The focus on lipo's emotional toll may prod insurers to pay up

Ho-down aside, neither San Diego's ICAAC nor a just-days-before lipo confab revealed any "paradigm shifts," said San Francisco AIDS doc Stephen Becker. The good news? Up-and-coming HIV meds like T-20 (see "Fuzeon Fever" December 2002). The rest? Mostly old news.

On the lipo front, Project Inform's Martin Delaney said he sat up for a study further ID'ing d4T [Zerit] as a "particular culprit" in fat-loss problems, and another asserting "the combination of ddI [Videx] and d4T is more toxic than others [like AZT plus 3TC]."

Studies showed -- again -- that polylactic acid (New-Fill) injections mask facial fat loss -- though follow-up stopped at 24 weeks. "My take-away," noted National AIDS Treatment Advocacy Project's Jules Levin, "is that surgery benefits appear to fade relatively quickly, requiring additional procedures." Sigh. Bright side? The new focus on the emotional toll lipo exacts from HIVers may prod health insurers to pony up for these so-called "cosmetic" treatments.

File these "same-olds" under H (but not for HIV): Genital herpes transmission is reduced by valacyclovir (Valtrex) -- reportedly the first study to report an antiviral med proving to block a viral STD, though we've long suspected that lowering viral load (HSV or HIV) makes people less contagious. The only new news came from a separate study showing genital herpes (which most HIVers have) still ups the chance of transmitting HIV even when you're not having outbreaks. (So glove it, luv.)

As for new-drug nuggets, POZ scooped the ICAAC PR machine last month on six HIV meds due in 2003 (see "Ahoy, New Meds Ahead!" November 2002). Did San Diego add anything else to the mix? Answering a question POZ posed in that scoop, Levin reports from ICAAC that "Atazanavir (Zrivada) [the two-pills-once-a-day protease inhibitor] hasn't led to increases in cholesterol, triglycerides or glucose, suggesting that [lipo] might be slower to develop." (So now will the "blockbuster marketing" begin?) And Duke's Bryan Cullen, MD, passed on word from ICAAC of "NNRTIs with a much better resistance profile than earlier ones." Example: Tibotec-Virco's TMC-125 -- but it's only in Phase II.