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[HATIP #23], February 6, 2004
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
 
1. About HIV & AIDS Treatment in Practice
2. News links from www.aidsmap.com
3. Treating HIV & AIDS: A training toolkit - new publication
4. South Africa's National Plan for HIV treatment: worries over progress

HATIP is published in partnership with the St Stephen's AIDS Trust and the International HIV/AIDS Alliance.



2. NEWS LINKS FROM WWW.AIDSMAP.COM
A selection of news stories which have appeared since 06/02/2004.


Allergic reaction to abacavir reported after treatment break, one year after starting the drug

  • A woman has developed a hypersensitivity reaction to the nucleoside analogue abacavir after restarting the drug after a treatment break. Investigators reporting the case in the January 23rd edition of AIDS believe that this case is unique as the woman had no symptoms of allergy to abacavir before treatment interruption, and because of the length of time the woman had been taking the drug prior to the development of the hypersensitivity.


Hormonal contraceptives increase shedding of HIV infected cells in the cervix

  • The use of hormonal contraception leads to a small but significant increase in the shedding of HIV-infected cells in the cervix, even though both cervical secretion and blood HIV viral load levels remained unchanged, according to a prospective study involving over 200 HIV-positive women in Kenya. The study was conducted between August 1996 and September 1998, and is published in the January 23rd edition of AIDS.



HAART clinically and immunologically effective in babies but high rate of virologic failure

  • A HAART regimen consisting of d4T, ddI and nelfinavir is clinically and immunologically effective when initiated in babies under three months, but is associated with a high rate of virologic failure, according to a small study published in the January 23rd edition of AIDS.



Nevirapine should not be used for PEP confirms US review

  • HIV-negative people appear to have a higher risk of side-effects when exposed to nevirapine, according to a review of case reports and toxicity reports from people exposed to the drug as a component of post-exposure prophylaxis after potential exposure to HIV, according to a study published in the Journal of Acquired Immune Deficiency Syndromes this month. The findings have implications not only for PEP regimens, but also for suggestions that nevirapine should be given to all pregnant women at the time of delivery in high HIV prevalence settings, in order to bypass concerns about HIV testing and disclosure that currently impede uptake of preventive treatment by mothers.



Three-fold increase in new HIV cases amongst UK Caribbeans between 1997 - 2001

  • The number of new HIV diagnoses amongst black Caribbeans living in the UK increased three-fold between 1997 and 2001, according to an editorial published in the February edition of Sexually Transmitted Infections. An editorial accompanying this article argues that high rates of gonorrhoea amongst the UK Caribbean population are “proving fuel for an explosive epidemic” of HIV.



Meta-analysis finds PI-based HAART better than NNRTI regimens in NRTI experienced

  • Protease inhibitor-based HAART regimens are superior to NNRTI-based triple combinations, according to a meta-analysis of 14 clinical trials published in the January 31st edition of the British Medical Journal. The indirect comparison of clinical trials found that individuals taking protease inhibitors (PI) were less likely to progress to a new AIDS-defining illness or death. Further analysis showed that patients taking a PI gained more CD4 cells and had better viral suppression than individuals taking NNRTIs.


New warning about nevirapine liver toxicities issued by manufacturer

  • Boehringer Ingelheim, the manufacturer of the non-nucleoside reverse transcriptase inhibitor (NNRTI) nevirapine (Viramune) has issued important new safety information in a letter to doctors in the US about the drug’s potentially fatal liver toxicities.



Vatican accuses drug companies of genocide

  • The Vatican has become embroiled in the battle to reduce the cost of anti-HIV medications, after a Vatican spokesman yesterday accused drug companies of “genocide” by refusing to lower their antiretroviral prices in Africa.



Are WHO and Global Fund supporting sub-standard malaria treatment?

  • “At least tens of thousands of children die every year” because the World Health Organisation and the Global Fund for AIDS, Tuberculosis, and Malaria (GFATM) continue to fund (or support the funding) the purchase of old drugs by African countries rather than the newer, more effective and dramatically more expensive artemisinin-class combination therapies (ACT), according to an editorial “viewpoint” published in the January 17th issue of The Lancet.



Once-daily topical tablet as effective as systemic drugs for oral thrush

  • A daily slow release topical oral treatment is as effective a treatment for oropharyngeal candida as systemic anti-fungal therapy in severely immunosuppressed individuals according to a study published in the February edition of the Journal of Acquired Immune Deficiency Syndrome.



French HIV-2 cohort study: treat only when plasma viral load can be measured.

  • HIV–2 is a genetically distinct virus from HIV-1, the latter of which is by far the most common form of HIV worldwide. HIV-2 is found almost exclusively in West Africa, and has tended to spread only to countries with strong links to this region of Africa: in Europe these are France and Portugal.


Swiss close to introducing voluntary HIV tests for asylum seekers

  • Switzerland looks set to offer voluntary HIV tests to asylum seekers from sub-Saharan Africa. Compulsory HIV testing is not allowed under Swiss law, and it's proposed that asylum seekers testing HIV-positive will be offered counselling, and advised about HIV transmission risks.


3. TREATING HIV & AIDS: A TRAINING TOOLKIT
NAM, the publisher of www.aidsmap.com and this electronic newsletter HIV & AIDS Treatment in Practice, has launched a major new resource, Treating HIV & AIDS: A Training Toolkit.

This project is a response to the scaling-up of antiretroviral therapy in
resource-limited settings, and was developed with the support of doctors providing training on ARVs in Botswana, Kenya and South Africa.

The training toolkit is designed to provide basic training on HIV
treatment and care for health care workers in resource-limited settings, to support the safe and effective introduction of antiretroviral therapy.

The training toolkit contains modules on:

  • Introduction to HIV and AIDS

  • Preparing the patient for treatment

  • Monitoring Tests

  • A Basic Package of Care

  • Introduction to anti-HIV Therapy

  • Changing Treatment

  • Drug Combinations: training module for each drug combination suitable for use in resource-limited settings

  • Tuberculosis and HIV

  • Treatment in Pregnancy

  • Infant Feeding


Further modules will be added during the course of 2004. Register today and receive alerts when new material is added or existing modules are updated.

This project was developed with financial support from Action Aid's Supporting the International Partnership Against AIDS in Africa programme.



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