Table of Contents: CATIE TreatmentUpdate - 2002


Canadian AIDS Treatment Information Exchange
Edited by: Sean Hosein

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TreatmentUpdate 131: November - Vol. 14, No. 8

English  Françaises
 SIDE EFFECTS: The usual suspects

 EFFETS SECONDAIRES: Les suspects usuels

HoseinSR
In this special "Side Effects" issue, we focus on reports from the 4th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, held in San Diego, 22-25 September 2002.

 SIDE EFFECTS: A brief history of HIV drug therapy

 EFFETS SECONDAIRES: Une courte histoire de la thérapie anti-VIH

HoseinSR
At the beginning of the 1990s, therapy for HIV usually consisted of one anti-HIV drug taken several times a day. This drug was one of several nukes — generally AZT, ddI or ddC. (The latter drug is hardly ever used in North America in 2002.)

 SIDE EFFECTS: Strange side effects

 EFFETS SECONDAIRES: Des effets secondaires bizarres

HoseinSR
By the end of 1998, doctors around the world had began to collect reports of strange changes in body shape, blood fats and hormones in their patients on HAART.

 SIDE EFFECTS: Focus on fat

 EFFETS SECONDIRES: Le point sur les graisses

HoseinSR
Some attendees at the above conference noticed that at previous lipodystrophy workshops there seemed to be excessive focus on describing and documenting the lipodystrophy syndrome.

 SIDE EFFECTS: Lots of volunteers needed

 EFFETS SECONDAIRES: Un appel aux volontaires

HoseinSR
Drug safety is an important issue for manufacturers, regulatory agencies and, most of all, the user. One of the problems with HIV clinical trials, according to researcher Andrew Hill from the UK, is that there may not be enough volunteers or research subjects enrolled in studies.

 SIDE EFFECTS: Lactic acid and nuke damage

 EFFETS SECONDAIRES: L'acide lactique et les dommages causés par les analogues nucléosidiques

HoseinSR
Nucleoside analogues (nukes or NRTIs) such as AZT, d4T and ddI may be associated with a number of side effects, including the following...

 SIDE EFFECTS: No nukes please

 EFFETS SECONDAIRES: Pas d'analogues nucléosidiques SVP

HoseinSR
Because nukes have been suspected of damaging mitochondria, the use of some of these drugs may be linked to fat wasting. This is why some doctors and their patients are interested in testing combination therapy that does not include nukes (nuke-sparing).

 SIDE EFFECTS: Fat wasting - AZT vs. d4T

 EFFETS SECONDAIRES: La fonte des graisses – L'AZT contre le d4T

HoseinSR
Researchers in Australia conducted a two-year study of HIV positive subjects who were using their first HAART regimen. Before starting therapy, DEXA scans of their legs were taken to assess fat levels. Doctors recruited 53 subjects, all of whom were male. Twenty-seven subjects received the nuke d4T and 26 received the nuke AZT, both in addition to other anti-HIV drugs. Thirty-three subjects received protease inhibitors.

 SIDE EFFECTS: Sugar blues

 EFFETS SECONDAIRES: Le blues du sucre

HoseinSR
Having higher-than-normal levels of blood sugar (glucose) is a problem that can occur in HAART users, particularly in those PHAs who take protease inhibitors. To find out just how common this problem is, researchers in Milan, Italy, conducted a large study with 1,481 subjects who had the following profile...

 SIDE EFFECTS: Predicting body shape changes

 EFFETS SECONDAIRES: La prévision des distorsions corporelles

HoseinSR
It may be useful for PHAs to know their risk of developing lipodystrophy, particularly early in the course of therapy. That way, those who are at high risk for this complication could perhaps take preventive measures to minimize its impact. Researchers in Italy suggest that a simple blood test — triglyceride (TG) measurements — may be useful in this regard.

 SIDE EFFECTS: Niacin for high triglycerides

 EFFETS SECONDAIRES: La niacine contre les excès de triglycérides

HoseinSR
High levels of blood fats such as triglycerides (TG) increase the risk for cardiovascular disease as well as diabetes. Unfortunately, in some HAART users, TG levels soar over time. Although changes to diet, an exercise program and lipid-lowering medication can lower TG levels, supplements of the B vitamin niacin can also do the same. In HIV negative people, high doses of niacin (between one and three grams daily) have been used to lower TG levels. Because of concern that high-dose niacin may pose a risk to the liver and increase the chance of developing type 2 diabetes, researchers at the University of Hawaii tested this supplement in a clinical trial of eight HIV positive subjects.

 SIDE EFFECTS: Supplement fix for nelfinavir-related diarrhea

 EFFETS SECONDAIRES: Des suppléments contre les diarrhées induites par le nelfinavir

HoseinSR
One of the side effects of protease inhibitor–based therapy can be diarrhea. If left untreated, diarrhea could, in theory, lead to wasting, tiredness and reduced quality of life.

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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