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HIV & AIDS Treatment in Practice #7, 12 June 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
IN THIS ISSUE
About HIV & AIDS Treatment in Practice
News links from www.aidsmap.com
Monitoring ARV Treatment (main feature)

NEWS LINKS FROM WWW.AIDSMAP.COM
A selection of news stories which have appeared since 23 May 2003.

Bush signs bill promising $15 billion over five years to fight HIV
  • In fulfillment of a pledge made this January in his State of the Union speech, President Bush has signed a bill which authorizes $15 billion of expenditure on HIV in Africa and the Caribbean over the next five years.


UK pledges $80 million to Global Fund, commits until 2008
  • The United Kingdom Department for International Development (DFID) has announced an extra $80 million contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria, extending its commitment for Fund support until 2008. DFID is now committed to contributing $280 million in total to the Fund between now and 2008. The UK is the second largest donor to the Fund.


European Union underpins tiered pricing for HIV, TB and malaria drugs
  • Earlier this week, the European Union adopted a new regulation to prevent the re-importation of drugs exported under a 'tiered pricing' system. This measure is intended to secure sustainable global access to a wider range of medicines, and will be promoted at next month's G-8 summit in Evian, France. While discounts will be voluntary, the aim is to maximise global access to medicines without damaging the commercial interests of manufacturers. It is also clearly aimed at heading off pressure for compulsory licensing of drugs to generic manufacturers to meet health emergencies, although it remains to be seen if it will achieve this.


Latin America to set lower prices for HIV treatments
  • Ten Latin American countries meeting last weekend in Lima, Peru, have signed a letter of intent with a number of pharmaceutical companies which opens the way to lower prices for antiretroviral drugs, HIV diagnostic and monitoring tests. While full details have not yet been released, the effect should be substantial: the cost of first-line triple therapy is reduced by between 30 and 92% from the best prices previously available and second-line treatments are also included. The overall impact could be to allow 150,000 more people with HIV to receive treatment in the region without increasing current levels of spending on ARV drugs, according to REDLA+, the Latin American network for positive people and others close to the negotiations.


US confirms HIV generic drug dosage claims
  • The first published analysis of the nevirapine content of several generic formulations of antiviral drugs has found them to be in line with the manufacturers' claims.


World Health Assembly puts health over profit
  • The World Health Assembly, the policy-framing body that gives guidance to WHO on the views of member states and sets global health policy, has voted to support a resolution affirming that public health interests should remain paramount when framing policy on pharmaceuticals.


HIV experts question observed therapy in poor nations
  • A team of HIV researchers at the University of California CSF recommend against establishing directly observed therapy (DOT) as the model for the provision of HIV medications in resource poor countries. Writing in the June 13, 2003 issue of AIDS (now available online), the researchers challenge the assumption that poverty is a risk factor for non-adherence to anti-HIV regimens and cite the issue of stigmatisation.


Timing of nevirapine for newborns: extra syrup for baby if mother late to dose
  • In many developing countries, a two-dose regimen of nevirapine (NVP) around the time of birth is advocated as the most cost-effective way to prevent mother to child HIV transmission. One dose is taken by the mother at the onset of labour and one dose is given to her baby, between 48 and 72 hours after birth. In some circumstances – when the mother's dose is given only shortly before birth – an extra dose for the baby is called for. A new report in the June 1st edition of the Journal of Acquired Immune Deficiency Syndromes argues, from clinical trial evidence, that this can safely be limited to cases where the dose-birth interval is two hours or less.


Cholesterol rises in HAART-treated men just return to pre-HIV levels says study
  • A small US study published in the June 11th edition of the Journal of the American Medical Association suggests that the increases in cholesterol levels seen in HAART-treated patients are, in fact, a return of cholesterol to their pre-HIV seroconversion levels.


Diet changes successfully reduce cholesterol in HAART-treated patients
  • Diet modification can successfully reduce cholesterol levels in HAART-treated HIV-positive patients, according to a small study published in the June 13th edition of the journal AIDS.


Discredited hydroxyurea back on the agenda
  • Hydroxyurea was back in the limelight at a meeting of scientists convened in Stresa, Italy, last week for a two day conference on Immune Reconstitution and Control of HIV.


Long-anticipated therapeutic vaccines show early promise
  • The use of therapeutic vaccines for treating both primary and chronic HIV infection - with and without concurrent HAART - was the major topic at the Immune Reconstitution and Control of HIV meeting in Stresa, Italy last week.


HAART improves survival in HIV-positive patients with wasting syndrome
  • HIV-positive patients diagnosed with wasting syndrome are more likely to survive if they have a CD4 cell count above 200 cells/mm3 and receive anti-HIV therapy with at least two antiretroviral drugs, according to a US study published in the June 1st edition of the Journal of Acquired Immune Deficiency Syndromes.


PEP is feasible in prisons
  • HIV transmission may be prevented in the prison setting by administering antiretroviral medication to prisoners within three days of needle-sharing with an HIV-positive prisoner, a new Australian study has reported.


BHIVA issues draft 2003 treatment guidelines
  • British HIV Association treatment guidelines have once again broken with the treatment orthodoxy that has prevailed since 1996, this time by declaring that considerations of toxicity and adherence are more important in the choice of first-line regimen than the likely resistance pattern if that regimen fails.




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