Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date. The annual HIV Minifellowship for Correctional Health Care Providers will be held in Providence, Rhode Island, on September 22, 23, and 24, 2003. Sponsored by the University of Texas Medical Branch and HEPP Report, the conference will feature discussions by leading correctional care providers and infectious disease specialists. Topics will include HIV epidemiology, opportunistic infections, HIV/HCV co-infection, mental health issues, guidelines for initiating and modifying ARV, and ethical issues. Call 409-747-8769 or email pwelsh@utmb.edu to register.
The number of New Jersey men diagnosed with syphilis has more than tripled in the last three years, and the rise in numbers could be due to increased risky behavior, ultimately leading to more HIV infections, according to the Bergen Record. The number of syphilis cases decreased throughout the 1990s but has spiked since 2000. New Jersey Health Department officials report that 121 men (mostly men who have sex with men) and 48 women were diagnosed with syphilis in 2002. Bergen Record, 5/4/03
An analysis of 200 HIV-infected patients who died at a Texas hospital in between 1995 and 2000 found that more than half of them were not taking HAART. Despite the availability of HAART, only 48% of patients who died in 1999-2000 were taking HAART at the time of death, according to the authors. The main reasons the patients were not taking the drugs were an inability to adhere to the regimen, an HIV diagnosis less than six months prior to death, or an inability to tolerate the drugs due to underlying liver disease. The study also found that many of the HIV-infected individuals who were not receiving HAART were minorities. Journal of Clinical Infectious Diseases, 2003;36(8):1030-1038
A study in the Journal of Hepatology found that an interval of at least four to five years is needed between liver biopsies to detect significant changes in patients with mild liver disease. One hundred and eighty patients with histologically proven chronic hepatitis C were studied. The authors concluded that fibrosis progression is very slow in patients with mild chronic hepatitis C, but that it appears to be accelerated in the later stages of disease. Increasing age and daily alcohol consumption are the main factors associated with significant fibrosis. Journal of Hepatology, 2003;38(3):307-314
Researchers from Johns Hopkins University presented results at the Digestive Disease Week (DDW) 2003 conference of a four-week study evaluating interactions between methadone and Pegasys. Methadone exposure increased by 10%-15% during the first four weeks of taking both medications together, but the study found that methadone did not have an impact on the pharmacokinetics or pharmacodynamics of Pegagys. The authors concluded that dose modifications of Pegasys are not required and the combination of the drugs is safe and well tolerated. NATAP (www.natap.org), 5/20/03
A man has been infected with two different strains of HIV, researchers report in the May 2, 2003 edition of AIDS. Although the immunological response to HIV-1 infection is believed to impede "superinfection" with a second virus, study authors report that this is not always the case. About four months after infection with drug-resistant clade B virus, the patient was infected by a second drug-sensitive wild-type virus from the same subtype. His viral load then jumped from 34,000 copies/mL to almost 200,000 copies/mL. AIDS 2003; 17:F11-F16 and Reuters, 5/19/03
At the DDW 2003 conference in Florida, researchers from the University of Vienna presented results of a prospective evaluation of 24-hour viral response in predicting outcome of treatment with Pegasys and ribavirin. While the 12 or 24 week response is more accurate at predicting ETR and SVR, the authors concluded that the 24-hour viral response rate is a sensitive predictor of the response to therapy, and may be useful in certain situations. NATAP (www.natap.org), 5/21/03
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©1997,1998,1999,2000,2001,2002, 2003. The recently formed HIV Education Prison Project (HEPP) is a medical education program that targets a growing population, inmates in correctional facilities, that has been underserved in HIV care. It is part of the Brown University AIDS Program. Permission to use and reproduce portions of this newsletter is hereby granted provided that author and publication are fully credited and both copyright and permission notice appear with reprinted material. Inquiries may be directed to heppnews@brown.edu. Website: HIV Education Prison Project.
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