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February 18, 2004
In This Update:
  • From the Editor
  • HIV Treatment
  • Life With HIV
  • HIV Tracking & Prevention
  • HIV Outside the U.S.
  • Web Highlights

    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, visit 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.

    - Bonnie Goldman, Editorial Director, The Body


    The Body's "Ask the Experts" Forum on Drug Resistance Reopens
    "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!

    Are 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.

    T-20 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.

    Atazanavir's 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.

    HIV 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.



    Which 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.

    AIDS-Related 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.

    Guide 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.

    A Novel Idea: Researchers Examine Effects of Treatment on Quality of Life
    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.



    New 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.

    Inborn 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.



    A 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 Lancet.



    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

    Nevirapine 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

    New 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 minorities.
    Article from The New York Times, January 31, 2004

    Rapid 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

    Sex 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

    Integrating HIV Voluntary Counseling and Testing Services Into Reproductive Health Settings (PDF)
    New international guidelines for those who plan or manage reproductive health programs.
    Resource from the International Planned Parenthood Federation and United Nations Population Fund, 2004

    Image from the February Visual AIDS Web Gallery
    Frosty, 1994; James Reich

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