure to comply with HAART (Highly Active Antiretroviral Therapy) which could lead to decreased levels of CD4's and thus place patients at risk for severe infections and possible early death.

Remune

Dr. F. Gotch (London, UK) gave an interesting presentation on her new trial that is in its 16th week of study. This study is designed to evaluate 4 different groups of HIV+ patients. Each group is comprised of 10 patients. One group is on HAART alone. The second group is receiving HAART and IL2. The third group is receiving HAART and the Remune vaccine and the final group is receiving HAART, IL2 and the Remune vaccine. This study will prove to be of great interest to the medical community, as it will hopefully demonstrate that increases in CD4 counts, in combination with a therapeutic vaccine may be of significant benefit. Dr. Gotch is hopeful for the development of the AIDS vaccine in light of the 300 billion dollar cost to treat the world's HIV+ population.

1,500 New Cases Daily

Following lunch, the community of activists met in a forum that seemed to be monopolized by the presentation given from Peter Busse who is representing the South African AIDS community. Busse's depiction of life for those people who are HIV+ in his country is very dismal. The Minister of Health for South Africa has mandated that there would be no governmental funding for perinatal use of AZT. Sixteen to 18% of the pregnant women in South Africa are HIV+. As previously reported, this country is leading the AIDS epidemic with 1,500 new cases daily. Mr. Busse is presently a participant in Boehringer trials program for nevirapine in South Africa. He will be discontinued from this program in February of 1999 leaving him with the likelihood that he will be without any treatment whatsoever, as no new trials are planned, nor is an expanded access program. This reporter encouraged Mr. Busse to plead with Boehringer to allow him to continue on treatment.

The Whole World Is Watching

Once again the plight of South Africa was discussed in a forum given by Dr. G. Gray (Bertsham, South Africa). She presented data showing that 60,000 children are dying annually of the AIDS virus and that 1,000 children are infected daily. Dr. Gray was extremely concerned about the recent governmental decision to discontinue the treatment of AZT to prevent maternal-fetal transmission. Glaxo Wellcome has been rumored to have offered the South African government free AZT for 3 years but this good will gesture has been declined. Several audience members asked Dr. Gray how the rest of the world can assist with the South African plight. She replied that the rest of the world should make the government of South Africa aware that the "Whole World Is Watching Them," and their refusal to treat with AZT is "Immoral."

The session ended with a moment of silence requested by E. Mbiddle (Kampala, Uganda) for those who lost their lives to AIDS. In a very solemn voice he emotionally uttered the simple words: "May their souls rest in peace."