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March 2, 2005

In This Update:
  • Breaking HIV Research From CROI 2005
  • Multi-Drug Resistance Update
  • HIV Treatment
  • Chat Transcript on Rescue Therapy
  • Living With HIV
  • HIV-Related Health Problems
  • HIV Pathogenesis (How HIV Works)
  • HIV Prevention News
  • HIV/AIDS Outside the U.S.

    Much of this week's newsletter features our expert coverage of the 12th Conference on Retroviruses and Opportunistic Infections (CROI 2005), the most important annual gathering of HIV researchers in the United States. Nearly a thousand studies were presented at this year's conference, which ended on Feb. 25 in Boston. The conference spanned a huge range of topics, from new antiretrovirals to drug resistance, from issues in the developing world to issues for pregnant women, from starting treatment to dealing with side effects ... the list goes on and on.

    Our team of talented writers, all of whom are HIV physicians themselves, have covered some of the most intriguing studies at this year's conference. Much of our planned coverage is already live, but many more articles -- including informative overviews of new drugs and treatment strategies -- will arrive in the days to come!

    Best regards,

    Bonnie Goldman
    Editorial Director, The Body



    World's Top HIV Researchers Ponder Implications of New York City Case
    The New York City Health Department's announcement three weeks ago about the case of a man who had acquired multi-drug resistant HIV and his subsequent rapid disease progression triggered many dramatic reactions. One of the most dramatic may have been the hastily organized special session called at CROI 2005. David Wohl, M.D., provides the details in this outstanding recap.

    For much more on this quickly changing story, read through The Body's collection of news recaps, press releases and often-emotional reactions.

    Debate Reignites Over Impact of Crystal Meth on Immune System, HIV Risk
    The fact that the New York City man diagnosed with multi-drug resistant HIV often had unprotected sex after taking crystal methamphetamine has brought new attention to the growing epidemic of meth use, particularly among gay men. Crystal meth's effect on sexual behavior clearly puts its users at risk for HIV, but its effect on the immune system and HIV's progression is still unclear. Lab and animal studies show that meth suppresses killer T cells. That, combined with the drug's propensity to dry out mucous membranes, could cause abrasions in the rectum and mouth which would slightly increase a person's vulnerability to the virus, says Dr. Antonio Urbina, the lead author of a study on crystal meth and HIV published last year in the medical journal Clinical Infectious Diseases.



    HAART Lowers Risk of Illness and Death, Regardless of Regimen
    No matter how low a person's CD4 count is or how high their viral load is when they start treatment, HAART works, according to the massive EuroSIDA study. The study looked at a wide range of HAART regimens and found that all of them
    similarly reduced HIVers' risk of illness and death. Cal Cohen, M.D., reports from CROI 2005.

    HAART Usually Works the Same in Women and Men
    Two studies presented at CROI 2005 found few differences in how well HAART works in HIV-positive U.S. women compared to men. Access to HIV care was also similar for women and men, although women tended to have higher CD4 counts when they started receiving HIV care, and HIV-positive women were more likely to be hospitalized than HIV-positive men. Lisa Hirschhorn, M.D., reports.

    Switching From Abacavir + 3TC to Epzicom Appears Safe, Effective
    The new once-a-day pill known as Epzicom (abacavir/3TC, Kivexa) has been proven to work well in clinical trials -- but is it as good as taking abacavir (Ziagen) and 3TC (lamivudine, Epivir) separately? In a word: yes, reports Edwin DeJesus, M.D., from CROI 2005.



    On Feb. 16, dozens of you joined Nelson Vergel at The Body's live chat on issues for HIVers with multi-drug resistance. Nelson, a dynamic HIV treatment advocate, answered more than 30 questions during the hour-long chat on topics ranging from new antiretrovirals to treatment strategies for people who are running out of HAART regimens. Click here to read the full transcript of the chat -- which includes Nelson's responses to more than a dozen additional questions we couldn't get to during the chat itself!

    This chat was sponsored by Trimeris and Roche.



    Life With Crystal Meth: When the Party Ends
    "Crystal made me feel good, made sex fabulous, and put me on somebody's A-list," writes AIDS advocate Eddie Young. "All it took was a harmless bump up my nose ... at first." As Eddie's habit grew into a full-blown addiction, though, he began to realize that the price he was paying was just too high.

    You're a Person, Not a Number: Take Charge of Your HIV Care
    Does your doctor treat you like some anonymous object? People with HIV should never settle for being treated like they're just another "number," writes physician assistant Paul Stabile. "It is important to remember that you, as the patient, are the leader of your individualized healthcare team," he says. "This is especially important if you feel that HIV has taken control of your life -- understand that you are still in charge."



    Anal Cancer: It's Not Just for the Boys
    While cervical cancer, which is caused by human papillomavirus (HPV), remains a concern for HIV-positive women, there's a growing (and long overdue!) realization that women with HIV are also at risk for anal HPV infection. Lisa Hirschhorn, M.D., reports from CROI 2005 on new research regarding both of these health risks.

    HIV Drugs May Not Need to Cross "Blood-Brain Barrier" to Prevent Mental Problems
    Protease inhibitors have a hard time making their way into a person's central nervous system, leaving many researchers concerned that such drugs might not be able to prevent HIV-related neurological problems, such as dementia. Fortunately, a small study presented at CROI 2005 suggests that nervous system penetration is not essential to prevent problems like dementia from occurring.
    Paul Sax, M.D., explains.

    The Importance of Early Hepatitis C Diagnosis and Treatment
    Hepatitis C is a dangerous disease for anybody, particularly HIV-positive people. But if it's spotted early, medications can often stop the disease from doing long-term damage, and can even reverse damage it may have already done. This quick overview by HIV treatment educator Tim Horn has more info.



    New Computer Model May Help Researchers Devise Effective HIV Vaccine
    Why is it so hard to develop a vaccine against HIV? Look no further than a little protein called gp120, a shapeshifter that lives on the outside of HIV's skin. It's gp120 that attaches HIV to CD4 cells and begins the process of turning them into HIV factories. Now researchers say they've developed a computerized, three-dimensional image of gp120, which could help them think of new ways to fight the devious protein and block HIV infection.



    U.S. Releases Updated Guidelines on Preventing HIV Transmission to Babies
    The U.S. health department has updated its guidelines on the prevention of mother-to-child HIV transmission. The revised guidelines include updated information about the potential side effects that several HIV meds can have on pregnant women or their babies -- particularly efavirenz (Sustiva, Stocrin), which is known to cause birth defects, and nevirapine (Viramune), which can cause potentially severe liver problems in some women.

    Condoms in Prison? Not as Easy as You Might Think
    Although it's illegal to have sex in prison, the U.S. government estimates that about 30% of federal male prison inmates engage in sex acts with other male inmates. This is particularly dangerous now, since many inmates enter the prison system having already been infected with HIV or other sexually transmitted diseases. Realizing that sex is simply a reality in prisons, some states have decided to allow the distribution of condoms to inmates. One California politician's proposal to do the same in his state, however, has set off a firestorm.



    Preventing Mother-Child HIV Transmission: "Does It Work?" Is Not Enough
    Although there has been much success in preventing mother-to-child transmission in the developing world, there are other important issues we need to take into account when determining just how successful we've been. Is the effectiveness of treatment worth the toxicity risks? The cost? The risk of resistance? Margaret Hoffman-Terry, M.D., reports from CROI 2005.

    Unprecedented Middle-East Meeting Discusses HIV and Women
    In a first-of-its-kind event, health officials gathered in Amman, Jordan last month to hold a three-day conference specifically to talk about HIV among Middle Eastern and North African women and girls. United Nations officials believe
    that more than half a million people in the region have HIV, but stigma is high and women are particularly at risk, given their second-class status in many of these countries. (Web highlight from BBC News)

    Beauty Pageant Fights HIV Stigma in Botswana
    Botswana has the second-highest HIV prevalence worldwide. In an attempt to remove some of the stigma people with HIV face, a Botswanan AIDS advocate came up with the idea to hold a "Miss HIV Stigma-Free" beauty pageant to help educate people about the disease. The pageant is now in its third year; Cynthia Leshomo, a 32-year-old HIV/AIDS counselor, was declared the winner last week.


    Connect With Others at
    The Body's Bulletin Boards

    Recent post:
    "Looking for Others Like Me"

    "I just found out that I am HIV+ (1/13/05). I am a 21-year-old black male and live in Philly. I am looking to talk to others who are HIV+ and my age or close to it (male or female). I haven't talked to ANYONE about my status except for my doctors. I really want to talk to someone, maybe hang out and see where it goes."
    -- Anonymous

    Click here to join this discussion thread, or to start your own!

    Art From HIV-Positive Artists
    Image from the March 2005 Visual AIDS Web Gallery
    "Road to Terni," 1999;
    Laurence Young
    Visit the March 2005 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists!
    Are You a Visual Artist
    Living With HIV/AIDS?
    Join Visual AIDS' Archive Project! The project supports artists living with HIV while preserving a visual record of the work that member artists produce.

    The Archive Project is a slide resource containing the works of visual artists with HIV. It welcomes submissions from artists living with HIV and the estates of those who have died from AIDS.

    Interested in joining the Archive Project? Click here to learn more.