Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date. The FDA has approved Bristol-Myers Squibb's (BMS) protease inhibitor Reyataz (atazanavir), the first once-daily protease inhibitor (PI). The once-a-day dose of two pills should be taken with food. Unlike other PIs, atazanavir (ATZ) does not appear to cause a rise in cholesterol. However, atazanavir can cause hyperbilirubinemia leading to jaundice or scleral icterus in up to 24% of patients. This abnormality disappears when patients stop taking ATZ, and, according to the FDA, does not appear to be associated with liver injury. BMS said ATZ will be available in July, but did not disclose a price, saying only that it would be competitive with other PIs. Associated Press, 6/20/03
Boehringer Ingelheim Pharmaceuticals, in conjunction with several leading correctional physicians, has launched the Patient History Card, designed to help HIV-infected inmates manage and monitor their HIV care both within prison and on the outside. The card enables patients to record current medications, viral loads, CD4+ counts, weight, drug allergies, vaccinations and other information. "We designed the Patient History Card as a foldable, wallet-sized card so that HIV-positive inmates can carry it with them at all times," said David Wohl, MD, assistant professor of medicine at the University of North Carolina, who helped design the card. Patient names and the words "HIV" and "AIDS" do not appear anywhere on the cards. Cards are available free of charge to all correctional facilities in the US by calling 1-877-933-4310 ext. 9527 or 9551. PRNewswire, 6/12/03
The annual HIV Minifellowship for Correctional Health Care Providers will be held in Providence, Rhode Island, on September 22, 23, and 24. 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.
Roche and Trimeris's new antiretroviral, Fuzeon (enfuvirtide or T-20) doubles the chances that an HIV-infected patient who has developed drug resistance can achieve undetectable levels of the virus, according to two studies published in the May 29, 2003 issue of the New England Journal of Medicine (NEJM). The NEJM published results from the T-20 vs. Optimized Regimen Only Study 1 (TORO 1) and T-20 vs. Optimized Regimen Only Study 2 (TORO 2). T-20 is administered via twice daily subcutaneous injections. NEJM, 5/29/03
The appellate division of the NY State Supreme Court ruled that state prison administrators did not improperly deny an inmate treatment for hepatitis C, largely because the inmate failed to undergo the substance abuse treatment prerequisite and continued to abuse illegal drugs while in prison. While the inmate argued that refusal to supply him with treatment constituted cruel and unusual punishment, the court said that the inmate didn't prove that there was "deliberate indifference" on the part of prison officials, and that the substance abuse program was a "reasonable" prerequisite. Associated Press, 6/23/03
The antibiotic linezolid (Zyvox) may be an effective treatment for some strains of multidrug resistant (MDR) tuberculosis (TB). Linezolid was used to treat four people at New York City's Bellevue Hospital who were infected with MDR TB when all other available therapies failed to improve the patients' health. The patients took linezolid twice a day for 9-33 months, and four patients also received interferon gamma three times a week. Following treatment, there was no sign of TB in patients' sputum. The NYU physicians who presented the cases at the 99th International Conference of the American Thoracic Society in Seattle said further studies are needed to confirm their case reports. CDC Prevention News Update, 6/11/03
As of June 14, 81 people with suspected monkeypox had been reported in Wisconsin (34), Illinois (19), Indiana (26), and Ohio (2). At least 14 of the 81 suspected cases were hospitalized, but there have been no deaths reported. It appears that most of the suspected cases became ill after having close contact with infected prairie dogs that had been purchased as pets. Human-to-human transmission has not been excluded as a means of transmission. For more information on monkeypox, visit the Centers for Disease Control and Prevention (CDC) website at www.cdc.gov/ncidod/monkeypox/. CDC, 6/23/03
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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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