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November 10, 2004

In This Update:
  • Life With HIV
  • HIV Treatment
  • HIV/HAART-Related Health Problems
  • HIV Prevention News
  • HIV-Related Legal & Policy Issues
  • HIV News Outside the United States
  •   LIFE WITH HIV

    Marathon Man (HIV Edition)
    To those of you who believe that HIV means an end to living your life to the fullest, we give you Jim Pickett, who in October completed his first Chicago Marathon in four hours, 15 minutes and 11 seconds. In this column, written just before he ran the marathon, the 38-year-old Pickett -- who was infected with HIV in 1995 -- talks about the heaven and hell (OK, mostly the hell) of marathon training.


    Woman-to-Woman Advice on Living With HIV
    If you're a woman living with HIV, don't just rely on advice geared towards men: There are plenty of HIV-positive women out there eager to share their knowledge and experience. In this article from Project Inform's Wise Words, Cathy, Linda and Dorothy offer their personal stories about coping with their HIV status, disclosure, treatment adherence and the importance of working closely with your doctor.

    Looking for more personal stories and advice from HIV-positive women? The Body is home to dozens of inspiring first-person articles and interviews.

    Want to join a U.S. support group for HIV-positive women? Start by visiting The Body's collection of articles and links, or contact the AIDS organization nearest you and ask about the types of support they have to offer for women!


    "The AIDS Eviction Capital": San Francisco's Castro District
    "Since the dot-com boom in the mid-'90s, 10,000 seniors and people with AIDS in rent-controlled apartments have been targets of real estate investors hell-bent on making big bucks in get-rich-quick schemes," write AIDS advocates Tommi Avicolli Mecca and Brian Basinger. (Web highlight from the San Francisco Bay Guardian)

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      HIV TREATMENT

    Tipranavir Safe, Effective in People With Considerable Protease Inhibitor Resistance
    In 24-week results from a major study on the experimental protease inhibitor tipranavir, the drug was found to be both safe and effective in HIV-positive people who had already developed resistance to many protease inhibitors. Mark Holodniy, M.D., reports from ICAAC 2004.

    The new tipranavir study results come right on the heels of an announcement by its maker, Boehringer Ingelheim, that it has applied for United States and European Union approval to sell and market tipranavir for use in treatment-experienced patients. The company is seeking accelerated evaluation in Europe and priority review from the U.S. Food and Drug Administration, which could result in a decision within six months.


    T-20 in Treatment-Experienced People: The Sooner, the Better
    When treatment-experienced HIVers switch to a new regimen, it may be best to add T-20 (enfuvirtide, Fuzeon) to that regimen sooner rather than later, according to the results of a new study presented at ICAAC 2004. Those who received a so-called "optimized background" regimen containing T-20 appeared more likely to keep their HIV at bay than people who added T-20 only after their optimized background regimen failed, reports Edwin DeJesus, M.D.


    Looking for the Latest Breaking HIV Research? Visit ICAAC 2004 at The Body
    In addition to the two studies summarized above, The Body's talented team of HIV physicians covered many other important studies presented at the 44th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2004), which ended on Nov. 1. To browse through our complete coverage of this conference, visit our ICAAC 2004 home page. More coverage is still coming in!


    White Doctors Delay HIV Treatment for Their Black Patients, Study Says
    White doctors start HIV treatment almost four months later for black patients than they do for white patients, a new study has shown. One of the study authors said that, despite the findings, it isn't clear that racism is actually the reason behind the disparity. (Web highlight from HealthDayNews)


    Low CD4 Count Not an Obstacle to Successful HAART -- But Detectable Viral Load Is
    Even people with a CD4 count as low as 50 can dramatically reduce their long-term risk of getting sicker if they start HAART -- provided they keep their viral load undetectable, according to new results from a large U.S. study. Of the 612 people involved in the study, all of whom experienced a CD4 count increase of at least 100 after starting HAART, only five people died from causes directly related to HIV, and only 33 developed a new AIDS-defining illness. People with detectable viral loads were more likely to develop an AIDS-defining illness than people with undetectable viral loads. Unexpectedly, the researchers found that many of the people who developed AIDS-defining illnesses did so when their CD4 counts were over 200, leading them to warn that HIVers and their doctors should always be on the lookout for signs of health problems. (Web highlight from aidsmap.com)


    Exploring the World of HIV Drug Resistance
    Earlier this year, clinicians and researchers gathered in the Canary Islands to review the most up-to-date research available regarding HIV drug resistance. A considerable amount of new information was presented -- including humbling news about an unsuccessful HAART regimen of didanosine (ddI, Videx), efavirenz (Sustiva, Stocrin) and tenofovir (Viread). Mark Mascolini provides this captivating summary of the XIII International HIV Drug Resistance Workshop.


    Johns Hopkins Launches Online Guide to HIV Clinical Care
    Johns Hopkins University has launched the Johns Hopkins HIV Guide, an online resource intended to serve as a reference to healthcare providers involved in the care of people with HIV. Free registration is required to access the guide, which will be kept up-to-date by several dozen U.S. experts in HIV treatment and care. (Web highlight from Johns Hopkins University)

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      HIV/HAART-RELATED HEALTH PROBLEMS

    Sculptra's Not the Only Facial Wasting Treatment Available -- If You've Got the Cash
    Although Matt Sharp considered using poly-L-lactic acid (Sculptra, New-Fill) to treat his severe facial wasting, he was intrigued by another product known as Bio-Alcamid, a permanent (and expensive) filler that has not been approved in the United States, although it is available in Europe and Mexico. In this article, Matt recounts his trip to Tijuana to receive the treatment, and marvels over its success.


    Treatment Options for Peripheral Neuropathy
    Peripheral neuropathy isn't just the "throbbing, tingling or aching" in the extremities that medical literature says it is. "It is like frostbite," says Carlos A. Perez, who lived with neuropathy for three years. "It's like walking slowly over hot coals." Thankfully, Carlos explains, there are several different treatments available for neuropathy, from pills to physical therapy to -- dare we say it? -- marijuana.

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      FUZEON CHAT TRANSCRIPTS

    Looking for Transcripts of Our Live Fuzeon Chats?

    The Body moderated two chats on Fuzeon (T-20, enfuvirtide) this year -- one in June and another in October. Both featured live question-and-answer sessions with a nurse experienced with Fuzeon and an HIV-positive person currently taking Fuzeon as part of his HAART regimen. Want to see what they had to say? Read the full transcripts here:

    These chats were sponsored by Trimeris and Roche, the makers of Fuzeon.

      HIV-RELATED LEGAL & POLICY ISSUES

    Lasik Doctor Accused of Discriminating Against HIV-Positive People
    The Lasik Vision Institute and its Glendale, Colo.-based doctor Paul Cutarelli refused to perform eye surgery on two HIV-positive customers, according to a complaint filed by the Legal Center for People With Disabilities. Under the Americans with Disabilities Act, Cutarelli should have conducted the procedure for the man unless there was a medical reason not to do so, the Legal Center says.


    Pennsylvania: Nurse Asks Judge to Order Patient to Take HIV Test
    In a case that highlights the controversy over where a person's right to privacy begins and where the public's right to health and safety end, a registered nurse has asked a Pittsburgh court to order a male hospital patient to undergo an HIV test. The nurse accidentally stuck herself with a needle she used to administer the man's insulin. The court petition states that the unnamed male patient is infected with hepatitis C and used drugs, placing him at high risk of having HIV as well.


    Bush's Re-Election Elicits Negative Reactions Worldwide; AIDS Issues Raise Concerns
    U.S. President George W. Bush's re-election last week has "produced a sense of gloom and foreboding" throughout the world, including mixed reactions to how he has addressed the HIV pandemic, the Chicago Tribune reports. Despite the president's five-year, $15 billion global AIDS initiative, many South Africans reportedly "bemoaned a black day for the world," and especially for Africa, according to the South African newspaper Mail & Guardian.

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      HIV PREVENTION NEWS

    University Residence Supervisor Fired for Dispensing Condoms
    King's University College in Alberta, Canada, has fired third-year student Daniel Grace as residence supervisor because he would not agree to stop providing condoms to students. The university, though a public school, operates on Catholic principles. "I'm a Catholic myself, but the reality is, if condoms aren't available, students will have sex anyway and risk getting pregnant, risk getting sexually transmitted disease[s], risk getting HIV," Grace said. "This is a health and safety issue, not an attack on the church. Catholic bishops in Africa hand out condoms to fight AIDS."

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      HIV NEWS OUTSIDE THE UNITED STATES

    Could HIV Protease Inhibitors Fight Malaria?
    HIV and malaria are two of the world's deadliest diseases; both are ending lives by the millions throughout much of the developing world, particularly sub-Saharan Africa. Now researchers say they've discovered signs that protease inhibitors used in HIV treatment may also harm the parasite that causes most types of malaria -- raising the possibility that a way could eventually be found to kill two bugs with one stone. (Web highlight from Medical News Today)


    Many South Africans Reluctant to Begin HIV Treatment
    It took years of fighting to set up an HIV treatment program in South Africa. But now that one is finally being put in place, a new obstacle has appeared: Free or not, many people don't even want to take the meds. (Web highlight from the United Nations Integrated Regional Information Networks)


    CDC Director Discusses HIV Care Priorities in Developing World
    There are two key ingredients to ensuring a successful fight against HIV in developing countries: a sufficient number of HIV healthcare professionals and a person-by-person approach to HIV care, writes Julie Gerberding, the director of the U.S. Centers for Disease Control and Prevention. Her article appears in the inaugural issue of PLoS Medicine, a free international medical journal that provides easy-to-follow summaries of each of its studies. (Web highlight from PLoS Medicine)

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    ART FROM HIV-POSITIVE ARTISTS
    Image from the November 2004 Visual AIDS Web Gallery
    "The Movement," 1994;
    Tara Popick
    Visit the November 2004 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists.