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About Just out. (Portland, OR) 1983-2013 | View Entire Issue (July 17, 1998)
10 t My 1?. Proudly Serving Our Community R ea so n s H o pe fo r Continued from previous page Cobb & 503 - 226-0088 IWoodworth A ttorneys at Law___ 920 Crown Plaza 1500 Sw First Avenue Portland, OR 97201 Fax 503-226-9005 'ay and Fred had been staying in the Cottage at the See Vue Motel south of Yachats for years. On this particular visit, Jay was very ill. His T-cells were low and he was too weak to walk. All indications were that this would be his last stay at their favorite spot on the Oregon Coast. It was the hardest thing Fred and Jay had ever had to do— say good-bye to their time spent together at the ocean. Two years later, after miracle-working drugs and Fred's love and support, Jay's T-cells are normal and all signs of his E xperien ce previous illness are gone. They return to the Cottage the u n u su a l to celebrate Jay's renewed health and the promise of a long life lived together. They stroll on the beach, play with their new puppy and spend the evenings snuggled in bed. Oh, and Fred beams. 6 .2 m ile s so u th o f Y ac h ats, on the O re g o n c o a st S ee V ue ( 5 4 1 ) 5 4 7 - 3 2 2 7 • ig u a n a g ra p h ic s.c o m / se e v u e Come in, bring a friend and get tested. You owe it to yourself. o lr Mind Isn't it time to know for sure? Needle-Free HIV Testing for Gay & Bi Men 6-8 p.m. Every Tuesday 620 SW 5th Ave., Suite 300 Cascade AIDS Project HIV Testing Hotline: (503) 223-5907, ext. 172 educator Elly Sendi. A lack of accessible and affordable antivirals isn’t the only problem facing those with HIV in the developing world. Clinical monitoring tools, such as helper-T-cell tests, are not easily obtain able. Even terms like “viral load" were com pletely foreign to many delegates who attended the conference due to the fact that many HIV- and AIDS-related tests are not available for their use. Additionally, it is almost impossible to get highly priced therapies to treat opportunistic infections. Few solutions on how to bridge this gap have been found. After much political pressure, the pharma ceutical giant Glaxo-Wellcome lowered the price of A ZT in develop ing countries. This dis count, however, is only available for HIV-positive pregnant woman to pre vent transmission of the virus to their children. The drawback is that it will still cost hundreds of dollars for a full course of the drug to prevent moth- er-to-infant transmission. “The price is still far out of reach for millions of women,” said Chip Lindner, an advisor to the conference chairman. In Geneva, the only program that seemed to offer hope for treating HIV in the Third World was the HIV Drug Access Initiative, which is a pilot program set up by the United Nations and the World Health Organization in cooperation five drug companies to introduce the latest HIV treatments along with the necessary counseling and testing to ensure the therapy is successful. The initiative will be limited, however, with only five countries receiving clinical support and medications. “World leaders such as Clinton should be playing a significant role in getting these drugs to all who are in need of them,” said one U .S. activist. Without increased support from the devel oped world, the future looks grim for HIV-posi tive people in poorer countries, many confer ence attendees said. seeks to make antiviral dosing less frequent. Clinicians hope this will help ensure patient adherence to a drug combination regimen. Data presented in Geneva show that once-a- day dosing of the drug DDI appears as effective as twice-a-day dosing. Some protease inhibitors, meanwhile, may also be dosed less frequently as long as they are combined with other protease inhibitors. Unfortunately, not all the data on these new dosing regimens has been conclusive. Drug lev els in the blood can vary significantly from per son to person, and less frequent dosing could put one at risk of developing resistance if drug levels fall too low. Another subject that received considerable attention in Geneva was lipodystrophy, a side effect thought by some to be caused by the use of protease inhibitors. Lipodystrophy involves wasting of muscle tissue on the face, limbs and but tocks, and an increase in fat on the abdomen, hips or breasts. This condition has been appearing in an increasing number of patients, especially women. Data presented showed some success in treating the problem through the use o f steroids and exercise. In addition, there have been a few reports of heart attacks in patients possibly as a result of increased cho lesterol levels due to pro tease inhibitor use. These levels will have to be care fully monitored in patients on protease drugs, especially those who have a history of heart disease. Perhaps the most frightening news of the conference dealt with the transmission of drug- resistant strains of virus from one person to another. One study of 67 recently seroconverted patients living in Geneva showed a small num ber of them had been infected with an HIV strain that is resistant to a variety of reverse tran scriptase inhibitors, such as 3 T C and Nevirapine (also known as Viramune). Furthermore, several patients were found to have a strain of virus resistant to all the protease inhibitors currently on the market. This data suggests that unless additional antivirals which can stop these resistant strains of HIV are forthcoming, an entirely new epi demic may be in the future. Another subject that received considerable attention in Geneva was lipodystrophy, a side effect thought by some to be caused by the use of protease inhibitors. Lipodystrophy involves wasting of muscle tissue on the face, limbs and buttocks, and an increase in fat on the abdomen, hips or breasts. F or those who are fortunate enough to have access to antivirals, other problems persist. Patients face complicated dosing regimens, drug side effects and viral resistance to the drugs. Data from Geneva suggest new developments may help alleviate some, but not all, of these prob lems. One current trend in HIV drug development T he S pecter of A ID S Continued from previous page while, took another hit with an updated report from Dr. Ruth Ruprecht of the Dana Farber Cancer Institute in Boston. She vaccinated 15 monkeys with a live attenuated HIV vaccine. In the ensuing 3 to 5 years, one has died of A ID S and three have high viral loads. Ruprecht obtained even more dead ly results in infant monkeys with immature immune systems. “There is a mini-Darwinian experiment going on in every single vaccinated animal,” she said. “In the end, we have disease.” ■ T he A ID S W riters G roup will report more on the Geneva conference in the coming months with “the hope that the world will soon recognize the chal - lenge facing our planet and unite in defeating this virus once and for all.” The core of therapy options in the United States is much the same as it was two years ago when protease inhibitors first came into wide spread use, said Dr. Robert Schooley of the University of Colorado Medical Center. What has changed, he added, is an increase in “data about how these drugs can be used in a larger number of combinations.” Several new drugs seem likely to become available within the next 6 to 12 months. All seem to be variations of existing approaches that may offer comparative advantages for some indi vidual patients. But any new breakthrough in therapy seems at least two years away, possibly longer.