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By John S. James
AIDS Treatment News
On November 6 a community forum, HIV Therapy Update from
the Recent ICAAC and Glasgow Meetings, was sponsored by
three San Francisco AIDS organizations (the Conant
Foundation, the San Francisco AIDS Foundation, and the AIDS
Research Institute of the University of California San
Francisco); unlike most medical meetings, this one was
funded by the organizations themselves without seeking
pharmaceutical-company support.
Here are a few bottom-line treatment messages that we found most important:
Stephen Becker, M.D., noted the impressive results with patients who were highly treatment experienced (but naive to the NNRTI class of antiretrovirals, in this trial). Also, very few patients discontinued the trial because of toxicity or because of virologic failure. Even patients with substantial resistance to other protease inhibitors were likely to do well. Doctors do not agree on whether to reserve this drug for "salvage" therapy when other treatment options have failed, or to use it earlier in treatment, perhaps in initial therapy. At least at this time Dr. Becker chooses to wait and use it later.
He also noted that there is now much excitement about HIV integrase inhibitors, a major target for new drugs. But these are farther away, probably about five years from widespread use.
A survey of very experienced HIV physicians in San Francisco found that most started treatment at a CD4 count averaging around 350 (and some as late as a count of 200)--depending on other information about the patient, of course. The survey also found that combinations including the NNRTI drug class were the most popular to start with [as opposed to either protease inhibitors, or the triple nucleoside analog treatment with abacavir]. [Note that this community forum took place in November 2000, and treatment strategies later will be different. Sometimes our articles circulate on the Internet forever and are read as fresh information after they are no longer applicable.] Other talks at the forum reviewed progress in preventive vaccines, and in microbicides to prevent HIV transmission. AIDS Treatment News Published twice monthly Subscription and Editorial Office: P.O. Box 411256 San Francisco, CA 94141 800/TREAT-1-2 toll-free U.S. and Canada 415/255-0588 regular office number Fax: 415/255-4659 E-mail: aidsnews@aidsnews.org
Editor and Publisher: John S. James Associate Editor: Tadd T. Tobias Reader Services: Tom Fontaine and Denny Smith Operations Manager: Danalan Richard Copeland Statement of Purpose: AIDS Treatment News reports on experimental and standard treatments, especially those available now. We interview physicians, scientists, other health professionals, and persons with AIDS or HIV; we also collect information from meetings and conferences, medical journals, and computer databases. Long-term survivors have usually tried many different treatments, and found combinations which work for them. AIDS Treatment News does not recommend particular therapies, but seeks to increase the options available. Subscription Information: Call 800/TREAT-1-2 Businesses, Institutions, Professionals: $270/year. Includes early delivery of an extra copy by email. Nonprofit organizations: $135/year. Includes early delivery of an extra copy by email. Individuals: $120/year, or $70 for six months. Special discount for persons with financial difficulties: $54/year, or $30 for six months. If you cannot afford a subscription, please write or call. Outside North, Central, or South America, add air mail postage: $20/year, $10 for six months. Back issues available. Fax subscriptions, bulk rates, and multiple subscriptions are available; contact our office for details. Please send U.S. funds: personal check or bank draft, international postal money order, or travelers checks. ISSN # 1052-4207 Copyright 2000 by John S. James. |
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