 |
• SEPTEMBER/OCTOBER HIV JOURNALVIEW EXAMINES LATEST PUBLISHED RESEARCH
Pablo Tebas, M.D., authors the latest edition of HIV JournalView, The Body PRO's regular examination of notable peer-reviewed studies on HIV disease management. In our September/October
issue, Dr. Tebas analyzes the significance of recently published research on:
Click here to read the full September/October issue, or browse
our full archive of past HIV JournalView issues! |
• HIV TREATMENT & PATIENT CARE
Exclusive Podcast: Dr. Ben Young Discusses the Latest in HIV Management
What do top HIV clinicians have to say about today's critical issues in HIV management? The Body PRO recently sat down with Benjamin Young, M.D., Ph.D., of Denver ID Consultants to discuss
the latest trends in first-line antiretroviral treatment, multidrug resistance, and the complications associated with HIV and its treatment. Read the full transcript or download the podcast.  Click Here
Our interview with Dr. Young is just one of several we conducted with prominent HIV clinicians as part of a new, regular podcast feature from The Body PRO. Click
here to listen to all of our recent interviews!
Strategic Use of Antiretroviral Therapy: What to Use -- and When?
What is the current state of HIV treatment? A comprehensive talk given by Sharon Riddler, M.D., at ICAAC 2006 attempted to answer this question. She focused both on
the timing and type of regimens appropriate for treatment-naive and treatment-experienced patients. The Body PRO's Monica Gandhi, M.D., M.P.H., reports. Click Here
Acute HIV Infection: Is It the Right Time to Start Treatment?
A quarter century into the study of HIV, and we still have a tremendous amount to learn about the pathogenesis of the disease. Take
acute infection, for instance: We are still discovering details about HIV's impact on the human immune system during the initial weeks following infection, and we have yet to understand the extent
to which antiretroviral therapy can prevent immunological damage from occurring. Three experts -- Mario Roederer, Marty Markowitz and Susan Little -- presented some of the latest data on this issue during
a symposium at ICAAC 2006. The Body PRO's Eric Daar, M.D., reports on what they discussed. Click Here
HIV-Experienced Physicians May Reduce Length of Hospital Stays
Logic may lead a reasonable clinician to conclude that an experienced HIV specialist is key to the provision of optimal HIV care. Now, a new study has provided data to support this assertion: The study
of 1,191 HIV-infected patients throughout the United States found that hospitalized patients who were cared for by providers with a high level of experience caring for HIV-infected patients tended
to experience shorter hospital stays. Click Here
New 300-mg Atazanavir Capsule Allows for One-Pill, Once-Daily Dosing
On Oct. 16, the U.S. Food and Drug Administration approved a 300-mg capsule dosage of atazanavir (Reyataz), which will allow for single-pill, once-daily administration of the drug for some patients. Prior
to the approval of the 300-mg capsule, treatment-experienced, adult patients were typically prescribed two 150-mg atazanavir capsules once daily. The approval of the 300-mg capsule does not change any
dosing recommendations; the recommended dose for treatment-experienced patients remains 300 mg atazanavir + 100 mg ritonavir (Norvir) once daily, and the recommended dose for treatment-naive patients remains
400 mg atazanavir (taken as two 200-mg capsules) once daily. Click Here
Once-Daily Epzicom as Safe, Effective as Its Twice-Daily Components
Ever since lamivudine (3TC, Epivir) and abacavir (Ziagen) became available as a single, once-daily pill (known as Epzicom or Kivexa), concerns have been raised that the potent pill may
pose heightened risks for adverse effects, particularly abacavir hypersensitivity. However, a large study of treatment-naive patients appears to put these concerns
to rest: The study found that coformulated abacavir/lamivudine was as safe and effective as a twice-daily dose of abacavir + lamivudine taken separately. The Body PRO's Mark Wainberg, Ph.D.,
reports from ICAAC 2006. Click Here
U.S. Releases Rewritten Pediatric HIV Treatment Guidelines
Revised pediatric HIV treatment guidelines have been released by the U.S. Department of Health and Human Services. The revision -- a near-complete rewrite and reorganization of the guidelines
-- includes adjusted recommendations regarding the use of antiretrovirals by HIV-infected children. Click Here
Fosamprenavir Efficacy, Safety Hold Up in First-Line Study
The latest version of the U.S. HIV treatment guidelines recommend fosamprenavir (908, Lexiva, Telzir) as one of several antiretrovirals to consider prescribing as part of a first-line HIV treatment regimen.
A growing number of studies support fosamprenavir's first-line use: In a study presented at ICAAC 2006, the combination of fosamprenavir + ritonavir (Norvir) was found to rival the efficacy and safety
of another potent combination, atazanavir (Reyataz) + ritonavir, in treatment-naive patients. Meanwhile, another study showed similar treatment outcomes in HIV-infected patients using fosamprenavir, regardless
of their gender. The Body PRO's Mark Wainberg, Ph.D., reports. Click Here
|
• U.S. AIDS DRUG ASSISTANCE PROGRAMS (ADAPs)
Three Patients Die on South Carolina's ADAP Waiting List
Three HIV-infected people have died while on a waiting list for the state's AIDS Drug Assistance Program (ADAP), the South Carolina Health Department has confirmed. South Carolina's ADAP currently
serves about 1,800 clients, with nearly 300 more on a waiting list due to a lack of funding. "It's like standing on a track watching the train coming at you, but you can't move," said
Kathie Hiers, Chief Executive Officer of AIDS Alabama. "The ADAP waiting list in South Carolina keeps getting longer. ... In a poor state like this one, it's inevitable that these tragedies
will continue to occur, simply due to a lack of resources." Click Here
Study Suggests ADAPs Should Not Be "First-Come, First-Served"
Many U.S. AIDS Drug Assistance Programs (ADAPs) provide antiretrovirals not to low-income HIV-infected patients with severe immunodeficiency, but simply to those who manage to sign up first. This fact
begs the question: Might enrolling people in an ADAP based on their CD4 count be a wiser use of scarce ADAP resources? A new study in Massachusetts has found that, indeed, CD4-based enrollment criteria
would improve the health of a greater number of the state's sickest HIV-infected patients. It also would help far more minority patients, the study found. Click Here
|
• HIV/HAART-RELATED COMPLICATIONS
Anal HPV More Common Than Cervical HPV in HIV-Infected Women
A new study of HIV-infected women has found that human papillomavirus (HPV) is more frequently diagnosed in the anus than the cervix. Of the 122 women in the study, 92% had anal HPV, compared to
86% who had cervical HPV. Anal intercourse did not appear to be linked to anal HPV risk. Click Here
Older People Diagnosed With More Advanced HIV Disease
When people who are 50 or older are diagnosed with HIV, it tends to be at a more advanced stage, Spanish researchers have found. However, a separate study of Spanish patients shows that this
does not appear to impact the success of HIV treatment: Patients over 50 still responded well to therapy. Still, the study emphasizes the necessity that health care providers consider patients of
all ages to be at risk for HIV. The Body PRO's Eric Daar, M.D., reports from ICAAC 2006. Click Here
Drug Combo May Help Offset Visceral Fat Gain
As HIV clinicians know all too well, there is no magic bullet that can "cure" lipoatrophy or lipohypertrophy. However, a few drugs may be used to offset specific symptoms: For instance,
new research shows how a combination of recombinant human growth hormone and rosiglitazone may be able to reduce visceral fat in HIV-infected patients with lipohypertrophy. The Body PRO's Eric Daar, M.D.,
reports from ICAAC 2006. Click Here
Effects of Recombinant Human Growth Hormone May Persist
As the above study notes, the role that recombinant human growth
hormone may play in treating visceral fat gain is growing more apparent. Researchers have found that using recombinant human growth hormone for six months can significantly reduce central fat accumulation,
and new data presented at ICAAC 2006 show that these reductions persist for months after hormone treatment is stopped. The Body PRO's Eric Daar, M.D., reports. Click Here
Antiretroviral Exposure in Womb Does Not Affect Child's Mental Development, Researchers Say
A small, prospective Canadian study has concluded that the use of antiretrovirals by HIV-infected women during pregnancy does not appear to damage a child's mental development. Researchers compared 39
children exposed to antiretrovirals in the womb with 24 children born to HIV-uninfected mothers. After controlling for drug and alcohol use by the mothers, there were no significant differences between
the two groups of children, leading the researchers to suggest that substance use is "a stronger predictor of a poor neurodevelopmental outcome" in children than antiretroviral use. Click Here
Treatments for Low Testosterone in HIV-Infected Patients
One of the possible adverse effects of HIV infection is unusually low testosterone levels, which can cause loss of muscle mass, sexual dysfunction (in men), fatigue and depression. Approximately 30% of
HIV-infected men, and many HIV-infected women, have low testosterone levels. In this slide presentation with audio commentary (provided by HIV InSite), Donald Abrams, M.D., discusses the connection between
HIV and low testosterone, and outlines options for -- and the potential risks of -- testosterone replacement therapy. Click Here |
• HIV/STD TRANSMISSION & TESTING
Reinfection With STDs Is Common Within a Year of Treatment, Study Finds
Many individuals who have been diagnosed and treated for chlamydia, gonorrhea or vaginal trichomoniasis are reinfected within months -- and most of them may be unaware of this because they show no symptoms,
a new study by U.S. researchers has found. The study revealed that, in the first year after a patient received treatment for chlamydia, gonorrhea or vaginal trichomoniasis, 26% of women
and 15% of men developed another one of the three infections. The findings highlight the importance of repeated testing not only for patients diagnosed with a sexually transmitted disease (STD), but for
their partners as well -- even if no symptoms are noticed. Click Here
JAMA Article Examines Legal Issues Surrounding New CDC Recommendations
The history of HIV testing, as well as legal issues surrounding the implementation of new HIV screening guidelines from the U.S. Centers for Disease Control and Prevention (CDC), were the focus of a recent
article by Lawrence Gostin, associate dean at the Georgetown University Law Center, in the Oct. 25 issue of the Journal of the American Medical Association. Gostin recounted how policies for HIV
screening began in the 1980s, "when
the scientific and social context was markedly different than it is today" because "rudimentary" treatments meant that people were "unlikely to benefit from HIV testing." Gostin
writes that protecting health care workers from legal liability surrounding testing recommendations "poses yet another legal dilemma." If health care professionals fail to offer HIV tests
according to CDC recommendations, they could be found negligent, according to Gostin. Additionally, if a health care professional conducts an HIV test and knows that the
patient's partners are at risk, not protecting those partners "could
result in liability," Gostin
writes. Click Here
|
• HIV/AIDS POLICY IN THE UNITED STATES
U.S. Immigration and HIV: The Full Story
The U.S. immigration process is a sea of red tape, paperwork and delays. For HIV-infected individuals, though, the nightmare is even worse: One of the
most embarrassing facts about U.S. immigration policy is that for nearly 20 years, people living with HIV have been officially banned from entering the United States, with some limited exceptions. The
U.S. Congress has long held that HIV is a "dangerous,
contagious disease" and that lifting the ban would harm public health and put financial burdens on the country. Activists, public health agencies, UNAIDS and the International Organization for Migration
have all condemned the ban. This article from AIDS Community Research Initiative of America outlines the history of the HIV ban and its impact on visitors, immigrants and refugees. Click Here |
• HIV RESEARCH NEWS
Research Center Withdraws Proposal to Conduct HIV Experiments on Sooty Mangabeys
The Yerkes National Primate Research Center has withdrawn a proposal to conduct HIV research on sooty mangabeys, an endangered monkey species that is believed to have provided the "bridge" between
simian immunodeficiency virus and HIV-2. Yerkes, based at Emory University, proposed to help conserve sooty mangabeys in the African wild in exchange for permission to conduct HIV research on captive sooties,
which Yerkes scientists have cared for since the late 1960s. Primate specialist Jane Goodall and 18 other researchers wrote a letter
to the U.S. Fish and Wildlife Service, calling on the agency to reject the Yerkes research proposal. Click Here
|
|
• HIV OUTSIDE THE UNITED STATES
Leprosy Emerging as Comorbidity in HIV-Infected Patients in Developing
World
As antiretrovirals become more readily available to HIV-infected patients in developing countries, an unexpected adverse effect has begun showing its spots: In some patients, treatment is awakening dormant
leprosy infections. As treatment yields immunologic recovery, newly produced white blood cells carry bacteria from dormant leprosy infections to the skin of a patient's face, hands and feet. Only 12 such
cases have been reported in medical literature since 2003, but experts believe the number is likely to increase in the developing world, where 300,000 new leprosy cases were reported last year and 38 million
people are living with HIV. "[This new comorbidity] is not a matter of concern for public health," according to the World Health Organization, since leprosy
can be treated with free antibiotics. However, those added pills could be a burden for HIV-infected patients, many of whom already take three antiretrovirals a day -- some of which interact with
rifampin, one of the primary drugs used in leprosy treatment. Click Here
Shortage of Health Workers in Developing Countries Affecting Global Health Efforts, Including Fight Against HIV
The critical shortage of health workers in developing countries is affecting global health efforts, including the fight against HIV, and must be addressed, a panel of experts said at a recent event
sponsored by the Global Health Council. According to the panel, the most significant challenge is retaining health workers in developing countries, particularly when they are being offered
better jobs and higher wages in wealthier nations. According to the World Health Organization, sub-Saharan Africa is experiencing a shortage of nearly 1.5 million doctors, nurses and
midwives. In a two-year research project examining health systems in five African countries, it was found that the rates of health workers leaving -- either to go to other countries or to the private sector
-- were usually higher than the number of health workers entering the market. Without increasing the number of health workers, experts say, the United Nations Millennium Development Goals,
which include stopping the spread of HIV, may not be feasible. Click Here
|
|
|
|
|
Back to Top
