NAPWA

HIV-related news in brief from the August-September 2005 edition of Positive Living.

News briefs

HIV ‘may be weakening’ over time

HIV samples from the early years of the AIDS epidemic are much more virulent and destructive than those found in HIV-positive people today, Belgian researchers have reported. Comparing stored HIV isolates taken from patients at a clinic in Antwerp between 1986 and 1989 with patients at the same clinic in 2002-03, the researchers found that the modern variants were only about 55 percent as ‘fit’ as the earlier samples. The difference is thought to be related to treatment resistance, which is known to reduce viral fitness, although all the patients studied were treatment-naive. _—AIDS 19: 1555-1564_

Blood ban challenged

A Tasmanian man has launched a legal challenge to the ban on gay men donating blood. Michael Cain, of Launceston, says he was turned away after trying to donate blood at the Red Cross Blood Service after he admitted being homosexual. Cain claims the blood bank’s policy discriminates against gay men. “Unsafe sex should be what the Red Cross screens potential donors for, not gay sex,” he told the Hobart Mercury.

HIV+ can be denied visas

The immigration department can deny HIV-positive people visas to Australia regardless of their personal circumstances, the Federal Court has ruled. The case concerned a Zambian man who was denied a student visa on the grounds of his HIV status. The court had earlier ruled that the immigration department had to take into account the fact that man was paying for his own antiretroviralA medication or other substance which is active against retroviruses such as HIV. treatment during his stay in Australia, and the only cost to the Australian health system would be the man’s regular blood tests. The full bench of the Federal Court accepted the appeal which argued that the department did not have to take into account individual circumstances but only to consider a hypothetical case.

Indigenous AIDS rise

The number of indigenous people diagnosed with AIDS has more than doubled in the last four years. The rate of HIV infection in the indigenous community also rose, but health experts say the rapid increase in the number of indigenous people with AIDS is a sign the health system is failing to reach this group, leading to late diagnosis and poorer health outcomes. Chairman of the MACASHHMinisterial Advisory Committee on AIDS, Sexual Health and Hepatides. The Australian Government Department of Health and Ageing’s high level expert committee, providing advice on issues relevant to HIV/AIDS, sexually transmissible infections and hepatitis C. HIV/AIDS subcommittee, Frank Bowden, called for urgent action to stem the rise: “We don’t have to invoke another crisis in Aboriginal health, this crisis is with us at the moment,” he said. _—The Australian_

AZT patent expires

The patent on the anti-HIV drug AZT has expired. AZT was the first antiretroviral drug to be developed, and was patented 17 years ago by Burroughs Wellcome, now part of GlaxoSmithKline. The patent on AZT expired at midnight on 17 September, making it legal for any drug manufacturer to produce generic AZT. In the US, the Food and Drug AdministrationThe U.S. Department of Health and Human Services agency responsible for ensuring the safety and effectiveness of all drugs, biologics, vaccines, and medical devices, including those used in the diagnosis, treatment, and prevention of HIV infection, AIDS, and AIDS-related opportunistic infections. The FDA also works with the blood banking industry to safeguard the nation's blood supply. The Australian equivalent is the Therapeutic Goods Administration (TGA). has approved two generic versions of AZT for sale in that country, however no generic manufacturer has sought approval to market AZT in Australia.

Dissident under investigation

Los Angeles police are investigating a self-described ‘AIDS skeptic’, Christine Maggiore, after her 3 year old daughter died of AIDS-related pneumoniaAn inflammation of the lung, usually caused by infection with bacteria or other microorganisms, in which the air sacs of the lung become filled with inflammatory cells which solidify and inhibit breathing. earlier in the year. Maggiore, the outspoken leader of an organisation called ‘Alive and Well AIDS Alternatives’, denies HIV leads to AIDS, refused to take treatments during her pregnancy and breastfed her baby. Just weeks before the child died, Maggiore had appeared on a radio program boasting of her child’s good health.

Treatments briefs

Thyroid dysfunction

People taking HAARTHighly Active AntiRetroviral Therapy ??? aggressive treatment of HIV infection using several different drugs together. should be routinely checked for abnormalities in thyroid gland function, British doctors told the 3rd IAS Conference in Rio de Janeiro. A pair of studies has shown that, while still relatively rare, positive people on treatment are more likely to have thyroid dysfunction than the general population. The researchers said protease inhibitors seemed to be linked to hyperthyroidism (overactive thyroid), and non-nucleosides to hypothyroidism (underactive thyroid). _—3rd IAS, abstract TuPe23C09_

New Kaletra tablet

A new tablet formulation of the protease inhibitor Kaletra (lopinavir/ritonavir) reduces pill burden and side effects while providing the same drug levels as the existing capsule form, according to data presented in Rio. The new formulation reduces the number of pills per day from six to four, requires no refrigeration and can be taken with or without food. The manufacturer, Abbott, is currently seeking approval in the US, with Australian approval expected to follow in due course. _—3rd IAS, abstract WeOa0206_

Next-generation non-nukeA type of anti-HIV drug that works by inhibiting a stage of the HIV life cycle called reverse transcription. Non-nucleosides work in a similar way, but are chemically different.

GlaxoSmithKline’s experimental(Of a drug) Not licensed for use in humans, or as a treatment for a particular condition. Experimental drugs are studied in clinical trials to determine their safety and efficacy, and are sometimes made available via Special Access Schemes prior to their approval. non-nucleoside GW695634 appears safe and effective in people who have become resistantHIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant. to the existing non-nucleosides efavirenz and nevirapine, according to a small study presented in Rio. The study enrolledThe act of signing up participants into a study. Generally this process involves evaluating a participant with respect to the eligibility criteria of the study and going through the informed consent process. 46 participants who took either one of four doses of GW695634 or a placeboA dummy medical treatment, designed to have no pharmacological effect, administered to the control group of a clinical trial. for seven days. Viral loadA measurement of the quantity of HIV RNA in the blood. Viral load blood test results are expressed as the number of copies (of HIV) per milliliter of blood plasma. reductions of between 1.1 and 1.6 logs were achieved, and the drug was “generally well tolerated” although a substantial number of participants developed a rash. _—3rd IAS, abstract WePe6.2C03_

Longer hepAny inflammation of the liver. It is usually caused by viral infection, toxic agents or drugs but may be an autoimmune response. It is characterised by jaundice, abdominal pain, liver enlargement and sometimes fever. The different types of viral hepatitis include hepatitis A (formerly called infectious hepatitis), hep B (serum hepatitis), hep C (formerly called non-A, non-B hepatitis), and hepatitis D, E, F and G. treatment suggested

HIV-positive people who undergo treatment for hepatitis C should receive 48 weeks of treatment, rather than the standard 28, according to an Italian study presented in Rio. In the study, involving 128 coinfected patients, significantly higher rates of relapse were seen in those who stopped treatment after 28 weeks compared with those who continued for 48 weeks. The researchers calculated that the chances of achieving a sustained virological response were 5.46 times higher if treatment continued for the longer period. _—3rd IAS, abstract MoPpLB0103_

CCR5 stumbles

A phase 2b trial of aplaviroc, an experimental CCR5 inhibitor being developed by GlaxoSmithKline, has been halted after two of the 250 trial participants developed serious liverA large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood. toxicity. The development came as a surprise as the drug was expected to have a low toxicity, and the company is hopeful that development on the drug can be restarted after the cause of the problem is identified.

HIV drugs can linger for weeks

Two separate studies have shown that some HIV drugs can linger in the body for much longer than expected in some people, leading to low levels of the drug and possible resistance. In a report published in the May edition of Antimicrobial Agents and Chemotherapy, researchers describe three patients who continued to have substantial levels of tenofovir more than three weeks after stopping the drug. A second study, published in the 15 October edition of AIDS, found that efavirenz can linger in substantial concentrations for as long as eight weeks after discontinuation of the drug. In both studies, researchers warned that careful monitoring is needed when stopping these drugs to avoid developing resistance.

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