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January 25, 2006

In This Update:
  • HIV Treatment
  • HIV Drugs in Development
  • Living With HIV
  • Side Effects of HIV & HIV Meds
  • HIV News & Views
  • HIV Prevention & Education
  • HIV Outside the U.S.

    There's Still Hope for HIV Treatment Holidays, Advocacy Group Says
    Earlier this month, researchers announced they were canceling SMART, the largest-ever study on structured HIV treatment interruptions. Their reason was simple: the treatment interruptions didn't work. However, the AIDS advocacy organization Treatment Action Group points out that even though SMART was large, it was still only one study on one type of HIV treatment interruption -- it focused solely on starting and stopping meds when a person's CD4 count reached a certain number. Many other types of HIV treatment interruptions may still have a benefit, so it is still too early call them a failed strategy, Treatment Action Group explains.

    What Was SMART All About?
    Now that the landmark SMART study has been cancelled, many of you may be wondering: What the heck was SMART? And why, exactly, did it get the axe? Fortunately, we've got the answers. The U.S. National Institute of Allergy and Infectious Diseases has put together this question-and-answer sheet spelling out some of the most important details of this clinical trial.

    FDA Announces New, Easier-to-Read Labeling for U.S. Prescription Drugs
    The U.S. Food and Drug Administration (FDA) has unveiled major changes to the way prescription drugs are labeled. The FDA hopes the changes will make it easier to read, and understand, the most important information about a drug. The new drug labeling requirements, which will be phased in gradually and will initially apply to new and recently approved drugs, include the introduction of a table of contents and a "Highlights" section summarizing critical information.

    For Many HIV Treatment Veterans, a "Fearsome Waiting Game" for New Options
    In this age of highly effective HIV treatment regimens, it's easy to forget that just 15 years ago, precious few HIV medications even existed. In the early 1990s, many people receiving HIV treatment were on "monotherapy," taking only a single drug. Often, that drug was AZT (zidovudine, Retrovir), now a component of two combination meds, Combivir (AZT/3TC) and Trizivir (AZT/3TC/abacavir). Unfortunately, monotherapy is not enough to keep HIV fully at bay, and many people developed resistance to AZT, as well as other meds in the same drug class. As a result, the Los Angeles Times reports, as many as 40,000 people are now "playing a fearsome waiting game" for new medications while their doctors try to cobble together working regimens with existing meds. The L.A. Times report puts a welcome focus on a group of people who are often ignored by the media: long-term HIV survivors.

    Initiating HIV Therapy: What Doctors Know Today
    Our knowledge of HIV and HIV medications improves every day, and HIV treatment guidelines are constantly changing. As a result, the debate over when to start HIV treatment -- and what to start with -- is forever evolving. In this detailed online resource geared toward healthcare professionals, two physicians from Brown University explain everything we know to date about first-line treatment for HIV, including recommendations on which meds to take -- and which to avoid. (Web highlight from HIV InSite)



    Etravirine May Help HIV-Positive People With NNRTI Resistance
    Etravirine (TMC125), a "second-generation" NNRTI in development, can suppress HIV that is already resistant to existing NNRTIs, like efavirenz (Sustiva, Stocrin) and nevirapine (Viramune), according to the results of a 24-week study. Two Phase 3 studies -- usually the final phase before a drug can be officially approved in the United States -- of etravirine have also begun, in which etravirine is combined with another drug in development, the protease inhibitor TMC114.

    Integrase Inhibitors: First Clear Success in Human Trial
    One of the most promising of a new class of antiretrovirals called "integrase inhibitors" has passed its first major test: It showed an impressive ability to suppress HIV in a 10-day study of HIVers who had never before taken HIV meds. The results on the drug, currently called MK-0518, were presented at a conference in Dublin, Ireland, last year. MK-0518's early success means it will now move on to a 48-week trial that will determine the drug's ideal dose.



    Being on Both Sides of HIV: An HIV-Positive Doctor Tells His Story
    In a way, Dr. Wayne Bockmon has always lived on both sides of the AIDS epidemic: As a doctor working in the 1980s, he watched as HIV was transformed from a medical curiosity into a mind-numbing horror that changed his career forever; meanwhile, as a gay man, he feared for his friends and the gay community. Then, in 1995, Dr. Bockmon was himself diagnosed with HIV. "I'm here today because of two things. I had one of the best doctors in the business, and I did everything he said," Dr. Bockmon says. His experience has convinced him more than ever that excellent medical care is pivotal for people living with HIV today.



    HIV-Positive African Americans May Have Lower Risk of Cholesterol, Triglyceride Problems on HIV Meds
    African Americans with HIV may be less likely than white or Hispanic HIVers to develop cholesterol or triglyceride problems while taking HIV meds, according to a new U.S. study. The researchers found that, overall, HIV-positive African Americans on treatment had lower triglycerides, higher HDL ("good") cholesterol and lower LDL ("bad" cholesterol) than HIV-positive people on treatment who were white or Hispanic. The researchers also found that Hispanic HIVers who possessed a certain type of gene may be somewhat protected from an increase in triglycerides. (Web highlight from



    European Scientists Reveal 3D Structure of HIV
    For the first time ever, researchers have created a three-dimensional model of HIV -- an achievement that may pave the way for new treatments. The varying sizes and shapes of each strain of HIV has made the virus hard to map, but a joint British-German team got around this problem by using a computer program to combine dozens of pictures of the virus into a single model. The end result could greatly increase scientists' knowledge of the way HIV grows, which may bring researchers closer to their long-term goal of learning how to stop the virus. (Web highlight from BBC News)



    Believe That HIV Will Be Beaten -- And Then Help Make It Happen
    "There is power in belief," says AIDS advocate Lisa Acogny. "We must keep hope alive; we must believe that AIDS will be eradicated." She urges each of us -- HIV positive or not -- to spread that belief, and to educate others about HIV, one person at a time: "If Christianity can start with 13 people and spread to 125 million worldwide, just imagine what you could do if you were to share the facts and educate your family, neighbors, friends, and co-workers about HIV and AIDS," she writes.



    HIVers in Iran Struggle With Stigma as Country Remains Silent
    Veteran war correspondent Kevin Sites came across a different type of battle in his recent trip to Iran: the country's silent, but growing, struggle with HIV. The existence of the virus is barely acknowledged in this Middle Eastern country, so ignorance is high -- and stigma may be even higher, making life for HIV-positive Iranians extremely difficult. "Even the doctors are a little afraid of the disease," says one HIV-positive person. "They tell me they aren't, but I know -- I can tell with the way they deal with me." Sites' coverage of Iran's HIV epidemic is available in this blog and multimedia report. (Web highlight from Yahoo! News)

    BBC Calls Off HIV Prevention Campaign in Africa Over Dispute With U.S. Policy
    The BBC World Service Trust decided to suspend an HIV prevention campaign in Tanzania rather than comply with a U.S. policy requiring that recipients of U.S. AIDS grants pledge to oppose commercial sex work. In early 2005, the BBC signed a US$4 million contract with USAID for a three-year HIV prevention campaign. BBC planned to team up with Tanzanian broadcasters to produce radio dramas, phone-ins and public service announcements. If the BBC World Service Trust had signed the pledge, U.S. government officials would have been allowed to scrutinize the organization's global projects for compliance with the pledge, and the Tanzanian campaign would have been required to promote abstinence by underlining the failure rates of condoms.

    Also Worth Noting

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the January 2006 Visual AIDS Web Gallery
    "Mom," 1997
    Albert J. Winn
    Visit the January 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! This month's gallery is entitled "Compassion, Responsibility and Independence"; it's curated by a group of 16 teenage photographers who completed a summer program at New York University's Tisch School of the Arts.

    Connect With Others
    t The Body's Bulletin Boards

    HIV and Alcohol: How Much Is Too Much?
    (A recent post from the
    "Gay Men With HIV" board)

    "I know this is a question for my doc, but thought I'd at least get a perspective on here from the people that actually feel what I feel. ... I am a very social person, work in [public relations] and therefore attend a plethora of events, which is no excuse for picking up a glass of wine ... or two ... OK, a dozen! :) I'm fully aware that meds are extremely taxing on our livers ... and consuming mass quantities of alcohol, or even any quantity for that matter, is not exactly the "best" additive to my regimen! I have previously asked my doc, who says it's OK in moderation ... but just how much is 'moderation'? Does that mean only the days that end in 'y'? :) Just looking for any insight from anyone who may have experienced the backlash of drinking and meds, or [who has] any guidance as to how much is too much."

    -- Anonymous

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

    Recently Tested Positive ... And That's Just the Beginning
    (A recent post from the
    "I Just Tested Positive" board)

    "I recently tested positive with a [CD4] count of 203 (not good). I went on meds immediately. ... My boyfriend of four years is positive. I did not know this until recently. He says he left me because he 'found someone else.' I got so depressed that I went out and drank (not good), and as luck would have it, I got caught ... [and] was charged with [being under the influence]. All this bad luck is weighing heavy on me. Is there anyone in the Portland, Maine, area who is positive and would like to talk? I am in counseling, but I really need a friend who is HIV positive."

    -- coreysopo

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