NAPWA

HIV-related news in brief from the April-May 2005 edition of Positive Living.

News briefs

Women’s satellite for NAPWA conference

The Tenth National Conference of people living with HIV/AIDS, to be held in Adelaide in November this year, will feature a special one-day satellite meeting for positive women, the conference organisers have announced. The satellite will take place at the University of Adelaide on Thursday 17 November.

HIV centres’ funding assured

The health minister, Tony Abbott, has given a commitment to renew the funding for Australia’s three national HIV research centres beyond the current contract expiry date in 2006. The commitment came at a meeting between Abbott and representatives of AFAOAustralian Federation of AIDS Organisations. AFAO is the peak non-government organisation representing Australia's community-based response to HIV/AIDS. AFAO's work includes education, policy, advocacy and international projects. and NAPWA in Canberra, and is expected to be confirmed in the text of the 5th National HIV strategy, due to be released at the end of June. —SSO

Travelling on treatment

“Negative practical and emotional experiences ” are commonly reported by HIV-positive people when travelling, due to fear of disclosure of their HIV status to immigration officials or travelling partners, a British conference has been told. Large numbers of HIV-positive people undertake international travel, including to the US despite its ban on HIV+ tourists, with a significant minority choosing to take breaks from treatment while travelling which can result in the development of medical problems. —Aidsmap

FIND awards

Drug manufacturer Roche has announced a $100,000 award for innovative HIV research projects in Australia. The inaugural FIND (Fuzeon Initiatives for National Discovery) awards are open to people working in clinicalPertaining to or founded on observation and treatment of participants, as distinguished from theoretical or basic science. and academic HIV research projects, and will be announced at the ASHMAustralasian Society for HIV Medicine. The peak Australasian organisation representing the medical and health sector in HIV/AIDS and related areas. conference in Hobart later in the year.

Brazil turns down US funds

The government of Brazil has forgone a US$40 million ($52 million) aid offer from the United States after refusing to sign a declaration condemning sex work which the US insisted on as a precondition for the grant. Brazil had successfully resisted US pressure to adopt abstinence-based programs ahead of condom use, but the US negotiators would not budge on the anti-sex work provisions. “The US is doing the same in other countries — bullying, pushing and forcing,” Brazilian AIDS activist Sonia Correa said. “But not every country has the chance to say no.” —Guardian

Woman killed over HIV remark

A man killed his stepmother after she told him he would not care for him following his HIV diagnosis, a Sydney court was told on 4 May. Gary Michael Dolan, 43, had been on a three-day drinking binge when he informed his stepmother of his recent HIV diagnosis, and later killed her with an axe. The judge hearing the case found the murder was most likely provoked by comments made by the woman that she would not care for the man should he become ill, nor would he be welcome in the family home. —Australian

Bec, Lleyton to open AIDS orphanage

Celebrity couple Bec Cartwright and Lleyton Hewitt are to build an orphanage for Cambodian children who have lost their parents to AIDS. The Home and Away star told a Melbourne newspaper that the idea came about when she visited Vietnam with the AIDS Trust of Australia. “What hurt me the most was the discrimination. Kids with AIDS weren’t allowed in the public swimming pools,” Cartwright said.

Treatments briefs

Once-daily Kaletra approved in the US

The US Food and Drug AdministrationThe U.S. Department of Health and Human Services agency responsible for ensuring the safety and effectiveness of all drugs, biologics, vaccines, and medical devices, including those used in the diagnosis, treatment, and prevention of HIV infection, AIDS, and AIDS-related opportunistic infections. The FDA also works with the blood banking industry to safeguard the nation's blood supply. The Australian equivalent is the Therapeutic Goods Administration (TGA). has approved a once-daily formulation of the protease inhibitor Kaletra (lopinavir + ritonavir). The approval follows a 190-person, 48-week clinical trialA clinical trial is a research study to answer specific questions about vaccines or new therapies or new ways of using known treatments. Clinical trials are used to determine whether new drugs or treatments are both safe and effective. Carefully conducted clinical trials are the fastest and safest way to find treatments that work in people. Trials are in four phases: Phase I tests a new drug or treatment in a small group; Phase II expands the study to a larger group of people; Phase III expands the study to an even larger group of people; and Phase IV takes place after the drug or treatment has been licensed and marketed. comparing the once-daily and twice-daily formulations of Kaletra which showed comparable levels of undetectable virusA small infective organism which is incapable of reproducing outside a host cell. between the two groups. The drug’s manufacturer, Abbott, also said both regimens were “generally well-tolerated,” however people taking the once-daily version had more frequent diarrhoea.

Depression and adherence

People who suffer from depression are more likely to have good adherence to antiretroviralA medication or other substance which is active against retroviruses such as HIV. dosing requirements if they are treated with antidepressants, according to a study in the 1 April edition of JAIDS. The retrospective study looked at the medical records of 1713 US HIV patients, and analysed them for signs of depression, medication adherence and antidepressant prescription. Among people who were depressed, adherence tended to be better if the patient was prescribed antidepressants. The researchers noted that depression was a common diagnosis among their cohortIn epidemiology, a group of individuals with some characteristics in common. A cohort study is a special kind of clinical trial which looks at a treatment or treatment strategy in a cohort of people., with 57 percent of patients affected.

Efavirenz in pregnancy…

The US manufacturer of efavirenz, Bristol-Myers Squibb, has issued an upgraded warning about the risks of using efavirenz in women who are or may become pregnant. The warning follows four reports of babies born with neural tube defects after their mother took efavirenz during the first trimester of pregnancy. The company recommends that women who are capable of becoming pregnant have a pregnancy test before starting efavirenz, and be warned about the risks.

...and in the brain

The neuropsychiatric disturbances which are a common side effectAn unwanted effect caused by the administration of drugs. Onset may be sudden or develop over time. of efavirenz can persist for several years in some patients, European researchers report in the 15 April edition of JAIDS. The study involved 120 Dutch and Spanish people, half of whom were on efavirenz and the balance on a protease inhibitor-based regimen, and all of whom had been on the same treatments for at least a year. Significantly more of the efavirenz group reported neuropsychological disorders including dizziness, mood changes, poor concentration and sleep disturbances, but these were generally mild and manageable, the researchers said. —JAIDS 38(5).

Low CD4s despite undetectable virus

Up to a quarter of people with HIV/AIDS fail to see substantial rises in their CD4 count despite maintaining undetectable viral loadA measurement of the quantity of HIV RNA in the blood. Viral load blood test results are expressed as the number of copies (of HIV) per milliliter of blood plasma. for long periods. French researchers investigating this phenomenon report that, despite their low T-cell counts, these patients appear to have responses to disease-causing organisms equivalent to people with higher CD4 levels, and no increased risk of opportunistic infection. The researchers suggest several possible reasons for the phenomenon including lower levels of CD4 cell production in the thymus. —Aidsmap

Undetectable without treatment

People who achieve undetectable viral load without treatment may be more common than previously thought, according to French research. A study reported in May found that 6.7 percent of people who had never taken treatments had viral load levels below 400-500 five years after seroconversion. The sustainability of these spontaneous undetectable viral loads was “highly variable,” but they were more likely to occur in women, younger men and those with higher CD4 counts. —CID 40 (online ed).

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