News and treatments briefs

News Briefs

Travellers at risk

The Western Australian health department says the number of people from that state who have contracted HIV while working or travelling overseas has more than doubled in the last two years. A significant number of the reported cases were among people employed in the mining, engineering and travel industries. The health department has launched an education campaign, in partnership with the WA AIDS Council, to increase awareness of the risk of contracting HIV while travelling. —ABC News

Clinton partnership launched

Visiting Australia in February, former US President Bill Clinton has announced a new partnership between the Clinton Foundation and the Australian government to fight HIV/AIDS in our region. Australia will provide $25 million through AusAID [1]Australian Agency for International Development. Australian Government agency responsible for managing the Australian Government's official overseas aid program. to support Clinton Foundation projects in China, Vietnam and Papua New Guinea. In 2005, more than half a million people in the Asia-Pacific region died from AIDS-related diseases. The former president also made headlines recently by calling for mandatory testing for HIV/AIDS in high-prevalence countries where treatments were available.

Make that ‘1.3 by 5’

The final report on the World Health Organisation’s ambitious ‘3 by 5’ plan to get three million people on HIV treatment by the end of 2005 has found that only 1.3 million people in poor countries had access to treatment by the 1 December deadline last year. Despite falling short of the goal, the WHO insisted that the plan had been successful, with a marked increase in the number of people on treatment from 400,000 at the plan’s commencement in 2003. The WHO has unveiled a new plan, to make treatment available to all people who need it by 1 December 2010.

HIV and the new IR laws

Changes to unfair dismissal rules under the federal government’s ‘WorkChoices’ industrial relations reforms, which came into operation in March, will not affect the protection of people with HIV/AIDS from employment-related discrimination. While unfair dismissal actions will now not be possible for many workers, the new laws specifically preserve prohibitions on ‘unlawful termination,’ including for reasons of disability, sexual preference or HIV status.

LA bans unprotected sex

New regulations passed in January by the Los Angeles Board of Supervisors in the US effectively ban all unprotected sex at commercial sex-on-premises venues (saunas and sex clubs) in the LA area. The regulations also require sex venues to pay an annual licence fee, undergo quarterly health inspections and display signs and posters reminding patrons that unprotected sex is not allowed. The changes were brought in after several studies showed that large numbers of HIV-positive men use the sex venues. —The Advocate

‘I showered to prevent HIV’

The former deputy president of South Africa, Jacob Zuma, currently on trial for the alleged rape of an HIV-positive AIDS activist, stunned courtroom observers on 6 April when he said he thought the risk of contracting HIV from the woman was small and that he had taken a shower after sex to prevent infection. “It was one of the things that would minimise the risk of contracting the disease,” said the former head of the country’s National AIDS Council, who denies raping the 31-year-old family friend at his home in Johannesburg. The trial continues.

Treatments Briefs

Darunavir on SAS [2]Before a drug has been approved, manufacturers often provide the drug free of charge to people who cannot participate in a clinical trial and who meet certain criteria under a Special Access Scheme (SAS).

A Special Access Scheme (SAS) has begun for darunavir (TMC-114), a protease inhibitor being developed by Janssen-Cilag. People with multiple exposure to other PIs who are having trouble constructing a viable treatment combination may now be eligible to access darunavir, which is still in clinical trials. While not yet licensed for use in Australia or overseas, data from clinical [3]Pertaining to or founded on observation and treatment of participants, as distinguished from theoretical or basic science. trials indicate that it could be an important emerging antiviral [4]A medication or substance which is active against one or more viruses. May include anti-HIV drugs, but these are more accurately termed antiretrovirals. option, especially for people with high-level resistance [5]HIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant. to other PIs.

As with all SAS programs, eligibility is limited to people with multiple treatments failure or who, for reasons of tolerance, toxicity or drug interactions, cannot construct an appropriate treatment combination with currently available PIs. You need to be referred into the program by your treating doctor.

Truvada approved

A once-daily combination treatment for HIV, Truvada was listed on the Pharmaceutical Benefits Scheme [6][Pharmaceutical Benefits Scheme] The federal government program which subsidises medication costs in Australia. Anti-HIV drugs are part of a special part of the PBS called Section 100 (S100) which is used for expensive, highly specialised drugs. effective 1 February. Combining a fixed dose of tenofovir and emtricitabine (FTC) in the same tablet, Truvada offers a reduced pill burden for those people for whom it is suitable. Truvada should be taken in combination with either a protease inhibitor or non-nucleoside.

Hep [7]Any inflammation of the liver. It is usually caused by viral infection, toxic agents or drugs but may be an autoimmune response. It is characterised by jaundice, abdominal pain, liver enlargement and sometimes fever. The different types of viral hepatitis include hepatitis A (formerly called infectious hepatitis), hep B (serum hepatitis), hep C (formerly called non-A, non-B hepatitis), and hepatitis D, E, F and G. C treatment expands

The availability of treatment for hepatitis C virus [8]A small infective organism which is incapable of reproducing outside a host cell. (HCV [9]Hepatitis C virus.) infection in Australia has been simplified, in the hope that more people with the virus will consider treatment. People with HCV infection will no longer have to undergo a liver [10]A large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood. biopsy [11]Surgical removal of a piece of tissue from a living subject for microscopic examination to make a diagnosis (e.g., to determine whether abnormal cells such as cancer cells are present). before being able to access pegylated interferon/ribavirin [12]An antiviral drug which is effective against a range of viruses including herpes, the hepatitis C virus and several strains of influenza. treatment, a move that has been welcomed by experts in the field, who had argued that the biopsy requirement had deterred many people from accessing the treatment.

Reverset abandoned

The development of the experimental [13](Of a drug) Not licensed for use in humans, or as a treatment for a particular condition. Experimental drugs are studied in clinical trials to determine their safety and efficacy, and are sometimes made available via Special Access Schemes prior to their approval. nucleoside analogue DFC (dexelvucitabine, formerly called D-D4FC or Reverset), has been discontinued due to concerns that the drug may cause damage to the pancreas, according to an announcement from Incyte Corporation, the company that had been developing the drug.

HAART [14]Highly Active AntiRetroviral Therapy ??? aggressive treatment of HIV infection using several different drugs together. failure rate falls by half

The risk of failing your first antiretroviral [15]A medication or other substance which is active against retroviruses such as HIV. treatment regimen more than halved between 1996 and 2002, according to an international study published in the March 13 edition of Archives of Internal Medicine. Researchers examined medical records of 3825 people who had started treatment during the seven-year period and noted that, due to more effective treatment strategies employed in recent years, the risk of treatment failure in the first year of treatment had fallen by between 48 and 79 percent. Among people who start and stay ion treatment, “initial failure risk is now very low and may have fallen as low as is realistically possible,” the researchers concluded. —Aidsmap

Buprenorphine interaction

A drug used as an opiate substitute for people dependent on heroin, buprenorphine appears to interact with atazanavir-based antiretroviral combinations, where the atazanavir (Reyataz) is boosted with low-dose ritonavir. In a report published in the March 21 edition of AIDS, doctors describe three cases of interaction between the drugs, leading to increased levels of buprenorphine in the bloodstream. The doctors recommend that the combination be avoided or used with caution, possibly requiring adjustment to the buprenorphine dose.