The Washington Blade - June 25, 1999
Lisa Keen

Reporting in the June 5 issue of the British medical journal The Lancet, the Henry Mondor Hospital researchers said they compared the use of a two-drug combination alone (AZT-ddI because, when the study started, protease inhibitors were not yet in use) against the use of the combination plus IL-2 administered either intravenously or subcutaneously in a total of 96 patients whose mean CD4 count was 384. As is common, all patients taking IL-2 in this study experienced symptoms similar to the flu. And while patients taking only antiviral drugs experienced about a 55-cell increase in CD4s, patients on subcutaneous IL-2 had experienced an increase of about 564 CD4 cells after a year, and those on intravenous IL-2 saw a gain of about 676 CD4s after a year. The researchers said the difference in subcutaneous and intravenous cell rises is not significant. But, they noted, "The duration and the severity of side-effects were ... less pronounced in the subcutaneous group and allowed patients to be treated at home."

Last December, German researchers reported that the addition of IL-2 to therapy involving the protease inhibitor saquinavir and two nucleoside analogs (AZT-3TC) in patients with similar CD4 counts triggered "significant increases" in CD4 counts but that this increase "steadily diminished" over time. But they also found that the risk of certain opportunistic infections seemed three to five times lower in patients receiving IL-2 with the three-drug combination.

In brief ...

DOUBLE WATER INTAKE: Doctors at Lenox Hill Hospital in New York suggest in the June issue of The Journal of Urology that patients taking indinavir drink about twice the amount of water recommended by its manufacturer. Merck advises patients on the protease inhibitor to drink at least 1.5 liters of water per day to help prevent one of the drug's side effects. (Although indinavir is considered the protease inhibitor with the fewest side effects, it is believed responsible for the formation of so-called "kidney stones.") The Lenox Hill doctors recommend 3.0 liters per day with particular attention to drinking more water "in the three hours after ingestion of the medication."

DON'T WORRY, BE HAPPY: Researchers at the University of North Carolina and other sites around the country have published some data illustrating what some people know intuitively: Stress is bad for one's health, while social support is good. This study, however, was specific to HIV disease. The researchers followed 82 Gay men with HIV infection, examining them every six months, for more than five years. On each visit, stressful events in their lives (except those associated with HIV disease) were given numerical ratings from zero (no stress) to four (posing severe threat) and calculated in an elaborate formula taking into account various control factors. A similar scoring was done concerning the social support each man experienced (on a scale of one to six). They found that for every four-point stress event or set of two two-point stress events, the man's risk of progressing to full-blown AIDS doubled. For every one-point drop in social support, the risk almost tripled. The study appears in the June issue of Psychosomatic Medicine.

ASSESSING THE RISK: A study of 52 men with HIV found that one test indicated that seven men had no virus in their semen, suggesting that their ability to transmit the infection sexually might be minimal. Evidence of virus could still be detected in three of the seven through other tests. "Our findings," noted the French researchers in the May 7 issue of the journal AIDS, "suggest that the use of low or undetectable HIV RNA levels in blood plasma and ... seminal plasma, to conclude on a minimal risk of HIV sexual transmission, should be subject to caution."

NATIONAL TEST DAY: The U.S. Centers for Disease Control and Prevention estimate that about 200,000 people in the United States have HIV infection but don't know it. To address this concern, the CDC, the National Association for People With AIDS, Whitman-Walker Clinic, and others are sponsoring "National HIV Testing Day" on Sunday, June 27, to urge people who might be at risk to take the test. The campaign emphasizes that there are a variety of ways to get the test -- from the use of an approved Home Access test in the privacy of one's own home to a doctor's office or a clinic specializing in HIV services.

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