Taking protease inhibitors may increase the risk of heart problems sevenfold, investigators have found. A study of 5,672 patients attending clinics has shown that between 1993 and 2002, 19 out of 3,247 patients who took PIs had heart attacks compared with two out of 2,425 who did not. That's a relative risk of 58 cases per 10,000. As people with HIV live longer, the long-term heart risk of protease inhibitor treatment may become more apparent, some scientists warn.
In a study published in Aids, structured treatment interruptions (STIs) - regular breaks in HIV treatment - have been shown not to work as a strategy for controlling HIV. The viral load of all 14 patients enrolled on a Swiss trial rebounded to detectable levels within two weeks of the beginning. This investigation discredits the theory that STIs could somehow 'prime' the immune system to control HIV without the support of anti-HIV drugs. The investigators concluded: "This therapy should not be considered as a general treatment option at the present time."
A study of 21 insomniac people with HIV has shown that, after receiving acupuncture, the subjects gained, on average, an extra two hours sleep per night. The patients received acupuncture on two evenings per week for five weeks. Chronic sleeping problems can lead to daytime fatigue, stress and decreased physical and psychological wellbeing.
The controversial drug thalidomide could soon be available to patients across Europe - 40 years after it was banned. EU authorities are considering whether recent studies suggesting the drug could help people with Aids and some forms of cancer are reason enough to license it again. At present, thalidomide is banned in Europe having caused mothers to give birth to deformed children in the 1950s and 60s.
Older people are just as likely as younger HIV-positive patients to succeed on HAART, according to a new study. The study compared the CD4 counts and HIV viral load between people over the age of 50 and younger people taking antiretrovirals. The trial found no difference in the increase in CD4 count, or in the fall in viral load, between both groups of patients.
The dosage of the first ever 'non-peptidic' protease inhibitor was announced last month. Manufactured by Boehringer Ingelheim, tipranavir has a different chemical structure from currently available protease inhibitors, and its flexibility means that it may be active against drug-resistant viruses. The ideal dosage has now been fixed - 500mg tipranavir with 200mg of ritonavir. Tipranavir is currently entering the final phase of clinical trials and is likely to be licensed in 2005.
Treatment with efavirenz (Sustiva) causes a greater incidence of severe psychiatric illness than previously thought, according to a study from San Francisco General Hospital. The study found that of patients who had taken efavirenz, 18.3 per cent reported having had vivid dreams and 14.7 per cent complained of insomnia. Talia Puzantian, a professor at the University of California, said: "The most serious side effects are suicidal depression including agitation, aggression and hallucinations."
The possibility that the smallpox vaccine may once again be used as an anti-biological warfare measure has raised the possibility that, in the era of HIV, people with damaged immune systems could come down with smallpox-like reactions to the jab. About 60 million people in the US, including those with HIV-related or other immune deficiencies, could be harmed by infection with Vaccinia - the live virus used to make the smallpox vaccine.
