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HATIP #51,14th July 2005

Published: 14 July 2005

News Headlines

Nevirapine lingers for two weeks after mums give birth

Dutch researchers this week confirmed the Thai findings reported last year, showing that women exposed to a single dose of nevirapine (Viramune)may still have detectable levels of the drug in their blood more than two weeks later. The authors of the study, published in the August 1st edition of the Journal of Acquired Immune Deficiency Syndromes, say that short three to five day courses of antiretroviral treatment after delivery may not be sufficient to prevent all mothers from developing nevirapine resistance.

Monkeys exposed to alcohol have higher SHIV viral load

Macaques infected with the simian immunodeficiency virus and exposed to alcohol in their drinking water had significantly higher SHIV viral load after 18 to 24 weeks of alcohol exposure, according to findings from a small study published in the August 1st edition of the Journal of Acquired Immune Deficiency Syndromes.

South Africa: keeping mum alive is the best medicine

It is tempting to call it a "no brainer": the idea that attempts to prevent transmission of HIV from mothers to children should be matched by initiatives to keep these mothers alive after they give birth. For all this, efforts in South Africa to prioritise the health of HIV-positive mothers have fallen short over past years, although there are signs that government may be starting to give the matter the attention it deserves.

South Africa: Nurses to fill the gaps

South Africa continues to lose skilled healthcare professionals as it rolls out the national treatment programme, leaving severe shortages in an already overstretched public health system.

Burkina Faso aims to put 30,000 on ARVs by 2010

The government of Burkina Faso has announced plans to double the number of people living with AIDS on subsidised antiretroviral (ARV) treatment to 10,000 by the end of this year and increase the number of people receiving the life-enhancing drugs to more than 30,000 by 2010.

India, China or Brazil - who will produce the second line ARVs?

Reproduced from Health and Development Networks SEA-AIDS Forum coverage of the 7th International Conference on AIDS in Asia and the Pacific

The rapid scale-up of antiretroviral (ARV) treatment programs around the Asian region is underway. However, with that rapid scale-up will come the inevitable growth of drug resistance and the need for second line ARV therapy. Much of the developing world currently depends on Indian generics to support its treatment scale-up, but with the recently revised Indian patent law restricting the production of generic ARVs, treatment advocates now warn of a looming 'ARV access crisis' that could sabotage efforts to control the epidemic.

Brazil reaches 11th hour deal on drug patent

The Brazilian government has reached a deal with Abbott Laboratories that will ensure cheaper supplies of lopinavir/ritonavir (Kaletra) without beginning the production of a generic version of the drug in Brazil, the country’s health minister announced on Friday.

Increased vaginal shedding of HIV in pregnant women infected with subtype C

Pregnant women infected with subtype C of HIV-1 shed more of the virus in their vaginal mucosa, than women infected with subtypes A or D, according to a study conducted in Kenya and published in the August 1st edition of the Journal of Infectious Diseases. However, the investigators found that the rate of mother-to-baby transmission of HIV was comparable between women infected with subtypes A, C and D.

Methadone included, tenofovir excluded, from new WHO essential drugs list

Methadone and the opiate substitute buprenorphine have been added to the World Health Organization’s Essential Drugs list, it was announced on Friday, ending nearly two years of lobbying by treatment advocates for inclusion of the drugs on the list.

3 million on treatment target unlikely to be met by end of 2005, says WHO

The ambitious global target to enrol three million people on antiretroviral treatment by the end of 2005 is not likely to be reached until midway through 2006, the World Health Organisation (WHO) admitted today on the release of its `3 x 5` progress report.

Bristol Myers Squibb to cut price of two HIV drugs for children

Bristol Myers Squibb announced yesterday that is is cutting the cost of its paediatric formulations of two drugs – stavudine (Zerit) and didanosine (Videx) – in least developed countries.

Generic efavirenz approved for PEPFAR use but 4 African countries reject US drug standard

The United States Food and Drug Administration (FDA) announced on Friday that it had granted tentative approval for efavirenz tablets manufactured by Aurobindo Pharma Ltd of Hyderabad, India. This product is the first tentatively approved generic version of efavirenz.

Brazil warns of generic Kaletra unless Abbott halves price within 10 days

In a bid to shave burgeoning drug budgets the Brazilian government this week issued a final ultimatum to Abbott Laboratories, manufacturer of Kaletra (lopinavir/ritonavir) yesterday: either cut the price of the drug in Brazil by 50%, or we will issue a compulsory license in ten days time so that the drug can be manufactured in Brazil more cheaply.

XIV International HIV Drug Resistance Workshop: preventing mother-to-child transmission

One message from PMTCT that has come through resoundingly clear is that administering a single dose of nevirapine (NVP, Viramune) can lead to drug resistance in both the mother and the child. This is because nevirapine may persist for up to 14-21 days in the mother’s body after a single dose. Dwindling drug levels create the ideal environment for the selection of drug-resistant viruses, which require only one mutation to occur for high-level nevirapine resistance to emerge. Although single dose nevirapine reduces the rate of HIV transmission, other strategies that supplement single dose nevirapine with zidovudine (Retrovir) or zidovudine/lamivudine result in lower rates of nevirapine resistance.

Key take-home messages from the XIV International HIV Drug Resistance Workshop

The XIV International HIV Drug Resistance Workshop took place between June 7 and 11 in Quebec City, Canada. At this year’s workshop there was evidence of a number of developments in areas, including prevention of mother-to-child transmission (PMTCT); epidemiology – in particular, the issue of drug transmission and its public health consequences; further understanding of the mechanisms of action of entry inhibitors, and finally some new insights into subtype variation.

XIV International HIV Drug Resistance Workshop: Epidemiology

An interesting, albeit inconclusive, theme that emerged at the workshop was the detection of minor viral populations and what that means for our understanding of epidemiology, the transmission of drug resistance including multi-drug resistant strains and their potential impact on future treatment outcomes.

Two generic versions of nevirapine approved for PEPFAR use

The United States Food and Drug Administration (FDA) has announced tentative approval of two applications for nevirapine tablets manufactured by Ranbaxy Laboratories and Aurobindo Pharma Limited, both based in India. These are the first generic versions of nevirapine tablets to be approved for purchase by the President's Emergency Plan for AIDS Relief (PEPFAR).

Lipid-lowering drugs better at lowering blood fats caused by protease inhibitors than switching to NNRTI

Managing hyperlypidaemia caused by protease inhibitors (PIs) with pravastatin (Lipostat) or bezafibrate (Bezalip) is significantly more effective than changing treatment to a non-nucleoside reverse transcriptase inhibitor (NNRTI), according to an Italian study published in the July 1st edition of AIDS. The investigators also found comparable immune and virological outcomes between patients taking lipid lowering drugs and those switching to an NNRTI. In addition they established that individuals taking pravastatin or bezafibrate were no more likely than those changing their highly active antiretroviral treatment (HAART) regimen to experience side-effects.

Duration of ddI treatment and dose risk factors for CD4 loss in patients taking ddI/tenofovir

Duration of ddI (Videx) therapy and ddI dose are risk factors for the loss of CD4 T-cells in patients with a controlled viral load taking a highly active antiretroviral therapy (HAART) combination including ddI and tenofovir (Viread), according to a French study published in the July 1st edition of AIDS. The investigators believe that the reason could be a build up of toxins in CD4 T-cells caused during the metabolising of ddI.

Cotrimoxazole prophylaxis for people with HIV reduces illness and death in other family members too

Cotrimoxazole prophylaxis appears to provide an indirect benefit to HIV-negative members of the household if an HIV-positive person is taking it, a prospective study from Uganda shows. The findings, published in the July 1st edition of the journal AIDS, show that children under the age of ten were nearly two-thirds less likely to die if a family member was receiving cotrimoxazole; all family members were less likely to become sick or die, and malarial parasitamia declined among HIV-negative family members too.

South African HIV prevalence steadily rising; researchers investigate why some communities are harder hit

Three studies presented last Wednesday at the 2nd South African AIDS Conference Durban show that there is room for improvement in the country’s “HIV intelligence gathering” (HIV surveillance). Better, more current data that includes information on risk behaviours could help the country develop more targeted and effective prevention.

US FDA approves second Indian generic HIV drug for use by PEPFAR

The United States Food and Drug Administration (FDA) announced yesterday that it has granted a tentative approval for generic lamivudine tablets, 150 mg and 300 mg, manufactured by Aurobindo Pharma Ltd., Hyderabad, India.

One in eight South African teachers may be HIV-positive

Around one in eight South African teachers may be HIV-positive and South Africa risks losing at least 4,000 teachers a year for the rest of the decade unless more active measures are taken to diagnose HIV amongst the profession and provide treatment, according to research presented last week at the Second South African AIDS Conference. Changes in working conditions for rural teachers could also have a big impact on the infection rate, researchers argue.

South Africa must declare war on AIDS, but respect human rights

Speakers at the Second South African AIDS Conference last week warned that unless South Africa adopted a war footing against HIV whilst maintaining vigilance on human rights, any limited gains in the struggle against AIDS in South Africa could be swiftly eroded.

Traditional risk factors, not PIs or HIV cause hardening of arteries in US study

Traditional risk factors for heart disease, not treatment with a protease inhibitor, are associated with hardening of the carotid artery, according to a US study published in the June 10th edition of AIDS. This finding is in contrast to some earlier studies, but the investigators stress the strength of their study, particularly their matching of HIV-positive patients taking a protease inhibitor with HIV-positive patients not on protease inhibitor therapy and HIV-negative controls according to traditional risk factors for cardiovascular disease.

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.