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Journal of the American Medical Association (01/26/00) Vol. 283,
No. 4, P. 492; Nachman, Sharon A.; Stanley, Kenneth; Yogev,
Ram; et al.
A 1997 study evaluated the role of protease inhibitors (PIs) in
the treatment of children with stable HIV infections. The trial
included 297 antiretroviral-experienced, but protease
inhibitor-naive, clinically stable HIV-positive children, who
were between the ages of two and 17. Three different treatment
regimens were tested: a combination of zidovudine and lamivudine;
zidovudine, lamivudine, and ritonavir; and ritonavir and
stavudine. During the 48-week study, about 72 percent of the
children had a moderate toxic event under therapy, and 21 percent
experienced a severe or worse toxic event. Out of the 297
children, 197 received ritonavir as an antiviral drug, as part of
either dual or triple therapy. There were no differences in CD4
cell counts after 48 weeks between the two ritonavir-containing
regimens. Ritonavir was well-tolerated by the children overall,
with chief side effects including nausea and vomiting. The
study's findings show that ritonavir treatments are powerful
antiviral regimens and that children who have taken nucleosides
should switch to a PI-containing treatment to reduce viral load.
"Structured Treatment Interruptions to Control HIV-1 Infection
(Research Letter)"
Lancet (01/22/00) Vol. 355, No. 9200, P. 287; Lori, F.; Maserati,
R.; Foli, A.; et al.
Italian and U.S. researchers tested the effectiveness of
structured treatment interruption to control HIV-1 infection.
Using three antiretroviral-naive patients and interrupting
treatment at five different times, the scientists based their
design on the case of a Berlin patient who received
hydroxycarbamide, ddI, and a protease inhibitor prior to complete
seroconversion and whose treatment was stopped twice before it
was discontinued permanently. After monitoring viral load
weekly, the results showed different patterns of rebound in each
patient. Results of the hydroxycarbamide-based treatment
combinations show they can be interrupted and restarted many
times, and there was no evidence of drug resistance after up to
five treatment discontinuations. Noting that one patient did not
demonstrate persistent control of HIV-1 in the absence of
treatment, the researchers conclude that "control of HIV
infection may require several structured treatment interruptions
in some patients and may not be successful in others."
Washington Post (01/27/00) P. A5
The first known case of an embalmer contracting tuberculosis (TB)
from a corpse is reported in today's New England Journal of
Medicine (2000;342:246-248). The funeral home worker was
infected with the disease from a dead man who had both AIDS and
active TB. Scientists used DNA fingerprinting to determine that
the embalmer's infection came from the corpse. The researchers
now recommend that funeral home workers take the same precautions
as medical workers to prevent TB transmission.
USA Today (01/27/00) P. 13A
A total of nine new HIV infections were recorded in Wyoming last
year, with four new cases of AIDS, according to HIV surveillance
coordinator Cheryl Corbin. In 1998, there were eight new HIV
cases and two new cases of AIDS. Since 1984, 173 AIDS cases have
been detected in Wyoming, and 56 of those individuals currently
live in the state.
Reuters (01/26/00)
News that six Kenyan women are infected with HIV may cause a
setback in an experimental AIDS vaccine project. The vaccine,
based on studies of 43 Kenyan prostitutes thought to be immune to
HIV, was developed by scientists in England and Kenya. According
to New Scientist magazine, the discovery that six of those women
are now infected may force the vaccine trials to start over from
the very beginning. The dual vaccine was supposed to stimulate
T-cells to fight HIV, and phase I safety trials for it are
expected to begin this year.
Reuters Health Information Services (01/26/00)
A multicenter team led by Dr. Lut Van Damme of the Institute of
Tropical Medicine in Antwerp, Belgium, has found that daily
applications of the COL-1492 nonoxynol-9 vaginal gel do not
appear to cause toxic adverse effects. The researchers, members
of the COL-1492 phase II trial, studied HIV-negative female sex
workers in Thailand or South Africa who had at least five sex
partners a week. The findings, published in the January 7 issue
of AIDS (2000;14:85-88), indicate that multiply daily use of the
gel did not cause lesions or an increase in local toxicity when
compared to a placebo.
PANA Wire Service (01/26/00)
AIDS cases are on the rise in Tanzania, as prostitutes and
tourists contribute to the spread of HIV. The region reported
2,287 AIDS cases last January, according the United Nations
Development Program. The Zanzibar AIDS Control Program noted
that HIV prevalence is increasing sharply in certain groups, and
AIDS is the leading cause of death among 15- to 59-year olds in
the Mbeya region. Risky behaviors like unsafe sex and drug abuse
are growing in mining and fishing towns, which are notorious for
prostitution. An estimated 242 new cases of HIV occur in
Tanzania each day. President Benjamin Mkapa has called on
churches, community leaders, and the private sector to help
prevent the spread of HIV.
Reuters (01/26/00)
In South Africa, 20 percent of all workers may be infected with
HIV by 2005, and that number could rise to 22.5 percent by 2010,
according to officials at a leading life assurer. During in
address in Cape Town on Monday, Maureen Visage, head of
Metropolitan Employee Benefits' AIDS Research Unit, said that HIV
is taking its toll on human resources in the country. An
estimated 1,700 South Africans are infected each day. Economists
warn that AIDS could drastically reduce the skilled labor pool
and prevent an anticipated rebound in the economy.
PANA Wire Service (01/26/00)
Tuberculosis (TB) continues to plague Malawi as a public health
problem. According to TB program manager Dr. Felix Salaniponi,
the country has recorded 22,000 TB cases a year since 1998,
mostly in young adults. The rise in TB cases is associated with
a rise in HIV/AIDS; statistics show that more than 90 percent of
TB patients in Malawian hospitals are coinfected with HIV. The
National AIDS Program of Malawi estimates that almost 1 million
people in the country are infected with HIV.