Welcome to The Body PRO Newsletter, a bi-weekly review of the latest breaking news and research in HIV medicine, aimed specifically at informing health care professionals.
August 21, 2008
In This Newsletter:
  • AIDS 2008 Highlights
  • HIV Treatment & Complications
  • Hepatits
  • HIV in the U.S. News
  • Hispanic Americans & HIV
  • Viewpoints

    David Wohl, M.D.Antiretroviral Strategy Update From Mexico City
    Which of the clinical developments presented at the XVII International AIDS Conference (AIDS 2008) are the most likely to impact HIV care? In this multimedia overview, David Wohl, M.D., guides you through the most noteworthy findings, including the latest data on abacavir (Ziagen), darunavir (Prezista), raltegravir (Isentress) and the experimental NNRTI TMC278 (rilpivirine). This CME/CE activity is available as an article, a podcast, a downloadable slide presentation and a narrated, online slide show. (Activity from The Body PRO)

    New Insights on HIV/HAART Complications & Coinfections
    What is the relationship between inflammation, HIV disease and antiretroviral therapy? What strategies can be effective at reducing visceral adipose tissue? Is pregabalin an effective treatment for peripheral neuropathy? What's new and noteworthy in the realm of hepatitis epidemiology and treatment strategy? In this discussion, David Wohl, M.D., reviews some of the key research presented at AIDS 2008 in these important areas. This CME/CE activity is available as an article, a podcast, a downloadable slide presentation and a narrated, online slide show. (Activity from The Body PRO)

    Paul Sax, M.D.AIDS 2008 Take-Home Interview: Paul Sax, M.D.
    As AIDS 2008 drew to a close, we asked some of the HIV clinical community's sharpest minds what they felt were the most important messages from the conference. In this interview, Paul Sax, M.D., offers his take, with a focus on new findings regarding cardiovascular disease and the "when to start" question. (Article and podcast from The Body PRO)


    AIDS 2008 Take-Home Interview (Patient Friendly): David Hardy, M.D.
    When we asked David Hardy, M.D., for his opinion on the most important messages from AIDS 2008, we expected a discussion on the timing of antiretroviral therapy, some thoughts on metabolic complications, and a mention of cardiovascular risk factors. We got all that and more: In this patient-friendly interview, Dr. Hardy also expressed alarm about the newly revised HIV incidence figures from the U.S. Centers for Disease Control and Prevention, as well as a damning critique of current U.S. HIV prevention efforts. (Article and podcast from TheBody.com, The Body PRO's sister site for HIV-infected and affected people)

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    Abacavir Use Yields Higher Failure Rates Than Tenofovir Among Patients With High Viral Load
    In an AIDS 2008 conference dotted by only a few truly noteworthy research presentations, ACTG 5202 was one of the big ones. Results from this important study found that patients with a baseline viral load above 100,000 were more likely to experience virologic failure when starting HAART with an abacavir (Ziagen)-based regimen than a tenofovir (Viread)-based regimen. In this one-on-one interview with The Body PRO, ACTG 5202 lead investigator Paul Sax, M.D., explains the study findings.

    TMC278 Nanosuspension Long-Acting, Well-Tolerated in HIV-Uninfected Subjects
    Could a single antiretroviral dose maintain activity for months? The answer may be yes, if the results of an early study of a novel formulation of TMC278 (rilpivirine) are any indication. In this interview with The Body PRO's Gerald Pierone, M.D., at AIDS 2008, Peter Williams, Ph.D., explains the findings, which showed that an injected nanosuspension of the experimental NNRTI was tolerable in HIV-uninfected volunteers and showed sustained plasma concentrations through 12 weeks. (Article and podcast from The Body PRO)

    Injection Drug Users Fare Just as Well on HIV Treatment, Study Says
    HAART is just as effective for injection drug users (IDUs) as it is for non-IDUs, according to a five-year study published in the Aug. 6 issue of the Journal of the American Medical Association. Previous reports had suggested that IDUs fared worse on antiretroviral therapy than their non-IDU counterparts, but the new study -- of more than 3,000 HIV-infected patients -- begs to differ: An examination of mortality rates among both groups of patients found no significant differences. (Article from the Journal of the American Medical Association)

    IAS-USA Revises Guidelines: Recommends Earlier Treatment Initiation
    Yet another expert panel has recommended HAART initiation at a CD4+ cell count of 350 instead of 200: The International AIDS Society-USA joined U.S. and European health authorities this month in urging an earlier start to HIV treatment in developed countries, saying that the faster start will help HIV-infected patients reduce their risk of experiencing long-term complications such as cardiovascular disease and cancer. (Article from kaisernetwork.org)

    The International AIDS Society-USA panel issued the new recommendations in the Aug. 6 edition of the Journal of the American Medical Association, and presented the recommendations at the opening of the XVII International AIDS Conference earlier this month.

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    Tenofovir Officially Approved by FDA as Hepatitis B Therapy
    The U.S. Food and Drug Administration (FDA) has granted Gilead Sciences Inc. permission to market tenofovir (Viread) as a treatment for hepatitis B (HBV) as well as HIV. With the decision, tenofovir becomes the second antiretroviral officially approved by the FDA as a treatment for both HBV and HIV in the United States, after lamivudine (3TC, Epivir). However, tenofovir, which has been approved for the treatment of HIV-infected patients since 2001, and has long been recognized as a treatment for hepatitis B in U.S. HIV treatment guidelines. (Article from kaisernetwork.org)

    HIV/Hepatitis C Coinfection May Increase Stroke, MI Risk, Study Finds
    HIV/hepatitis C (HCV)-coinfected patients appear more likely to experience a cardiovascular event, such as a stroke or myocardial infarction (MI), than HIV-monoinfected patients, according to the results of a massive analysis of long-term data from the U.S. Veterans Administration HIV Clinical Case Registry. In a study presentation at AIDS 2008, the investigators reported that HIV/HCV coinfection was associated with a 20% increased risk of cerebrovascular disease in the HAART era; acute MI risk was approximately 25% higher among coinfected patients in the HAART era, but this finding fell slightly short of statistical significance (P = 0.072). (Article from aidsmap.com)

    To learn more about this study, you can read the abstract or peruse the PowerPoint slide set the researchers presented at the XVII International AIDS Conference.

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    Three HIV Pharmaceuticals Promise More Assistance to ADAPs, Patients With Private Insurance
    Promises from three large HIV pharmaceutical firms could help temper costs for U.S. AIDS Drug Assistance Programs (ADAPs) and HIV-infected patients in the United States who access their antiretrovirals through private insurance. In response to a request from the HIV advocacy group Fair Pricing Coalition, GlaxoSmithKline and Gilead Sciences Inc. have promised to pay rebates for co-pays that private health insurance companies charge for their antiretrovirals. Merck & Co. refused to reimburse co-pays, but it and Gilead vowed to freeze until 2010 the prices they charge ADAPs for their antiretrovirals. (Press release from Fair Pricing Coalition)

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    As Treatment of MSM in Latin America Improves, Winning Asylum in U.S. Gets Harder
    Some Latin American countries are becoming more tolerant toward men who have sex with men (MSM) and women who have sex with women (WSW): Laws against homosexuality are being cast aside and antiretroviral access is improving. However, as discrimination and bigotry against MSM and WSW declines, it is growing more difficult for Latin American MSM and WSW to win political asylum in the United States, according to immigrant advocates. Public health officials express concern that despite the political reforms, underlying social stigma may still leave many HIV-infected individuals, MSM and WSW in Latin American countries in a difficult position, as they experience difficulties accessing health care despite a lack of official discrimination. (Article from kaisernetwork.org)

    Culture of Silence Blamed for High Rates of HIV Among Hispanic Americans
    "We have been invisible," says Guillermo Chacon, the vice president of the Latino Commission on AIDS. "I keep reminding people this is a killer in our communities." The data don't lie: Hispanics are at higher risk for HIV than whites, and are less likely to be tested for HIV until they develop symptoms -- in part because of language barriers, limited access to health care, legal problems and conservative social values. (Article from The Dallas Morning News)

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    It's Time to Demand Respect for Black People With HIV, Actress Declares
    "I am black. I am in the world. And I matter just like anybody else," says actress and longtime HIV activist Sheryl Lee Ralph. "It cannot be business as usual when it comes to black people and AIDS." In an impassioned speech at the XVII International AIDS Conference last week, Ralph poured out her anger and frustration over how little the United States seems to be doing to fight HIV among African Americans. "When will the national emergency take place? When will somebody get truly outraged?" she asked. "When is somebody going to value black people?" (Audio and article from TheBody.com)

    Shortly after her speech, TheBody.com spoke with Sheryl Lee Ralph one-on-one. In this emotional interview, she dares people to join her in a protest at the Lincoln Memorial in Washington, D.C., this September.

    "Lady With Dildos" Travels the World to Promote Women's Self-Empowerment
    What does farming have to do with dildos? Dazon Dixon Diallo knows. Known as "the lady with the dildos" in parts of the United States, Diallo and her organization, SisterLove, Inc., are famous in the Atlanta, Ga., area for the explicit parties they host for women as a fun way to promote sexual health education. Meanwhile, in South Africa, Diallo spends several months each year on a collective farm she helped form for women affected by HIV. The connection? Helping women empower themselves. "When women are ... dependent on men" -- whether economically or emotionally -- "they are vulnerable to HIV," Diallo explains. (Article from Black AIDS Institute)

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    Also Worth Noting
    CME/CE Central: Get the Credit You Deserve

    Experience insightful, clinically relevant, free presentations by top HIV clinician-researchers. Free CME/CE credit is available for U.S. physicians, nurses and pharmacists. All activities include slide presentations and accompanying audio.

    African Americans and HIV: New Developments in Clinical Management, by Adaora Adimora, M.D.

    An Update on New HIV Antiretroviral Agents, by Edwin DeJesus, M.D.

    Top 10 HIV Clinical Developments of 2007, by David Wohl, M.D.

    Women and HIV -- Natural History, Prevention and Treatment: CROI 2008 Highlights, by Kathryn Anastos, M.D.

    Management of Treatment-Experienced Patients: CROI 2008 Highlights, by Cal Cohen, M.D., M.S.

    Complications of HIV/HAART: CROI 2008 Highlights, by David Wohl, M.D.

    First-Line HIV Therapy and Treatment Strategies: CROI 2008 Highlights, by David Wohl, M.D.

    A wealth of additional activities awaits you at The Body PRO's CME/CE Central!