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HIV & AIDS Treatment in Practice #17, November 6 2003
A regular electronic newsletter for health care workers and community-based organisations on HIV treatment in resource-limited settings. It is supported by and produced in collaboration with St Stephen's AIDS Trust and the International HIV/AIDS Alliance.

Its publication is also supported by Positive Action of GlaxoSmithKline, Boehringer Ingelheim and the Access 4 Trust.
   Last updated: 18.06.04
 
A selection of news stories which have appeared since October 23 2003.

Low viral load rebound does not affect medium term outcome says French
study

  • A low rebound in viral load in patients taking a protease inhibitor does

not have significant clinical or immunological consequences – in the
mid-term at least, according to a French study published in the December
1st edition of the Clinical Infectious Diseases, which is available now
online.



New CD4 counting method may lead to cheaper tests in developing world

  • A simple enzyme-based method that uses dried blood spots could

significantly reduce the cost of CD4 cell counting for developing
countries now implementing antiretroviral treatment programmes,
according to findings published today in The Lancet.



Scaling up treatments and monitoring in Asia

  • Access to HIV treatments and diagnostics is improving in some parts of Asia, the Annual Conference of the Australasian Society for HIV Medicine heard last week in Cairns.




Triglycerides can normalise after switch from d4T to tenofovir

  • Triglyceride levels returned to normal levels in one third of patients

with elevated triglyceride levels within 12 weeks of switching from d4T to tenofovir, according to findings from the Recover study, a large
Spanish trial following adverse events among patients receiving
nucleoside analogue treatment.

http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2383

  • Response to the new protease inhibitor atazanavir is blunted in

individuals with four or more protease inhibitor-associated resistance
mutations, even when drug levels are boosted with ritonavir, according to an analysis of the 045 study presented yesterday at the Ninth European AIDS Conference in Warsaw. However, lopinavir-treated patients in the same study showed a similar fall off in response, suggesting that most of the current crop of protease inhibitors begin to lose their clout in roughly the same territory.

Combination of indinavir/AZT/3TC still effective for majority of
patients at 6 years, says US study

  • A HAART regimen comprising indinavir, 3TC and AZT is still being taken by a majority of patients enrolled in a study into the combination`s safety and efficacy six years later, according to US research published in the November 7th edition of AIDS. Investigators also established that the combination was continuing to suppress HIV viral load to below 500 copies/mL in a clear majority of patients, and to below 50 copies/mL in a little under 50% of individuals.



Herpes and genital warts most common symptoms of immune reconstitution inflammatory syndrome (IRIS)

Immune reconstitution inflammatory syndrome (IRIS) is the name given to a diverse group of syptoms that can occur soon after the initiation of HAART. This can include the first appearance or the recurrence of previously-treated opportunistic infections, like TB, CMV, PCP or MAI, or the flare-up of viral infections that include hepatitis and herpes.


Induction/maintenance approach revived – but will patients stick with it?

In the early years of the protease inhibitor era, there was much
interest in an approach called induction/maintenance – starting with
three or four drugs and stepping down to one or two after viral load had been controlled. Results were disappointing and the approach fell into disuse. At this week’s Ninth European AIDS Conference, results of a trial called TIME showed that drug companies at least have not given up on the idea of induction/maintenance. Whether it will suit patients is another question.


Clinton Foundation secures triple HIV therapy for $132 a year

  • A new benchmark promising further downward pressure on drug prices emerged yesterday with the announcement that the Clinton Foundation has secured an agreement from Indian and South African drug manufacturers to supply a triple combination of AZT/3TC and nevirapine for $132 a year.



Don't assume African patients in UK are treatment-naive, report UK
docs

  • Physicians in the UK who prescribe HAART to Africans should not assume that their patients are naïve to antiretrovirals, caution doctors from Portsmouth writing in the November 7th edition of AIDS (now available online).




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