Treatment News

Compiled by Gus Cairns

Bad news for abacavir…

The dual-drug pill Kivexa® (abacavir plus 3TC) has been downgraded to a second-choice component of initial HIV drug regimens in the 2008 draft treatment guidelines issued by the British HIV Association (BHIVA). The guidelines now state that Truvada (tenofovir/FTC) plus efavirenz is the preferred first-choice regimen.

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…but good news for heart attacks

Other research, however, in contrast to the news on abacavir (see above), has produced good news on heart attacks. In one study, Dr Caroline Sabin of Royal Free and University College Medical School found that the risk of heart attack in patients on HIV treatment initially increased up to 2001, when the rate was now was one case in 233 patients per year, but then fell to one case in 450 a year by 2006. Dr Sabin put the reduction down to the efficient use of prevention measured such as cholesterol-lowering drugs.

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Paying for prevention: World Bank rewards women who remain STD-free

In an innovative and controversial HIV pilot prevention programme, the World Bank and three other sponsors will pay 3,000 Tanzanian women aged 15-30 45 US dollars every time they attend for a scheduled sexual health checkup over a three-year period – as long as they remain free of sexually transmitted infections.

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Generic lopinavir and ritonavir tablets often deficient in drug

Drug company Abbott has found that generic tablet versions of their drugs ritonavir and lopinavir/ritonavir sometimes provide sub-optimal levels of drugs in the body and in one case virtually no drug.

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New guidelines encourage widespread HIV testing

New UK draft guidelines on HIV testing urge a big expansion of the number of HIV tests done, the settings in which they’re done and the professionals who should do the test.

They also recommend new assays that should reduce the ‘window period’ (the lag between HIV infection and signs of it appearing in the blood) to 15 days.

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Resistance tests still not being performed

Despite the BHIVA guidelines recommending that patients get tested for HIV drug resistance both when diagnosed and before starting HIV therapy for the first time, a study has found that pre-treatment resistance tests are still only being performed on 50% of patients.

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A slippery hope

The search for a microbicide against HIV. Gus Cairns reports.

The last couple of years have seen a series of disappointing results in the search for a new method of preventing HIV infection. While a number of exciting new drugs, including some from totally new classes, were being made available, at the same time there was a series of failures in prevention trials.

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