Bay Area Reporter - December 27, 2007
Bob Roehr

The good news is that two new classes of drugs for treatment were approved by the federal Food and Drug Administration and became available for use. It was the most important addition to therapy since the introduction of protease inhibitors more than a decade ago.

The CCR5 entry inhibitor maraviroc came first, approved in August. It prevents HIV from entering the cell in the first place. In October the integrase inhibitor raltegravir followed; it blocks the virus from becoming part of the cell DNA and making additional copies of the pathogen. Both must be used in combination with other active drugs or the virus will quickly develop resistance to them.

However, earlier drugs had so radically changed therapy, with many people literally rising from their deathbeds, that few truly realized how important the introduction of the new therapies might prove to be.

Prevention science took a double blow this year. In January, a trial of microbicides in Africa was stopped when women using the vaginal gel were found to be more likely to become infected with HIV than those using a placebo gel.

More shocking was the news in September that the leading HIV vaccine trial, run in North America and South America, was being stopped for the same reason - those who received it were more likely to become infected than those who did not. Researchers still do not understand why.

There was at least the appearance of some good news on the prevention front as UNAIDS cut its estimate of the number of people infected with HIV from 40 million to about 33 million in its annual report issued in November. The numbers reflected better estimates, not a change in the number of people living with the virus.

Even while international estimates were falling, there were rumblings that estimates of new infections in the U.S. were going up - by as much as 50 percent, to 60,000 a year. This reflects better data from testing and names reporting that results in cleaner data. But the CDC refused to release those new numbers until the figures undergo outside expert review.

Prevention activities continue to fade in the U.S., as the CDC budget has been held steady since 2000, with the purchasing power of those dollars declining by 19 percent due to inflation.

The treatment side fared a little better. The modest increases in funding for AIDS services under the Ryan White CARE Act have not kept pace with the larger number of people the program must serve. That's because the drugs work so well; more people are living longer, healthier lives.

The pressure on services will get worse in 2008 as the CDC's program to test more people at risk to learn of their HIV status kicks into higher gear. More people will learn they are HIV-positive and seek services.

071227
BR071215

Always watch for outdated information. This article first appeared in 2007. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2007. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .