Freedom of choice

The recent approval of three protease inhibitors introduces a welcome element of choice into HIV treatment programs. Ritonavir (Norvir), indinavir (Crixivan), and saquinavir (Invirase) all prevent HIV from replicating, leading to lower viral loads and a slower disease progression. However, patients must continue taking the drugs once they begin therapy; stopping the treatment or reducing the dosage can lead to resistance. Long term data is not yet available on toxicity or drug interactions. All three drugs are most effective when used in combination therapy.     

CMV retinitis trial expanding

Hoffmann-La Roche is expanding its trial of oral ganciclovir, which promises to be as effective as the intravenous form (Cytovene) in preventing CMV retinitis. The trial will open new sites in the United States, Canada, Europe, and Latin America. A telephone number is provided for enrollment information.     

Interscience Conference on Antimicrobial Agents and Chemotherapy. Conference update

Results from ongoing clinical trials presented at the 1997 Interscience Conference on Antimicrobial Agents and Chemotherapy are summarized. Most of the trials have not been completed, and some are still enrolling new people. The clinical trial summaries include the drug combination and dosage, number of participants, clinical notes, median viral load change, and median T-cell change.     

Differential inhibition of interleukin 2- and interleukin 4-mediated human B cell proliferation by ionomycin: a possible regulatory role for apoptosis

Surface immunoglobulin (Ig) cross-linking by anti-IgM (mu) antibodies leads to B cell activation resulting in numerous early biochemical events including an increase in intracellular [Ca2+]. Furthermore, anti-mu-activated B cells become able to proliferate in response to interleukin (IL)2 and IL4. These studies examined the effect of the calcium ionophore ionomycin, an enhancer of cytoplasmic [Ca2+] levels, on IL2 and IL4-mediated proliferation of anti-mu-stimulated normal human B cells. Ionomycin inhibited the proliferative response of anti-mu-activated B cells to IL4. In contrast, IL2 and phorbol 12,13 dibutyrate (PBu2)-mediated B cell proliferation was refractory to the growth inhibitory effects of ionomycin. In an attempt to delineate a possible mechanism(s) for this differential growth effect of ionomycin, we first studied direct effects of ionomycin on activated B cells. Our data suggested that ionomycin induced DNA fragmentation in anti-mu-costimulated B cells. Interestingly, in contrast to PBu2, IL4 did not prevent ionomycin-dependent DNA fragmentation. Importantly, H7, an inhibitor of protein kinase C activation, down-regulated only the IL2 and PBu2-driven B cell proliferation but not B cell proliferative response to IL4. These results suggest that putative protein kinase C activation, either by direct treatment with phorbol ester or during IL2 signaling, counteracts the inhibitory effects of ionomycin. In contrast, IL4 signaling does not exhibit the same protective properties.     

Poniendo tu granito de arena: Latinos and HIV

Because the Latino community often lacks the money and power of large, white-run agencies in HIV prevention efforts, Latino HIV-service providers often turn to bootstrap efforts that are well-grounded in cultural realities. The community response to HIV prevention efforts is examined in terms of the cultural sensitivity needed to reach this ethnic group more effectively. Reasons why grassroots efforts are more effective in a Latino community than traditional agencies, and some examples of successful programs are outlined. The discrepancies seen in HIV services due to lack of resources and connections to needed funding are also discussed. Discussions on the Latino understanding of fatalism, homophobia, family values, and machismo that all affect the spread of HIV are highlighted.     

Epivir for younger children

The US Food and Drug Administration (FDA) has expanded its approval of the anti-HIV drug Epivir (3TC) to include children 3 months of age and older. Pediatric doses are 4 mg per 2.2 pounds of weight twice daily (up to a maximum of 150 mg twice a day). Most commonly reported side effects include headache, nasal congestion and runny nose, and diarrhea.     

More Medicare money

People receiving less than $947 a month from SSDI (Social Security Disability Income) and other income can now apply to have $45.50 restored to their payments. Some people may also qualify to have their deductibles and other benefits covered, including 20 percent of doctor and outpatient bills that Medicare does not pay for. Programs taking applications for these benefits are listed. Contact the writer for more information.     

Drug tips

A bullet outline of tips is presented to assist patients on anti-HIV drug therapy. Tips include clarifications of dosing schedules (e.g., three times a day means every 7 to 8 hours at the same times each day), hints for snacks to eat when a medication requires food but you are not hungry, explanations for lipodystrophy (buffalo hump) and possible treatments for "protease paunch." Contact information is provided.