The Washington Blade Online - July 31, 1998
Lisa Keen

"The reason for the racial predilection of [HIV-associated nephropathy] is unknown," wrote the researchers, according to Reuters. But, they noted, a number of medical conditions, such as hypertension and diabetes mellitus, also occur more frequently among blacks.

Researchers see perils in halting therapy

In a follow-up to similar reports at the AIDS conference earlier this month, researchers at the National Institute of Allergy and Infectious Diseases (NIAID) reported that, even when a person's viral load has gone below the level of detection, it "almost invariably" shoots back up after a person with HIV stops taking antiviral therapy.

According to an NIAID press release, HIV lying dormant in "resting" CD4 cells are like "embers" of a smoldering fire and --to follow the metaphor-- triple-drug therapy is like rain which can douse a fire, while certain substances in the immune system (cytokines) are like oxygen which can feed the fire. Once the rain stops, the oxygen can feed the embers, enabling them to re-ignite.

The researchers, led by Tae-Wook Chun, published their findings in the July 6 Journal of Experimental Medicine.

Another try at maintenance therapy fails

Researchers from Amsterdam reported in the July 18 issue of the British medical journal The Lancet that the latest attempt to find a "maintenance therapy" of antivirals that is less burdensome than triple-drug or quadruple-drug combinations has not found success.

The researchers took 62 people with HIV who were on a four-drug therapy of two proteases and two nucleosides and who had undetectable viral loads. They then put these people on either a two-drug regimen or kept them on the four-drug combination. After nine months, 64 percent of the patients who had been switched to a two-drug maintenance therapy saw their viral loads increased to the point of detection. That compared to only nine percent of the patients who stayed on the four-drug regimen. A handful of previous studies have produced similar results in attempting to find maintenance therapies.

In brief ...

ANTIBIOTICS TO THE RESCUE? Researchers in New Zealand believe antibiotics may help stall the progression of HIV disease into full-blown AIDS, according to a report from Reuters this month. Warren Tate of Otago University told the news service that two antibiotics appear to be able to "disrupt" the proteins that HIV uses to infect and replicate.

SEE BETTER WITH C AND E: Some people with HIV who take the nucleoside analog AZT suffer from nearsightedness as a side effect. In the July 1 issue of the Journal of Clinical Investigation, a team of researchers from Spain say patients can help avert this side effect by taking high doses of the vitamins C and E. The researchers made no recommendations on how much of the vitamins patients should consider taking.

ANEMIA COULD BE DEADLY: Researchers at Johns Hopkins University reported this month that people with HIV and anemia are at increased risk for death even when their viral loads are low and their CD4 counts are improving. Anemia is a condition in which the blood has a deficiency of red blood cells, which causes paleness of skin, lethargy, and shortness of breath. Some people with HIV have experienced anemia while taking the antiviral AZT. Anemia can be treated with the drug erythropoetin or with blood transfusions.

DELAVIRDINE-INDINAVIR DOSING: A report in the July 1 issue Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology suggests that people with HIV taking the protease inhibitor indinavir may be able to reduce their dosage of that drug by taking the non-nucleoside delavirdine. According to the study, from the Upjohn Company, a small group of patients was able to reduce their daily dose of indinavir from 800mg to 400mg by adding delavirdine to their regimens. The company said further investigation is needed.

RARE RESPIRATORY INFECTION CITED: Researchers at the University of California-Los Angeles reported in the July issue of Chest that 1.6 percent of 1,171 patients with HIV infection had a fungal infection called aspergillosis associated with high risk for death. The doctors recommended that patients with advanced HIV disease be monitored for the infection, particularly if the patients have had pneumocystis carinii pneumonia or have been treated with cortisteroids. The doctors recommended patients at high risk be treated with amphotericin.
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