EATN: European AIDS Treatment News

see the antiviral activity in 3
different immune system areas. In a
group of 17 persons, naive or not,
recently seroconverted or not. Viral
load became undetectable in all
patients. CD4s went from 450 to
609 on average. Possibly because of
the drugs' different mechanisms of
action, viral load in plasma, semen
and lymph nodes was all reduced.
(130)
LTNP
WT/D32 genotyping may identify
those with a tendency to control
HIV1 progression through a higher
production of IL2, according to a
study at the University of Milan
(117)
Again, more IL2 and less IL10 was
produced in "true" LTNPs followed in
northern Italy (University of Milan).
A large number of these people have
natural virus isolation negative
counts. (11 3)
TB
Dr Gingolani in Rome presented a
paper on the high correlation
between phenotypic and genotypic
drug resistance measures for TB.
Although the efficacy of the genetic
test may depend on the viral burden,
it is a fast way (6 days average) to
evaluate and correctly treat TB.
(681)
A TB resistance study from Genova
had a curious anecdote: TB
multiresistance was not a negative
prognostic factor. Also, there was a
high rate of rifabutin resistance,
which caused them to reconsider its
prophylactic role. (680)
Another Hospital in Bari did a
retrospective study of TB
geographically, and found that it
accounts for most mycobacterial
infections. (678)
One study from La Sapienza
University in Rome showed 5 cases
of people on triple therapy who all
reacted well in regards to CD4 gains
etc, but who also developed
tubercular meningitis within 2-12
weeks of beginning therapy. One of
them stopped therapy, the
symptoms disappeared, started
again, and the symptoms came back.
The authors propose that an
Inflammatory reaction to the
mycobacteria may be the cause

(reactivation of a preexisting
disease). (674)

QUALITY OF LIFE
In a study from The Catholic
University in Rome, 17% of
nonsymptomatic HIV+ persons report
a strongly limited sexual life due to
HIV, while 34% were partially
limited. These persons generally
reported higher levels of energy
limitations, cognitive limitations and
health perception limitations. Older
people were more influenced,
heterosexuals less so, they didn't
measure drug use:sex life limitation.
(506)
A study on how knowing your
seropositivity affects your quality of
life was done by Glaxo Italy. The
general perceptions of the quality of
the HIV population is "dramatically
lower" than the population-at-large.
In four areas, social functioning,
physical well-being, mental health,
and emotional well-being were
clearly lower than expected. A
possible cause according to the
authors: social stigma. Another
possibility is the lack of information
available to this population. (504)
Glaxo also did a study on the
differences in quality of life
depending on the clinical category
of the patient. They found, working
with persons from 46 different
hospitals, that people in Category C
generally have a much-impaired
quality of life from those in either
category B or A. They suggest that
the effect of "different therapies"
may have an effect on the quality of
life, regarding issues such as
"physical limitations, bodily pain,
social function reduction and bad
perception of general health". (503)
These papers were presented in a
session called "Quality of Care and
Quality of Life". 50 people attended
in a room with seating for 400. Of
six speakers, 2 did not show. We
have far to go in the understanding
of pain and its management (for
example) as an element of chronic
infection, if this session was any
example. People started to leave the
room after the second presentation.
The state of the patient and patients'
rights interests very few people. Few
doctors seem to care about it and
few people are interested in studying
it or even attending the session.
CMV

Looking for virological markers of
infection and the efficacy of

treatment, a team from the Umberto
I Hospital in Rome measured the role
of the pp65 levels as a marker, and
conclude that it is a way of
optimising antiCMV strategies, by
monitoring those patients most at
risk of developing CMV. (661)

The safety of Vistide was reported
on by a group from Pharmacia &
Upjohn Milan. In the named-patient
program in Europe (March 96 - June
97, 408 persons), 40% of the people
by the end of the follow-up had
dropped out due to toxicity, death or
progression of the disease. The
largest group of dropouts were due
to "others" or "unknown". Renal
disfunction and uveitis are the major
sides. (663)
A nested PCR of the SCF showed
itself to be a rapid and specific tool
allowing for early diagnosis of CMV
encephalitis, according to the
University of Modena. (227)
ONCOLOGY
Italy took part in the European
Intergroup Study concerning nonHodgkin's lymphoma. The two
therapies were "aggressive" ACVB
and the less aggressive CHOP. A
larger percentage had a complete
response in the ACVB arm, although
these patients also had a much
higher incidence of severe
hematoxicity. There was a 4%
therapy-related death rate in each
arm, in people who started at 214
CD4s. (241)At the National Cancer
Institute in Aviano, they studied the

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