The Washington Blade - Friday, April 2, 1999
Lisa Keen

St. John's wort is an herb used by some to help in the healing of wounds and to treat depression, insomnia, diarrhea, and some gastrointestinal problems. According to researchers at New York University Medical Center, Harvard University and Beth Israel Hospital in Boston, and the National Institutes of Health in Maryland, some people with HIV also use the herb to fight HIV infection. To examine the efficacy of the herb against HIV, the researchers studied the treatment of 30 patients with the key compound of St. John's wort, hypericin.

Their findings, reported in the March 16th issue of the Annals of Internal Medicine, indicated that hypericin had "no antiretroviral activity" and produced a "serious" painful skin reaction that required more than half of the patients to stop treatment.

Studying urological problems with indinavir

A report from researchers in California published in the April issue of the Journal of Urology indicates that x-rays are not useful in detecting kidney stones in the urinary tract. According to researchers at the University of California-San Francisco, indinavir in the urinary tract has a "soft putty-like quality" that can "obstruct, cause renal colic and may eventually calcify." Because it takes this form, noted the researchers, neither x-rays, computed tomography (CT) scans, nor other similar diagnostic scans were reliably able to diagnose the indinavir calculi.

Meanwhile, a researcher in the Netherlands reported in the March 11 issue of the journal AIDS that 14 of 15 patients experiencing urological problems while on indinavir had concentrations of the protease inhibitor in their blood that were significantly greater than the concentrations of another group of 15 patients on indinavir who were not experiencing such problems. After reducing the dosages of six patients experiencing the problems, he found they were able to keep their viral loads below 500 while resolving the urological problems. The researcher suggested further research "to determine the long-term effects of dose reductions."

Researchers at the Aaron Diamond AIDS Research Center in New York and other institutes reported in the March issue of the Journal of Infectious Diseases that alterations in doses for protease inhibitors and/or replacing one protease drug with another protease drug "did not compromise suppression of HIV-1 replication." The changes were necessary after four of 12 research participants had to withdraw from a study of a ritonavir-combination, adjustments had to be made in dosing of two others, and three subjects had "poor" compliance.

In brief ...

SUSTIVA-AZT-3TC COMBO: Researchers in New England reported last week that the combination of the non-nucleoside efavirenz plus the two nuceloside analogs AZT and 3TC has shown significant success in reducing the viral loads in a small group of patients. The reports were made at an international conference on infectious diseases, held in Berlin last week. According to a summary from the Journal of the American Medical Association's Web site, all 39 patients taking the combination for six months in one trial got their viral loads below 400 and 97 percent of them got their viral loads below 50. A second study found that the combination also lowered the amount of virus in cerebrospinal fluid, a hard-to-penetrate sanctuary for HIV in the body.

RULING OUT BLOOD CLOT: Patients with HIV who have respiratory infections that do not respond to antibiotic therapy should be evaluated for the possibility they have a blood clot in their pulmonary artery, according to a report published in the February issue of the Sexually Transmitted Infections journal. The recommendation came from a London researcher who examined the medical records of more than 3,000 patients with HIV/AIDS between April 1993 and August 1997. She found that while only 10 of these patients suffered from the severe respiratory distress caused by these blood clots, all 10 were initially diagnosed as having a respiratory infection and treated with antibiotics. Diagnosis with a blood clot calls for treatment with an anticoagulant.

OF MEASLES AND MONKEYS: New reports this month link the AIDS virus to a different monkey than the one blamed in January and to viruses that cause such common ailments as measles and the flu. In January, the report from U.S. researchers was that the AIDS virus appeared to have derived from a virus in certain west African chimpanzees. This month, researchers from Japan told a conference in Atlanta that they have found viruses similar to HIV in long-tailed monkeys in central Africa. Also, in the current journal of Molecular Cell, a Chicago researcher reported finding evidence that HIV may have a "common ancestor" with the viruses that cause measles, flu, and Ebola.

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