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. Last Updated: 07/27/2016

Cheap Drug Could Help AIDS Sufferers




A widely used antibiotic that costs as little as 9 cents per dose could sharply alleviate suffering among millions of AIDS victims in Africa by preventing pneumonia, toxoplasmosis and many of the other opportunistic infections that characterize full-blown AIDS, researchers said this week.


"Other drugs that are far cheaper and easier to use than protease inhibitors can have a big effect,'' said Dr. Kenneth Castro of the U.S. Centers for Disease Control and Prevention Tuesday at the 13th International AIDS Conference in Durban, South Africa.


The antibiotic has no impact on the AIDS virus, which is killing 5,500 people a day in Africa, but is simply a means to minimize symptoms. "We are not going to cure HIV with our present drugs, so we need long-term strategies'' to alleviate suffering, said Dr. Mauro Schechter of the British Columbia Center for Excellence in HIV/AIDS in Vancouver.


Other reports delivered at the world conference indicated that brief interruptions in conventional AIDS therapy can make the drug regimen cheaper and more comfortable for patients and that some long-used drugs can help prevent mother-to-child transmission of the AIDS virus.


The antibiotic that was in the spotlight Tuesday is trimethoprim-sulphamethoxazole, trade-named Bactrim by Roche or Septra by Glaxo-Wellcome. It has been used widely for years in the United States to prevent pneumocystis carinii pneumonia, or PCP, one of the defining infections for AIDS.


In studies in the United States, Dr. Mark Dworkin and his colleagues at the CDC found that Bactrim worked against a variety of AIDS-related illnesses. He said it reduced the occurrence of PCP by 40 percent, of toxoplasmosis by 30 percent and of salmonella infections by 60 percent. It also prevented about 40 percent of infections by several varieties of haemophilus and streptococcus bacteria.


"All those infections are quite common in Africa,'' he told a press conference. "It's a very cheap drug. In the United States, it's priced at $60 a year,'' compared with the estimated $15,000 annual cost of AIDS therapy.


Another piece of promising news was presented by Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases. He described new experiments following up on earlier reports that briefly interrupting AIDS drug therapy can be beneficial.


Conventional drug therapy can reduce the amount of HIV in the patient's blood to undetectable levels. Some researchers believe that this intense suppression of the virus allows the immune system to relax its antiviral surveillance.


Researchers such as Dr. Franco Lori of the Research Institute for Genetic and Human Therapy in Washington, argue that temporarily halting therapy in so-called structured treatment interruptions allows viral levels to rebound high enough to restimulate the immune system.


Fauci's new findings seem to support that idea. In one study, which will eventually test 70 people, patients are being given conventional anti-AIDS cocktails for two months and then are taken off the medications for a month.


Fauci said Tuesday that, after three complete cycles, the immune systems of some patients seemed better able to suppress the virus during the periods of no therapy.


In a second, smaller study, patients are going through cycles of one week on therapy and one week off. Fauci said that the virus never rises above minimal levels during the periods of no therapy, suggesting that the regimen could work for long periods of time. Some of the patients in the study also show rising levels of CD8 memory T-cells, white blood cells that could help control the HIV infection, he said.


If successful, the therapy would halve the cost of AIDS treatment. And that's not all. "Patients are absolutely delighted at the prospect of spending half their lives off therapy,'' he said.


Women at high risk of contracting the AIDS virus should not use the widely sold spermicide nonoxynol-9 because it may increase the risk of contracting HIV rather than protecting against it, the United Nations warned Wednesda y.


The bulk of evidence from a number of studies shows that nonoxynol-9 is either ineffective or, if used with high frequency, can be as harmful as an anti-HIV agent, said Dr. Joseph Perriens, who oversaw the trial for Unaids, a UN agency, at a news conference here Wednesday.


"If you use nonoxynol-9, you are either wasting your money or possibly wasting your life,'' Perriens said at the 13th international AIDS conference here. Nonoxynol-9 is marketed in the United States and around the world as a contraceptive, and the chemical is also included as a lubricant in many male condoms.


Women using nonoxynol-9 solely as a contraceptive should not worry about the findings because normal usage generally will not cause the ulcers that are believed to increase risk of HIV transmission, said an official with the Food and Drug Administration in the United States.