May #91 : Brains, Not Beauty - by David Gelman, MD

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Children of a Lesser God

Virgin With A Vengeance

Liver and Let Live

Submission: Impossible

Now They C It

Drug Trade

Insecurity Council

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Big Easy

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Warts and All

On Your Feet

Brains, Not Beauty

Math Hysteria

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14%

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A Fish Called Tuna

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May 2003

Brains, Not Beauty

by David Gelman, MD

If the world AIDS conference is a dazzling diva, sashaying every other summer to exotic locales like Barcelona (2002) and Bangkok (2004), the annual Conference on Retroviruses and Opportunistic Infections (clued-ins dub it “Retrovirus”) is her brainy plain-Jane sister, a weeklong data-dump of the year’s top HIV research. With February’s confab convening in bone-cold Boston, you couldn’t accuse wonkerati of flying in for fun in the sun. Instead, they featured treatment tidbits like…

Viread very rad: HIVers on a combo with nucleotide Viread (tenofovir) did as well 96 weeks out as those on the same combo with nuke Zerit (d4T) instead—and had less neuropathy, lipid drama and fat loss in the face and limbs.

Two’s a crowd: Folks on non-nuke Sustiva (efavirenz) did better than those on both Sustiva and non-nuke Viramune (nevirapine), mainly due to high side effects in the twosome group.

Switch hit: In a study supporting that some HIVers can quit protease inhibitors (PI) without sacrificing anti-HIV punch, those undetectable on two nukes and a PI swapped their PI for Viramune, Sustiva or the nuke Ziagen (abacavir)—and all stayed the course, except Ziageners who had once been on only one or two nukes.

Kaletra KO: HIVers on PI Kaletra (lopinavir/ritonavir) and nukes 3TC (Epivir) and d4T had less PI resistance after 15 months than those on the same two nukes plus PI Viracept (nelfinavir).

Pipeline peek: But watch out, Kaletra! In one study, almost 70 percent of patients with resistance to every PI saw major viral-load drop on pipeline PI tipranavir “boosted” with a shot of ritonavir—the same kicker that helped the new “908” model of PI Agenerase (amprenavir) undo resistance to its dad, who demands 16 pills a day vs. four for 908. Tip’s due date? Fall 2003.

The future’s future: The confab buzzed just what might become of TMX-355, a CD4-protecting synthetic antibody that Harvard heavies said showed early promise in squashing virus. Also chatted up was RNA-interference gene therapy, the latest great hope for an AIDS cure. So stay tuned.




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