Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
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The San Francisco Examiner; Wednesday, February, 4, 1998
Lisa M. Krieger of the Examiner Staff
They credit the decline to new potent drugs called protease inhibitors, used in combination with older anti-viral agents. Between 1994 and 1997, diagnoses of cytomegalovirus retinitis have dropped 94 percent; pneumocystis pneumonia, 71 percent; mycobacterium avium, 83 percent, and cryptococcus meningitis, 63 percent.
During this same period, the use of protease inhibitors rose 70 percent.
"The decrease in opportunistic infections is remarkable in this study," said clinical pharmacist Christopher Holtzer, lead author of the study. "And the rise in protease inhibitor use correlates with this decline."
While the data is encouraging, more research must be done to clarify the findings, Holtzer said.
The findings were presented at the ongoing Fifth Conference on Retroviruses and Opportunistic Infections in Chicago.
Vaccine update
*A physicians group that plans to test an AIDS vaccine on humans - a vaccine that features live strains of the virus - says test subjects will get free medicine if they contract the disease.
More than 200 people, mostly doctors and other health care workers, have volunteered to test the vaccine, according to The International Association of Physicians in AIDS Care.
"We don't expect people to progress into AIDS, but we're trying to avoid that "reckless' label that some people have assigned to us in the world," said volunteer Joe Zuniga.
The Food and Drug Administration, which has not yet approved any AIDS vaccines that include a live virus, is reviewing the plan. The group hopes to begin the trial in 2000 and have an effective, safe vaccine by 2007. The first trial would begin by injecting five volunteers. If it appears safe, the number of participants would be gradually increased.
Asked whether he personally would try such a vaccine, Dr. David Baltimore of the AIDS Vaccine Research Committee of the National Institutes of Health replied, "No, I would not."
Baltimore believes the vaccine is still too risky for human tests. There is increasing evidence in monkeys that the vaccine itself can cause HIV infection in some cases, he said.
But he stopped short of saying that the physicians group shouldn't be allowed to test the vaccine. "I think the group is fully aware of the consequences," he said.
The group said it had lined up three pharmaceutical makers to provide free medicine to the volunteers if they needed it. *A safe and effective HIV vaccine is probably a decade or more away, Baltimore said.
In December 1996 President Clinton appointed Baltimore to head a new HIV vaccine committee and challenged the scientific community to develop an effective vaccine within a decade.
The problem is that researchers still don't know exactly what kind of approach is needed to make a vaccine work, Baltimore said. It has been believed that vaccines work by either prompting the body to produce antibodies or by mobilizing special immune system cells, called cytotoxic T lymphocytes.
But recent discoveries from unsuccessful attempts at creating HIV vaccines suggest there may be a third mechanism, still not understood, said Baltimore.
More than 2,400 Americans have taken part in at least 24 different vaccine trials.
Drug news
*Glaxo Wellcome's new AIDS drug abacavir, also known as 1592, has potent effects in combination with any of five protease inhibitor drugs, research shows.
A two-drug regimen with abacavir could be superior to current three-drug regimens, offering fewer side effects and a less complex pill-taking regimen, according to Glaxo.
Glaxo plans to file for FDA approval of abacavir within the next six months.
*New data suggest the experimental protease inhibitor drug, amprenavir, could be a cornerstone of powerful dual-drug therapy involving any one of three other protease drugs.
Patients on the combination drug therapy saw their HIV levels drop by about 3 logs, a measurement that means a 1,000-fold drop or a reduction of about 99.99 percent.
The drug is made by Vertex and Glaxo Wellcome. Unlike other protease inhibitors, amprenavir is designed to be taken twice a day without regard to meals, and it has relatively few side effects.
Local news
*The final report from last week's AIDS Summit is available, for free, to interested individuals. Call (415) 554-6657.
*A free, interactive telephone conference, called "Report From the Fifth Conference on Retroviruses and Opportunistic Infections" will be held at noon Thursday, featuring Dr. Stephen Follansbee of Davies Medical Center and others. Advance registration is required. Call 1-800-707-BETA to register.
* "Fifth Conference on Retroviruses: A Report," a town meeting sponsored by Project Inform, is scheduled for next Wednesday from 6:30 to 9 p.m. at UCSF Laurel Heights Conference Center. Call (415) 558-8669.
*The Positive Center, a nonprofit community-based organization in San Anselmo, is offering a new series of free weekly workshops for Marin residents living with HIV and AIDS. Topics include: returning to work, medication compliance, cooking and hepatitis C. Call (415) 456-8065.
The toll
Steven R. Pastrone, 44, who started his own house-cleaning business Decent Help and who loved the fine arts, theater, architecture and history of the Bay Area . . . Larry L. Romano, 39, who loved music and the Art Deco style of the 1920s and 1930s and who enjoyed collecting and restoring old phonographs, radios, clocks and antiques.
. . . . . .Date . . . . . .reported. . Cases. . Deaths S.F.. . . .2/1 . . . . 25,073. .17,027 Calif.. . .2/1 . . . .105,121 . 66,450 U.S.. . . .2/1 . . . .612,078 .379,258 WHO(rprtd) 2/1 . . .8,400,000 6,400,000 Figures are cumulative since June 1981. Government officials now compile and release statistics quarterly, not monthly.
To contribute to AIDSweek, call (415) 777-7867.
Figures are cumulative since June 1981. Government officials now compile and release statistics quarterly, not monthly. To contribute to AIDSweek, call (415) 777-7867. AIDSweek columns are available on the Internet at www.examiner.com / aidsweek / aidsweek.html
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