Roche Products have announced that their pioneering new HIV drug T-20 (efurvirtide, Fuzeon®) will cost nearly £12,500 a year. This is over three times the cost of most other HIV drugs. But Roche maintain that though a T-20-containing regime will cost the NHS over £21,500 net per patient per year, it is still cost-effective. The National Institute for Clinical Excellence has a cutoff point - around £30,000 a year - beyond which they generally regard a drug too expensive for the benefit it coveys. Dr Leroy Benons, Roche's medical advisor, told Positive Nation: "Limited supplies of T-20 are available now for any patient who needs it at any clinic."
The 10th Retrovirus Conference heard the results of the 2NN study, which directly compared the effectiveness of the two non-nucleoside (NNRTI) drugs efavirenz (Sustiva®) and nevirapine (Viramune®). This study was of interest because efavirenz has had a reputation for being the more potent drug. But at the end of the 48-week study the same percentage of patients on once-daily nevirapine had viral loads under 50 as those on efavirenz - 70 per cent (nevirapine is currently licensed for twice-daily). Slightly more people were defined by the study as 'failing' on nevirapine, though the difference was so small it could have been due to chance: 39 per cent on efavirenz 'failed' and 44 per cent on nevirapine.
Efavirenz (Sustiva®) is known to cause psychological side effects such as dizziness, depression and intense dreams. Two studies suggested a possible cause. Efavirenz may change the pattern of sleep so that people are actually dreaming less than they should. They found that patients starting efavirenz experienced an apparently permanent decrease in the time spent in REM sleep - the 'busy' sleep during which we dream. Preventing dreaming can result in symptoms similar to efavirenz - disorientation, inability to concentrate and vivid dreams when they do occur.
L-carnitine (LC) isn't cheap if you buy it at your health food store, but is available on the NHS. Researchers looked at whether LC was able to prevent the side effects of d4T (stavudine, Zerit®) in mice. d4T is implicated in causing fat loss. It is also associated with liver problems, pancreatitis, and peripheral neuropathy. The mice were given 37 times the human dose equivalent of d4T, some with and some without LC. They found that LC was able to counteract the effects even of this high dose of d4T, which means that it may help with lipo and neuropathy.
The prostate gland - aka the male G-spot - appears to contain loads of HIV, even in those with an undetectable viral load on treatment. Four out of seven men had detectable viral load in their semen an hour after their prostate was massaged for just a minute. Since this was like a short burst of receptive anal intercourse, this could mean that someone who was shagged or had other kinds of anal fun first, and then returned the favour, might transmit HIV more easily.
Positive gay men who have never been the passive partner in anal sex are still at risk of anal cancer, according to a New York survey. The study estimated a 40 per cent likelihood of developing anal cancer in the next 20 years - if it was left undiagnosed or untreated. This backs calls for regular anal cancer smear tests to become standard in HIV clinics. Unlike previous reports, however, the study found being on HIV drugs was somewhat protective.
New York internet users are taking slightly higher risks than non-users, according to a study that questioned 6000 users of www.gay.com 64 per cent of those who used the internet to meet sexual partners had unprotected intercourse, compared with 58 per cent who picked up partners elsewhere. Positive were 50 per cent more likely to bareback than negative men.
