Welcome to HIV Treatment Bulletin (incorporating DrFax)
When we put out feelers for a name for this new publication, the one that amused us most was, ‘a publication formerly known as DrFax’, there were some other worthy contenders: Dr FAQs — very quick off the mark, not entirely accurate though, but fulfilled the advice from one marketing man who pleaded, ‘for heavens sake hang on to your brand name’; then there was Dr Email — ‘after all you’re not faxing it any more’, ‘or maybe DrPost’, the list goes on so thanks to everyone who came up with suggestions.
Finally after much deliberation we settled for ditching the old and giving it the more prosaic title of HIV Treatment Bulletin (incorporating Dr Fax) — ‘like comics when you were a kid’ — which continues under the editorship of Paul Blanchard. Nomenclature aside, apart from steering clear of the fax machine, we’re developing our content (more of this later), giving it a re-vamp looks wise and producing the publication under the auspices of our new organisation HIV i-Base.
Time for a little history — Dr Fax began in 1996, in response to what we believed to be an urgent need to disseminate important information about fast advancing HIV treatment. In the UK these developments, though we felt hugely exciting, were often greeted with little more than a lukewarm reception. It therefore seemed essential for us to be at the cutting edge of information provision, and, despite being non-medical professionals, we were able to accurately assimilate and report treatment advances and clinical innovations as fast as possible on a fortnightly basis.
We have always taken pride in our fast turn around, balanced reporting and critical appraisal of the data, but have frequently been asked the question ‘why don’t you have a medical advisory panel’ so after looking back at past reports and comparing them to opinions or guidelines written elsewhere in the UK, we came up with a rather interesting timeline. This revealed that there are as many takes on the meaning, interpretation and implication of data as there is data itself.
In June 1996 we reported that, ‘Viral load measurements provide physicians with a powerful diagnostic tool. HIV RNA in the plasma of infected individuals can accurately predict how quickly people with HIV infection will progress to AIDS’, while a simultaneous report in another publication warned, ‘Caution over viral load — viral load tests give information that no-one knows how to interpret or in what way to respond’.
And on the subject of using at least triple combination protease inhibitor based therapy, in August 1996 we wrote that ‘There is no excuse for giving anything less to an HIV positive person than three drugs. And in some cases more may be appropriate.’ While elsewhere in September of the same year it was stated that ‘All the clinicians agreed that the minimum anyone should be offered is a two-drug combination such as AZT/ddI, AZT/ddC or AZT/3TC’.
At times our work has been considered somewhat controversial, though at risk of sounding churlish, in their relatively short lifetime our publications have championed and criticised usually well in advance of what has latterly become medical consensus. Over the past four years we have emphasised – getting below 50 copies; using a minimum of three drugs; caution over saquinavir (Invirase) and using resistance testing (to name but a few issues) way before they were accepted as standard of care. Of course consensus is important, but the majority of the time we would prefer to present you with the unadulterated data and let you make up your own minds. We like to think of you, our readers, as our ‘medical advisory panel’. As such, please tell us if you feel we are losing our way!
Now in the face of a slightly less fast-evolving background, although continuing to espouse the same philosophy, we think that the time is right to allow ourselves a little more leeway for originating and commissioning more articles and giving our publication a more grown up appearance, hence the move to monthly distribution.
Throughout 2000 we will continue to support our current obsessions, such as use of therapeutic drug monitoring to measure drug concentration which, as our co-worker, Simon Collins said, seems ‘so much better than guessing’, and parity of research and objectives in paediatric care, ‘which’ Utrecht’s David Burger explained ‘should run in parallel, though often lags behind that of adults by two or three years’. Practically we intend to continue to develop distribution in Europe and are looking toward collaboration with treatment activist organisations in the US and Africa.
We are also producing our community publication Positive Treatment News (PTN), under the continued editorship of Simon Collins and Polly Clayden, support booklets for positive people on treatment — Introduction to Combination Therapy and Changing Treatment: A Guide to Second-line and Salvage Therapy — intermittent single issue reports, and will be holding scientific meetings throughout the year. Two of the forthcoming subjects for these seminars will be paediatric care and salvage therapy.
Finally we would like to thank everyone that has supported our publications with comments, articles, funding, help with distribution etc, etc (and those of you that read them). We hope that you will continue to do so and to share our objectives of the best possible quality of care and equality of access of treatment for people with HIV.