The Washington Blade - Friday, October 16, 1998
Lisa Keen

In its press release Oct. 7, HHS reported that AIDS-related deaths in the United States "declined an unprecedented 47 percent from 1996 to 1997. It showed HIV and AIDS as responsible for 16,685 deaths in 1997, placing the disease as the 14th leading cause of death in the United States that year. Heart disease was in first place, claiming 725,790 deaths in 1997; followed by cancer with 537,390 deaths. The press release quoted Shalala as attributing the decline in AIDS deaths "primarily" to antiviral treatments. It also quoted her cautioning that the drop in the number of deaths does not mean "that we have significantly reduced HIV transmission."

In brief ...

GETTING BELOW 20: Echoing a report made at the AIDS conference in Geneva, researchers from Vancouver reported in the Sept. 10 issue of the journal AIDS that antiviral combinations must get a patient's viral load below 20 particles per milliliter in order to achieve long-term suppression of HIV. In a study of 150 patients on one of three different combination therapies, the researchers, led by Julio Montaner of Vancouver, said their results "clearly illustrate" the risk of failure on the regimens was "substantially reduced" when the regimens dropped viral load below 20. The researchers noted that current guidelines recommend a goal of dropping viral loads below 400. But they recommended that doctors try to use more sensitive viral load tests and that the guidelines be revised to target a goal of below 20.

NEW TEST SUCCESS: A company marketing a relatively new test that can help doctors decide which drugs might be most effective against an individual patient's particular strain of virus issued a press release Sept. 24 saying the test is proving itself useful. The company, Visible Genetics, said looked at the success of patients who started on a "standard of care" triple-drug regimen and compared it with patients who chose their drug regimen based on the results of the test. The test, genotyping, takes a very close look at the specific strain of virus in one patient's blood to see what mutations that virus may have that would signal which drugs it is already capable of evading. Thus far, only 47 patients have been evaluated in the study at the six-month point. But based on this small number, the company said that 39 percent who chose their regimens based on genotyping had undetectable viral loads at month six, compared to 10 percent of the patients who took a standard of care regimen.

COMPLIANCE PROBLEM: A study from researchers in Italy indicates that patients' inability to comply with the protease combinations is mainly due to side effects and those side effects are primarily gastrointestinal. The study looked at 250 patients on combinations involving one of three protease inhibitors. It found that the protease inhibitor saquinavir was best tolerated but that indinavir and ritonavir were more effective in suppressing the virus. The study results were, however, deemed "encouraging" because, while 30 percent of the patients were unable to benefit from the triple-drug combinations, 70 percent did, even though they had been on some antiviral treatment previously. Their report appears in the Sept. 10 issue of the journal AIDS.

AIDS CONFERENCE OCT. 28: The National Minority AIDS Council is holding its big annual conference in Dallas this month, with experts covering a wide range of topics concerning the delivery of services to people with HIV and AIDS. Keynote speakers, including two former surgeons general and two current U.S. House representatives, will address an estimated 2,500 AIDS educators and service providers gathered to share ideas on how to better serve people with HIV/AIDS, especially racial minorities. For more information, call (202) 483-6622 or e-mail Lwilliams@nmac.org.
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