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HIV & AIDS Treatment in Practice #3, 10 April 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
Update: Nevirapine-based Fixed-dose Combination ARVs
News links from www.aidsmap.com
Combining ARVs with treatment for tuberculosis (main feature)

UPDATE: NEVIRAPINE-BASED FIXED-DOSE COMBINATION ARVs
Gilead Sciences have now announced 'at-cost' pricing of tenofovir for all African countries and selected countries elsewhere, at US $39 for 30 days' supply. Full details are included in the news story given as a link below.

NEWS LINKS FROM WWW.AIDSMAP.COM
A selection of news stories which have appeared since 27 March 2003.

Gilead announces pricing, procedures for low-cost access to tenofovir
  • Gilead Sciences has released further details of the access programme it announced last December, as reported here on aidsmap [for Africa and selected countries elsewhere].


HIV-positive man dies of kidney failure and lactic acidosis due to tenofovir/ddI interaction
  • In the April 15 edition of Clinical Infectious Diseases doctors from Portland, Oregon, report the death of a man taking a HAART regimen containing tenofovir and ddI from kidney failure and lactic acidosis. Although the man had pre-existing impaired kidney function, this case adds to the growing body of evidence that tenofovir can be toxic to the kidneys and adds to cautions about the use of tenofovir and ddI together in people with impaired renal function.


Three French cases of tenofovir kidney toxicity reported amongst HIV-positive patients
  • Doctors from the Hopital Saint-Loius in Paris report three cases of tenofovir related kidney toxicity in the 15thApril 2003 edition of Clinical Infectious Diseases. There have now been several reports of tenofovir-related renal toxicity (see link below for aidsmap news stories).


Case report of kidney lesions in HIV-positive man treated with tenofovir
  • In the April edition of AIDS French doctors report a case of kidney lesions in a 60 year old HIV-positive man treated with a HAART regimen including tenofovir. The case report adds to the growing body of evidence that kidney toxicity - specifically, proximal tubular dysfunction - is a rare side-effect of tenofovir.


BMS data confirm potential for dosing ddI and tenofovir with food
  • A study conducted by Bristol Myers Squibb, presented at the 4th International Workshop on Clinical Pharmacology of HIV therapy in Cannes last week, confirms that dosing of its anti-HIV drug ddI (didanosine, Videx EC) 250mg once daily with tenofovir 300mg and a light meal results in similar ddI exposure to once daily dosing of Videx 400mg on an empty stomach without tenofovir.


First European HIV Resistance Workshop highlights non-B subtypes, replicative capacity
  • Thanks to Professor Deenan Pillay, University College London, for comment and review.


New British test may improve TB diagnosis rate
  • A paper in today's Lancet reports a study in a British school which showed that a new test for exposure to tuberculosis is superior to the existing Heaf Tuberculin Skin Test (TST) used in the UK.


Incidence of lipodystrophy increases the longer HIV-positive children stay on HAART
  • Lipodystrophy worsens and becomes more common the longer HIV-positive children are treated with HAART, according to Italian research published in the April 15th 2003 edition of the Journal of Acquired Immune Deficiency Syndromes.


Multiple risk factors found for diabetes in HIV-positive HAART patients
  • Patients treated with HAART who are obese when anti-HIV treatment is initiated, those who have taken protease inhibitors for longer, and those who have lipodystrophy are at greater risk of developing diabetes mellitus, according to Spanish research published as research correspondence in the April 2003 edition of AIDS.


Fibrates and statins safe and effective in HIV-positive patients with high lipids
  • Statins and fibrates, the two classes of drugs used to treat abnormally high blood fats, are equally safe and effective in HIV-positive patients treated with protease inhibitors who have hyperlipidaemia, according to Italian research published in the April 2003 edition of AIDS.




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