The Washington Blade Online - Friday, September 18, 1998
Lisa Keen

In the Sept. 1 issue of the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, the researchers report that they observed 2,343 patients between 1989 and 1996, and found that 498 (21 percent) had some degree of anemia. Patients treated with erythropoietin had longer survival time, while treatment of anemia using blood transfusions was found to diminish survival time.

Of the 498, only 91 received treatment with the anti-anemia medication erythropoietin. Interestingly, while only 16 percent of the African American patients received erythropoietin, 28 percent of the white patients did.

For diarrhea-associated wasting: Eat more

People with HIV who lose significant amounts of body weight are often doing so because of "low nutrient intake" as well as chronic diarrhea, says researchers in France.

The researchers studied 124 patients with HIV who had been suffering from diarrhea for more than four weeks. They found that the amount of wasting experienced by the patients correlated significantly with the amount of food they ate, more so than did their digestive systems' abilities to absorb nutrients from food.

"Our results stress the major role of inadequate nutrient intake in the wasting of patients with HIV and chronic diarrhea," wrote the researchers in the Sept. 1 issue of the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology. "Thus, optimizing the caloric intake must be regarded as an important goal of the management of patients with HIV and chronic diarrhea."

Baseline triglyceride level important to know

Doctors in Italy reported in the Sept. 10 issue of the New England Journal of Medicine that a person with HIV's baseline level of triglycerides can be a strong predictor of whether he or she will suffer a risky level of triglycerides after beginning protease inhibitor therapy with ritonavir.

In a letter to the Journal, three doctors from the University of Verona noted that an earlier report had suggested that only about 5 percent of patients on ritonavir suffered from dangerously increased levels of triglycerides. Triglycerides are a form of fat in the blood, and normal levels are considered less than 200 milligrams per deciliter. When levels go above 400, they are considered "high" and can lead to heart disease.

The Italian doctors said they found that 42 percent of their 52 patients on ritonavir had levels above 500 after only six months and that 15 percent had levels above 1,000 (which is considered very high). They noted that the higher a patient's level was at initiation of therapy, the greater his or her likelihood of experiencing dangerously high levels after therapy began.

The doctors suggested physicians measure patients' triglyceride levels at the start of therapy and that, if they are borderline-to-high at the start of therapy, that physicians continue to monitor them carefully.

In brief ...

KS CONTRADICTION: Contradicting an earlier study, a report in the Aug. 20 issue of the journal AIDS says that people with HIV who develop Kaposi's sarcoma have more profoundly suppressed immune systems and, therefore, shorter survival. The researchers, from Germany, compared 241 people with HIV and KS and 241 people with HIV but without KS who had similar levels of CD4 cells. The report speculates that the shorter survival time might be due to the chemotherapy administered to treat KS (treatment which suppresses the immune system) or may be due to the "interaction" of HIV with the virus believed to cause KS.

MINDING THE ABCs: Noting that malnutrition becomes a complication for as many as 90 percent of people with HIV infection, the Carl Vogel Center recently released a concise guide to help them understand the basics about ten various vitamins and minerals which people with HIV should be most concerned about. The easy-to-digest guide explains the function of each vitamin and mineral, how much of each a person with HIV should strive to take in each day, natural food sources for obtaining those levels, and other quick notes. Sponsored by the Serono Laboratories, the guide is available from the Vogel Foundation at (202) 638-0750 or e-mail at cvc@erols.com.

TREATMENT FOR BRAIN LESIONS: A report from Italian researchers suggests that a drug commonly used to fend off pneumocystis carinii pneumonia is also useful in treating toxoplasmosis which causes brain lesions. Some current treatments for the infection result in toxic side effects. Researchers in Italy studied 71 patients and found that 87 percent responded favorably and 70 percent did so well as "complete and partial resolution" of disease. The report appears in the most recent issue of the British medical journal known as the Journal of Infection.
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