Coverage is coming in daily from the U.S.'s most important AIDS
conference of the year, the 11th
Conference on Retroviruses and Opportunistic Infections (CROI
2004) which ended last week. For the latest research on HIV treatment
options, side effects and other issues related to HIV infection,
our conference home page or browse through some of the highlights
presented in our weekly update below.
We hope you find this week's update useful! As always, please write
if you have any thoughts or questions.
Goldman, Editorial Director, The Body
Body's "Ask the Experts" Forum on Drug
"Resistance" is one word that someone taking HIV treatment
doesn't want to hear from his or her doctor. Resistance to one drug
can also mean resistance to other drugs, limiting the number of
treatment options. The Body has chosen one of the experts in the
field, Renslow Sherer, M.D., to host our "Ask the Experts"
forum on drug resistance. He's now available to answer your questions!
There Benefits to Starting HAART When HIV Infection Is New?
It is still unclear what benefit there is to starting HIV treatment
during the acute infection stage, which takes place from one to
three months after a person has contracted the virus. Little benefit
to the strategy was found in this follow-up to a well-known study
by Dr. Bruce Walker. Cal Cohen, M.D., reports from CROI.
and Metabolic Disorders: No Relationship Found
How does T-20 (enfuvirtide, Fuzeon) stack up in terms of causing
body fat abnormalities? A recent study showed no evidence that it
contributes to the metabolic disturbances that complicate the treatment
of HIV, reports Cal Cohen, M.D., from CROI.
Effectiveness Continues to Impress Doctors
Most healthcare professionals were surprised when boosted atazanavir
(Reyataz) showed similar potency to lopinavir/ritonavir (Kaletra)
after 24 weeks in a study. The newly presented 48-week data confirm
these findings, as well as findings that atazanavir use causes fewer
gastrointestinal problems and lipid disturbances than lopinavir/ritonavir
does. Cal Cohen, M.D., reports from CROI.
Treatment Overview: Advancing in Leaps and Bounds
As we've seen in both the flood of new drug approvals in 2003 and
in the research presented at conferences like CROI 2004, the development
of new treatments for HIV is still heating up. What are the priorities
of HIV treatment researchers, and where does the short-term future
of treatment lie? Dr. Daniel S. Berger provides a review.
HIV Symptoms Do You Most Urgently Need to Tell Your Doctor About?
Some people think every symptom they have is a medical emergency.
Other people will wait until they're practically immobile before
they call a doctor. Here's a handy guide from a physician listing
the top nine reasons you should immediately call your doctor.
Illnesses Now Less Common Than Other Problems in HIVers
It's a historic
change that began with the introduction of protease inhibitors:
The dramatic drop in overall death rate and deaths due to AIDS-related
causes in the U.S. However, death due to non-opportunistic infections
has increased."If someone takes [antiretrovirals], they will
live longer and when death occurs, it will not be due to
an AIDS-related condition," said Dr. Frank Palella, the author
of a large study presented at CROI. Corklin Steinhart, M.D., reports.
to the Safe Use of Vitamins and Supplements
Although HIV-positive people are often recommended to take vitamins
and supplements, some supplements have been shown to have negative
effects. St. John's wort, for instance, can interfere with birth
control drugs or some HIV medications. Ginseng can increase the
stimulant effects of caffeine as well as lower blood sugar levels.
Here's a helpful guide from the National Center for Complementary
and Alternative Medicine at the National Institutes of Health.
Novel Idea: Researchers Examine Effects of Treatment on Quality
What impact do various HIV treatments have on a person's emotional
and social well-being? Few clinical studies take this important
question into account. However, the inclusion of quality-of-life
evaluations in many studies is now increasing. Corklin Steinhart,
M.D., reports from CROI.
TRACKING & PREVENTION
HIV Testing Program Can Pinpoint Outbreaks as They Happen
A unique HIV testing program in North Carolina screens high-risk
people to detect those who are still in the process of seroconverting,
before a standard HIV test will come out positive. This new program,
which recently discovered an increase in HIV infections among black
college men in North Carolina, can give experts the ability to spot
HIV outbreaks as they occur, mapping out so-called "sexual
networks" of HIV infection. This could potentially allow experts
to prevent further HIV transmission at a time when the risk of infection
is highest. Keith Henry, M.D., reports from CROI.
Resistance to HIV Infection: Where Does It Come From?
How is it that some people seem to be naturally resistant to HIV?
A genetic variation in the CCR5 receptors of some people's immune
cells makes HIV unable to latch on and infect them. Some experts
have suggested that this mutation was caused 800 years ago by selective
pressure from the Black Plague. However, a study published in this
week's issue of Nature says this theory may be unfounded.
OUTSIDE THE U.S.
New Precedent for Access to Cheaper HIV Meds
Thai AIDS advocacy groups' successful lawsuit against drug maker
Bristol-Myers Squibb (BMS), in which BMS was forced to return the
patent for its antiretroviral drug didanosine to Thailand, has "set
an important precedent that essential drugs are not just another
consumer product but a human right, and that patients are injured
by patents," members of Doctors Without Borders write in the
Mortality Rates Low When HIV Therapy Begins Early
"Early" in this study meant starting HAART with a CD4
count above 200. The death rates of people who began treatment with
a CD4 count at that level were comparable with the death rates of
people with other chronic diseases.
Article from Reuters Health, February 17, 2004
Should Not Be Used for PEP, Confirms U.S. Review
In a finding that could impact post-exposure prophylaxis guidelines,
a new study finds that nevirapine holds a higher risk of severe
side effects, including liver toxicity and severe skin reactions,
in HIV-negative people.
Article from aidsmap.com, February 2, 2004
Yorkers Can't Beat Death, but Data Says They're Gaining
2002 saw fewer deaths in New York City than any year in the past
century, but AIDS remains a major cause of death, especially among
Article from The New York Times, January 31, 2004
HIV-1 Antibody Testing During Labor and Delivery for Women of Unknown
HIV Status: A Practical Guide and Model Protocol
New guidelines for healthcare professionals on the use of rapid
HIV tests for pregnant women in the U.S.
Resource from the U.S. Centers for Disease Control & Prevention,
January 30, 2004
Education in America
A new multimedia project examines Americans' views about sex education
in U.S. public schools. It includes various survey results and a
series of news reports available in audio.
Project from National Public Radio, the Kaiser Family Foundation
and Harvard University's Kennedy School, January 29, 2004
HIV Voluntary Counseling and Testing Services Into Reproductive
Health Settings (PDF)
New international guidelines for those who plan or manage reproductive
Resource from the International Planned Parenthood Federation and
United Nations Population Fund, 2004
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