In the current fiscal year, July 2002–June 2003, three rather than four quarterly new print editions of English BETA and two new print editions of Spanish BETA will be published. This is but one measure that will ensure the continuity of SFAF’s treatment publications through this transitional period.
In the past few years disturbing reports have begun to accumulate about young, relatively healthy HIV positive men who have developed heart disease or suffered heart attacks. Researchers and health-care providers treating people with HIV are taking these reports seriously, and increasing attention has been devoted to cardiovascular disease at recent medical conferences.
Looking in the mirror can be a humbling experience. For HIV positive people with facial wasting, or lipoatrophy, the experience can be traumatic. Facial lipoatrophy refers to subcutaneous fat loss in the cheeks and temples resulting in a bony, emaciated appearance. The condition may be mild to severe.
People with HIV/AIDS frequently experience symptoms that affect the gastrointestinal (GI) tract, made up of the oral cavity (mouth), esophagus (swallowing tube), stomach, intestines, and anus. The most common of these are nausea, vomiting, and diarrhea. Nausea refers to queasiness, feeling sick to the stomach, or having an urge to vomit, or "throw up." Diarrhea refers to frequent, loose, unformed stools (bowel movements). Both may be accompanied by abdominal cramps. Nausea and diarrhea are not diseases themselves, but rather are symptoms that may be caused by a wide variety of conditions.
Scientists, like judges, are supposed to be impartial. They are expected to weigh evidence and examine data without emotion or prejudice. If a researcher reports that a certain drug is effective or a specific test is useful, that conclusion is assumed to have been based on an objective evaluation of the data, not on the possibility that the scientist owns stock in the company that makes it.
This edition of The Global Epidemic presents a perspective on the innovative Global Fund to Fight AIDS, Tuberculosis and Malaria by Tim France, PhD. Dr. France is the director and cofounder of Health & Development Networks (HDN), a nonprofit organization based in Dublin, Ireland; Pretoria, South Africa; and Chiang Mai, Thailand. Dr. France has worked throughout the developing world with the World Health Organization's (WHO's) Global Programme on AIDS, the United Nations Joint Programme on HIV/AIDS (UNAIDS), and various nongovernmental organizations (NGOs) in preparing HIV/AIDS-related technical guidelines and policy materials, and in developing information dissemination strategies.
Janneke van de Wijgert, PhD, MPH, and Christiana Coggins, MPH
The development of topical microbicides for HIV prevention originated in response to the unabated spread of HIV despite the availability of an effective HIV prevention tool (condoms), as well as the lack of an effective HIV vaccine. Initially, hopes were pinned on existing over-the-counter spermicides containing nonoxynol-9. Concern about the toxicity of nonoxynol-9 with frequent use, and its small or nonexistent protective effect against HIV and other sexually transmitted infections (STIs), has spurred the development of new microbicides with a number of novel mechanisms of action. Significant progress has been made in the last decade.
The 41st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) took place December 16-19, 2001, in Chicago, following a two-month delay due to the events of September 11. Although no major breakthroughs were announced, several presentations looked at refinements to antiretroviral therapy that aim to make treatment more simple and effective with fewer side effects.
The HIV treatment climate has changed yet again. On an international level, the discussion has become a highly charged debate about socioeconomics and politics as much as science and medicine. Experts have proposed a host of "solutions," many of which, if implemented, would entail revolutionary changes of public policy or social beliefs.
Of the many symptoms associated with HIV/AIDS and its treatment, peripheral neuropathy (PN) can be among the most painful and debilitating. The most common estimate is that about one-third of people with AIDS experience some degree of nerve damage. However, PN usually occurs in the later stages of HIV disease, and many people experience mild or no symptoms. Nerve damage may be caused by HIV itself, by opportunistic infections (OIs) such as cytomegalovirus (CMV), or as a side effect of certain anti-HIV drugs, notably ddI (Videx), ddC (Hivid), and d4T (Zerit).
Clinicians are increasingly aware of bone disease in people with HIV infection. As reported in the Summer/Autumn 2001 issue of BETA, bone mineral deficiencies (osteopenia and osteoporosis) are being seen in a growing number of HIV positive men, women, and children. At the same time, unusually high rates of osteonecrosis (bone death) in adults and children with HIV have been detected in recent studies.
On November 29, 2001, the San Francisco AIDS Foundation (SFAF) announced the launch of the Pangaea Global AIDS Foundation, a new organization dedicated to working on HIV/AIDS at the international level, particularly in the developing world. (Pangaea is the hypothetical supercontinent that included all the landmasses of the earth; the single landmass presumably split apart about 200 million years ago. The word comes from Greek pan, or all, combined with gaia, or earth.)
Since the mid-1990s and an historic clinical trial that changed clinical practice (ACTG 076), significant lessons have been learned about effective methods to prevent mother-to-child transmission (MTCT) of HIV. These largely involve protocols that use antiretroviral medications during the perinatal period (around the time of birth). Such advances have resulted in a steep decline in the developed world in the number of infants infected with HIV by their mothers during pregnancy, labor, or delivery. Conversely, the lack of access to antiretroviral medicines in the developing world contributes significantly to the fact that the rate of perinatal infections there remains critically high.
The following U.S. organizations collect anti-HIV medications for donation abroad. Each organization follows its own set of rules; the majority request that all drugs be delivered in their original prescription bottles (all patient and doctor names will be removed before distribution).
The tragic events of September 11, 2001 have had an effect on the world of HIV/AIDS. AIDS service organizations and other nonprofit groups are feeling financial pressure due to the weakening U.S. economy and because charitable giving has been redirected to victims of the terrorist attacks. The October wave of anthrax exposures drew attention to the poor state of the nation’s public health infrastructure, and the high price of Cipro (ciprofloxacin, the most well known antibiotic for the life-threatening disease) has brought renewed attention to drug prices, patents, and generic drugs for HIV/AIDS.
This information is designed to support, not replace, the relationship that exists between you and your doctor.