September 2003

Contents

Editorial

• Volume 4 Number 7 August/September 2003

Treatment alerts

• EMEA public statement on early virologic non-response in patients with HIV infection treated with tenofovir in combination with lamivudine and abacavir

Conference reports

• XII International HIV Drug Resistance Workshop, Los Cabos, Mexico, 10-14 June 2003

• Transmission of drug resistance – at 11% in Europe and 17% in the UK

• HIV coinfection, reinfection and superinfection

• Single-dose nevirapine resistance in over 75% of mothers

• Transmission of drug resistant virus does not revert to wild-type and does not appear ‘less fit’

• Standard genotype assays may miss 75% of mutations when present in less than 35% of plasma sample

• Low-level resistance and minority populations: cross resistance between nevirapine and efavirenz occurs even in the absence of genotypic mutations found using population sequencing

• Persistent effect of d4T and 3TC, but not NNRTIs in the presence of associated genotypic mutations

• Replicative capacity results complicated by minority wild-type virus

• Tenofovir, resistance and K65R and concomitant nucleosides

• Response to STI is determined by virus rather than immunological response

• Why resistance rarely develops with viral suppression <50 copies/mL

• Long-term persistence of distinct mutations in genital tract

• 5th International Workshop on Adverse Drug Reactions and Lipodystrophy, 8-11 July 2003, Paris

• Underlying mechanisms: adipocytes and cytokines

• More mitochondrial DNA depletion

• IMT and cardiovascular risk

• Reduced bone mineral density in HIV-positive women

• Rosiglitazone with insulin resistance

• Additional benefits of exercise with metformin

• Mitochondrial toxicity with AZT and d4T – and benefits of switch to abacavir

• Facial fat loss – measuring and treatment

• Uridine treatment for mitochondrial toxicity

• Breast enlargement in men and testosterone treatment

• Severe efavirenz psychotic events

• Treatment interruption: a real choice

• 2nd IAS Conference on HIV Pathogenesis and Treatment, 13-16 July 2003, Paris

• Nevirapine and MTCT: the single-dose backlash

• Triple nucleoside combinations fail patients again

• Nucleoside-sparing regimens

• Dual boosted PIs in salvage therapy

• BMS reports on atazanavir efficacy and safety in treatment experienced patients

• Unsupervised treatment interruptions are associated with increased risk of AIDS or death

• Uridine as a potential treatment for NRTI related mitochondrial toxicity

• Long term exposure to nucleoside analogues and peripheral nerve function

• Step-wise intervention eases diarrhoea linked to PI nelfinavir (Viracept) therapy

• First results from ESPRIT study: CD4 response to IL-2 is associated with higher nadir and baseline CD4 and younger age

• Lessons learned from early HAART in acute HIV infection

• CD4 cell reconstitution is significantly slower in older patients

• Pharmacology studies at the 2nd IAS conference

• Studies highlight problems of rectal disease in HIV-positive patients

Antiretrovirals

• T-20 launched in UK

• US approval of FTC (emtricitabine)

Treatment access

• Appointment of industry executive to supervise US AIDS initiative provokes criticism

Guidelines

• US guidelines updated (July 2003)

Side effects

• Bone mineral metabolism and HIV-infection

Coinfections and complications

• Protease inhibitors and Kaposi’s sarcoma (KS): KS relapse seen after switch from PI to NNRTI

Drug resistance

• Resistance summary of new PIs: atazanavir and tipranavir

Other news

• UK highest rate of new infections at over 5,000 cases

• Medicines Control Agency slated by Commons committee

On the web

• Conference reports and abstracts

• Medscape articles

• Newletters and reports

PDFs

• Volume 4 Number 7 August/September 2003 PDF