[HSF] endocarditis and AIDS

Wed Oct 17 13:40:44 EDT 2007

                           Patients with low CD4 counts and a long history
of antiretroviral therapy behave differently than those that have not been
treated for a long time or are virgin of therapy and low CD4 counts. The
first case might mean cocktail drug- induced damage to the immune system,
and, if the patient has already started opportunistic infections, might be a
bad prognosis case - or a patient that is coming to his/her end - so,
surgery might not be exactly a good idea. The second case, especially if
there are no opportunistic infections related, might represent a patient who
can have a good chance with the HAART. To make such a decision, the
patient´s  viral burden, the number and types of related infections, and
anamnesis details are important. Answering your question, HAART has not been
proven yet as an agent capable of increasing longevity, but if they make it
as a single pill, with a slightly better safety profile, who knows. Many
people would candidate themselves to take it...as long as the HIV is not
included in the deal, of course...;-)   Claudia
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  EPIDEMICS <http://www.terradaily.com/index-plague.html>
*AIDS Cocktail Could Be Soon Down To Just One Pill
*  *
*The candy jar could be about to get a whole lot smaller.by Ed Susman
New York (UPI) Apr 28, 2006
In a unique collaboration, two pharmaceutical companies have developed a
one-a-day, single-pill anti-retroviral cocktail taken to treat the virus
that causes AIDS. The drug cocktail merged into one yet-to-be-named pill
represents the Holy Grail for treatment of human immunodeficiency virus.

The pill contains emtricitabine (Emtriva) and tenofovir (Viread), developed
by Gilead Sciences, and efavirenz (Sustiva), developed by Bristol-Myers
Squibb.

"It is amazing that we are going to have one pill a day for the treatment of
HIV when you consider that it was like 10 years ago when patients were
taking handfuls of drugs all day long," Cal Cohen, research director for CRI
New England and Harvard Vanguard Medical Associates, told United Press
International.

"But not only is this going to be more convenient, the pill also represents
the best drugs we have on the market for treating HIV," he said. "These
drugs have potency to suppress HIV and yet they have a very safe side-effect
profile."

Doctors have long suggested that by reducing the pill burden, there is a
greater likelihood patients will adhere to their regimens. Ten years ago
when researchers discovered that anti-retroviral drug cocktails suppressed
HIV replication -- dramatically changing the course of AIDS -- patients were
faced with dizzying regimens that included taking dozens of pills a day.

"This combination pill will become the most used drug by HIV-infected
patients," predicted Keith Folger, director of community mobilization for
the New York-based National Association of People With AIDS.

"The idea of being able to take one pill, once a day is unbelievable,"
Folger told UPI. "Ten years ago I was taking 36 pills a day. My life was
ruled by my pill schedule. I had to take pills every eight hours; some I had
to take an hour before a meal; others I had to take two hours after a meal;
some I couldn't eat with fatty foods; etc."

Folger said that the combination already is the most prescribed regimen for
patients newly diagnosed with HIV and who do not have a virus that is
resistant to the drugs in the cocktail. Putting the drugs into one pill, he
said, is bound to improve patient adherence.

He said studies showed that taking this pill with all the ingredients mashed
together has the same bioequivalence as taking the pills separately. He said
that he would not expect the combination product would have many issues in
getting Food and Drug Administration approval, suggesting it might be
available within a year.

About 18 months ago Gilead and Bristol-Myers Squibb agreed to jointly
develop the one-pill, once-a-day regimen. The companies announced Thursday
they had filed a New Drug Application for the drug with the FDA.

"The partnership between Bristol-Myers Squibb and Gilead was founded on the
companies' shared commitment to addressing the needs of people living with
HIV," John Martin, president of Gilead Sciences, Foster City, Calif., said
in a statement. "Significant progress in science and medicine has been
achieved since the advent of the first combination regimens 10 years ago,
but more work is needed and we view this partnership to create the
first-ever once-daily single tablet regimen for HIV as an important step
toward further simplifying dosing of HIV therapy for physicians and
patients."

Anthony Hooper, president of U.S. Pharmaceuticals, Bristol-Myers Squibb,
said in a statement, "The collaboration between the companies is an
important milestone for patients living with HIV. Working together,
Bristol-Myers Squibb and Gilead Sciences are ushering in a new era of
collaboration driven by the need to deliver HIV therapies to patients in
need."

Cohen said the partnership "seems to be a win/win situation for both
companies."

The proposed once-daily single-tablet regimen contains 600 mg of efavirenz,
from the class of drugs known as non-nucleoside reverse transcriptase
inhibitors; 200 mg of emtricitabine, a nucleoside reverse transcriptase
inhibitor, and 300 mg of tenofovir disoproxil fumarate, a nucleotide reserve
transcriptase inhibitor.

All three active ingredients work by blocking reverse transcriptase, an
enzyme necessary for HIV replication. As with all HIV drugs, the new tablet
does not cure HIV or prevent HIV from being transmitted to others.

The drugs, however, severely limit the ability of HIV to replicate and
destroy the host immune system, allowing opportunistic infections to emerge.
These are diseases caused by infectious agents that a healthy immune system
keeps in check. The unchecked infections result in AIDS.

Source: United Press International

Related Links

2007/10/16, Tea Acuff <tacuff at swbell.net>:
>
> So you are saying that HARRT will let you live to 90! Do you need HIV,
> too, or can we just skip that step?
>
> tea
>
>
> ----- Original Message ----
> From: Claudia Teles <cvteles at gmail.com>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Tuesday, October 16, 2007 7:51:51 AM
> Subject: Re: [HSF] endocarditis and AIDS
>
>
> They are right, IMHO.
> The reason for the low CD4 count might be on the chronic valve infection.
> HAART is a great scheme.
>
> claudia
>
>
> 2007/10/15, Pigott, John D III <jdpigott at tulane.edu>:
> >
> > Our ID fellow claimed 20 year survival with HAART; his staff ID
> attending
> > said to tell us 50 years!  So, my interpretation is that they will say
> > anything to get us to operate.  My partner replaced the valve
> today.  More
> > updates later.
> > John
> >
> >
> > -----Original Message-----
> > From: Hgrmd at aol.com [mailto:Hgrmd at aol.com]
> > Sent: Mon 10/15/2007 5:32 AM
> > To: OpenHeart-L at lists.hsforum.com
> > Subject: Re: [HSF] endocarditis and AIDS
> >
> > Never underestimate the bravado of the noncombatant.
> >
> > Hal
> >
> >
> >
> > ************************************** See what's new at
> > http://www.aol.com
> >
> >
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>
> --
> Claudia Teles
> Hemostasis Section - INCARDIO
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-- 
Claudia Teles
Hemostasis Section - INCARDIO