The Washington Blade; Friday, February 6, 1998
Lisa Keen

Anemia is a condition marked by a deficiency of red blood cells which carry oxygen to the rest of the body. In a study of medical records for more than 13,000 people with HIV or AIDS, CDC found that almost 37 percent of people with full-blown AIDS had anemia, as did 12 percent of people with HIV infection and CD4 counts below 200. About 3 percent of people with HIV infection and CD4 counts above 200 had anemia.

"The incidence of anemia was strongly and consistently associated with progression of HIV disease," noted a CDC press release.

Acyclovir study raises red flag

A study in New York, published in last month's Clinical Infectious Diseases journal, indicated that acyclovir, commonly used to treat herpes in people with HIV, does not prolong survival, as two earlier studies suggested. The study involved analysis of data from more than 2,300 patients with AIDS over a four-year period.

Instead, according to Reuters, the study, conducted at New York's St. Vincent's Hospital, indicated the use of acyclovir was "associated with an increased risk of death," particularly when the acyclovir was taken periodically (as opposed to continuously). The researchers said the study results should be interpreted "very cautiously" because they were not part of a controlled study and thus "it is not clear why some patients" were given acyclovir.

In brief ...

MAC CHECK ADVISED: Researchers in Boston reported in the Jan. 24 issue of The Lancet that five out of five of their patients with HIV, Mycobacterium avium complex (MAC), and a CD4 count of less than 50 developed "severe" MAC-associated illness requiring hospitalization within one to three weeks of starting indinavir therapy. They recommended screening patients for MAC before initiating indinavir and/or that preventive therapy for MAC be initiated before indinavir. Meanwhile, another study in The Lancet found that triple-drug therapy helped resolve two other opportunistic infections: cryptosporidiosis and microsporidiosis.

MEGESTROL WARNING: A report in the Jan. 1 issue of the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology notes that researchers in Alabama have found a strong possibility that the use of megestrol to fight AIDS-related wasting might be associated with hyperglycemia in some people with AIDS. The data, according to Reuters, "indicate hyperglycemia developed after starting or increasing megestrol." The hyperglycemia resolved after the patients stopped taking megestrol, but reappeared when the patient tried taking the drug again. Reuters noted that the doctors suggested people with AIDS be screened for hyperglycemia before initiating therapy with megestrol.

FAMCICLOVIR REDUCES SHEDDING: Researchers at the University of Minnesota reported in last month's Annals of Internal Medicine that famciclovir "significantly reduces" the shedding of the herpes virus during times when the person has no symptoms. A recent report estimated that at least one in five people over age 5 is infected with the herpes virus, which often causes painful sores on the mouth or genitals (typically when the person's immune system is weakened). But the virus can be transmitted during the asymptomatic stage if it is shedding. The Minnesota study found that twice-daily doses of famciclovir reduced shedding during the asymptomatic phase in 76 percent of patients studied.

D4T CLAIMS EDGE OVER AZT: Bristol-Myers, the maker of the nucleoside analog d4T issued a press release Jan. 28 saying that a market study showed that the "total prescriptions for d4T à surpassed AZT for the first time," according to the "latest monthly data." Doctors surveyed by GMHC mentioned combinations involving 3TC most often (19 times), then d4T (17 times), and AZT (14 times).

DOSING NEAR DEATH: Researchers at the University of California-San Francisco reported in the Jan. 12 issue of the Archives of Internal Medicine that about 48 percent of caregivers for 140 men near death from AIDS acknowledged giving an increased dose of medication (usually morphine) to hasten the patient's death. In most cases, noted Reuters about the study, the caretaker was carrying out the request of the patient "after discussion with the patient's physician."

TREATING HEPATITIS C: Reuters reported last month that a study published in the Journal of Infection suggests people with HIV and hepatitis C suffer from an "accelerated course" of hepatitis C, an increasingly common problem for people with HIV, and that it doesn't help to escalate the dosage of alpha-interferon against the hepatitis.

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