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October 4, 2006

In This Update:
  • HIV Treatment
  • Health Problems for HIVers
  • HIV Testing
  • HIV-Related Policy in the U.S.
  • HIV Outside the U.S.
  •   HIV TREATMENT

    MK-0518 May Have Better Lipid Profile Than Efavirenz, Short-Term Study Finds
    The buzz surrounding MK-0518 is growing louder. The drug, the first in a new class of HIV meds known as integrase inhibitors, has already shown signs that it is a powerful antiretroviral, and that it works well even in people with resistance to all major HIV drug classes. Now, 24-week results from an ongoing study of people on their first treatment regimen have shown another big plus: MK-0518 appears to be even gentler on a person's cholesterol and triglyceride levels than efavirenz (Sustiva, Stocrin), which is one of the world's most preferred HIV meds. The Body's Benjamin Young, M.D., reports from the 46th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2006).


    Dueling Receptors: Does It Matter How HIV Attaches to Your CD4 Cells?
    The complexity of understanding HIV and HIV treatment continues to grow as we learn more about how the virus works. There is even a test that can look at whether your HIV enters CD4 cells through a coreceptor known as CCR5 (R5 for short) or through the CXCR4 (X4) coreceptor. This is significant, because studies have shown that HIV using the X4 coreceptor is associated with more rapid disease progression compared to HIV that uses the X5 coreceptor. Fortunately, a new study from London demonstrates that HIV treatment works just as well no matter which kind of coreceptor your HIV uses: In addition to similar CD4 count recovery, the time to virological suppression and the rates of viral suppression at six, 12, and 24 months were the same. The Body's Graeme Moyle, M.D., who was an author on the study, reports from ICAAC 2006.

    Looking for more breaking research from ICAAC 2006? The Body's coverage has only begun! Over the next two weeks we'll add expert coverage to our ICAAC 2006 section, including podcast interviews with top physicians and researchers. Check back often for the very latest!


    Viral Load Is a Not Reliable Indicator for CD4 Count, Study Says
    Not on HIV treatment and watching your viral load rise? This does not necessarily mean that your CD4 count -- the primary measure of your immune health -- is also dropping, researchers say. In a large, new study published in the Journal of the American Medical Association, researchers found only a "minimal" relationship between changes in a person's viral load level and changes in their CD4 count. The researchers suggested that the findings drive home the point that CD4 count, not viral load, is what really matters when it comes to determining whether to start HIV treatment.


    HIV Medication Pipeline Update
    At any given time, there are literally dozens of HIV medications in various stages of development. Many of them won't make it past the earliest stages of study, but some -- such as the integrase inhibitor MK-0518, the CCR5 inhibitor maraviroc (UK-427,857) and the non-nucleoside reverse transcriptase inhibitor TMC125 (etravirine) -- have already moved into their final stage of development before hopefully receiving U.S. approval. Check out this chart by Treatment Action Group for a complete rundown of all of the HIV medications currently in the development pipeline.


    Providing Health Care to an HIV-Positive Adolescent
    Having HIV makes just about any doctor's appointment more complicated. But if you're HIV positive and you're also going through the emotional and physical changes of adolescent, dealing with all of these issues at the same time can be overwhelming -- not just for the teenage HIVer, but for his/her doctor as well. In this article, HIV pediatrician Dr. Margo Bell reviews some of the challenges and concerns involving health care for an adolescent who is HIV positive.

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      HEALTH PROBLEMS FOR HIVERS

    AIDS Often Not the Reason for HIVers' Deaths, Study Finds
    Now that HIV meds are keeping HIV-positive people healthy for longer than ever before, it's becoming more important for HIV doctors to pay attention to other health problems that can put HIVers at risk. A huge new study of HIV-positive New Yorkers has found that when they die, it's happening more and more often because of health problems not related to AIDS, such as substance abuse, heart disease and non-AIDS defining cancers. In fact, the study found that in 2004, a quarter of all deaths among HIVers were unrelated to AIDS, up from about 20 percent in 1999. It wasn't so long ago that HIV-positive people and their doctors didn’t even have the luxury of worrying about other, more "ordinary" health problems. But in developed countries today, managing a person's HIV alone is no longer enough: Doctors now must start thinking of people with HIV as whole patients, not people living with a single disease. (Web highlight from WebMD)

    To read the abstract of the New York City study, which was published in the Sept. 19 issue of the Annals of Internal Medicine, click here.


    The "NeuroAIDS" Dilemma: Many Questions, Few Answers
    How much of an effect does HIV have on your brain? Experts still aren't sure, although there are some signs that having HIV for a long time may impact a person's memory or other mental functions, even among people taking successful HIV treatment -- although normal aging may also have something to do with this. Clearly, there are far more questions than answers at this point, but researchers are now trying to investigate both the causes of, and potential treatments for, so-called "neuroAIDS."

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      HIV TESTING

    Newspapers Sound Off on New CDC Recommendations for Expanded HIV Testing
    Still not sure whether you support the new U.S. Centers for Disease Control and Prevention (CDC) HIV testing recommendations, which call for routine testing for adults ages 13 to 64, as well as the elimination of requirements for written consent and pretest counseling? If you want to gain a little more perspective, you’ll find plenty of it in the nation's newspapers: Many editorials have offered their two cents worth since the CDC announced its new recommendations on Sept. 21. Read this article for summaries of more than a dozen editorials and opinion pieces weighing the pros and cons of the recommendations.

    Click here for more information about the CDC's new HIV testing recommendations, or click here to read the full recommendations as published in the CDC's Morbidity and Mortality Weekly Report.


    New York City Increases HIV Testing by 50 Percent, but Still More Testing Needed
    Although universal HIV testing was just recommended by The U.S. Centers for Disease Control and Prevention, New York City began an expanded testing program in 2004. The program has increased HIV testing in city health clinics, jails and hospitals by nearly 50 percent in the last year. As a result, the city has already diagnosed 1,514 people with HIV in 2006, more than double the total for all of 2005. However, the expanded testing program only applies to city agencies; private hospitals, doctor's offices and AIDS organizations aren't affected, meaning many people in this city of 8 million remain untested.

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      HIV-RELATED POLICY IN THE UNITED STATES

    In Spite of U.S. House Approval, Senate Adjourns Without Reauthorizing Ryan White CARE Act
    The U.S. Congress adjourned last weekend without passing a measure to reauthorize the Ryan White CARE Act, which provides funding for HIV services in the United States for people who could not otherwise afford care. Senators from New Jersey and New York blocked Senate consideration of a House-approved bill sponsored by Rep. Mary Bono (R-Calif.). The bill would change CARE Act funding formulas so that rural areas experiencing increasing numbers of HIV cases would receive more funding, which would decrease funding allocated to urban areas. Some legislators from states with large cities have opposed the new formulas, saying they could harm HIV programs in those areas. The bill's future remains uncertain, and may not be seriously considered by the Senate again this year.

    To read through a trove of background information, news, releases and much more on the Ryan White CARE Act's lengthy reauthorization process, click here.


    Gov. Schwarzenegger Blocks Condom Distribution in Calif. Prisons
    Condom distribution in prisons: Makes sense for HIV prevention, right? Not according to California Gov. Arnold Schwarzenegger. He recently vetoed a bill that would have allowed not-for-profit groups to distribute condoms, dental dams and similar prevention tools to California's 162,000 inmates. The bill’s author, Democratic Assemblyman Paul Koretz, argued that condom distribution in prisons is simply a smart public health measure. In American prisons, sex between inmates or between inmates and correctional officers is common, and the incidence of sexually transmitted diseases is high. But Benjamin Lopez of the Traditional Values Coalition, a conservative religious advocacy group which opposed the bill, called the idea "obscene, disgusting and absurd." Opponents of the bill also pointed out that sexual intercourse between inmates is a crime.

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      HIV OUTSIDE THE UNITED STATES

    Europeans Just Say No ... to HIV Prevention?
    It seems many people in Europe think that HIV is something they'll never have to worry about. In a recent poll of about 25,000 European Union (EU) citizens, more than 40 percent said they don't take any precautions against HIV during intercourse. "We must not lose sight of the fact that HIV is still one of the biggest preventable killers worldwide," warned EU health commissioner Markos Kyprianou. However, it looks like many Europeans have already forgotten: Nearly half of those polled lacked even a basic understanding of HIV transmission and risk, with many believing that sharing glasses, sitting on a toilet seat or kissing on the mouth would put them at risk -- a finding that makes it even more remarkable that so many take no precautions against HIV during sex.


    Tuberculosis: Deadly New Strains Threaten HIVers Around the World
    Deadly new strains of tuberculosis appear to be spreading around the world, posing an especially high risk for HIVers in the developing world, according to the World Health Organization (WHO). Already the world's fourth most-fatal infectious disease, so-called "extreme-drug-resistant" tuberculosis (XDR-TB) strains can't be treated using traditional, inexpensive meds. Two percent of all tuberculosis cases worldwide are now XDR-TB cases, and people with HIV in developing countries are especially vulnerable. (Web highlight from Newsweek)


    India Increases Access to Free HIV Meds
    India's government has nearly doubled the number of treatment centers providing free HIV medications in the past year, according to the top official in the country's HIV/AIDS program. A part of India's national campaign to increase access to HIV treatment, these treatment centers, which have increased in number from 54 to 91, provide no-cost meds and are staffed with licensed physicians, lab technicians and counselors in Indian states with high rates of HIV. Currently, India has the largest population of HIVers in the world, with 5.7 million people living with the virus. "Our first priority now will be to launch a massive publicity campaign to let people know ... that they should reach out for free treatment," said Sujatha Rao, head of India's National AIDS Control Organization.


    Tough Anti-Gay Law in Jamaica Hurts HIV Prevention, Advocates Say
    The island of Jamaica may seem like a tropical paradise to a tourist, but a closer look at some of its laws may quickly dispel that notion. One such law bans sexual relations between men; the penalty, advocates say, is up to 10 years in prison. Despite recent gains against homophobia in Jamaica, advocates worry that this extremely harsh law only hinders efforts to educate people about HIV.

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    Also Worth Noting

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the October 2006 Visual AIDS Web Gallery
    "Haring in the Pop Shop," 1986;
    Keith Haring
    Visit the brand-new October 2006 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery is entitled "Stardust: A Two-Part Show"; it's curated by Leah Oates, an artist and independent curator living in New York.

    Connect With Others
    A
    t The Body's Bulletin Boards

    Diving Back Into the Dating Pool
    (A recent post from the
    "Gay Men With HIV" board)

    "Lately I've been thinking about dating. It's been a year since my last relationship. I've grown since then and am now ready to date again. But this is the first time that I've been in the dating pool since being infected. I don't know how to negotiate that. Any suggestions?"

    -- Ronnie

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

    Any HIVers in Edmonton?
    (A recent post from the
    "Living With HIV" board)

    "I have had HIV since 1996, and was wondering if there was anyone from Edmonton, Alberta. I [want] to meet with people in my area, because I don't know anyone in my situation."

    -- Laura

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

    Calling All Artists!
    Calling All Artists:
    Submit Your Postcard!
    Postcards From the Edge
    Visual AIDS is now accepting submissions for its ninth annual Postcards From the Edge benefit -- a charity event being held on Dec. 2-3 in New York City, at which the public will be able to purchase original, postcard-size artworks from artists around the country! Painting, drawing, photography, printmaking and mixed media are welcomed; proceeds go to Visual AIDS.

    The postmark deadline for submissions is Nov. 10. For more information on how to be a part of this unique event, click here!