Table of Contents: CATIE TreatmentUpdate - 2001


Canadian AIDS Treatment Information Exchange
Edited by: Sean Hosein

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TreatmentUpdate 114: January - Vol. 12, No. 10

English  Françaises

 Some women may be at high risk for anal cancer

 Risque élevé de cancer anal chez certaines femmes
HoseinSR
Although cases of anal cancer are increasing in both men and women in the U.S., anal cancer is twice as common in women than in men, according to researchers in that country. Researchers in San Francisco conducted a study among women with HIV and women who were at high risk for HIV infection to find out about their risk of anal cancer.


 DHEA — Cautions and concerns

 DHEA – Avertissements et préoccupations
HoseinSR
In small, short studies in HIV positive people, DHEA appears to help relieve depression but this needs to be confirmed in large studies. As well, most studies of DHEA have been in middle-aged or elderly subjects.


 DHEA for depression?

 DHEA contre la dépression?
HoseinSR
Researchers have found that depression is relatively common in HIV positive people. Such depression may also be associated with loss of sex drive and energy. In the 1990s, a number of double-blind studies found that DHEA between 30 mg to 90 mg per day for six to 12 weeks resulted in improved mood and increased energy and sex drive in subjects with and without major depression.


 Changes in DHEA levels in people taking anti-HIV therapy

 Changements dans le taux de DHEA chez les personnes sous thérapie antirétrovirale
HoseinSR
Most of the studies that measured DHEA levels in HIV positive subjects were done before the availability of highly active antiretoviral therapy (HAART). So researchers in New York conducted a study to find out about the changes in DHEA and testosterone levels in HIV positive people, some of whom were using HAART. The researchers found that as CD4+ counts fell and viral load rose, DHEA levels were also likely to be reduced. Moreover, PHAs on HAART tended to have increased levels of DHEA compared to their levels before they used HAART.


 DHEA — Background

 La DHEA – Historique
HoseinSR
The hormone DHEA (dehydroepiandrosterone) is produced by the adrenal glands, which sit on top the kidneys. DHEA is converted by the body into testosterone and estrogen. DHEA may also have other functions but scientists aren't sure what they might be. The body's production of DHEA is highest between the ages of 20 to 30 years and then gradually declines, reaching its lowest level in the elderly. Researchers have found that cells of the immune system, such as CD4+ and CD8+ cells, send signals to the adrenal glands, perhaps triggering their production of DHEA. When T-cell activity is suppressed by the use of drugs such as transplant drugs cyclosporin or tacrolimus, DHEA production falls. In people with HIV infection, HIV-infected cells could also play a role in reducing the production of DHEA.


 Nukes linked to fat wasting

 Analogues nucléosidiques et la fonte de graisses
HoseinSR
In the late 1990s, PHAs using HAART began to report strange changes in body shape. There were also reports of increased levels of sugar, insulin and fatty substances in the blood of these people. These changes increased the risk of non-insulin-dependent diabetes and cardiovascular disease, among other complications. Together, these changes have been called the lipodystrophy syndrome.


 Triple nuke therapy — results after one year

 Trithérapie nucléosidique – un an plus tard
HoseinSR
Therapy with at least three anti-HIV drugs — one of which being a protease inhibitor — has been the standard of care in North America over the past four years. Such drug combinations often have complicated dosing schedules and food and meal restrictions, and require PHAs to take many pills several times daily. In addition to potential drug interactions with the use of protease inhibitors and non-nucleoside analogues, or non-nukes, there's the risk of developing diabetes, cardiovascular illness and liver damage with certain combinations. In an effort to create simpler, more tolerable combinations, drug companies and doctors are testing different regimens.


 Switching meds: from protease inhibitors to non-nukes

 Substitution des non-nucléosides aux inhibiteurs de la protéase
HoseinSR
Collectively, these signs/symptoms have been called the lipodystrophy syndrome. At first there was a tendency to place the blame for all of these problems on PIs. However, as doctors have spent more time studying these issues, it has become clear that there is no one cause for the many changes that are part of the lipodystrophy syndrome. Indeed, there may be several syndromes occurring at the same time and the role played by different types of anti-HIV drugs is still not quite clear. Nevertheless, some PHAs may wish to switch from a PI-based regimen to a combination based on a non-nucleoside analogue, or non-nuke, such as nevirapine (Viramune) or efavirenz (Sustiva).

Table Of Contents

TreatmentUpdate 123: November/December - Vol. 13, No. 7
Can delavirdine substitute for ritonavir?; Hepatitis C treatment, HAART and side effects; Toxicity profile of HAART; Rosiglitazone for lipodstrophy?; Actos (pioglitazone); Focus on fat; Metformin — long-term results; Sugar blues and protease inhibitors; Glucose — from food to blood sugar; Lipodystrophy - introduction; Caution with nelfinavir and some lipid-lowering drugs; Trizivir approved in Canada;

TreatmentUpdate 122: October - Vol. 13, No. 6
Looking at soluble CD23 levels to predict lymphoma; Cidofovir for KS lesions; Can low-dose shark cartilage make Kaposi's sarcoma disappear?; Chemo and HAART extend survival with lymphoma; Encouraging news on lymphoma from France; AIDS and lymphoma; New formulation of ddI approved in Canada — Videx EC; Expanded access to tenofovir

TreatmentUpdate 121: September - Vol. 13, No. 5
SIDE EFFECTS - Andractim for HAART-associated breast enlargement; SIDE EFFECTS - Does efavirenz cause breast enlargement?; IMMUNE BOOSTERS - Interleukin-12 may be useful for hepatitis C; ANTI-HIV AGENTS - Study finds HIV subtly damages vision; ANTI-HIV AGENTS - Searching for the right dose of ritonavir-saquinavir; ANTI-HIV AGENTS - Different combinations of ritonavir-indinavir

TreatmentUpdate 120: August - Vol. 13, No. 4
Depression linked to immune system decline in women; Carnitine for high triglycerides; Lipid-lowering drugs and changes to diet can make a difference; Sexual dysfunction and HAART; Immune booster used to fight drug-resistant herpes; Effect of HAART on cervical growths; Switching to nevirapine — results after one year

TreatmentUpdate 119: July - Vol. 13, No. 3
Fosamax for HIV-related bone problems?; Indinavir and bones: Does thickness = strength?; Lipodystrophy — nukes vs. protease inhibitors; Spanish study looks at nevirapine's effect on the liver; Pesticides found in many ginseng supplements in the U.S.; Can ginseng help suppress HIV?; Large Italian study looks at when to start HAART;

TreatmentUpdate 118: June - Vol. 13, No. 2
Protease inhibitors and blood sugar problems; Indinavir - effect on sugar and insulin; Background on glucose — from food to blood sugar; Extra co-enzyme Q10 for statin-users?; Can vitamin E help people recover from hepatitis B?; Study examines link between low levels of zinc and survival; Zinc and the immune system;

TreatmentUpdate 117: May - Vol. 13, No. 1
Bone damage - more than just nukes involved; Australian study links nukes, lactic acid to bone loss;High levels of lactic acid in some users of HAART ;Nukes may be linked to hearing loss; Of power plants and energy shortages; German study finds whey protein supplement boosts antioxidants; Spanish doctors try switching therapy from month to month

TreatmentUpdate 115: February - Vol. 12, No. 11
St. John's wort found to lower nevirapine levels; Are deaths due to liver damage becoming more common?; St. John's wort extract found not helpful for hepatitis C; Canadian researchers study "immune healing"; Kaletra approved in Canada;

TreatmentUpdate 114: January - Vol. 12, No. 10
Some women may be at high risk for anal cancer; DHEA — Cautions and concerns; DHEA for depression?; Changes in DHEA levels in people taking anti-HIV therapy; DHEA — Background; Nukes linked to fat wasting; Triple nuke therapy — results after one year; Switching meds: from protease inhibitors to non-nukes

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