THIS WEEK, a study in the Journal of the American Medical
Association concludes that the cost of AIDS care, although
expensive, falls within the price range of widely accepted
treatments for other diseases.
The most cost-effective combination of antiviral and antibiotic
medicines to treat HIV costs between $29,000 and $40,000 to
extend life expectancy one year, according to the study by
researcher Dr. Kenneth Freedberg and colleagues at Boston
Medical Center in the Jan. 14 edition of the medical journal.
This compares with $15,000 for hypertensive drug therapy,
$22,000 for breast cancer treatment, $26,000 for coronary
artery bypass graft surgery, $46,000 for renal dialysis and
$154,000 for one form of high cholesterol treatment. "The most
highly recommended and effective treatments are worth their
costs," wrote Dr. David N. Rose of Long Island Jewish Medical
Center in New Hyde Park, N.Y., in an accompanying editorial.
"Providing timely access to these cost-effective AIDS drugs to
all patients with HIV infection can add quality years to their
The study focused most closely on the use of antibiotics to
prevent AIDS-related infections like pneumonia, toxoplasmosis
and Mycobacterium avium complex. Freedberg's team developed a
computer-based model to compare the clinical impact, cost and
cost-effectiveness of drug therapies to prevent these
They compared different antibiotics and found that:
*Trimethoprim-sulfamethoxazole to prevent pneumonia and
toxoplasmosis cost $16,000 per year of life saved.
*Azithromycin to prevent Mycobacterium cost $35,000 per year
*Fluconazole to prevent fungal infections cost $100,000 per
*Ganciclovir to prevent cytomegalovirus cost $314,000 per year
When the new triple combination anti-viral drugs were added to
the regimen, cost-effectiveness remained, the researchers
found. Although the data were too speculative to provide firm
conclusions, Freedberg found that adding these very expensive
drugs boosted life expectancy between 43 and 47 months, for a
total lifetime cost of between $72,300 and $79,100.
Officials at a Bay Area-based AIDS vaccine company are seeking
approval from the U.S. Food and Drug Administration to begin
human trials of their vaccine later this year.
The $20 million study by Vaxgen Inc. of South San Francisco
would involve 7,500 healthy volunteers and take about three
years to complete. About 5,000 volunteers would be Americans;
the other 2,500 would be Thai. Half of the participants would
get the vaccine, and half would get an inactive placebo.
The vaccine, based on HIV's gp120 protein, reintroduces a
strategy that several years ago was widely thought to have
failed. The approach has been improved by incorporating two
strains of HIV rather than just one, according to the company.
Thus far, all but a handful of the 1,000 people who have been
injected with the vaccine show a strong immune response, said
Vaxgen's president, Dr. Donald Francis.
Still unknown is whether this immune response will actually
*The 1998-99 state budget proposal unveiled by Gov. Wilson
provides an increase of $35.9 million to expand the AIDS Drug
Assistance Program, which provides HIV drugs to people who
otherwise would be unable to afford them. Events
*UC-San Francisco researchers are holding a town meeting to
discuss the risk of anal cancer in HIV-infected men with a
history of receptive anal intercourse. The cancer, although
deadly, can be identified and treated with regular Pap smears.
The results of a new study on the cancer will be disclosed at a
meeting Jan. 28 from 7:30-9 p.m. at the Metropolitan Community
Church, 150 Eureka St. Call (415) 476-2909.
*A free, interactive telephone conference, called "Report From
the Fifth Conference on Retroviruses and Opportunistic
Infections" will be held at noon Feb. 5, featuring Dr. Stephen
Follansbee of Davies Medical Center and others. Advance
registration is required. Call 1-800-707-BETA to register. The
conference will be held Feb. 1-5 in Chicago.
*The annual AIDS Theater Festival will be held at the San
Francisco Civic Auditorium March 24-27. It will feature
HIV-related plays, performance art, music and dance. Call (415)
* "The Changes Project" is recruiting participants. The UC-San
Francisco study is designed to find the best way to help gay
men master the new challenges of living with HIV. The study,
which pays volunteers $90 to $120, seeks gay, HIV-infected men
who are experiencing stress, medical side effects, financial
worries or other concerns. Its findings will be used to develop
health care guidelines for infected men, their doctors and
communities. Call (415) 597-9169.
Jon Fryman, 46, an accomplished Los Angeles-based artist whose
artwork appeared in the feature films "Red Ribbon Blues" and
"Touch Me" . . . William Garcia, 29, a Costa Rican AIDS
activist who sued his country's government after he was refused
payment assistance for costly HIV medications; he won the legal
battle but died three weeks later . . . Lawyer Jerry Roemer,
32. He gained national attention as a model of the "Lazarus"
effect of protease inhibitors, described in the New York Times
after his boss, Attorney General Janet Reno, declared him an
inspiration after he became well enough to return to work at
the Department of Justice, in Washington, D.C. . . . Harriet
Browne, 67, mother, grandmother, church member, and tap dancer
extraordinaire who shared bills with Cab Calloway, Billie
Holiday and Gregory Hines in Carnegie Hall and elsewhere in New
. . . . . .Date . . . . . .reported. . Cases. . Deaths S.F.. . . .1/1 .
. . . 24,881. 16,974 Calif.. . .1/1 . . . .104,638 . 66,263 U.S.. . .
.1/1 . . . .612,078 .379,258 WHO(rprtd) 1/1 . . .8,400,000 6,400,000
Figures are cumulative since June 1981. Government officials
now compile and release statistics quarterly, not monthly. To
contribute to AIDSweek, call (415) 777-7867.
AIDSweek columns are available on the Internet at
www.examiner.com / aidsweek / aidsweek.html Figures are
cumulative since June 1981. Government officials now compile
and release statistics quarterly, not monthly.
To contribute to AIDSweek, call (415) 777-7867. AIDSweek
columns are available on the Internet at www.examiner.com /
aidsweek / aidsweek.html