December #119 : Steps to the Future - by Ivan Oransky MD

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Table of Contents

On the Cover-Juliano Innocenti

Melting the Winter Blues

Higher Ground

Sex in the Age of Meds

WHY...December 2005

Steps to the Future

The Fright Before Xmas

Striking Oil

A Gift to Yourself

A New Year Bathed in Promise

Weighing CD4 Counts

Trainer's Bench - December 2005

The Legal Eye - December 2005

Sexy Holiday Toys


LeRoy Whitfield 1969-2005

Earthwatch - December 2005

Tripped Up

Buzz - December 2005

Out of the Blues

A Lifeline for All

Yesterday's News

As the Virus Turns

Mentors - December 2005

Mailbox - December 2005

Editor's Letter - December 2005

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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December 2005

Steps to the Future

by Ivan Oransky MD

2005 gave boosts to folks with HIV

The year yielded few HIV headlines (besides “supervirus” hysteria). But a handful of developments—some with little media fanfare—are paving the way to positive well-being in 2006 and beyond.

RELIEF FOR RESISTANCE The year’s big story has been entry inhibitor (EI) development. By hitting HIV at a unique spot in its reproductive cycle, EIs may open a brand-new door for containing HIV—and treating people with resistant virus. Alas, in September, GlaxoSmithKline’s (GSK) EI, aplaviroc, hit a wall, with some liver toxicity halting trials in those new to meds. But aplaviroc tests in “treatment-experienced” people continue, and four other EIs are moving through the pipeline. And unlike the first approved EI (injectible Fuzeon), these are pills.

EVEN MORE OPTIONS Two new protease inhibitors (PIs) arrived in ’05 to offer additional hope for people dealing with resistance: Aptivus (tipranavir), debuted in June, and TMC-114 is in expanded access, with approval anticipated in ’06. “Aptivus is not for those new to therapy,” says treatment activist Tim Horn. “It’s for HIV that’s resistant to the older PIs on the market.” TMC-114 is being tested among the treatment-experienced and -inexperienced alike. Both PIs must be taken with at least one other drug to which your HIV isn’t resistant.

A NEW CLASS OF DRUG Maturation inhibitors disable HIV at yet another point in its reproductive cycle—when newly formed HIV matures enough to infect other cells. PA-457 is the first. The pill (likely a once-a-day) has only graduated from early trials. But it suppressed HIV well enough to create a minor stir at conferences this year, and Panacos, the med’s maker, hopes PA-457 will do well enough in studies planned for ’06 and ’07 to get FDA approval in ’08.

A VACCINE FOR HPV 2005 saw progress on vaccines for human papillomavirus (HPV), an STD that plagues and endangers those with HIV. Some strains of HPV cause genital warts; others cause serious lesions in the cervix and anus that can lead to cancer. Cervical cancer—an AIDS-defining illness—progresses faster in positive women than negative ones. In a study (of 25,000-plus women in 33 countries) announced in October, Merck’s vax for cancer-causing HPV, Gardasil, blocked 100% of cancerous and precancerous cervical lesions in those who got all the vax doses. Even women who got HPV before getting all the doses had a lower risk of getting the lesions. GSK is testing an HPV vax, too. However, neither has been tested in positive women. If the vax does work in women with HIV, it could cut cancer risk, although prospects are iffier for those with CD4 cells below 200.

FULLER FACES Only one filler (Sculptra) is approved in the U.S. for HIV’s facial wasting. But Bio-Alcamid (polyalkylamide gel), for which HIVers have trekked to Tijuana, can now be had via “special access” in Canada (see It’s another potential step—although across a border—to better quality of life for those with HIV.

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