News Briefs
‘Three million on treatment by 2005’: WHO
The newly appointed director-general of the World Health Organisation, Dr Lee Jong-Wook, has promised a global plan to make antiretroviral treatment available to three million people with HIV/AIDS by the end of 2005. AIDS activists have cautiously welcomed the plan, while questioning whether sufficient funds will be available for such an extensive treatment rollout. Dr Lee has appointed the head of the successful Brazilian AIDS program to lead the WHO response to AIDS, and undertook to have a detailed plan in place to meet the three million target by December. — AIDSmap
Australia and France fight AIDS in Pacific
The Australian and French governments have launched a joint initiative to combat HIV/AIDS and sexually-transmitted infections in the Pacific region. The two countries will each contribute around $1.8 million over five years to fund the program. Describing the initiative as “timely,” foreign minister Alexander Downer said the program would develop a regional HIV/AIDS strategy. “While small by global standards, the incidence of HIV/AIDS in the Pacific has risen sharply in some countries,” Mr Downer said. “If unchecked, it could become the major development problem in the Pacific region.”
Increased testicular cancer risk for pos men
HIV-positive men may be at increased risk of developing testicular cancer, according to a study published in the Journal of Clinical Oncology in May. Examining the medical records of 8600 British men, researchers found the incidence of testicular cancer was 3.32 cases per 100,000 patient years, compared with 0.76 in HIV-negative men. The incidence rate had not declined significantly since the introduction of HAART, the researchers noted, however the response rate to treatment was similar between HIV-positive and HIV-negative men. —AIDSmap
PLWHA rights protected in PNG
The government of Papua New Guinea has passed legislation to help protect the rights of people with HIV/AIDS. Drafted in consultation with Australia, the new legislation ensures the confidentiality of medical records and prohibits discrimination against PLWHAs. The law also supports pre- and post-test counselling while outlawing deliberate transmission of HIV. An estimated 20,000 to 25,000 of the PNG population is HIV-positive, with the number increasing by 15-30 percent annually.
Mexico to offer free HIV treatment
Mexican President Vicente Fox has announced a plan to provide free antiretrovirals to all people with AIDS in Mexico by the end of the year. Mexico recently joined a Latin American purchasing syndicate to purchase low-cost generic antiretrovirals, however details of which drugs the scheme will provide, or who will be eligible, were not provided. The Mexican Health Department estimates that as many as 177,000 of its citizens are HIV-positive, although some analysts say the real number could be twice that. —AP, AIDSmap
Life expectancy in Zimbabwe falls to 33 years
The life expectancy of people in Zimbabwe has fallen from 67.5 years to about 33 years due to HIV/AIDS, according to a UN report. About 3000 Zimbabweans die from HIV/AIDS-related illnesses every week. “By 2020, the hardest-hit African countries could lose more than a quarter of their workforces,” the report warned. —AllAfrica.com
Treatments Briefs
FTC approved in US
The US Food and Drug Administration announced in early July that it had approved the nucleoside analogue drug emtricitabine (FTC). The drug, manufactured by Gilead Sciences, will be sold in the US under the brand name Emtriva. Chemically related to 3TC, FTC can be taken once a day and so far appears to have few significant side effects. Because of its long half-life, patients taking FTC are expected to be less likely to develop resistance than those on 3TC, even though the resistance pathway is similar. Australian approval for FTC is not expected before the end of 2004.
Drug toxicity in HIV- children of HIV+ mothers
Children of HIV-positive mothers may be at risk of developing long-term mitochondrial toxicities, even if they do not become infected with HIV. An American study compared 20 children born to HIV-negative mothers with 20 children whose mothers were HIV-positive. None of the children became infected with HIV, but the researchers found higher rates of mitochondrial DNA damage in the children whose mothers were positive, with the most damage occurring in those whose mothers were on treatment during pregnancy. The researchers stressed the importance of long-term health monitoring of the children of HIV-positive mothers. —JAIDS 2003; 33(2):175-183
TDM helps improve treatment success
The Dutch ATHENA study has suggested that people taking protease inhibitors are more likely to maintain an undetectable viral load and avoid toxicity-related side effects if therapeutic drug monitoring (TDM) is used to adjust dosage levels to ensure the right levels of drug are being absorbed into the bloodstream. 147 patients taking either nelfinavir (Viracept) or indinavir (Crixivan) participated in the study, and were randomly assigned to either TDM or non- TDM arms. Patients were followed for a year, with significantly more of the patients in the TDM arm maintaining low viral load at both six and twelve months, particularly among those taking nelfinavir. Indinavir patients using TDM were also significantly less likely to discontinue their treatment due to drug toxicity.
Poor adherence is too common, study finds
Using special pill bottles with microprocessors in the caps which record when they are opened and closed, researchers in Nebraska have concluded that many people with HIV fail to comply with their medication dosing schedules. Only 54 percent of the 40 people studied were rated as having adequate levels of adherence. Among the 37 people taking more than one drug, just three did so at the correct times. Perhaps unsurprisingly, the researchers noted that regimens requiring three or more doses per day were the hardest to stick to. —AIDS 2003; 17:1763-1767
Heavy alcohol use and HAART
Two American studies of HIV in drug and alcohol users have found that people on antiretroviral therapy who drink alcohol more than three or four times a week tend to have higher viral loads and lower CD4 counts than those who drink less or not at all. The researchers suggest several factors could be responsible, including poor drug absorption, interactions, and adherence, and conclude that heavy alcohol use could “block the effectiveness“ of HAART. _ — AIDSmap_
