ARV in the News

HIV's Spread Is Unchecked: AIDS-Slowing Treatments Eclipse Rising Infection Rate, Study Says, Rick Weiss, Washington Post, April 24, 1998; Page A01
Although the number of new AIDS cases in the United States has declined substantially in recent years, HIV continues to spread through the population essentially unabated, according to data released yesterday by the Centers for Disease Control and Prevention.

AIDS Drugs Still Too Expensive, New Vision,  Kampala, Uganda, March 7, 1998

Drug Costs Increase Significantly For HIV-Positive Outpatients, Mar 26, 1998 (Reuters)
Between 1995 and 1996 the overall cost of drug therapy for HIV-infected patients increased significantly, especially cost of antiretroviral drugs, according to a Maryland-based team of researchers. These cost increases "...appear to be the result of increasing complexity of drug regimens, particularly antiretroviral therapy in combinations," they conclude.

AIDS Victim Wins Right to Drugs, Tico Times, Costa Rica
[Reprinted with permission of The Tico Times.]

Budget axe falls on free condoms to the sex trade; Anti-retroviral drug supply to be cut back, Bangkok Post, Thailand
[Reprinted with permission of the Bangkok Post.]

UNAIDS launches initiative to help bridge gap in access to HIV/AIDS-related drugs in developing world, November, 5 1997
The Joint United Nations Programme on HIV/AIDS (UNAIDS) today announced the launch of the pilot phase of the "UNAIDS HIV Drug Access Initiative"

Project to Test How Therapies for AIDS Work in Poor Nations, Washington Post, (11/05/97),  Brown, David

France's Chirac Calls for AIDS Therapy Fund Reuters (12/07/97); Bunce, Matthew

AIDS Vaccine Hunters Seek Cash Injection
Reuters (12/10/97); Bunce, Matthew

Access to Antiviral Therapies in African Countries [summary only]
Dominique Kerouedan, Lancet, Vol. 349, June 7, 1997, page
In a letter to the editor of The Lancet, Dominique Kerouedan warns decision-makers to prepare themselves for demands that new triple therapies against AIDS be made available in developing nations

HAART Results In Steep Decline In AIDS Mortality And Morbidity In US, Mar 26, 1998 (Reuters)
A "dramatic" decline in morbidity and mortality among patients with advanced HIV infection has occurred since highly active antiretroviral therapy (HAART) has become routinely available, according to HIV Outpatient Study investigators.

AIDS Patients Demand Drugs as Government Hesitates Nature Medicine, Volume 3, Number 9, September 1997, page 943.
Indian AIDS activists are joining state and private medical professionals in petitioning their government to approve the use of newly developed AIDS-fighting drugs.

Time names AIDS researcher as Man of the Year, US News,  December 22, 1996
Time magazine picked AIDS researcher Dr. David Ho, who has pioneered the use of drug "cocktails" to fight HIV, as its 1996 Man of the Year.

ARV Testing and Developing Countries

An ethical dilemma: Peter E Cleaton-Jones, British Medical Journal, No 7084 Volume 314, March 22, 1997
Availability of antiretroviral therapy after clinical trials with HIV infected patients are ended

Scientific imperialism: British Medical Journal No 7084 Volume 314, Editorial  March 22, 1997
If they won't benefit from the findings, poor people in the developing world shouldn't be used in research

HIV/AIDS Prevention

Diagnosis and Reporting of HIV and AIDS in States with Integrated HIV and AIDS Surveillance — United States, January 1994-June 1997, CDC, MMWR, April 24, 1998, p. 309+.
[article (PDF format)]
Data from 25 states suggests that HIV infection has an increasing impact among women and minorities.

Impact on HIV: Linking Care and Prevention, Volume 1, Number 1, October 1998

Opinion: Policymaking and ARVs: A Framework for Rational Decision Making
...policymakers in low- and middle-income countries are being forced to make decisions about providing access to antiretroviral (ARV) treatment for HIV. In some cases, they are making investments that will not be affordable, cost-effective, sustainable or equitable over the long term, which may eventually lead to the withdrawal of subsidized access in the future. Conversely, some policymakers in countries that could realistically afford to subsidize open access to ARVs incorrectly assume that these medications cannot be affordably purchased.

Improving Access to Antiretroviral Therapy in Latin America
In many developing regions of the world, the high cost of the new antiretroviral (ARV) drugs has been a near-unbreachable barrier to governments struggling to care for their HIV-infected citizens...

U.S. Patients and Doctors Find HAART Poses Challenges
The benefits of highly active antiretroviral therapy (HAART), the three- and four-drug combinations against HIV, have been widely publicized. In many industrialized countries, these potent drug regimens have reduced deaths from AIDS and prolonged the lives of thousands of people...

Success of  ARV treatment:

Declining Morbidity and Mortality among Patients with Advanced Human Immunodeficiency Virus Infection, The New England Journal of Medicine, March 26, 1998
The recent declines in morbidity and mortality due to AIDS are attributable to the use of more intensive antiretroviral therapies.

Studies Reveal Early Impact of HIV Infection, Effects of Treatment, JAMA, Mar. 4, 1998

Progress and Problems in the Fight against AIDS, The New England Journal of Medicine, March 26, 1998, Volume 338, Number 13
Palella et al. provide evidence of a massive decrease in morbidity and mortality related to human immunodeficiency virus (HIV) infection. 

Short-Course Regimen of AZT Proven Effective in Reducing Perinatal HIV Transmission: Offers Hope for Reducing Mother-to-Child HIV Transmission in Developing World, CDC

Combination Therapy for HIV Infection When to Use More Than One Drug and Which Drugs to Use
Dr. Mark Markowitz, Aaron Diamond AIDS Research Center and Assistant Professor of Medicine at New York University School of Medicine in New York City.

Progress and Problems in the Fight against AIDS, The New England Journal of Medicine -- March 26, 1998
Should we hit HIV early and hard?

Absence of Viral Rebound after Treatment of HIV-Infected Patients with Didanosine and Hydroxycarbamide [requires registration to view]
Jorge Vila et al., The Lancet, Volume 350, August 30, 1997, pages 635-636.
In these two patients there was no viral rebound when antiviral treatment was stopped for 1 year after 1 year's treatment. Proviral DNA is still present, albeit at very low levels.

Short-Course TB Prophylaxis Is Effective In Developing Countries, Mar, 1998 (NIAID)
Two shorter-course prophylactic regimens for HIV-positive individuals at risk of tuberculosis appear to be practical options for use in developing countries

Cost of ARV Treatment

The Affordability Of Antiretroviral Therapy In Developing Countries:  Steven S. Forsythe, [PDF format]
What Policymakers Need To Know

Developing countries anti-HIV programme
On March 5, 1998 Glaxo Wellcome announced a programme of preferential public sector pricing of anti-HIV medicine for the reduction of maternal-foetal transmission of HIV in developing countries.

The Costs of Triple-Drug Anti-HIV Therapy for Adults in the Americas, Montaner, et al., JAMA,  April 22/29, 1998
... results demonstrate that the cost of making triple-drug anti-HIV therapy available to adults in the Americas may be quite substantial. However, wide variation in the relative cost of such intervention can be seen, particularly when it is considered as a percentage of the GNP. Our analysis suggests that the implementation of triple-drug anti-HIV therapy may not be completely outside of the financial resources of many countries in the Americas.

Caring for patients with HIV and AIDS in middle income countries:
BMJ Editorial, British Medical Journal, No. 7055 Volume 313, August 24, 1996
Preventing transmission from mother to child is far more cost effective than treating symptomatic infection

The Cost-Effectiveness of Preventing AIDS-Related Opportunistic Infections, Freedberg, et al., JAMA, January 14, 1998.
The cost-effectiveness of prophylaxis against HIV-related opportunistic infections varies widely, but prophylaxis against PCP or toxoplasmosis and against MAC delivers the greatest comparative value. In an era of limited resources, these results can be used to set priorities and explore new alternatives for improving HIV patient care.

Economic Impact of Treatment of HIV-Positive Pregnant Women and Their Newborns with Zidovudine
Josephine A. Mauskopf et al. JAMA, volume 276, number 2, July 10, 1996, pages 132-138.
Offering zidovudine treatment to pregnant women known to be HIV-positive will decrease the number of cases of pediatric HIV infection and reduce health care costs. Voluntary screening programs for pregnant women will further decrease the number of cases of pediatric HIV infection. The effect of a screening program on health care costs varies according to HIV prevalence and the costs associated with the screening program.