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HATIP #43/#44, 14th March 2005

Published: 14 March 2005

News headlines

South Africa awards antiretroviral supply contracts

On March 3rd, South Africa's government awarded contracts to seven pharmaceutical companies to supply the country's public health system with antiretroviral drugs over the next three years. The national antiretroviral drug treatment programme aims to provide antiretroviral drugs to 1.2 million people -- or about 25% of the country's HIV-positive population - by 2008. This £300 million tender should supply drug for 500,000 patients the programme aims to reach by 2007.

Seroreversion possible, but rare, after early treatment of acute HIV infection

Early treatment of acute HIV infection resulted in loss of HIV-specific antibodies or 'seroreversion' in three of 150 patients treated at two Boston hospitals, according to a study published in the 15th March edition of Clinical Infectious Diseases.

Two cases of occupational HIV transmission occur despite prompt PEP

Between 1999 and the end of 2002 six definite and 18 possible cases of occupational transmission of HIV have been reported internationally, according to a paper in the March 10th edition of Eurosurveillance Weekly. In two instances, HIV transmission occurred despite the provision of post-exposure prophylaxis.

First randomised study of treatment in primary HIV infection begins recruitment

An international study to test whether a short period of treatment in the early stages of HIV infection can delay the need for antiretroviral treatment is likely to begin recruitment in South Africa, Italy, France and Denmark shortly. The study is already recruiting in the United Kingdom, Ireland and Australia, and is coordinated by the UK's Medical Research Council Clinical Trials Unit.

Histoplasmosis common and severe even after HAART became available in Panama

Histoplasmosis has remained a common and severe infection in HIV-positive patients in Panama, even after the introduction of HAART, according to an article to be published in the April 15th edition of Clinical Infectious Diseases (now available on-line). The investigators found that patients presenting with histoplasmosis often had another opportunistic infection, undiagnosed HIV infection and severe immune suppression.

Stavudine and efavirenz in short supply for developing world, say manufacturers

The antiretrovirals stavudine and efavirenz may be in short supply in the coming months because their manufacturers cannot keep up with demand in the developing world, according to a report in the Wall Street Journal.

Thai tenofovir trial runs into trouble after ethics protests from drug users

Another trial of tenofovir as pre-exposure prophylaxis to prevent HIV infection has run into trouble on ethical grounds, this time in Thailand.

Hepatitis C virus coinfection does not lead to faster HIV disease progression in US women's study

HIV-positive women coinfected with hepatitis C virus do not experience faster HIV disease progression, according to a US study published in the March 15th edition of Clinical Infectious Diseases.

Coinfection with hepatitis G has no benefit, finds study conducted amongst African women with HIV-1 and HIV-2

Coinfection with hepatitis G virus does not confer any survival benefit, boost CD4 cell count or lower HIV viral load, according to a study conducted amongst pregnant women in Africa infected with HIV-1 and HIV-2 published in the March 15th edition of Clinical Infectious Diseases. The findings of this research stand in marked contrast to several other studies which found that individuals coinfected with hepatitis G virus had a slower rate of HIV disease progression, lived longer, and had a better immunological profile and lower HIV viral load.

HAART can be safely interrupted for over a year by patients with lowest ever CD4 cell count above 250 and a sustained treatment CD4 cell count of 500 or more

Individuals who started HAART with a lowest ever CD4 cell count above 250 cells/mm3 and achieved a sustained increase in CD4 cell count above 500 cells/mm3 appear to be able to safely interrupt HIV therapy for over a year, according to an international study published in the February 18th edition of AIDS. It is likely that the investigators' findings will be viewed with considerable interest by researchers involved in the SMART study into the safety and efficacy of CD4 cell guided treatment interruptions.

Report suggests short course of rifampicin/isoniazid as effective as standard course of isoniazid for the treatment of latent TB

A 3-month course of isoniazid (INH) plus rifampicin (RIF) is as effective a treatment of latent tuberculosis (TB) as the standard six to twelve month course of INH alone, according to review published in the March 1 issue of the journal Clinical Infectious Diseases. The review (actually an analysis of the combined data from five randomised controlled clinical trials) also concluded that severe side effects and mortality were similar on both regimens.

Denying HIV treatment to failed asylum seekers makes no economic, public health or moral sense, say leading UK HIV doctors

Denying anti-HIV treatment to failed asylum seekers or individuals of doubtful immigration status has no sound economic, public health, or moral justifications, a panel of four leading UK HIV physicians said in a report published today. They recommend that HIV should be reclassified in government health care eligibility criteria as a sexually transmitted infection, therefore allowing individuals to access free treatment and care irrespective of their immigration status.

AIDS events with a viral cause decline most steeply after starting HAART

The incidence of all new AIDS-defining events decreases significantly in the first three years after the initiation of HAART, according to an international study published in the February 28th edition of The Archives of Internal Medicine. Investigators also found that the incidence of AIDS-defining events with a viral cause declined most rapidly.

Pilot study suggests that Kaletra maintenance therapy safe

Maintenance therapy with the boosted protease inhibitor Kaletra alone may be able to offer effective suppression of HIV with little risk of resistance according to a small pilot study published in the March 4th edition of AIDS.

'Dear Dr' letter issued about risks of using tenofovir and ddI together

Use of the nucleotide analogue tenofovir (VireadTM) and the nucleoside analogue ddI (didanosine, VidexTM) together is not recommended, particularly in patients with a low CD4 cell count and high viral load, European clinicians are being warned by a "Dear Doctor" letter issued by the drugs' manufacturers, Gilead Sciences and Bristol Myers Squibb (BMS). The letter also warns that in circumstances where the two drugs have to be used in conjunction, patients should be carefully monitored for the efficacy of the combination and ddI-related side-effects.

US pressure for UN needle/syringe exchange u-turn 'overrules science', campaigners say in open letter prior to Vienna drugs meeting

An open letter signed by AIDS organisations, human rights groups, scientific researchers, policy analysts, and influential individuals from 56 countries urges delegates at next week's meeting of the United Nations Commission on Narcotic Drugs in Vienna to stand up to the US, which appears to have recently pressured the influential UN Office on Drugs and Crime (UNODC) to reverse its support for needle/syringe exchange and methadone programmes - known under the umbrella term of 'harm reduction'.

Slow progress on HIV vaccines reported at CROI

A symposium at the Conference on Retroviruses and Opportunistic Infections on HIV vaccine development served as a reminder of many unanswered questions about the prospects for effective vaccines. Leading US vaccine researchers focussed in turn on neutralising antibodies, viral vectors, cytotoxic T-lymphocytes, and the relevance of animal studies to results seen in human clinical trials.

Unusual eye lesions should be warning sign for possibility of HIV, suggests case report

A case involving a rare pre-cancerous eye lesion in an HIV-positive women is reported by Scottish doctors in the February 18th edition of AIDS. The doctors recommend that doctors should consider the possibility of HIV infection in all young people presenting with atypical conjuctival lesions.

HATIP #43/#44, 14th March 2005

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.