FTC (emtricitabine, Emtriva®) was approved for general prescription in the EU on 28 October. It is a once-a-day drug that is similar in chemistry to the current drug 3TC and, as with that drug, HIV easily acquires a mutation that makes it completely resistant. However, FTC maintains high levels in the body for such a long time that taking it once a day should guard against resistance developing. Manufacturer Gilead plans to combine FTC in one tablet with its other antiretroviral drug tenofovir (Viread®), though this combination may not be available till 2005.
The transmission of HIV is greatly reduced with effective treatment of other sexually-transmitted infections (STIs), the BHIVA autumn conference heard last month. Dr Tariq Sadiq, of St George’s Hospital London, explained that people with untreated STIs are at much higher risk of both catching and passing on HIV, due to inflammation in the genital tract. People with genital herpes ulcers also shed HIV: “The more herpes shed, the more HIV shed,” said Sadiq. The recent outbreak of syphilis among gay men has increased transmission of HIV via oral sex, and an African study found that semen HIV viral load levels were double among men infected with gonorrhoea. Treating STIs is much cheaper than treating HIV and controlling them can have a remarkable effect on slowing the spread of HIV, Sadiq added.
The idea that gay sex only contributes marginally to the African epidemic has been challenged by a Zimbabwean doctor who found that around two-thirds of prisoners in Zimbabwean jails admit to having sex with each other. Dr Blessing Mukumba said: “Out of all the prisoners we attend to, about 60-70 per cent admit to having sex with other males at one time or another.” Aids-related illness accounts for six out of 10 admissions to hospital of Zimbabwean prisoners.
In the last issue of PN we stated that the face-filling product Bio-Alcamid was a silicon-based product. It is not silicon-based but is a water-based gel. We apologise for any confusion this may have caused.
Patients switching from the drug d4T to either abacavir or AZT experienced a 25 per cent increase in their body fat over a year, a study has found. This is a much higher rate of fat restoration than seen previously. Sixteen patients with significant lipoatrophy were switched from d4T to abacavir or AZT over a 48-week period. Researcher Dr Grace McComsey said: “Lipoatrophy is a condition that develops over years of treatment. So reversal of the condition after only a year with no other intervention was amazing.”
The US Food and Drug Agency (FDA) has said it will ‘fast track’ the approval process of a TNX-355, a promising new HIV drug that may be able to be given as a twice-monthly injection. TNX-355 is an anti-CD4 antibody. The CD4 molecule is also the first part of the cell that HIV sticks to in the process of infection, and a sufficiently large dose of TNX-355 prevents HIV from making any kind of attachment to the cell at all. In preliminary human trials of TNX-355 it was found that a single injection of the drug produced an antiviral effect lasting over two weeks.
Researchers supported by the Bill and Melinda Gates Foundation are giving the anti-HIV drug tenofovir to 800 HIV negative women in Cambodia to see if it can be used to prevent the spread of HIV. “With both a vaccine and a microbicide many years down the road, we are hoping that this potent, low toxicity medication can be taken by uninfected people at high risk of HIV infection and keep them from becoming infected,” said study principal investigator Kimberly Page Shafer.
