News headlines

A selection of news stories which have appeared since 8 May 2003.

31% of African TB now due to HIV epidemic

A new WHO study of the burden of tuberculosis has found that most of the world's largest and fastest-growing epidemics of TB, in Africa, are increasingly attributable to the effects of HIV.

SA government gets chance to rethink AIDS treatment policy

A review of the cost of AIDS treatment options, jointly undertaken by the South African Health and Treasury Departments, is reported to have found that widespread ARV provision could be cheaper than previously thought. After reviewing a number of scenarios, it suggests that 500,000 people could be on antiretroviral treatment by 2008 for as little as 4 billion rands/year (equivalent to a little more than US $1,000 per person per year at present exchange rates).

Expert panel maps global 'HIV prevention gap': $6 billion needed by 2007

A report released today with backing from UNAIDS and WHO spells out the gap between what could be done to control the global HIV epidemic and the resources available or promised to do so. The report, co-sponsored by two major US Foundations (Bill and Melinda Gates and the Kaiser Family Foundation) has been compiled by an international 40-member working group. It calls for global HIV prevention spending to be tripled from US $1.9 billion at present to $5.7 billion by 2005 and $6.6 billion by 2007. The bulk of this funding should come from wealthier countries as international development aid, which should be increased to 0.02 per cent of national income (GDP) for this purpose. At present, none of the donor countries meets this target. In addition, the report endorses the view that access to treatment and care needs to expand alongside HIV prevention.

HIV treatment interruption reported successful in African children

Use of structured treatment interruptions to manage limited drug supplies has proven surprisingly successful in a Nairobi orphanage, according to a brief report published in the online edition of Clinical Infectious Diseases.

EDITOR'S NOTE: This is a very preliminary report of a small study which cannot be taken as a basis for recommending the wider use of this strategy. There must be further research, closely supervised and with a proper assessment of the risk of drug-resistance. This is especially important where very few treatment options are available for children.

Atazanavir approval recommended in US

A panel of US HIV experts has voted unanimously in favour of US Food and Drug Administration approval of atazanavir, the new once daily protease inhibitor developed by Bristol Myers Squibb. The FDA is likely to announce its decision by June 20.

Atazanavir in treatment-experienced people: boosted looks better

Atazanavir, the new protease inhibitor recommended for approval yesterday by the US Food and Drug Administration's Antiviral Advisory Committee, is likely to be best used in treatment-experienced patients when boosted with ritonavir, according to data unveiled at yesterday's hearing. The drug shows comparable activity to lopinavir/ritonavir when dosed as atazanavir/ritonavir 300/100mg, but results in less triglyceride and cholesterol elevation. (Click here to view main report on atazanavir approval).

Atazanavir resistance: independent study finds high cross-resistance to atazanavir

German researchers have reported higher levels of reduced susceptibility to atazanavir in single protease inhibitor experienced patients than recently reported by the drugs manufacturer, Bristol Myers Squibb (see previous news report). The new findings, published in the May 23rd edition of AIDS, are likely to increase curiosity about the resistance profiles of patients who benefited from atazanavir alone in the 043 study, or who experienced failure of ritonavir-boosted atazanavir in the 045 studies (see previous news report), since this information will help define the parameters within which ritonavir-boosted atazanavir is likely to be useful.

High levels of HDL cholesterol associated with longer undetectable viral load in HAART patients

Higher levels of high-density lipoprotein (HDL) cholesterol, often called good cholesterol, are associated with better reduction in viral load in HAART treated patients, according to a Spanish study published in the May 2003 edition of AIDS.

The longer HIV-positive drug users have HIV, then greater the risk of active TB

Duration of infection with HIV increases the risk of injecting drug users developing active TB, independent of CD4 cell count, according to a study conducted in several European cities and published in the May 23rd 2003 edition of AIDS. However, the study also found that the risk of developing TB was greater for patients with severe immune damage and was also greater for HIV-positive drug users in southern Europe than northern Europe.

Chronic HCV transmitted by tattooing, but unlikely to cause acute symptoms

Tattooing could be responsible for more cases of hepatitis C virus infection (HCV) in the US than previously thought, according to a study in the May 12th edition of the Archives of Internal Medicine. The investigators suggest that US public health guidelines should be changed to recognise tattooing as a common mode of HCV transmission, and that commercial tattoo parlours are inspected and regulated to control the spread of HCV.

T-cell activation means lower CD4 gains in HAART treated HIV patients

Ongoing T-cell activation is associated with smaller gains in CD4 cell count in patients on HAART with effective suppression of HIV viral load, according to a US study published in the May 15th edition of The Journal of Infectious Diseases. The investigators believe that T-cell activation may explain why some patients have only modest gains in CD4 cell count despite receiving anti-HIV therapy and achieving an undetectable viral load.

GlaxoSmithKline licenses new HIV and HBV drug from Swedish company

Glaxo Smith Kline announced yesterday that it has obtained a licensing agreement from the Swedish company Medivir for the development and marketing of MIV-210, a nucleoside analogue active against HIV with high level resistance to other nucleoside analogues. If trials prove successful, GSK will market the drug worldwide (except for Scandanavia).