Here's what the SF Examiner had to say about PIs:
S.F. docs review drug therapies
LISA M. KRIEGER
OF THE EXAMINER STAFF
THIS WEEK, San Francisco AIDS researchers have published the nation's
first major review and commentary on the use of the new anti-viral drugs
called protease inhibitors.
The review, published in the latest Journal of the American Medical
Association, pulls together information from many sources, including other
journals, abstracts from medical conferences and product information from
pharmaceutical companies.
The goal is to assist doctors and patients in their use of these complicated
medicines, according to the team.
"This is an attempt to put all the information together and into some
perspective," said senior author Dr. James Kahn, UCSF associate professor
of medicine and co-director of the AIDS Program at S.F. General Hospital.
Kahn and the other UCSF researchers support the widespread use of the
drugs in combination with nucleoside inhibitors such as AZT, DDI, DDC,
3TC and D4T.
"But the bottom line is there is no magic formula or pattern" for their use,
Kahn said. "Each drug offers unique and important characteristics, and the
decision on which drugs to use is a decision that has to be individualized to
each patient."
Many questions about the drugs remain, including the best time to initiate
therapy, whether therapies are equal in efficacy and tolerability, whether
patients can comply outside a monitored research setting, and finally, who
will pay for these therapies, which cost more than $10,000 per year.
Researchers also warn that patients may develop resistance to the drugs and
"cross-resistance" to other protease inhibitors is also likely. To delay
resistance, the drugs must be used in the right combinations, at full doses -
and patients need to comply with the dosage schedule, they wrote.
The four drugs included in the review are saquinavir (Invirase), ritonavir
(Norvir), indinavir (Crixivan), and nelfinavir (Viracept).
"Although these drugs are clearly powerful, there's limited long-term data" on
their effectiveness, said Dr. Steven Deeks, an AIDS researcher at UCSF.
"These drugs were approved in record time by the Food and Drug
Administration and we are still learning about some of the pros and cons.
Nevertheless, it is clear they work and they should be made widely
available."
Women and HIV
*Rebekka Armstrong's dream of a perfect Playmate life ended because of a
night of unprotected sex on a California beach.
The 29-year-old blonde, Playboy's Miss September 1986, still turns heads
with her looks - and her story of battling AIDS. Now living in
Massachusetts, she speaks at high schools, discussing the perils of unsafe
sex.
"I give AIDS a face, and I give it reality," she told the Associated Press. "I'm
still a Playmate, and I'm really glad, because Playboy gave me a voice. And
I'm using my voice now to fight AIDS."
After being featured in the centerfold, Armstrong lived in Hugh Hefner's
Playboy Mansion. She blames her HIV infection, detected in 1989, on a
brief 1984 liaison with a man with whom she had unprotected sex.
*The fifth annual "Women & HIV Conference" will be Jan. 30 and 31 at the
Ramada Hotel Civic Center in San Francisco. The conference, sponsored
by the Health Department, UCSF, and U.S. Centers for Disease Control
and Prevention, is intended for women with HIV and their health care
providers. Cost is $75, with scholarships available. Call (415) 554-9630.
*A national conference on Woman and HIV, called "Innovation for Care,
Policy and Prevention," will be May 4-7 in Los Angeles. Call
1-800-845-2115.
*Applications are being accepted for a retreat for HIV-positive women at
Bishop's Ranch in Healdsburg on May 12-14, sponsored by WORLD, or
Women Organized to Respond to Life-threatening Diseases. The $110 cost
includes meals, transportation, housing and activities. Limited scholarships
are available. Call (510) 658-6930 or (415) 621-4160.
* "Don't Shut Me Out" is a new documentary film about parents struggling
with how to disclose their HIV status with their children. It relates the stories
of families who have, and have not, spoken openly about the illness, and
offers advice and opinions of an expert in the field. To order the videotape,
send $20 payable to New York Hospital to The Center for Special Studies,
New York Hospital, 525 E. 68th St., F-24, New York, NY. Call (212)
746-4417 or fax (212) 746-8415.
Warning to doctors
The National Institutes of Health has sent a note to physicians telling them
that patients taking a combination of the anti-viral drugs D4T and AZT suffer
a significant drop in immune system health. In a major study of the two
drugs, patients not only failed to improve, but lost an average of 82 CD4
cells after nine weeks.
No one knows why the decline occurred. No information is available on
drug resistance in these patients. It is possible that this observation applies
only to patients who have been on AZT more than six months, the NIH
noted.
Events
*This Wednesday Project Inform hosts "An Introduction to HIV Treatment
Options" from 6:30 to 8 p.m. at their office at 1965 Market St., Suite 220.
* "Grief and Multiple Loss," a community forum sponsored by the Marin
AIDS Project, will be this Wednesday night at First Methodist Church, 9
Ross Valley Drive, San Rafael. Free. Call (415) 457-2487.
* "Positives Being Positive" hosts a video night Jan. 15 from 6:15 to 8:45
p.m. Call (415) 476-6448.
* "Clinical Challenges in Protease Inhibitor Therapy," a consortium for
doctors, will be Jan. 15 at 5:30 p.m. at 1855 Folsom at 15th streets, Room
126.
The toll
Felix Parroquin, 30, who loved traveling, dancing and being with friends . . .
Richard C. Sword, 42, employed for 16 years as a speech pathologist for
the San Francisco Unified School District and skilled in remodeling . . .
Douglas Walsh, 49, who worked in the dining rooms of the Huntington
Hotel and the Press Club.
. . . . . Date . . . . . reported / Cases / Deaths S.F.. . . 1/1 23,841 16,604
Calif.. . 1/1 97,690 63,063 U.S.. . . 1/1 548,102 343,000 WHO(rprtd) 1/1
8,400,000 6,400,000 Figures are cumulative since June 1981. To contribute
to AIDSWEEK, call (415) 777-7867. |
