Table of Contents: CATIE TreatmentUpdate - 2002


Canadian AIDS Treatment Information Exchange
Edited by: Sean Hosein

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TreatmentUpdate 127: May/June - Vol. 14, No. 4

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 ANTI-HIV AGENTS: Delavirdine in rescue regimens

 AGENTS ANTI-VIH: La delavirdine à la rescousse

HoseinSR
The most commonly used drugs in this class are efavirenz and nevirapine. However, delavirdine is increasingly being considered for study as a booster for protease inhibitors (PIs) because it can block the activity of liver enzymes that break down PIs.

 ANTI-HIV AGENTS: Could cimetidine be used as a booster?

 AGENTS ANTI-VIH: La cimétidine pourrait-elle accroître les taux d'IP?

HoseinSR
The protease inhibitor (PI) ritonavir (Norvir) is commonly used in dual-PI combinations as a booster because ritonavir significantly raises the level of other PIs and prolongs the time they remain at high levels in the blood. This has led to the creation of twice- or even once-daily PI-based regimens. However, ritonavir is not always well tolerated. And, according to Italian researchers, there is also the theoretical risk that by exposing HIV to two simultaneous PIs, the virus may more easily develop resistance to PIs, limiting future treatment options.

 ANTI-HIV AGENTS: Teaching adherence to substance users

 AGENTS ANTI-VIH: Enseigner l'observance aux toxicomanes

HoseinSR
Taking medications every day exactly as directed — called adherence — is difficult for some people, particularly those who have chaotic lives and substance abuse problems. To ensure that such people take their treatment, researchers developed Directly Observed Therapy (DOT) programs where medication-taking is observed and confirmed by health care workers. This has been particularly useful in helping to control tuberculosis.

 Fine-tuning saquinavir

 Vers une mise au point du saquinavir

HoseinSR
Some HIV treatment regimens can be complex — people with HIV/AIDS (PHAs) may have to take their medications several times daily, with food and water restrictions. As well, some treatments need to be taken on a strict schedule. Such complexities may make it difficult for PHAs to take their medicines exactly as prescribed and directed — an issue called adherence. Not adhering to one's drug regimen will lead to the growth of HIV that is drug resistant. Having drug-resistant virus reduces treatment options and possibly increases the risk of developing AIDS-related complications.

 ANTI-HIV AGENTS: Invirase vs. Fortovase: unexpected results?

 AGENTS ANTI-VIH: Invirase contre Fortovase : des résultats inattendus?

HoseinSR
Two formulations of saquinavir are currently manufactured — Invirase, the original hard-gel form, and Fortovase, the newer soft-gel form. A capsule of each product contains 200 mg of saquinavir. Results from a very small study suggest that saquinavir (either Invirase or Fortovase) 1,000 mg, in combination with ritonavir 100 mg, both taken twice daily, leads to roughly equivalent levels of saquinavir in the blood. So researchers in Berlin decided to conduct a larger study.

 ANTI-HIV AGENTS: Saquinavir once daily

 AGENTS ANTI-VIH: Le saquinavir une fois par jour

HoseinSR
A team of Australian, Dutch and Thai researchers has been testing a combination of the soft-gel formulation of saquinavir (Fortovase) 1,600 mg in combination with ritonavir 100 mg, both protease inhibitors taken once daily. Taken in this way, ritonavir greatly increases saquinavir levels in the blood and prolongs the time that saquinavir remains in circulation. According to their results, after six months of observating 69 HIV positive subjects who were taking this combination of protease inhibitors together with two nukes (nucleoside reverse transcriptase inhibitors, or NRTIs), this regimen was able to suppress levels of HIV to fewer than 50 copies in the blood of 93% of subjects. In the remaining subjects, viral load remained below the 300 copy mark. This boosted regimen of saquinavir was associated with a significant increase in CD4+ cells.

 ANTI-HIV AGENTS: Saquinavir with low-dose ritonavir twice daily

 AGENTS ANTI-VIH: Le saquinavir en association avec le ritonavir à faible dose, deux fois par jour

HoseinSR
Researchers at several sites in the U.S. recruited 21 HIV positive subjects for this study which compared the effect of two different boosted protease inhibitor (PI) regimens...

 ANTI-HIV AGENTS: Highlights from the 3rd International Workshop on Clinical Pharmacology of HIV Therapy

 AGENTS ANTI-VIH: Faits saillants du 3rd International Workshop on Clinical Pharmacology of HIV Therapy

HoseinSR
The 3rd International Workshop on Clinical Pharmacology of HIV Therapy was held 11- 13 April 2002, in Washington, DC. At this meeting, researchers from Europe and North America gathered to mostly present and exchange information about how some anti-HIV drugs, when taken together, can affect levels of one another in the blood. This effect is something that occurs when certain anti-HIV drugs — protease inhibitors and non-nukes (non-nucleoside reverse transcriptase inhibitors, or NNRTIs) — are taken.

Table Of Contents

TreatmentUpdate 132: December - Vol. 14, No. 9
INTRODUCTION: What's a conference about ?; SIDE EFFECTS: Who gets treatment and... side effects; SIDE EFFECTS: Protection from nuke side effects; SIDE EFFECTS: Breaking free from nukes; ADHERENCE: What helps adherence to therapy?; VACCINES: Rub-on vaccine study planned; CANCER: Cancer risk falls in some HAART users; INFECTIONS: Syphilis - the great masquerader; INFECTIONS: Is hepatitis C virus going to become a major STD

TreatmentUpdate 131: November - Vol. 14, No. 8
SIDE EFFECTS: The usual suspects; SIDE EFFECTS: A brief history of HIV drug therapy; SIDE EFFECTS: Strange side effects; SIDE EFFECTS: Focus on fat; SIDE EFFECTS: Lots of volunteers needed; SIDE EFFECTS: Lactic acid and nuke damage; SIDE EFFECTS: No nukes please; SIDE EFFECTS: Fat wasting - AZT vs. d4T; SIDE EFFECTS: Sugar blues; SIDE EFFECTS: Predicting body shape changes; SIDE EFFECTS: Niacin for high triglycerides; SIDE EFFECTS: Supplement fix for nelfinavir-related diarrhea

TreatmentUpdate 130: September/October - Vol. 14, No. 7
ANTI-HIV AGENTS - Drug holidays - an overview ; ANTI-HIV AGENTS - Here's a story about a drug holiday ; TOXICITY - Milk thistle and indinavir ; TESTING - Some factors affecting survival in HIV positive women ; ANTI-CANCER AGENTS - A new treatment for Kaposi's sarcoma

TreatmentUpdate 129: August - Vol. 14, No. 6
THE XIV INTERNATIONAL AIDS CONFERENCE - Overview of conferencel; ANTI-HIV AGENTS : American-Italian study produces unexpected results; ANTI-HIV AGENTS : Tenofovir looks good in initial therapy; ANTI-HIV AGENTS : Tenofovir and Videx (ddI) EC — some caution required; ANTI-HIV AGENTS : T-20 shows its potency; ANTI-HIV AGENTS : Efavirenz makes its mark in AIDS; TESTING : Study finds fatigue linked to quality of sleep; TESTING : High liver enzyme levels — a warning about survival?; NUTRITION : Nutrient deficits found in some HIV positive people; NUTRITION : Low zinc intake linked to reduced survival

TreatmentUpdate 128: July - Vol. 14, No. 5
SIDE EFFECTS: Sexual dysfunction in men: A report from France; SIDE EFFECTS: Sexual dysfunction in men: A report from Boston; SIDE EFFECTS: Male sexual dysfunction and HAART — the confusion continues; SIDE EFFECTS: Study finds problems with reporting side effects; ANTI-CANCER AGENTS: Recurring cervical growths; ANTI-HIV AGENTS: Starting therapy: study finds guidelines linked to level of immunity

TreatmentUpdate 127: May/June - Vol. 14, No. 4
ANTI-HIV AGENTS: Delavirdine in rescue regimens; ANTI-HIV AGENTS: Could cimetidine be used as a booster?; ANTI-HIV AGENTS: Teaching adherence to substance users; Fine-tuning saquinavir; ANTI-HIV AGENTS: Invirase vs. Fortovase: unexpected results?; ANTI-HIV AGENTS: Saquinavir once daily; ANTI-HIV AGENTS: Saquinavir with low-dose ritonavir twice daily; ANTI-HIV AGENTS: Highlights from the 3rd International Workshop on Clinical Pharmacology of HIV Therapy

TreatmentUpdate 126: March - Vol. 14, No. 3
SIDE EFFECTS : Protease inhibitors and lipid-lowering drugs -- interactions; Cause of serious illness among HAART-users not clear; Using abacavir to avoid lipid problems; Switching to abacavir to reduce fat wasting; 9th Retrovirus Overview; SIDE EFFECTS : Assessing nuke toxicity; SIDE EFFECTS : Check-ups for the power plant?; SIDE EFFECTS : Damage to the power plant

TreatmentUpdate 125: February - Vol. 14, No. 2
SIDE EFFECTS: Comparing liver toxicity between efavirenz and nevirapine; SIDE EFFECTS: Nevirapine levels may predict toxicity; SIDE EFFECTS: Health Canada advises against kava; SIDE EFFECTS: Birth defect in baby born to efavirenz-user; SIDE EFFECTS: Viagra and grapefruit juice - not a good mix; INFECTION FIGHTERS: Cidofovir and surgery for genital warts; ANTI-HIV AGENTS: Swiss study switching to efavirenz

TreatmentUpdate 124: January - Vol. 14, No. 1
SIDE EFFECTS: Testosterone troubles; SIDE EFFECTS: Growth hormone: Does less equal more?; SIDE EFFECTS: Thyroid troubles in Montreal; SIDE EFFECTS: Thyroid troubles in France; HIGHLIGHTS FROM ICAAC: Directly observed therapy (DOT); HIGHLIGHTS FROM ICAAC: Amprenavir and low-dose ritonavir; HIGHLIGHTS FROM ICAAC: Saquinavir vs. Sustiva once daily; HIGHLIGHTS FROM ICAAC: Tenofovir; HIGHLIGHTS FROM ICAAC: Atazanavir boosts saquinavir; HIGHLIGHTS FROM ICAAC: Atazanavir vs. nelfinavir; HIGHLIGHTS FROM ICAAC: Atazanavir overview; ANTI-HIV AGENTS: Starting HAART and its effect on survival; ANTI-HIV AGENTS: Response to HAART depends on T-cell count; ANTI-HIV AGENTS: Delaying therapy - the pendulum swings back

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