News Briefs, 'Positively Aware'.

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News Briefs
by Enid Vázquez

Update from the IAS Conference

This year’s international IAS Conference on HIV Pathogenesis, Treatment and Prevention, held in Sydney, Australia in July, presented progress, as ever, in the treatment of HIV. In a year in which two entirely new types of drugs are expected to come to market and help turn AIDS around for many, other drugs continue moving forward in the treatment pipeline.

Key research

Dr. Pedro Cahn of Argentina, president of the International AIDS Society (IAS), organizer of the conference, provided an overview for reporters.

Around the world

On the global front, UNAIDS reports that the number of people from middle-income countries (like Mexico) and low-income countries who take HIV therapy almost doubled in 2005 alone. That year the United Nations General Assembly passed a resolution to make 2010 the target year for universal access—HIV treatment for all who need it and want it. “Meanwhile,” said Cahn, “research from several countries, beginning with Haiti, demonstrates that community-based programs can deliver ART effectively. An abstract report from Uganda will demonstrate the viability of this approach in Africa.”

Circumcision and penis cleansing

Following reports showing that circumcision can cut the risk of HIV infection in half among heterosexual men in Kenya and Uganda, one of the follow-up reports at this conference was a modeling study calculating the need for substantial funding and experienced surgeons to conduct rapid development of this prevention technique in 14 sub-Saharan countries, where the epidemic hits the hardest worldwide. Furthermore, cost effectiveness analysis supports this endeavor. On the flip side, a study looking at cleansing of the penis immediately following sexual intercourse in uncircumcised men was associated with a higher risk of infection and should not be recommended.

Single-dose for new moms

Recently published data noted, as has been previously reported, that women who take a single dose of Viramune (nevirapine) to prevent HIV infection to their newborn infant around the time of labor can usually take the drug again effectively six months following birth. There is tremendous concern about HIV developing drug resistance to Viramune when women take a single dose while in labor. In addition, two other IAS reports showed a greatly reduced risk of transmission through breastfeeding when mothers take triple-drug HIV therapy.

Clinical research

Several reports covered drugs that are new, soon-to-be-approved, or in early development. New options are always needed and older options are constantly re-examined.

Maraviroc vs. Sustiva

As Positively Aware went to press, Selzentry (maraviroc) was approved by the U.S. Food and Drug Administration (FDA). Part of the excitement around this particular new drug is that it’s a brand new type of HIV medication. Maraviroc is a CCR5 inhibitor, blocking HIV from latching on to a co-receptor (called “CCR5”) that it needs to enter a human cell. Here maraviroc’s effectiveness was about the same as a currently approved medication, Sustiva, in 48-week data. Under a required FDA analysis called “non-inferiority,” maraviroc was found to be non-inferior to Sustiva in getting study participants (around 360 patients on each drug) to less than 400 viral load, but was inferior in getting them to reach less than 50. More people stopped taking maraviroc than Sustiva because of ineffectiveness, but more stopped Sustiva because of adverse events and CD4+ T-cell counts (T-cells) went up more with maraviroc. Still, maraviroc has the benefit of being a new drug working in a different way, with a different viral resistance pattern, and a tolerable side effect profile. All of that gives maraviroc a place at the table, where new HIV medications are badly needed.

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http://positivelyaware.com/2007/07_04/news_briefs.html