YOU ARE HERE:
[HATIP] #28, May 20 2004: News
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: 19.10.05
News
A selection of news stories which have appeared since April 29 2004.



A randomised double blind study in Thailand has shown that primary prophylaxis with the anti-fungal drug fluconazole reduced the risk of death fourfold in people with advanced HIV disease, but did not significantly reduce the incidence of cryptococcal meningitis (the main opportunistic infection that fluconazole prophylaxis might prevent).




HIV-positive individuals who are coinfected with hepatitis B virus (HBV), or hepatitis C virus (HCV), and receive treatment with anti-HIV drugs, are no less likely to achieve an undetectable viral load or a sustained increase in their CD4 cell count, than HIV-positive individuals who are not coinfected with viral hepatitis, according to research conducted in Thailand and published in the May edition of AIDS. The investigators also found that coinfected individuals did not experience faster HIV disease progression.




Stopping the nevirapine component of nevirapine-based HAART five days prior to the nucleoside backbone when stopping or interrupting treatment appears to be a "reasonable strategy" and was not associated with evidence of resistance mutations to either nevirapine or 3TC, according to the results of a nine patient study that are published in the May edition of HIV Medicine.




The United States plans to speed up the review of brand name fixed dose combination products and allow generic manufacturers outside the United States to apply for US Food and Drug Administration approval of their antiretroviral products. FDA approval would in turn allow the US government to buy generic antiretrovirals for use in developing countries - if they can beat branded products on price.




A group of activists and physicians has asked the World Health Organization (WHO) to prevent the proposed reclassification of buprenorphine as a narcotic. If successful, this will allow the use of the drug as a treatment for heroin addiction to continue, helping to curb the transmission of HIV through intravenous drug use.




A fixed dose combination of three branded antiretrovirals could be on the market within 18 months if manufacturers can solve co-formulation problems, following an announcement yesterday by Gilead Sciences (manufacturers of tenofovir (Viread) and FTC (Emtriva) and Merck & Co and Bristol-Myers Squibb (manufacturers of efavirenz (Sustiva/Stocrin).




The Canadian Senate has passed a bill that will allow generic drug manufacturers in Canada to produce copies of patented treatments for HIV, AIDS, tuberculosis and malaria and export them to resource-limited countries.




The case of a Zimbabwean man who was treated with Combivir/efavirenz for his newly-diagnosed HIV infection in Brighton, but who was already resistant to nucleoside analogues due to undisclosed Combivir treatment prior to arriving in the UK, highlights the need to provide baseline resistance tests to newly-diagnosed immigrants, argue two clinicians from Brighton and Sussex University Hospitals in the latest issue of the Journal of Sexually Transmitted Infections.




The incidence of the AIDS-defining cancer Kaposi's sarcoma (KS) has fallen significantly in Europe since the introduction of HAART, according to a prospective cohort study published in the June 15th edition of Cancer, which is now available on-line. The investigators from the EuroSIDA study found that only 1% of patients who commenced treatment with HAART developed KS, and that the main risk factor for the development of KS was a poor immunological response to HAART. However, KS has not gone away, they report; around 6% of people diagnosed with AIDS still have KS.


  • Impact of HIV on South African children underestimated

    Nearly 7% of South African children between the ages of two and nine are infected with HIV according to a survey presented this week at the Social Aspects of HIV and Aids Research Alliance (Sahara) conference in Cape Town, South Africa.




    South Africa will need 14,000 extra health care workers by 2008 to deal with the effects of HIV/AIDS, according to findings presented this week at the Social Aspects of HIV and Aids Research Alliance (SAHARA) conference in Cape Town, South Africa.



    Canada's Prime Minister Paul Martin yesterday pledged CAD$100 million (US$72m/£41m) to the World Health Organisation's 3x5 initiative to bring antiretroviral treatment to three million people living with HIV by the end of 2005.



    The glucocorticoid drug prednisolone can delay the depletion of CD4 T-cells in HIV-positive people, according to a retrospective study published on 5 May 2004 in the online journal BMC Medicine. Although it acts as an immunosuppressant, the authors argue that prednisolone may slow the death of CD4 T-cells by reducing the chronic immune activation caused by HIV infection.




    A single dose of the BCG tuberculosis (TB) vaccine can provide protection for up to 60 years, according to a long-term follow-up study published in the May 5th edition of the Journal of the American Medical Association.




    The international courier DHL is the latest multinational company to join the ranks of those providing services at no profit to assist in the roll-out of antiretroviral therapy with the announcement on May 5th that it is to provide non-profit courier services to deliver antiretrovirals. Products manufactured by Merck & Co will be delivered to treatment centres and distribution centres in Africa at a no-profit cost that will reflect the costs of shipping.




    Although there have been several case reports of tenofovir-associated kidney toxicities since the drug was licensed a year ago, it appears to be a rare occurrence, is reversible and risk-factors may include combining the drug with ritonavir and pre-existing renal insufficiency, concludes a report from Paris' largest HIV treatment centre, published in the latest issue of the journal, AIDS.




    A study of the way that HIV viral load in semen varies during early infection has led researchers to conclude that half or even the majority of HIV transmission from men to women in sub-Saharan Africa occurs during the first two months of the men's infection.




    The strongest predictor of how quickly a person will progress to AIDS is the speed with which they reach their viral 'set point' after acute infection according to a US study published in the May 15th edition of the Journal of Infectious Diseases (now available online). It also finds that having at least seven HIV-related symptoms during the first four months or so of infection is predictive of slower progression to AIDS.




    International HIV prevention efforts need to take much greater account of violence against women and sexual coercion if they are to be successful, say two US researchers in the May 1st edition of The Lancet. Their comments come in response to South African research published in the same edition that shows women reporting violence or a high degree of control from a sexual partner were almost 50% more likely to be HIV-positive.




    HIV prevalence in Uganda declined in the 1990s by 70%, thanks to community mobilisation and risk-avoidance at a population level, according to a study published in the April 30th edition of Science. In particular, investigators from Cambridge University attribute the dramatic decline in HIV prevalence in Uganda to a later average age of sexual debut, and a reduction in the number of sexual partners, backed by a consistent message from the Ugandan government and high levels of awareness communicated by word of mouth. "The outcome was equivalent to a highly effective vaccine," the researchers say.








aidsmap resources