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Once-A-Day AIDS Pill Is In The Works
Randy Dotinga, Gay.com / PlanetOut.com Network
Monday, September 30, 2002 / 03:48 PM
SUMMARY: A leading medical conference over the weekend brought promising news for those who take multiple AIDS drugs per day.
A leading medical conference over the weekend brought promising news for those who take AIDS drugs, but it also revealed that HIV-positive people are especially susceptible to appendicitis even if they're on medication and otherwise healthy.
AIDS was a major topic at the 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy, which ended Monday in San Diego. In one study, Italian researchers reported that a once-a-day AIDS pill controlled HIV as well or even better than traditional drug regimens.
Many HIV patients take a dozen or more pills a day, and some have to be very careful about the timing of their doses. "But over six years a lot of progress has been made in combining more than one drug in one pill," said Dr. Donald Abrams, a longtime AIDS expert and professor of medicine at the University of California at San Francisco.
Even so, doctors worry that a pill taken just once a day may not adequately protect a patient if he or she forgets a dose, Abrams said. A missed dose can increase the possibility that the AIDS virus will mutate and become immune to one or more drugs.
"If you miss a dose of your twice-a-day drug, well, at least you've had a dose in the morning and maybe that will get you through the day, maybe not," Abrams said. "If you miss a dose of your once-a-day drug, then what does that mean?"
In a related study, researchers in Spain found that HIV-positive patients could take breaks from AIDS drugs without suffering from bad effects when they go back on the medications. The researchers said the breaks may work for patients who lack symptoms, have strong immune systems and aren't harboring high levels of the AIDS virus.
But so-called "drug holidays" remain controversial, and some experts are waiting for more research. "I do my best to try to talk my patients out of it," said Dr. Michael Horberg, an AIDS specialist in San Jose, Calif.
If patients insist on taking breaks from their drug regiments, Horberg tells them to come in frequently for checkups to make sure their immune systems are in good shape.
In another study released at the conference, researchers with the Kaiser Permanente Health Plan in Northern California found that HIV-positive men were four times more likely to suffer from appendicitis than HIV-negative men. All the men in the study were covered by the health plan at some point between 1996 and 2001.
Horberg, a co-author of the study, said researchers launched the study after doctors noticed an unusual number of appendicitis cases among their HIV patients.
It's not clear why the men were more likely to suffer from appendicitis even if they hadn't developed AIDS, Horberg said. But the findings show why it's important for HIV patients to go to doctors who specialize in AIDS and are aware of the complexities of the disease, he said.
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