The Washington Blade - July 9, 1999
Lisa Keen

The company stopped producing its original ritonavir capsules last summer after discovering a problem with how the capsules were dissolving. For the past year, patients taking ritonavir had to use a less convenient liquid formulation instead. Abbott said this week that the new formulation is a soft-gel capsule -- more convenient than liquid, but Abbott cautioned that it recommends patients keep the capsules refrigerated or stored below 77 degrees Fahrenheit if they are not used within 30 days.

Abbott said the new soft-gel capsules would be available in pharmacies this week.

French laud genotype benefit; Lancet cautious

A team of researchers from France published a report in the British medical journal The Lancet June 26, giving a strong endorsement to the use of the relatively new "genotype" test for determining on what drugs to start a patient with HIV.

Genotyping takes a very close look at the virus in a patient's blood to see what mutations it may have that would signal which drugs it is already capable of evading.

The French researchers took a group of about 100 patients with HIV and split them into two groups. With one group, doctors made treatment decisions -- what drugs to use and when to switch -- based solely on the standard guidelines available. With the second group, doctors made treatment decisions based on the guidelines plus genotype information from each patient. They found that 94 percent of those using genotyping saw reduction in their viral loads compared to 66 percent of those not using genotyping.

But an editorial accompanying the article warned that while "many physicians are already obtaining genotypes on viruses from their patients," they are also "experiencing difficulty in interpreting the results."

While "genotype data, added to knowledge of a patient's drug history, may improve the ability of clinicians to select a regimen for patients," noted the editorial, doctors still don't understand it well enough to use it.

In brief ...

4-DRUG COMBO FOR LATE DISEASE: A team of French researchers recommended last month that patients with late-stage HIV disease be treated with a combination of two protease inhibitors and two nucleoside analogs. Writing in the June issue of the Clinical Pharmacology & Therapeutics journal, the researchers noted that they tried the combination in 14 patients whose CD4 counts had gone below 200.

PML CONCERN PERSISTS: In February, researchers at 10 universities around the country reported that the use of triple-drug combinations with protease inhibitors had brought about "significant gains" in the survival of patients developing the opportunistic infection PML (progressive multifocal leukoencephalopathy). Until recently, they noted, the prognosis of PML was à so dismal that efforts to treat these patients outside of research programs were often forsaken." Patients on such combinations survived about 46 weeks while patients not on the combinations survived only about 11 weeks. But in the May issue of Clinical Infectious Diseases, doctors at Washington University in St. Louis warned that patients are still developing PML even when they are having success on combination therapies.

PAP SMEARS FOR MEN? A report from the University of California-San Francisco in the May 19 issue of the Journal of the American Medical Association suggests that a test currently in wide use to detect cervical cancer in women may be helpful to detect anal cancer in men and women. Anal cancer occurs in about 35 out of 100,000 Gay men and about twice as often in Gay men with HIV, noted the study. Cervical cancer occurred in about 40 of every 100,000 women before the widespread use of the "Pap smear." Now, that rate is about 8 of 100,000 women. Both anal and cervical cancers are believed caused by the human papillomavirus.

NO Y2K WORRY FOR MEDS: POZ magazine reports in its July issue that a Pharmaceutical Researcher and Manufacturers of America magazine survey found 24 drug manufacturers already "have Y2K plans in place" and expect no problems. But the magazine noted that AIDS treatment activist Spencer Cox in New York said he plans to fill his prescriptions on Dec. 30 just in case.

AEROBICS AND PRAYER? A study of the "10 most commonly noted alternative activities" used by 1,016 people with HIV to help combat their disease found that the most popular was aerobic exercise (64 percent used it), followed by prayer (56 percent). The study was conducted by the Bastyr University in Seattle, funded by the National Institutes of Health, and published in the May/June issue of the Journal of the Association of Nurses in AIDS Care. Eighty percent of those surveyed were men.

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