Kaiser Daily HIV/AIDS Report Summarizes Study Results Presented at the Sixth International Congress on Drug Therapy in HIV Infection
The Kaiser Daily HIV/AIDS Report has summarized statements and study results presented at the Sixth International Congress on Drug Therapy in HIV Infection. The conference, which began Nov. 17 and ends today in Glasgow, Scotland, provides researchers and health providers with information about new discoveries and emerging trends in HIV/AIDS treatment research (Conference Chair welcome, November 2002). Summaries of news from the conference appears below.
Nearly Half of HAART Patients Experience Resurgence of Viral Levels
Nearly 50% of HIV-positive patients who initially respond to highly active antiretroviral therapy experience a "rebound" in viral levels, according to a study presented Tuesday, Reuters Health reports. Researchers from University College in London examined 1,470 patients whose viral load had initially dropped to undetectable levels after beginning HAART. Participants' viral levels were measured at six-month intervals. According to the study, 45.9% of patients experienced a rebound in viral levels; however, while 38.8% of patients rebounded within the first six months of viral suppression, only 9.8% of patients who had two or more years of initial viral suppression experienced a resurgence in viral load. Patients on five or more drugs and treatment-experienced patients were more likely to experience a viral rebound, while older patients and patients with higher current CD4 T-cell counts were less likely to experience a rebound. The researchers concluded that patients are at greatest risk for viral rebound within the first six months of initial viral suppression (Woodman, Reuters Health, 11/19).
Patients on Nevirapine-Based Regimen Sustained Viral Suppression
Patients who switched from a protease inhibitor-based treatment regimen to a nevirapine-based regimen continued to effectively suppress viral load, experienced an improvement in triglyceride levels and had fewer treatment interruptions, according to a study conducted by Dr. Franco Maggiolo of the Ospedali Riuniti and colleagues. The study evaluated 124 patients whose treatment regimens included a protease inhibitor and whose viral load remained stable for at least six months. Participants either continued with the protease inhibitor-based treatment or substituted nevirapine, a non-nucleoside reverse transcriptase inhibitor, for the protease inhibitor. After 48 weeks of study, 90% of participants who had switched to nevirapine maintained a viral load of lower than 50 copies/mL, while 92% of protease inhibitor patients sustained this level. Patients on the nevirapine regimen had a significant decline in triglyceride levels, while patients using protease inhibitors experienced an increase in triglyceride levels. Nine nevirapine patients and 18 protease inhibitor patients interrupted treatment due to adverse side effects (Boehringer Ingelheim release, 11/20).
AIDS Activists Urge Research on Link Between Heart Disease, AIDS Drugs
The European AIDS Treatment Group on Tuesday urged drug companies and regulators to continue to monitor whether antiretroviral drugs increase the risk of heart disease and other complications, Reuters Health reports. Several studies have shown that AIDS drugs -- particularly protease inhibitors -- may increase the risk of heart disease, and the European Medicines Evaluation Agency three years ago launched several studies investigating the possible link. The studies are nearly finished, but the EATG said that it fears that the steering committee on the Metabolic Complications of Highly Active Antiretroviral Therapy may vote to discontinue the trials. AIDS activists and researchers say that it will take years to conduct proper follow-up studies on individuals participating in the studies (Woodman, Reuters Health, 11/19).
Clinics Need Funding to Monitor Patients' Treatment Adherence
Based on recent study findings, additional funding should be given to health clinics to monitor patients' adherence to antiretroviral drug regimens, researchers stated at the conference Tuesday, Reuters Health reports. Jonathan Schapiro of Stanford University and Tel Aviv University said that study findings have shown that a 10% increase in treatment adherence can reduce the risk of disease progression by 21%. A separate study conducted by scientists at the University of Bonn found that only 64% of German doctors interviewed always discussed drug adherence with HIV-positive patients at each visit. Researchers at the University of Brighton in England stated that based on patient questionnaire responses, adherence may improve when patients feel that providers are not being "intrusive." Schapiro concluded that more time and money must be allocated toward educating providers about the need to talk to their patients about treatment adherence (Woodman, Reuters Health, 11/19).
Men Whose Partners are Pregnant Should be Tested for HIV
Pregnant women and their male partners should be tested simultaneously for HIV, according to a study presented Wednesday by researchers at London's North Middlesex Hospital, Reuters Health reports. The researchers state that a large portion of women who test positive for HIV during pregnancy do not disclose their diagnosis to their male partners. The researchers studied 59 pregnant women who were diagnosed as HIV-positive during prenatal testing. Fifteen of the women did not disclose their HIV diagnosis to the man responsible for the pregnancy, although five of the women had lost contact with that partner and two of the women had been raped. But eight of the women chose not to tell their partner they were HIV-positive, the researchers stated (Woodman, Reuters Health, 11/20).