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New Research Study
A new large HIV drug study is off to a very slow start, at least in Chicago. ACTG 5202 is comparing four state-of-the-art drug regimens, so what’s the hold-up?
Study coordinator Baiba Berzins at Northwestern University said that doctors used to refer many patients to the clinic, but it seems they now just write out prescriptions. (I am a member of the Community Advisory Board—CAB—at Northwestern.) It’s ironic that the success of the past 10 years of HIV research could be hurting treatment advances today.
People who are recently diagnosed or have never taken HIV drugs before should stop to consider joining a study before simply going on medication. It’s the previous involvement of many other people with HIV in clinical studies that give them the options they have today, and those people took greater risks. Newer studies, such as this one, often involve treatment with successful drugs that have well-known—and often very tolerable or manageable—side effect profiles.
ACTG 5202, from the Adult AIDS Clinical Trials Group (AACTG), is for people who’ve never taken HIV drugs before (called “treatment naïve”). (They could have taken a week or less of treatment to be eligible.) The study compares Sustiva plus Epzicom; Sustiva plus Truvada; Reyataz with Norvir plus Epzicom, and Reyataz with Norvir plus Truvada.
Sustiva may be the most commonly used HIV drug in the country. An ACTG study (ACTG 384) looking at which drug regimen to start with found Sustiva plus Combivir to be far-and-away the best one of those examined (see March/April 2004 News Briefs) and Sustiva is one of the two “preferred” leading HIV drugs in U.S. treatment guidelines. Reyataz, a newer drug from the same company that makes Sustiva, is gaining on older meds in its drug class. The buzz on Reyataz is that unlike other drugs in its class, it doesn’t raise blood levels of cholesterol and triglycerides, making it more heart-friendly.
Joining a study requires some work, like regular visits and blood draws, but also brings close contact with attentive healthcare professionals who are cutting edge HIV treatment providers. For an AACTG site near you, visit www.aactg.org, or contact me for a list. In Chicago, visit www.hivclinicaltrials.northwestern.edu, or contact JoAnne Despotes, the CORE Center, 1–312–572–4545; Jan Fritsche, Rush University Medical Center, 1–312–942–4810; or Berzins at 1–312–695–5012. The study aims to enroll a large number of people of color.
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HIV Services Directory
The 2006–2007 Chicago Area HIV Services Directory is now available from TPAN. It lists nearly 400 service and medical providers in the Chicago area. New features of this year’s directory are resources for people transitioning out of correctional facilities and their loved ones, an HIV information handbook, and a revamped online version that has more search capabilities. Funding from the Illinois Department of Health helped make the directory possible after the agency’s Ryan White Title II funding was cut last year. For your free copy of the services directory, call TPAN at 1-773-989-9400. Visit www.tpan.com/online_directory/directory_index.shtml.
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Reverset Bites The Dust
Development of the experimental HIV drug Reverset (DFC) was discontinued in April after toxicity to the pancreas was seen. Incyte Corporation reported that the grade 4 hyperlipasemia occurring in people taking the medication “is now well above the 10% to 15% level that we believe is acceptable.” Hyperlipasemia indicates pancreatic inflammation. The condition was seen in 2% of patients taking 200 mg of DFC along with Epivir or Emtriva, but increased to 40% when taken without one of those two drugs. Paul A. Friedman, M.D., president and CEO of Incyte, said in a conference call that it’s still unknown why this would happen, but a possible (“although not necessarily probable”) reason is that those two drugs compete for cellular levels of a chemical used by Reverset. By lowering the levels of that interaction, toxicity from Reverset may be reduced. DFC, a nucleoside analog drug (like Retrovir and Viread, and the other two drugs, among others), had exhibited good potency against HIV. Reverset studies were being conducted by Pharmasset. Development of a CCR5 inhibitor, a new class of HIV drugs, continues.s body. Kissing is not considered to be risky behavior for transmission.
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TPAN Grant Cut By 77%
Test Positive Aware Network (TPAN), publisher of Positively Aware was notified in March that one of its federally funded Ryan White CARE Act Title I grants was being cut by 77%. The grant falls under the Minority AIDS Initiative (MAI) and will dramatically affect the TEAM (Treatment Education Advocacy Management) program.
The city of Chicago received overall flat funding appropriations from Congress for Ryan White Title I in this cycle; however, the Minority AIDS Initiative was cut in half. Five clinics and TPAN, Chicago’s oldest peer-led AIDS service organization, received MAI funding for Treatment Adherence programs. TPAN sustained by far the largest cut out of all the MAI/Treatment Adherence grants.
The loss accounts for 9% of the total annual TPAN budget. Two-thirds of TPAN’s growing client caseload is people of color. The Minority AIDS Initiative is a government-sponsored program to serve minority populations, of which African Americans are the highest proportion and those most impacted by HIV in this country today.
The Chicago Department of Public Health is the Ryan White Title I grantee from the federal agency administrator, HRSA (Health Resources Services Administration) and created the formula in which TPAN’s TEAM program funding was cut.
“The TEAM program is a one-of-a-kind peer educational and empowerment training program that motivates and educates people with HIV who are newly diagnosed, and those who may have been living with HIV a long time,” said Matt Sharp, Director of Treatment Education and TEAM creator.
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