* Exposure to HIV A researcher exploring why some individuals remain uninfected with HIV, despite having been sexually exposed to the virus on numerous occasions, is keen to interview HIV-positive people who were infected recently. By interviewing people who were infected within the last year and can recall their own l
Last autumn, the results of the Delta trial established that starting treatment with the combination of AZT /ddI or AZT/ ddC resulted in delayed disease progression and longer life compared with treatment with AZT alone.
Nine months ago, when the results of the Delta trial had just been reported, AIDS Treatment Update reported on two of the key questions facing many people living with HIV - when is the best time to start treatment with anti-HIV drugs, and with what drug(s)? Since then, many further trials involving a greater range of d
Gaining weight The Mortimer Market Centre in London is running programmes on weight gain for HIV-positive gay men. The sessions include information on nutrition; healthy eating; maintaining weight and regaining weight, plus one-to-one sessions with the Senior Community Dietician. For more information, contact Colin Dix
A small study found that HIV-positive people who develop tuberculosis (TB) have increases in their viral load, and the increase persists even after the TB has been effectively treated (We.B.414). It is believed that infection with mycobacteria such as TB encourages HIV to reproduce.
Clarithromycin is more effective than rifabutin at preventing symptomatic MAI among people with CD4 counts below 100, according to American research. The combination of both drugs was also better than rifabutin alone, but not significantly better than clarithromycin alone. However, nearly a third of people given clarit
Much previous research has established that women infected with certain strains of the virus HPV , which causes genital warts, are also at increased risk of pre-cancerous abnormalities and cervical cancer. HPV is also relatively common among gay men. A study estimated that in HIV-negative gay men, 6% develop pre-cancer
A single 200 mg dose of the anti-fungal fluconazole each week effectively reduces the occurrence of oral and vaginal Candida in HIV-positive women, according to an American study which enrolled 323 women with CD4 counts below 300. Taking fluconazole prophylaxis did not appear to increase the risk of developing fluconaz
Two studies found that measuring CMV levels in the blood (CMV viraemia) using a PCR test could provide an indication of which people may benefit most from anti-CMV drugs. A study at the Royal Free Hospital found that among 80 people with CD4 counts below 50, those who developed detectable blood levels of CMV, indicatin
Two studies examined why people are still developing PCP as their first AIDS-defining illness even though highly effective prophylactic drugs such as co-trimoxazole (Septrin) are available. Both the Swiss and the American researchers concluded that these cases almost exclusively occur in people who are not receiving pr
A meta-analysis of four trials in which the combination of AZT plus 3TC was compared with a control arm of AZT alone or AZT plus ddC concluded that the combination was associated with a
One of the world s largest studies of long term non-progressors has found no evidence that psychological or lifestyle factors make any difference to the likelihood that people with HIV will develop AIDS. The study at the Chelsea and Westminster Hospital found that factors such as personality, depressive tendencies, cop
Last month AIDS Treatment Update reported on the US approval of nevirapine, based on a trial which had followed patients for 26 weeks. In Vancouver researchers presented almost one year s follow-up on this study. Participants who received the triple combination of AZT , ddI and nevirapine still had
The protease inhibitor nelfinavir, currently undergoing trials at two hospitals in London, exerts an extremely potent anti-HIV effect in combination with AZT and 3TC , reported Dr David Ho. The study recruited twelve anti-retroviral naive patients with high initi
Two small studies which looked at the combination of d4T plus 3TC suggested it was superior to the combination of AZT plus 3TC for people who had previously taken AZT.
The protease inhibitors ritonavir and saquinavir can be used safely in combination, according to the first six weeks results of an ongoing study. Since the discovery that ritonavir can boost saquinavir levels thi
Researchers from Houston, Texas, presented further evidence that the combination of d4T ( stavudine ) and ddI is effective and well-tolerated. Follow-up of 75 patients with a mean CD4 count of 340 showed that the average fall in viral load after eight weeks was 1.
People who added 3TC to their existing anti-HIV therapy experienced a halving in their risk of developing AIDS or dying, according to the results of a trial that was halted in late July. The CAESAR trial, also known as NUCB3007, was described in detail in AIDS Treatment Update issue 26. It recruited 1892 people with CD
According to Dr Doug Richman, the leading US authority on anti-retroviral drug resistance, AIDS research is currently going through two paradigm shifts . The first, discussed on pages 4-5, is the view that the aim of treatment should be to achieve complete suppression of HIV replication in as many parts of the body as
New research on viral load is leading researchers to view the test as central to the effective monitoring and treatment of people with HIV. Studies presented in Vancouver provided important new evidence of the usefulness of measuring the amount of HIV in infected people s blood for two purposes: - predicting the risk o
It was a discussion that could not have taken place six months ago, and scientists at the Eleventh International Conference on AIDS in Vancouver knew it. In a packed auditorium, Dr David Ho of the Aaron Diamond AIDS Research Center in New York, presented the first of a series of studies which suggest that the amount of
The major themes of the Eleventh International Conference on AIDS in Vancouver were the effectiveness of combination therapies and the importance of viral load testing. Some of the new studies will have an immediate impact on the way people with HIV are treated. A single measure of viral load appears to be a better pre
* Drug approvals Several of the newer anti-HIV drugs are likely to be fully licensed and available in hospital pharmacies by the end of the summer. In recent months, the pan-European drug licensing agency, the EMEA, has given the go-ahead to 3TC ,
* Bone marrow The soft substance inside bones, where red blood cells, platelets and granular white blood cells are produced * CD4 A molecule on the surface of some cells onto which HIV can bind. The CD4 cell count roughly reflects the health of the immune system * combination therapy Using more than one
* Workshops offered NAM, in association with the Treatment Action Taskforce and the Network of Self-Help HIV/AIDS Groups, is developing a national programme of treatment workshops. The workshops are delivered by a trained team of facilitators, many of whom are living with HIV. They provide an easy to understand introdu
Cytomegalovirus ( CMV ) is a common virus that is normally controlled by the immune system. But among HIV-positive people with low CD4 counts, CMV can become active in various parts of the body. If it becomes active in one or both of the eyes, it causes lesions on the retina (retinitis) that may affect sight, and could
The anti-HIV drugs developed to date fall into three major categories: - nucleoside analogue reverse transcriptase inhibitors, such as AZT , ddI, ddC , 3TC and
Nevirapine, the first of a new class of anti-HIV drugs, was approved by the US Food and Drug Administration ( FDA ) in late June. The FDA approval followed a one-day hearing earlier in the month at which results of trials of nevirapine, a non-nucleoside reverse transcriptase inhibitor (NNRTI), were reviewed. The approv
* antibody A protein substance produced by the immune system in response to a foreign organism * anti-histamine A drug that counteracts allergic symptoms such as hayfever * anti-retroviral Something that acts against retroviruses, the family of viruses to which HIV belongs * CD4 A molecule on the surface of some cells
* Saquinavir & ddC The longest study of a protease inhibitor to date has found that for people who had previously taken AZT , those treated with the combination of ddC plus
If you have ever wondered how NAM gets the money to send AIDS Treatment Update free to people living with HIV, here are your answers. Most of NAM s income comes from subscriptions to its publications. This includes the fees from the professionals who receive AIDS Treatment Update, and the income from the rest of our pu
Three different protease inhibitor drugs are now available in the UK. Saquinavir is available for people who are not benefiting from currently approved anti-HIV drugs, through an open label study in which everyone receives the drug. Indinavir and ritonavi
Molluscum contagiosum are skin lesions caused by a common pox virus. The lesions can occur in HIV-negative people, but among people with HIV who are exposed to the virus or have previously been infected, they can spread widely over the skin. The lesions are small, dome-shaped bumps a few millimetres across. They are th
Use of viral load tests may in some cases lead to premature or mistaken treatment decisions, according to a leading clinician. Professor Tony Pinching told AIDS Treatment Update that viral load tests give us information that no-one knows how to interpret or in what way to respond . His concerns are likely to fuel the d
* Living Proof The Living Proof conference for long-term survivors of HIV and AIDS took place in London on 12th - 13th April. Workshops looked at medical, psychological and political issues, and the conference ended with a plenary session looking at what needs to happen next. Unanimously, delegates felt it would be a s
* Appointment of Director NAM Publications is the UK s leading provider of information on HIV and AIDS, with an established profile of high quality publications. NAM s mission is to support the fight against AIDS and HIV with relevant, up-to-date, accurate and comprehensive information. NAM is especially committed to d
* Access to ritonavir The protease inhibitor ritonavir is now available in the UK on a named patient basis. This scheme allows doctors to prescribe the drug at their discretion to individuals who might benefit from it. Ritonavir s manufacturer, Abbott Laboratories , has said that it
The availability of more and more treatments for HIV infection, opportunistic infections and other HIV-related conditions, whether on prescription or through clinical trials and expanded access schemes, increases the choices for people with HIV and their doctors. But as well as their potential benefits, virtually every
* antibody A protein substance produced by the immune system in response to a foreign organism * anti-retroviral Something that acts against retroviruses, the family of viruses to which HIV belongsasymptomatic Having no symptoms * CD4 A molecule on the surface of some cells onto which HIV can bind. The CD4 cell count r
* Treatment Action Taskforce TAT announces its next public information forum: Access to promising new drugs , a discussion on access to treatments including trials, expanded access, government approval and costs. Find out what your options are and how you can increase them. All welcome! Palm s Hall, 4th Floor, Universi
In late 1995 an advertisement appeared in The Pink Paper offering a œ31000 reward to the first person finding one scientific paper establishing actual isolation of HIV . The advert was placed by the group Continuum, who do not accept that HIV is the cause of AIDS. In effect, they were arguing that not only does HIV not
Resistance to anti-HIV drugs is thought to occur due to evolutionary pressures. When HIV reproduces mutations often occur so that the new viruses that are produced have small changes in their structure. Some of these mutations occur in the enzymes that are targeted by anti-HIV drugs, such as reverse transcriptase or pr
* Indinavir A small number of people at three UK clinics are already receiving Merck s indinavir (also known as Crixivan ) through an expanded access scheme, which is now fully enrolled. Merck says indinavir will be available for any person with HIV on a named pa
Indinavir , the potent protease inhibitor manufactured by Merck, is to become available to people with HIV in the UK through a special scheme, at least six months ahead of being granted a formal licence. The drug will be available from the company when a doctor applies on behalf of an individual patient, a system kno
* Treatment Action Taskforce TAT announces its second Public Information Forum, on Preventing opportunistic infections . Dr Ian Williams of the Mortimer Market Centre will summarise the latest news on treatments to prevent OIs. Plus a report on OI research at the Washington conference. All welcome! Venue: Palm s Hall,
* More Delta results An updated analysis of the Delta trial results extended the preliminary results reported last year. Among previously untreated people, those taking AZT plus either ddI or ddC lived significantly longer than those taking AZT alone.
Ritonavir can reduce the symptoms and prolong the life of people with advanced HIV infection, according to trial results presented in Washington. Triple drug combinations that included a protease inhibitor were also shown to have strong short-term anti-HIV effects. CLINICAL BENEFITS The most striking study fo
Measuring the amount of HIV in an HIV-positive person s blood may be the best available indicator of their prognosis, according to the latest research presented at the Third Conference on Retroviruses and Opportunistic Infections in Washington in January. Changes in viral load within the first few weeks of taking anti-
* Trials news The Chelsea and Westminster Hospital has just published the latest issue of its newsletter providing information on clinical trials available at the centre. The newsletter contains details of 22 trials of anti-retroviral drugs and treatments for opportunistic infections. To obtain a copy, write to Sandra
* Stavudine licensed The US Food and Drug Administration has formally approved the anti-HIV drug stavudine (also known as d4T , or by the trade-name Zerit ) as a treatment for people who h
The Kobler Centre in London is to take part in a trial of a new drug called tucaresol, which appears to have an immune boosting effect. Tucaresol was originally developed by Wellcome for treating sickle cell anaemia, an abnormality of the red blood cells. Initial studies in people with sickle cell anaemia and in health
Guidelines on avoiding and preventing opportunistic infections were updated in the USA last year. The guidelines, drawn up by a working party of the US Public Health Service (USPHS) and the Infectious Diseases Society of America (IDSA) cover all the infections to which people with HIV-related immune damage are vulnerab
AZT may provide considerable protection to health care workers who have accidentally stabbed themselves with needles contaminated with HIV-infected blood, according to a new study. The international study reviewed the records of 710 health care workers in France , the USA and the U
In recent issues AIDS Treatment Update has reported on the rapid approval of three new anti-HIV drugs - 3TC , saquinavir and stavudine - in the United States .
* A Manual For You First published in 1993 and recently updated, A Manual For You is now available for sale throughout the UK. The manual is a complete guide to living with HIV and a major source of self-help support. It includes 27 chapters on a multitude of subjects including medical and wider health issues, relation
* Liposomal KS drugs The two liposome-encapsulated chemotherapy drugs used to treat Kaposi s sarcoma are gaining international approval. Liposomal doxorubicin (Doxil or DOX-SL) was licensed in the USA in late November for the treatment of people with KS that has progressed despite prior combination chemotherapy, or who
In recent months AIDS Treatment Update has reported on the new treatment decisions which are facing people with HIV in the wake of the Delta trial. In discussions with doctors on the implications of Delta, one concern has arisen time and time again. It s all very well knowing that combinations prolong life, say doctors
Many HIV-positive people desire to live the normal lives they feel they would have been living were it not for HIV. For some people, having children is a natural part of this process of getting on with life. For HIV-positive women, several approaches may reduce the risk of HIV being transmitted to the child, such as us
Mycobacterium avium intracellulare complex (MAI, also known as MAC ) are a group of micro-organisms that belong to the Mycobacteria family. They are common bacteria and most people have probably been exposed to them. The organisms rarely cause illness in people with properly working immune systems, but if your CD4 coun
This information is designed to support, not replace, the relationship that exists between you and your doctor.