AIDS Treatment News, the world's first treatment newsletter for people with HIV, reports on mainstream and alternative treatment, access to care, Web resources, public policy, and political action.
In mid December 2004 three Associated Press stories created widespread doubts about nevirapine, a well-known, critically important drug that can prevent HIV in many of the 1,800 babies now infected every day by their mothers in childbirth. The media allegations that went around the world grew out of a bitter personal and personnel dispute between two employees at the U.S. National Institutes of Health. No new information about nevirapine was released; doctors know that it still has the same risks and benefits after the newspaper stories as before. But many experts fear that the emotions released by the worldwide misinformation will result in many HIV-positive mothers getting no treatment and unnecessarily infecting their children with HIV. Here is background that has been missing in many of the news reports.
The abstracts of four major AIDS conferences that were unavailable online or in libraries around the world have now been found after AIDS Treatment News asked people to look for copies. Please check old files, boxes, bookshelves, and other archives for other missing conferences listed here.
Dermik Laboratories is now starting a patient-assistance program that provides free or low-cost drug to patients that meet certain imcome and other eligibility requirements. Information is changing rapidly, so we provide Web, email, and telephone sources to check.
Dr. Cohen and others at the Community Research Initiative are studying a schedule of five days on certain antiretroviral regimens and two days off, for certain patients whose virus is well suppressed. The goal is to reduce side effects and cost, and to make the regimens easier to take. We asked about the results so far.
AIDS Treatment News publishes a buyers' club list each December. For a short overview and introduction to the meaning, history, and services of these organizations, see AIDS Treatment News #309, December 18, 1998.
Some of the most important AIDS conferences are not online, and even the U.S. National Library of Medicine and the conference organizers do not have a paper or electronic copy of the abstracts presented. Some may be lost forever. But they could be saved if a copy can be found, and you might be able to help. Here we interview the founder of AEGIS (www.aegis.org/), the well-known AIDS database that has done critically important work in preserving conferences as well as making AIDS news and other information available around the world.
Two more three-drug antiretroviral regimens have unexpectedly failed to control HIV in many patients. But some related regimens do seem to be working well.
While the U.S. fights over abstinence vs. condoms, neither one is an option for many women, due to sexual violence -- throughout the world, from a fifth to half of all girls and young women report that their first sexual experience was forced. Women are twice as likely as men to be infected through a single act of unprotected sex. In parts of Africa, more than a third of all teenage girls have HIV. But going to school is protective. These are just a few of the facts about HIV and gender that need to be more widely known.
A new activist group wants to force medical practices in prisons to meet national standards for treatment and care, especially for hepatitis C and HIV.
It is too early to know exactly how the recent elections will affect people with AIDS. But clearly the community will have to do more to improve and support advocacy for treatment and care, and for policies that work.
A leading AIDS physician looks at the advantages and disadvantages of once-a day treatment with two new fixed-dose combinations of previously approved drugs, for patients who are first starting antiretrovirals.
Diver Greg Louganis and actor Chad Allen spoke in New York at a public forum to raise awareness of depression in the gay community. They will speak again in San Francisco.
A study of medical records found that combining the antibiotic erythromycin with strong inhibitors of the liver enzyme CYP3A increased the risk of sudden death from cardiac causes -- probably by abnormally raising the blood levels of erythromycin.
A study of medical records found that combining the antibiotic erythromycin with strong inhibitors of the liver enzyme CYP3A increased the risk of sudden death from cardiac causes -- probably by abnormally raising the blood levels of erythromycin.
The U.S. National Institutes of Health has proposed making reports of NIH-funded research freely available six months after their commercial publication. We show why this proposal is a step forward but far from a solution to the problem. We also refer readers to a micropayment idea we developed that might ease some of the remaining problems.
Despite recent short-term improvement, the AIDS Drug Assistance Program needs activist attention nationally to prevent thousands of Americans from going without the treatment they need.
An excellent Web site, primarily for medical professionals but freely available to anyone, summarizes what doctors need to know from the International AIDS Conference in Bangkok, Thailand.
A coalition of over 200 AIDS organizations is supporting a platform of policies for controlling the AIDS epidemic both in the U.S. and globally. It is encouraging voter registration, including absentee registration of people with AIDS when necessary, so that they will not miss voting due to illness.
Due to persistent misinformation about voter qualifications in Pennsylvania, we looked up the facts on the official state Web site. Other states face similar problems.
Americans for Safe Access, a medical marijuana organization, is organizing a rally in Washington to urge the federal government to stop preventing doctors from prescribing marijuana as medicine.
A huge decrease in the number of fundamentally new antibiotics -- driven by commercial not scientific problems -- seriously threatens public health in the near future, as bacteria develop resistance to the existing drugs, and previously treatable infections will often be fatal.
A study that could open the door to pharmacological HIV prevention until a vaccine is available was stopped in Cambodia, after sex workers objected to lack of health insurance after the trial.
Two combinations of currently available drugs, dosed for once-daily use, were approved by the FDA. We are concerned about too fast a rush to once-a-day.
New studies are using modern technology early, to get important dosing, safety, and efficacy information about a new drug, starting with the first volunteer who takes it.
A recent report on two specialized scientific conferences looks at some of the most important current ideas on developing new kinds of HIV treatments. The conferences took place in April 2004, and the report(1), by immunologist Gareth Hardy, PhD, was published in July.
$400 a year will save a life in Uganda. A U.S. scientist who works there has created a fund that has guaranteed five years of treatment for ten people so far.
If abstinence is 100% effective in preventing sexual transmission, why does abstinence-only not work well? And what is the personal psychology of the stigma that prevents individuals, communities, and nations from protecting themselves against the epidemic? We offer some fairly obvious analysis that has been largely overlooked in public discussion.
Congress will vote soon on an amendment to stop Attorney General Ashcroft's crusade against medical marijuana, in states where laws recognize medical use. This amendment received 152 votes in Congress last year.
Patients who are on Medicare and have income under 135% of Federal poverty level and are not on Medicaid probably should obtain one of the new Medicare discount cards that became available on June 1, 2004, because all these cards include $600 annual credit for prescription-drug purchases for persons within that income limit. Unfortunately this program is complex, no one yet knows how it will work in practice, and after choosing a card one is locked in until November 15. The most difficult part of the choice of which card to get may involve how it interacts with other programs, including ADAP, and pharmaceutical company patient assistance programs.
The U.S. could prevent thousands of unnecessary deaths by creating a comprehensive HIV care program. It would be administered by the states under Federal standards of patient care and physician reimbursement, and replace Medicaid (for persons with HIV), ADAP, and much of Ryan White as well.
Over 1600 people are currently on waiting lists to receive antiretroviral treatment through the AIDS Drug Assistance Program -- a crisis predicted for over a year. In the next few weeks, Congress will consider funding for next year. Starting now and during the summer it will be important for people to talk to their representatives and let them know why this program is important.
GlaxoSmithKline is offering research grants to scientists for certain innovative projects involving the development of HIV treatment, vaccines, or microbicides.
The XV International AIDS Conference in Bangkok next month is expecting 15,000 attendees and may be the largest AIDS conference ever. Anyone can receive free daily email updates during the conference, and many other reports will be presented later. Unfortunately the Bush Administration told about 80% of the U.S. government scientists expecting to go that they will not be sent.
An new NNRTI that greatly reduces HIV resistance to this major class of drugs is now recruiting at about 50 U.S. medical centers. It is active against virus resistant to efavirenz and nevirapine.
On April 30, 2004 the U.S. CDC changed the gonorrhea treatment recommendation for men who have sex with men, due to development of resistance to the oral antibiotics otherwise preferred.
Rallies at the Democratic and Republican headquarters will call for more serious attention to the disease that is now the leading cause of death worldwide for all people age 15 through 59.
Here are three HIV-related Web sites and one printed document that you can use to check for some of the interactions between HIV drugs and other drugs you are using at the same time. Some of them also have information on known interactions between AIDS-related drugs and some herbal treatments or foods.
The Clinton Foundation, World Bank, UNICEF, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria announced that they could negotiate prices as low as $140 per year for triple-combination antiretroviral therapy. But the Bush Administration is refusing to buy generic medicines for its major HIV treatment program.
A major report on heart disease and HIV found that HIV infection itself is associated with increased risk, independently of other factors like age, cholesterol, and smoking. Another major report did find differences among antiretrovirals, but the information is hard to summarize.
An FDA advisory committee unanimously recommended approval of this facial treatment for people with HIV -- with restrictions to prevent general cosmetic use, pending data to justify such approval.
A CME (continuing medical education) module for physicians explains the problem with two antiretroviral regimens that failed last year. Several possible causes for the failure had been proposed. Now it appears that the problem was too low a genetic barrier to HIV developing certain resistance mutations.
This collection of CME trainings for physicians gives an in-depth review of major reports from the Retroviruses conference (February 8-11 in San Francisco), focusing on what HIV physicians need to know.
For poor and middle-income countries we should negotiate large sales involving many countries, with all the interests at the table. Large deals and public consensus could make it viable for companies to develop treatments for diseases affecting poor regions.
On March 19 the FDA notified the public of new prescribing information and precautions for atazanavir (brand name Reyataz), if taken in combination with tenofovir (Viread) -- and warned of risks with Viagra or similar drugs.
Political action alerts could be much more effective if they were designed to be shared -- to be easily picked up by other interested organizations and sent to their members, or to other people and organizations that listen to them. From our experience we suggest five ways to make existing action alert work this way.
Summary: The FDA will discuss U.S. approval for New-Fill, a facial treatment that Americans have had to go abroad for, although it is approved in Europe and has been used by about 100,000 people worldwide. Those who want to speak at the hearing should notify the FDA by March 15.
The three experimental drugs most discussed at the important 11th Conference on Retroviruses and Opportunistic Infections (February 8-11, San Francisco) were: BMS-488043, a new kind of entry inhibitor; Reverset, a nucleoside analog active against most resistant viruses; and Schering D, which blocks viral attachment to the CCR5 co-receptor on the cell. Other compounds discussed included PA-457, SPD-754, GW873140, GW678248, SN1212/1461, TMC114, TNX-355, PRO140, UK-427,857, AK602, KRH-2731, mifepristone (RU-486), and chloroquine.
New instructions tell physicians who is most at risk for rare but serious side effects when starting this important drug -- for example, women with a CD4 count above 250.
A supplement containing 33 vitamins, minerals, and antioxidants seemed to help persons with HIV. This trial was organized by Jon Kaiser, M.D., who has specialized in combining mainstream and complementary HIV treatments, and is based in part on the work of Marianna Baum, Ph.D., who has studied nutritional deficiencies in persons with HIV.
Users of amphetamines ("crystal"), hallucinogens, or inhaled nitrites ("poppers") had higher rates of HIV infection than non-users,(1) in an analysis of the Vaxgen trial data presented at the 11th Conference on Retroviruses and Opportunistic Infections, February 8-11, 2004.
Because persons newly infected with HIV may be especially infectious before the body has created antibodies to partially control the infection, there is a new public-health push to also look for the virus itself in routine HIV testing. North Carolina has used this approach statewide for over a year, and discovered the first indications of a new HIV epidemic among college students, especially African-American men. Results were reported at the recent Retroviruses conference.
Today, scientists and others arrive at major conferences without knowing whom they should meet and talk to outside of their own field. The whole medical-research enterprise is damaged when researchers miss these connections. The key to improvement is to have the main data presentations online, allowing conferences to focus on exploration and discussion, instead of lectures that must rush through the new data. We outline many other advantages, such as allowing researchers to update their online presentations before or after the conference if they wish.
On January 14, 2004 the prestigious Institute of Medicine (IOM) called for the U.S. to implement universal health care by 2010. Currently 43,000,000 Americans are uninsured, and lack of health insurance causes 18,000 unnecessary deaths each year in the U.S. Eighty percent of the uninsured are members of working families -- but a quarter of U.S. workers are not offered health insurance at all, and few Americans can afford to buy the expensive individual policies. These and dozens of other facts in the new report will help anyone who is making a case for change.
This information is designed to support, not replace, the relationship that exists between you and your doctor.