•  IAS 2007: EXCLUSIVE PREVIEW PODCAST

What new research does IAS 2007 hold in store? What presentations have the potential to change the way we practice HIV medicine? Listen to this exclusive preview podcast to find out!

•  HIV TREATMENT

Graeme Moyle, M.D., Authors the July 2007 Issue of HIV JournalView
Read the latest edition of The Body PRO's digest of the most important, recently published studies on HIV. In our July issue, Graeme Moyle, M.D., examines topical issues such as the potential for shifting HIV tropism (and its possible impact on the use of CCR5 antagonists), the metabolic effects of NNRTIs vs. protease inhibitors, and recent research on valproic acid, which appears not to have the decaying effect on latent HIV reservoirs that some researchers had initially hoped. Click Here


Darunavir Beats Lopinavir Virologically in Treatment-Experienced Patients, Study Reveals
HIV treatment-experienced patients are significantly more likely to achieve an undetectable viral load after 48 weeks of treatment if they are taking a regimen based on darunavir (TMC114, Prezista) + ritonavir (Norvir) than lopinavir/ritonavir (Kaletra), according to newly published TITAN study results. The study found that 71% of patients receiving darunavir reached an undetectable viral load by week 48, compared to 60% of patients receiving lopinavir/ritonavir. Rates of treatment discontinuation due to adverse events were similar between the two arms, although the lopinavir/ritonavir patients received the old capsule formulation of the drug, which appears more likely to cause diarrhea than the new tablet formulation. The TITAN results appear in the July 7 issue of The Lancet. Click Here


Darunavir + Etravirine More Effective Than Darunavir Alone in Treatment-Experienced Patients, DUET Studies Find
A highly protease inhibitor- and NNRTI-experienced patient receiving ritonavir (Norvir)-boosted darunavir (TMC114, Prezista) is more likely to achieve an undetectable viral load if the experimental NNRTI etravirine (TMC125) is added to the patient's regimen, according to newly published results from the DUET studies in the July 7 issue of The Lancet. The authors of an accompanying commentary note that a pooled analysis reveals a statistically significant decreased likelihood of clinical events among patients taking darunavir + etravirine as compared to patients taking only darunavir. Click Here

The new DUET 1 study results, DUET 2 study results and accompanying commentary are available online.


FDA Agrees to Accelerate Review of First HIV Integrase Inhibitor
MK-0518 (raltegravir) is on the fast track toward possible U.S. approval, thanks to a decision last week by the U.S. Food and Drug Administration (FDA). The FDA's decision to grant priority review status to MK-0518 means the drug could be approved as early as mid-October. MK-0518 is the first in a new class of antiretrovirals known as integrase inhibitors. Clinical trials of MK-0518 have indicated strong activity in patients with multidrug-resistant HIV. Click Here


Cross-Resistance Among Integrase Inhibitors Appears Likely
MK-0518 (raltegravir) has generated a great deal of excitement among HIV clinicians due to what appears to be an impressive level of efficacy in heavily treatment-experienced patients. But what effect could resistance to MK-0518 have on other integrase inhibitors, such as as elvitegravir (GS9137), an integrase inhibitor in development? Early signs don't appear very promising, according to research presented in June at the XVI International HIV Drug Resistance Workshop. The studies suggest that cross-resistance may be an Achilles' heel of this budding class of drugs, at least when it comes to MK-0518 and GS9137. Click Here


Early, Short-Term Treatment May Slow CD4 Decline, Study Suggests
A three-month course of HAART during acute infection may reduce a patient's rate of CD4+ cell count decline, thus delaying the need to initiate long-term antiretroviral therapy, a study by United Kingdom researchers suggests. The study, published in the June 2007 edition of AIDS, compared 89 patients who began a short-course of HAART during their second month (on average) after HIV seroconversion to 179 controls. The results, through a median of 2.5 years of followup among the short-course patients, found no significant difference in terms of viral load, but a significantly lower rate of CD4+ cell count decline. However, the lack of longer-term data and the non-randomized study design, among other limitations, led the researchers to warn that they were unable to conclude that short-course treatment during primary infection is superior to no treatment at all. Click Here

A more robust, international study examining the potential benefits of short-course therapy during primary HIV infection is currently underway. To read more about the study (SPARTAC), click here.

•  COMPLICATIONS IN HIV-INFECTED PATIENTS

Outbreak of Severe Syphilis Reported Among HIV-Infected MSM in U.S.
Researchers are warning about the potential spread of symptomatic early neurosyphilis in the United States among men who have sex with men (MSM). A study published in the June 29 edition of Morbidity and Mortality Weekly Report reported 49 such cases among HIV-infected MSM in four major U.S. cities between January 2002 and June 2004. Symptomatic early neurosyphilis, which occurs during the first 12 months of infection, is considered rare, but can lead to blindness or stroke if untreated, pointing to the importance of frequent sexually transmitted disease screening for sexually active MSM. Click Here


Early HCV Treatment Successful in HIV-Infected Gay Men
Nearly two-thirds of HIV/hepatitis C (HCV)-coinfected patients can achieve a sustained virological response when treated during the acute phase of HCV, reported researchers on June 7 at the Third International Workshop on HIV and Hepatitis Coinfection in Paris. The British researchers collected retrospective data from four treatment centres between 1999 and early 2006. Seventy percent of the patients had genotype 1 HCV, which is considered hard to treat. Patients most likely to be successfully treated were those whose baseline HCV viral load was under 800,000 copies/ml and whose HCV viral load became undetectable after four weeks of treatment. Click Here


AIDS Patients at Greater Risk for More Than 20 Cancers
Are patients with AIDS at greater risk than HIV-uninfected patients for malignancies? The answer, according to a study published in July 7 issue of The Lancet, is yes. Researchers from the University of New South Wales in Sydney, Australia, write that "immune deficiency is the probable explanation for the increased cancer risk." An increase in AIDS-related cancers such as Kaposi's sarcoma was seen, as well as malignancies linked to human papillomavirus infection, which include anal, oral and esophogeal cancers. However, the researchers, acknowledged that "the bulk of the data came from studies that followed people only after the onset of AIDS, and in the era of highly active antiretroviral therapy (HAART), these people comprise an increasing minority of HIV-infected people." Click Here

•  HIV IN THE U.S. NEWS

HIV-Infected Man Sues for Right to Use Marijuana to Treat Nausea
An HIV-infected man is suing the U.S. state of Colorado, claiming that state regulations have made it impossible for him to obtain medical marijuana to relieve intense nausea that he says is caused by his HIV and hepatitis C medications. Colorado, along with 10 other U.S. states, does permit the medical use of marijuana. But Damien LaGoy, who was been living with HIV since 1987, says that stringent rules have forced him to choose between buying marijuana illegally and skipping his prescribed medications. Click Here


Democratic Presidential Candidates Talk HIV
Democratic presidential candidates in the United States recently weighed in on current efforts to fight HIV domestically. Each of the eight candidates expressed their views during a televised debate in June that was dedicated specifically to domestic problems among minorities. "Let me just put this in perspective," said Sen. Hilary Rodham Clinton. "If HIV/AIDS were the leading cause of death of white women between the ages of 25 and 34, there would be an outraged outcry in this country. If we don't begin to take [HIV] seriously ... we will never get the services and the public education that we need." Click Here

•  U.S. HIV TESTING

Illinois Law Allows HIV Testing Without Written Consent
A new law allows people in Illinois to provide consent for HIV tests verbally instead of filling out formal paperwork. The law, which was signed by Governor Rod Blagojevich on June 27, requires pretest counseling and post-diagnosis referral to care. Patients are guaranteed the right to refuse testing. Click Here


Despite Obstacles, U.S. Health Officials Are Slowly Transforming HIV Testing
U.S. health officials are expanding and reshaping HIV testing programs, but major obstacles to improving access to HIV tests remain, a survey of AIDS program directors in 49 states shows. While the U.S. Centers for Disease Control and Prevention (CDC) has called for routine HIV testing and a simplified testing process, some health officials say that wide-scale testing is too costly and state laws often require the very kinds of time-consuming procedures the CDC would like to do away with. Click Here

•  HIV OUTSIDE THE UNITED STATES

Kazakh Health Care Workers Sentenced for Infecting Kids With HIV
Seventeen health care workers in Kazakhstan have been sentenced to prison for infecting 118 children with HIV through tainted blood transfusions. Poverty seems to be the catalyst for these infections: Some of the convicted physicians, who earn as little as US$175 a month, say they had no choice but to sell patients' blood -- which turned out to be tainted -- in order to earn additional income. Click Here


Not Enough Money in the Bank for HIV Prevention Programs Worldwide
It's not exactly ground-breaking news that the world's HIV prevention programs need more funding. But what may surprise you is that -- if they had the money -- these programs could prevent half of the 60 million new cases of HIV expected by 2015, according to a new report by the Global HIV Prevention Working Group. The report says global spending on HIV must double within three years, to US$22 billion per year, and about half of that money should be spent on prevention to noticeably decrease the number of new HIV cases. Click Here