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Another year has come and
gone, all too quickly. It seems like only yesterday that we
were frantically putting the finishing touches on the 2003
HIV Drug Guide. While we have made so many advances in our
understanding and treatment of HIV, so much remains unknown.
World AIDS was front and
center in the media throughout 2003. Following the 2003 Drug
Guide, we also turned our attention to China, South Africa
and Ecuador (Mar/Apr)
and ended the year focusing on Eastern Europe, Vietnam and
Botswana (Nov/Dec).
AIDS is a worldwide pandemic. Access to and costs associated
with antiretroviral therapy, care and treatment remains a
huge problem in many parts of the globe.
However, HIV is still “alive
and well” here in the United States as well. While our
government polices the globe, too many individuals right here
at home are dealing with reduced or no healthcare coverage,
escalating insurance premiums with reduced access to care,
and unaffordable drugs. HIV continues to rage at uncontrollable
rates in the African American community. The rates of new
HIV-infections are on the upswing among gay men across the
country. People in the rural and southeast regions of the
U.S. are testing positive at alarming rates. There are far
too few services and support networks available for them.
Club drugs, recreational drugs and injection drug use are
creating dangerous liaisons in many communities (Jul/Aug).
In the fall of 2003, we published
a special issue of Positively Aware, “Positive
Parenting” (September/October),
which turned out to be one of the most popular issues in years.
Once thought to be impossible, more and more HIV-positive
men and women are creating life and raising healthy and happy
children.
As we move into 2004 there
are many questions that remain unanswered:
- What’s the status on research
into new drug classes that will be useful for treatment
experienced and naïve people?
- Will the new drugs be any better
against cross-resistant viruses?
- How do we improve our knowledge
on managing drug side effects, toxicities and drug-drug
interactions?
- When should people start taking
antiretroviral therapy, and who should interrupt therapy
and when?
- How does one manage lipodystrophy
and other metabolic complications of living long term with
HIV?
- How does one treat HIV/HCV and
other co-infections?
As always, we remain committed
to bringing you, our readers, the most accurate and up-to-date
HIV treatment information as soon as possible.
We open the year 2004 with
our 8th Annual HIV Drug Guide. This issue brings you the latest
information on the twenty-two currently FDA approved anti-HIV
drugs. This year, as in past years, the drugs are listed by
class in the order that they were approved by the FDA. This
year’s Drug Guide benefited from the knowledge of the
following individuals. Dr. Stephen L. Becker, with the Pacific
Horizon Medical Group in San Francisco, who wrote “New
Targets, New Drugs, Failed Trials” and provided the doctor’s
comments for this year’s publication. Deneen Robinson,
a treatment educator and former columnist for Positively
Aware, contributed “What’s New in HIV”
and the activist’s comments for the Drug Guide. Dr. Daniel
Berger provides an insightful analysis of new strategies to
attack the virus. Matt Sharp gives us a good overview of the
revised Department of Health and Human Services (DHHS) Guidelines.
An excellent panel of pharmacists
was convened by returning contributing editor Patrick G. Clay,
Pharm.D. Positively Aware thanks the following experts
for their volunteer contribution to the guide: Tom Chin, BScPhm,
Pharm. D., Clinical Pharmacy Specialist, St. Michael’s
Hospital, Toronto; Monica Shieh, Pharm. D., Detroit Receiving
Hospital; Mark Bernstein, Pharm. D., Gilead Sciences; Michael
L. Lim, Pharm. D., HIV Clinical Development & Medical
Affairs, GSK; Jennifer Justice Kiser, Pharm. D., Antiretroviral
Clinical Pharmacology Fellow, University of Colorado School
of Pharmacy; Guy Boccia, Pfizer Inc.; Cynthia Feucht, Pharm.
D., BCPS, Clinical Infectious Diseases Pharmacist; Louis Stokes
Cleveland Veterans Affairs Medical Center; Christopher McCoy,
Pharm.D., Clinical Pharmacy Coordinator, Infectious Diseases
Specialist, Beth Israel Deaconess Medical Center, Boston;
Lynne Spearbraker, Pharm. D., Clinical Pharmacist, Aurora
Sinai Medical Center, Milwaukee; Eric G. Sahloff, Pharm. D.,
Assistant Professor of Pharmacy Practice, University of Toledo,
College of Pharmacy; Linda W. Kam, Pharm.D., Infectious Disease
Clinical Specialist; James A. Haley, VA, Tampa; Kristi M.
Kuper, Pharm.D.; Eli Korner, Pharm.D., MPH, Kaiser Permanente
of Colorado; Deanna Merrill, Pharm. D., MBA, CDE, National
Coordinator, Chair Consortium for HIV/AIDS Inter-Regional
Research; Beulah P. Sabundayo, Pharm.D., MPH, The Johns Hopkins
University School of Medicine; Nafeesa Chin-Beckford, Pharm.D.,
Jackson Memorial Hospital, Miami; Shellee A. Grim, Pharm.D.,
University of Illinois at Chicago; Jean Lee, Pharm.D., McAuley
Heath Center, Grand Rapids; Monika N. Daftary, Pharm.D., Assistant
Professor and Ambulatory Care Pharmacist, Howard University
School of Pharmacy; Cindy Perfect, Pharm. D., The Medical
Center of Central Georgia; Marisel Segarra-Newnham, Pharm.
D., MPH, VA Medical Center, West Palm Beach; and Raymond Pecini,
Pharm.D. and Medical Liaison, Roche Laboratories.
Chin-Beckford, Pharm.D. advises,
“Each HIV drug is only one part of your drug regimen.
You’ll need to take all your medications to get the full
benefit of the therapy and to reduce the risk of resistance.
Do not let your medications run out. The amount of virus in
your blood could increase drastically if you stop. Always
consult your healthcare provider before stopping your meds.
The common side effects that can occur will usually go away
within a few weeks. So hang in there! Also, your doctor should
be notified of all medications that you are taking, both prescription
and non-prescription (over-the-counter, including herbal ones).”
Remember that pharmacists
are also great sources of information. In addition, for more
information on possible drug interactions, visit a great website
at the University of Liverpool: www.hiv-druginteractions.org.
And last but not least, I
would like to especially thank my supporting cast—Enid
Vázquez, Jeff Berry, Matt Sharp and Dr. Daniel Berger
for their dedication to this cause and hard work on this issue
and every issue of Positively Aware. And a big thanks
to Russell McGonagle for making us look good every issue and
for putting up with our constant rewrites [A privilege
I have grown to love very much!—RM].
In the course of this year,
we lost several friends and some brilliant AIDS activists,
who stood strong for many, many years, to AIDS and other complications.
Please take a moment to reflect on the importance of your
life and on those individuals who mean the most to you. Time
flies.
Be Strong. Stay Safe.
Charles E. Clifton
Executive Director / Editor
Send comments and reactions
to ed@tpan.com
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