It may seem like forever, but we have only had quantitative HIV viral load measurements widely available for about three years. In that time, viral load has matched (if not supplanted) T-cells as the most important marker for clinical trials, drug approval, prognosis, and treatment decision-making. Three generations of
Many people with HIV are experiencing changes in their physical appearance due to new anti-viral combination therapies. Facial wasting is one of the most noticeable of these body shape changes which, according to some recent studies, affect to some degree nearly three-quarters of all people on combination therapy. Desp
The long fight for access to legal medical marijuana may finally be paying off. Last week voters passed new state initiatives for medical marijuana legalization in five different states. Voters also rejected referendums that opposed and would have changed previous pro-marijuana initiatives. The people of Alaska, Colora
Many people with HIV find themselves faced with detectable viral loads, and are unsure what to do next. There are several trials now enrolling in the Bay Area for people who are currently failing protease inhibitor containing regimens. What follows are the highlights of some of them as well as excerpts from interviews
Phil Alden is on the AIDS Drug Assistance Program (ADAP) and went to his pharmacy in Redwood City to refill a prescription. Much to his surprise, he was denied his HIV drugs. Somehow he was no longer eligible for ADAP. Actually the pharmacist told Alden that he received a message from ADAP indicating policy limits exce
Back in the darkest ages of AIDS - before there were even any unsatisfactory drugs - activists in the U.S., led by ACT UP in its heyday, went to a lot to trouble to get an influence on the way drugs got tested and the way information about them was shared. A few farsighted government officials in NIAID, the National In
Two weeks ago, the B.A.R. printed a front page article about University of California, San Francisco (UCSF) researcher Dr. Jay Levy s concerns that people with HIV are starting treatment too early. In his Lancet article, Levy, a respected, but contrarian, scientist, questioned whether early treatment of HIV was doing m
People with HIV/AIDS clearly need new options. The need for new drugs and new targets is evident by the growing number of people who are breaking through current combination therapy, and seeing their viral loads rebound into the detectable range and beyond. As in battle, the more targets that are hit, the more the enem
Full disclosure: The author is a volunteer in one of the first trials of Sustiva , DMP-003, and has been taking Sustiva in combination with Crixivan and nucleoside analogs since May 1996, with very good results. On September 18, the U.S. Food and Drug Administration ( FDA ) granted ac
The HIV community has participated in clinical trials since the early trials of AZT . Advocates have always lobbied for drug continuation for the participants in trials, as well as expanded access programs before drug approval from the Food and Drug Administration ( FDA ). Large, established
This is another report back from the Geneva World AIDS Conference. People in San Francisco are being infected with HIV that is resistant to currently available drug therapies, according to research presented at the 12th World AIDS Conference in Geneva last month. University of California, San Francisco (UCSF) doctors d
This is another report from the 12th World AIDS Conference in Geneva, Switzerland . Although the Geneva World AIDS Conference focused little on new therapies for HIV, there was a scattering of less exciting, yet important reports of new drugs in early testing. Talk of new targets for drug delivery was probably bigger n
Dr. Jay Levy, from the University of California, San Francisco (UCSF), a rapporteur for the basic science track at the XII International AIDS Conference in Geneva last month, presented data from his ongoing studies in search of the elusive and yet to be characterized CD8-associated factor (CAF). Levy, with a slight tou
Many San Francisco safe-sex media efforts during the last several years have largely de-emphasized providing basic AIDS education information or direct tools, like condoms or microbicides, to their target audiences. Now that scientists are documenting dramatic shifts in the AIDS epidemic, some activists say it s time f
In mid-April of this year, I underwent an experimental radiation treatment for HIV. Since then, friends have been making jokes about how radiant I look and how I must glow in the dark, etc. But I laugh along with them because I was lucky enough to be chosen to be the first subject in a trial to attempt to eradicate hid
Setting aside for a moment the well-known difficulties of discovering or designing new drugs and vaccines, perhaps the most complicated problem for modern medicine is how to find out if they really work in humans without putting people at unnecessary risk. This puzzle has several well-defined pieces, but it is particul
Heart disease, a very odd and possible serious consequence of living longer with HIV, has been reported in two men using antiretroviral therapy. Although heart attacks were seen before antiretrovirals were in wide spread use years ago, new reports are coming from physicians who are noticing heart attacks, angina and ot
Nearly one year has passed since the University of California announced it was moving forward with liver and kidney transplants for HIV+ patients. Unfortunately, since that announcement UC has performed only one HIV+ liver transplant, which the patient s insurance company evidently covered. Although UC officials refuse
Arguably the most essential area of AIDS research is conducted at basic science laboratories across the country and around the world. Since there is so little understanding and awareness of either the science or the process of basic research, this writer sat down with one of basic science s rising stars to discuss the
Cryptosporidium, the microscopic parasite that causes cryptosporidial diarrhea, is back in the news. San Francisco General Hospital has reported three new cases of cryptosporidosis (crypto) in the last month, after having no diagnosed cases in the previous six months. On May 6, 1998, the Antiviral Drug Advisory Committ
Last September an article in this space, entitled San Francisco s Vaccine Vanguard, described enrollment in San Francisco and 13 other cities of HIVNET 014/AVEG 202, a Phase II trial of two candidate preventive vaccines, Pasteur Merieux Connaught (PMC) s ALVAC vCP205, used with and without Chiron rgp120. A Phase II tri
In January the hump of fat that had grown on John s upper back and neck had become so large that he knew something needed to be done. I couldn t keep my head erect, he now recalls. I was starting to feel like I was suffocating. Three weeks ago John had more than a half liter of fat removed from the hump, in a liposucti
One month ago the moratorium on federal funding for needle exchange expired, and the AIDS community saw the first hope that a long fought battle might be won. Inside the White House, rumors circulated that Clinton was going to support future funding. But in a typical Clinton switch, the ban was not lifted even though t
Ask any person with advanced HIV or AIDS about their feet and you will probably hear a litany of complaints ranging from ingrown hairs to rampant warts, fungus, and neuropathy. Not only are HIV-positive people s feet immune suppressed, they are also under increased strain because they are an extremity with less circula
While many people with HIV have clearly benefited since the advent of using protease inhibitors, there still remain relatively large numbers who, for whatever reason (adherence, toxicity, malabsorption, hypermetabolism, resistance) have broken through and through a narrow definition can be defined as virologic failures
Thirty-seven percent of gay men recently surveyed by ACT UP/Golden Gate report having had unprotected anal sex as a bottom or a top in the last six months. Unprotected anal sex, sometimes referred to as barebacking, is on the rise; in 1994 24 percent of gay men reported barebacking in STOP AIDS street surveys. Although
Bill Snow and Larry Hanbrook, ACT UP/Golden Gate Writers Pool
San Francisco, The Bay Area Reporter, and ACT UP/Golden Gate have been in the forefront of educating people about the pros, cons, and availability of Post Exposure Prophylaxis for HIV. This seems an appropriate moment to look at what s available in San Francisco today. The idea of offering antiviral medication to HIV-n
We are seeing another crisis developing in the health delivery system for people with HIV/AIDS. Opportunistic infections and death rates are down because of the use of protease inhibitors, but there are side effects to these drugs. The increase of liver toxicity, high levels of triglycerides, and fat redistribution are
The advent of Highly Active Anti-Retroviral Therapy (HAART) has been a blessing to the HIV/AIDS community for the last 18 months: AIDS deaths dropped almost 50 percent, a figure displayed proudly on the cover of Time magazine. Many people, even those with high viral loads and low CD4 counts, didn t progress from HIV-in
It s a sure bet that Glaxo Wellcome s antiviral drug 1592 ( abacavir ) is another important option for people with AIDS, but whether it s the remedy activists desperately demanded months ago with zaps, civil disobedience, and boycotts is another question. New data from abacavir is becoming available as researchers, cli
Allen Hext is an HIV-positive person who also happens to have Hepatitis C. Unlike most HIV patients, Hext s most immediate concern is liver damage caused by Hep C. Hext has been denied access to liver transplantation because he also carries the AIDS virus. Hepatitis C (HCV) is a frightening new epidemic that is spreadi
The greatest success to date in the history of the HIV epidemic has been the use of Highly Active Antiretroviral Therapy (HAART). Nevertheless, it is clear that, considering the number of viral breakthroughs, the persistence of latently infected cells that remain untouched by HAART, and the anecdotal reports of people
In an article last September, ACT UP/Golden Gate first addressed the question of discontinuing prophylaxis for Opportunistic Infections (OI) like Pneumocystis carinii pneumonia ( PCP ), cytomegalovirus ( CMV ), and mycobacterium avium complex (
In 1992 Mark Misrok had been driving a San Francisco cab for four years. He had attended two prestigious universities, but with dozens of friends ill and many dead from AIDS, he recalls, I spent most of the 80s waiting to get sick myself. The idea of me developing a career seemed absurd. Misrok did not get sick, and I
Two weeks ago, you may have seen and been confused by a news story circulating among mainstream media outlets - not the B.A.R. - about a preventive HIV vaccine from the local company VaxGen going into clinical trials. The story of this story, how it began, how it took off, how it ended, and what it meant tells a lot ab
If clinical trials continue in the current trend, AIDS research will suffer and the advances made up to now will be for naught. There are inherent design problems with trials today that must be changed if progress is to continue in the coming years. Hopefully a change is in the works that may resolve most of the issues
Starting immediately, people with AIDS who have failed combination drug treatments will have wider access to a new anti-HIV drug before its final approval by the FDA . The drug, adefovir dipivoxil (brand name Preveon), is manufactured by Gilead Sciences , a pharmaceutical company in Foster City, California.
Proposition 215, the California initiative that allows the cultivation, prescription, distribution, and use of medical marijuana to people with life-threatening illnesses, has been a source of constant controversy since it was passed by voters. On one side are law enforcement agencies and anti-drug groups, and on the o
This information is designed to support, not replace, the relationship that exists between you and your doctor.