by Enid Vázquez
FDA grants approval for Intelence
Rapid testing in the community
New drug targets
Physician assistance
Abstinence and condoms
100 Questions & Answers About HIV and AIDS
FDA grants approval for Intelence
The U.S. Food and Drug Administration (FDA) in January granted accelerated approval to Intelence (etravirine), or TMC-125, the first non-nucleoside reverse transcriptase inhibitor (NNRTI) proven to be effective in people who have developed resistance to the other drugs in that class (Sustiva and Viramune).
“NNRTIs have been used in HIV combination therapy for more than a decade, but their use has been limited by cross-resistance within the class. Resistance to one NNRTI generally meant resistance to all NNRTI’s,” said Richard Haubrich, M.D., Professor of Medicine in the Division of Infectious Diseases at the University of California, San Diego. Haubrich was also an investigator in the Phase III DUET studies of the drug. “Etravirine breaks new ground in the NNRTI class, and provides a new option to thousands of treatment-experienced patients with NNRTI-resistant HIV.”
Intelence was studied in clinically advanced, treatment experienced adults and is approved for people within this group who have a detectable viral load and virus that is resistant to an NNRTI and other HIV drugs. The most common side effects of any intensity in the studies of the drug were rash and nausea.—Keith R. Green
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Rapid testing in the community
A third of the almost 24,000 individuals being tested for HIV in a community outreach project were taking the test for the first time in their lives. The project was part of the efforts of the U.S. Centers for Disease Control and Prevention (CDC) to decrease the number of positive people who are unaware of their infection, estimated by the CDC to be 25% of all people living with HIV in this country. Findings of the project were published in the November 30, 2007 issue of the CDC’s Morbidity and Mortality Weekly Report.
Rapid testing and referral to medical care was conducted in eight community-based organizations (CBOs) in seven cities—Boston, Chicago, Detroit, Kansas City, Missouri, Los Angeles, San Francisco, and Washington, D.C. (Here in Chicago, testing was done through a mobile unit of the Night Ministry.) Sites used for testing in either mobile units or inside were deemed used by high-risk people, including parks, shelters, and syringe exchanges. Of the 267 individuals testing positive for HIV (1%, same as other CDC testing sites), 200 returned for a confirmatory test result. The most common reason given for not providing a confirmatory test to the other 67 persons is that they could not be found.
“These results suggest that rapid HIV testing in outreach and other community settings can effectively target substantial numbers of persons at high risk for HIV infection,” editorial comments to the report noted. The commentary also suggested that people with a preliminary positive test result for HIV can be immediately referred to medical care without waiting for confirmatory results.
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New drug targets
Harvard researchers reported finding more than 200 proteins that HIV uses to infect people. That’s 200+ targets for new HIV medications. One media report quoted one of the researchers as saying that medications already existing which affect these proteins may be able to fight the virus. Whether medications that can hit these targets exist or not, it will take a long time to see any effective drugs for HIV. At any rate, progress is good. The report was published in the February 8 edition of Science.
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Physician assistance
The outstanding AIDS Clinical Care newsletter, written by and for HIV medical providers, now offers a free daily e-mail alert reviewing medical news affecting HIV care. Providers can go to jwatch.org to sign up. The newsletter is from the publishers of Journal Watch and the New England Journal of Medicine.
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Abstinence and condoms
Speaking of AIDS Clinical Care, kudos to Associate Editor Carlos del Rio, MD, of Atlanta’s Grady Hospital, for a witty turn of phrase in his editorial comments. Looking at study results showing that abstinence programs do not effectively prevent risks from sexual contacts here in the U.S., he noted that, “In the end, abstinence vows break more than condoms do!”
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100 Questions & Answers About HIV and AIDS
This new book by Positively Aware contributor and internationally recognized HIV expert Joel Gallant, MD, MPH, of Johns Hopkins University, provides answers to many of the most common questions asked by people living with HIV/AIDS, their partners, and family members. Written in easy to understand lay language, this is an invaluable resource for those living with HIV as well as those who care for them. Also included is commentary by two HIV-positive individuals, as well as information on testing and prevention. Available at most bookstores and online booksellers; or call (800) 832-0034. Visit www.jbpub.com. —Jeff Berry
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