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News Briefs

Australians ‘don’t discuss’ HIV: study

A national survey of 1100 people conducted by Galaxy research has found that 60 percent of respondents had not discussed HIV/AIDS in the last 12 months, because they did not believe the disease affects them. “Increasingly, the community perception in Australia is that HIV is a diminishing problem,” said Dr Roger Garsia, chairman of the NSW Ministerial Advisory Committee on HIV and Sexually Transmissible Infections. But, noted Garsia, “on a daily basis, people are being infected with HIV in our community.”

Trethowan bows out

After ten years at the helm, the CEO of the AIDS Trust of Australia, Terry Trethowan, has announced his departure from the organisation. “It has been a labour of love in a tough job, but the time has come to move on” said Terry in a statement. “I will miss the Trust and all the wonderful people who I have had the pleasure of working with; I wish the Trust well in all its future endeavours.” Trethowan’s resignation came as the Trust announced it had distributed more than $630,000 in the previous year, including over $200,000 to AIDS Councils and PLWHAPerson (or People) Living with HIV/AIDS. organisations, and $27,000 to support Camp Goodtime.

HIV+ women often receive poor gyno care

A European study has found that many HIV-positive women receive suboptimal gynaecological care, despite living in one of the richest countries in the world. The Swiss HIV CohortIn epidemiology, a group of individuals with some characteristics in common. A cohort study is a special kind of clinical trial which looks at a treatment or treatment strategy in a cohort of people. study found that too few of the 2150 women in the trial had regular gynaecological examinations and PAP smears, but noted that positive women are at increased risk of a range of gynaecological conditions. The current recommendation for positive women is that they should have a gynaecological check-up, including a PAP test, once a year. —Aidsmap

AIDS likely to be third leading cause of death by 2030

AIDS-related illnesses are likely to become the third leading cause of death globally within 25 years, after heart disease and stroke, according to the World Health Organisation. AIDS is currently the fourth-worst killer, with respiratory infections in third place. The report also found that, unlike today when causes of death in developed and developing countries are quite different, within three decades the causes of death will be similar around the globe, although AIDS will continue to be more prevalent in poor countries.

S Africa embraces abstinence

The South African government has announced ambitious plans to cut the rate of new infections by half within five years, by encouraging young people to abstain from sex. The draft plan unveiled to mark World AIDS Day also called for comprehensive care and treatment to be made available to 80 percent of those who need it, but was criticised for being short on detail about how the goals will be achieved. “South Africa has received a lot of negative publicity recently, and while this dramatic shift in government policy must be commended, too many people have yet to see any difference in their daily struggle to fight the illness,” said Sipho Mthathi from the Treatment Action Campaign.

Treatments Briefs

Tipranavir trial halted

A clinical trialA clinical trial is a research study to answer specific questions about vaccines or new therapies or new ways of using known treatments. Clinical trials are used to determine whether new drugs or treatments are both safe and effective. Carefully conducted clinical trials are the fastest and safest way to find treatments that work in people. Trials are in four phases: Phase I tests a new drug or treatment in a small group; Phase II expands the study to a larger group of people; Phase III expands the study to an even larger group of people; and Phase IV takes place after the drug or treatment has been licensed and marketed. of the protease inhibitor tipranavir (Aptivus) in treatment-naive people has been halted early, after it became apparent the treatment was inferior to Kaletra, the drug it was being compared with. The BI 11882.33 trial had been planned to go for three years, comparing two different tipranavir doses with Kaletra, however after 60 weeks researchers concluded that the lower dose was inferior to Kaletra, while the higher dose caused more side effects. Tipranavir is available on the SASBefore a drug has been approved, manufacturers often provide the drug free of charge to people who cannot participate in a clinical trial and who meet certain criteria under a Special Access Scheme (SAS). in Australia in people who have failed other treatments.

Treatment combats vitamin deficiency

US researchers have found that micronutrient deficiencies are relatively uncommon in people taking antiretroviralsA medication or other substance which is active against retroviruses such as HIV.. Studies before the widespread use of HAARTHighly Active AntiRetroviral Therapy ??? aggressive treatment of HIV infection using several different drugs together. found significantly low levels of some vitamins and minerals in people with HIV, leading some to speculate on a possible link to disease progression. The researchers looked at levels of vitamin A, vitamin E, zinc and selenium in 288 positive people taking antiretroviral therapy. Except for zinc, the rate of deficiency was less common than among people not on antiretrovirals, and none of the micronutrients had a significant effect on CD4 counts. —Aidsmap

No benefit in continuing 3TC after rebound

A European study has found no benefit in continuing to take 3TC after experiencing 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. rebound, contradicting earlier findings which found a beneficial effect. The signature mutation for 3TC resistance, M184V, is thought to reduce viral fitness, leading many physicians to recommend continuing 3TC even after failing treatment, but this is the first randomised trialA clinical trial in which participants are randomly (i.e., by chance) assigned to one of two or more treatment arms of a clinical trial. to look at the issue. The 131 participants, all of whom had experience viral load rises while on 3TC, were randomisedA method based on chance by which study participants are assigned to a treatment group. Randomization minimizes the differences among groups by equally distributing people with particular characteristics among all the trial arms. The researchers do not know which treatment is better. From what is known at the time, any one of the treatments chosen could be of benefit to the participant to either continue taking 3TC with their new regimen or switch to a new non-3TC combination. After 48 weeks, there was no significant difference between the groups. Although the study found no benefit in continuing 3TC after failure, the investigators noted that the approach may still have merit in heavily pre-treated people. —Aidsmap

Treatments work despite resistance

A French man with resistance to virtually every antiretroviral drug still gained some benefit from antiretroviral therapy, raising his CD4 count and reducing viral load. In a case with striking similarities to the New York ‘superbug’ case which generated world headlines in early 2005, resistance testing showed the man, who had never taken treatment, was resistantHIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant. to all available antiretrovirals except 3TC, FTC and T-20. Treatment was started after his CD4 count fell to 184, initially with 3TC, tenofovir and Kaletra, which was later switched to atazanavir. More than four years after seroconversion, the man remains relatively stable with a CD4 count of over 300 and a viral load about 10,000. —Aidsmap

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