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News Briefs
by Enid Vázquez
Subjects:
Genotyping added
to latest guideline changes
Pregnancy guidelines also
updated
Harm reduction conference
AIDS numbers: Men of color outpacing
whites
Stop-and-go therapy
Crixivan and Viracept
Viracept now film coated
Muscle up for survival
New HIV magazine
New Videx formulation
Propulsid dead
Aidsmed.com website
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Genotyping added to latest
guideline changes
Resistance testing is now
recommended in U.S. HIV treatment guidelines. That’s
good news because it helps convince reluctant insurance companies
to pay for the tests. These tests have been found useful in
helping achieve the goal of reducing HIV in the blood to undetectable
levels. According to the National Institutes of Health (NIH),
the Guidelines for the Use of Antiretroviral Agents in
HIV-Infected Adults and Adolescents, updated January 28,
now “include a number of drugs the [expert] Panel feels
can accomplish many therapeutic goals with minimal negative
effects on an HIV-infected individual’s quality of life.”
Also, a new section, titled “The Goals of Therapy,”
clarifies that eradication (getting rid of the virus in the
body) is probably not possible with currently available treatments.
The guidelines are available in PDF or HTML format at www.hivatis.org.
Free single copies can be ordered from (800) 448-0440 or through
e-mail at atis@hiavatis.org;
international callers dial (301) 519-0459. Write ATIS, P.O.
Box 6303, Rockville, MD 20849-6303
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Pregnancy guidelines also
updated
For the first time since 1998,
the U.S. guidelines for HIV positive pregnant women have been
updated. Included are discussions of mitochondrial (cell)
toxicity, protease inhibitors and hyperglycemia, and pregnancy
outcomes based on antiviral drug combinations. There’s
also a section outlining options for women in labor with no
prior anti-HIV therapy. See the above item for how to obtain
a copy. Ask for the perinatal guidelines.
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Harm reduction conference
The 3rd National Harm Reduction
Conference takes place October 21-25 in Miami. Titled “Communities
Respond to Drug Related Harm: AIDS, Hepatitis, Prison, Overdose
and Beyond,” the conference includes a Spanish language
track and a look at the effects of welfare reform on drug
users. For a conference brochure, contact the Harm Reduction
Coalition, 22 W. 27th St., 5th Floor, New York, NY 10001,
Attn.: Conference Coordinator. Fax (212) 213-6582 or e-mail
hrcconf@harmreduction.org.
The cost of the conference is $360 before August 15 (or $90
a day) and $450 afterwards. The deadline for scholarships
is July 3.
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AIDS numbers: Men of color
outpacing whites
The U.S. Centers for Disease
Control and Prevention (CDC) has reported that for gay and
bisexual men in 1998, there were more new cases of AIDS among
men of color than among white men. For years AIDS cases among
African Americans and Latinos (both men and women) have been
out of proportion to their number in the general population.
This is the first time, however, that their numbers outpaced
that of whites in any category.
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Stop-and-go therapy
The National Institutes of
Health still has openings in a study comparing a group of
HIV positive people receiving continuous HAART (highly active
antiretroviral therapy) with a group using HAART on and off
(“intermittent therapy”) with intervals of one month
off therapy followed by two months on therapy for 22 months.
Participants must have a T-cell count of at least 300 and
a viral load less than 500 for three months prior to enrollment,
and a viral load less than 50 on screening. NIH will provide
travel to the Clinical Center in Bethesda, MD. For more information,
contact Christian Yoder, RN, MPH, at (800) 772–5464,
ext. 57745.
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Crixivan and Viracept
Which is it—does Crixivan
(indinavir) go up or down in the double protease inhibitor
combination with Viracept (nelfinavir)? We had it both ways
in our annual HIV Drug Guide in the January/February issue.
It was correct on the Viracept page: Crixivan blood levels
go up. However, the doses of both drugs remain standard. Thanks
go to a careful reader in Kentucky for catching that.
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Viracept now film coated
Oh, happy day. In March, Viracept
(nelfinavir) protease inhibitor tablets became available with
a film coating, so they no longer dissolve in your mouth,
leaving that icky taste and feeling. They’re also a little
smaller. Dosage remains 750 mg three times a day (as with
breakfast, lunch and dinner, three tablets each time). Or
people can use the recent Food and Drug Administration (FDA)
approved dosage of 1250 mg (five tablets) twice a day. For
more information, call toll free (888) VIRACEPT (847-2237).
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Muscle up for survival
HIV wrecks muscle tissue
as well as immune cells. Weakness, fatigue, wasting and even
death can result. Now the non-profit PoWeR (Program for Wellness
Restoration) has come out with a new book on beating the virus
at its own game. Built to Survive: A Comprehensive Guide
to the Medical Use of Anabolic Steroids, Nutrition and Exercise
for HIV(+) Men and Women is available for $24.95 retail
or for $18 plus shipping and handling through the Houston
Buyer Club, (800) 350-2392 or (713) 520-5288, or visit amazon.com.
Founded in 1994, PoWeR helps people with HIV regain their
health through a comprehensive program of nutrition, exercise
and anabolic steroids. Perhaps by reading the book, you don’t
need to lose health in the first place. If you (or a stubborn
doctor) are afraid of anabolic steroids, the book covers the
myths behind such fears. Read the organization’s newsletter,
Medibolics, at www.medibolics.com.
The group also runs a hotline (although not toll-free); call
(310) 360–0650.
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New HIV magazine
The Los Angeles-based AIDS
Healthcare Foundation expects to have its first issue of Thrive
magazine out this summer. The new national magazine targets
minorities living with and impacted by HIV. According to a
foundation press release, the publication “seeks to address
the severity of the impact of AIDS among people of color by
providing minority communities a unique, multicultural perspective
on resources and information concerning HIV education and
treatment.” It goes on to quote editor Peter Hale as
saying, “Our intent is to reach communities most challenged
by the AIDS crisis, who, for a number of reasons, are not
accessing medical care for the treatment of HIV. By providing
a magazine that is informative, accessible and entertaining,
we hope to empower readers with vital information to assist
them in effectively managing their health.” The magazine
also hopes to make healthcare providers more sensitive to
the needs of people of color living with HIV. AIDS Healthcare
Foundation operates six full-service healthcare centers where
patients are seen regardless of ability to pay. For more information,
contact Monica Sudduth at (510) 450-0190. Visit www.aidshealth.org.
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New Videx formulation
In late January the manufacturer
of Videx (ddI) submitted an application to the FDA for approval
of the long-awaited enteric coated formulation of the drug.
“Enteric” means the drug won’t dissolve until
after it gets past the stomach. The big, chalky Videx tablets
have an antacid buffer coating that’s necessary for absorption
by fighting off destructive stomach acid, but causes a bad
taste, as well as diarrhea. An enteric coating eliminates
all of that. The new formula is a capsule filled with enteric
coated Videx beads. And it’s a dose of only one capsule
once a day, rather than the two tablets once a day. Last year
Videx became the first nucleoside analog HIV drug (the kind
that’s in the same category as AZT and Epivir) to be
given once a day. The FDA expects to make its decision by
the end of July.
The Fair Price Working Group,
made up of HIV treatment advocates, warns that, “Although
Bristol Myers Squibb hopes to position the improved formulation
as a virtually ‘new drug’ (and thus justify a major
price increase) it is simply a new version of an old drug
that solves a long-standing problem in its formulation. Discussions
with the company suggest that they hope to be pricing the
EC ddI as much as 35–40% above the price of the current
version of the drug.” The group said this proposal would
add approximately $1,000 to the annual price of Videx.
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Propulsid dead
Propulsid (cisapride) will
be off the shelves come July. The drug, used for treating
severe heartburn, has caused heart rhythm problems, and even
death, in people with heart conditions or those taking certain
drugs, including antidepressants and HIV medications.
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Aidsmed.com website
There’s a new website
in town, and it’s quite handy. Check it out: www.aidsmeds.com.
It’s written by people with HIV, including respected
writers like Spencer Cox. Besides basic (but comprehensive)
information, there are question-and-answer sections for various
topics.
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