News Tips from the XV International Conference on AIDS

(Embargoed for release at 10 p.m. ET, Saturday, July 10; or 9 a.m. local, Bangkok time, Sunday, July 11. JAMA will hold a media briefing about this study and others included in its special edition on HIV/AIDS, from 9 a.m. to 11 a.m., local time, Sunday, July 11, Chao Phya Room, Oriental Hotel, Bangkok, Thailand.)

In the July 14 issue of The Journal of the American Medical Association (JAMA), researchers from Johns Hopkins and other institutions will present results from what is believed to be the first three-year, randomized, double-blind, clinical trial comparing antiretroviral therapies for HIV infection.

Their findings, to be made public July 11 at a JAMA media briefing, show that combination regimens including tenofovir DF (Viread) or stavudine (d4T, Zerit) are equally effective, but tenofovir DF has less toxic outcomes with respect to cholesterol levels, lipodystrophy (changes in distribution of body fat) and peripheral neuropathy (pain or numbness in legs.)

The study involved more than 600 patients in 81 centers in the United States, South America and Europe, and was conducted from July 2000 to January 2004.

"These results support the use of tenofovir DF as a component of initial therapy for HIV infection," says study lead author Joel Gallant, M.D., M.P.H., assistant professor and associate director of the AIDS Service at The Johns Hopkins University School of Medicine.

Comparing the Efficacy and Safety of Tenofovir DF vs. Stavudine in Combination Therapy in Antiretroviral-Na ve Patients. Joel E. Gallant, Schlomo Staszewski, Anton L. Pozniak, Edwin DeJesus, Jamal M.A.H. Suleiman, Michael D. Miller, Dion F. Coakley, Biao Lu, John J. Toole, Andrew K. Cheng,. (JAMA. 2004; 292:191-201. Available post-embargo at JAMA.com)

UP-FRONT COST FOR TREATING AN HIV-INFECTED PATIENT IN AFRICA IS $30 USD PER VISIT

(Embargoed for release at 6 a.m. ET, or 5 p.m. local, Bangkok time, Sunday, July 11. This oral presentation will take place from 4 p.m. to 5:30 p.m., local, Bangkok time, Tuesday, July 13, Session Room D, IMPACT Exhibition Center, Bangkok, Thailand.)

Researchers at Johns Hopkins and the Perinatal HIV Research Unit, University of Witwatersrand, South Africa, have determined that the actual average cost for providing primary care to an HIV-infected patient is $30 USD per visit.

"Health care providers and government policy makers can use the information to plan and prepare budgets for aid programs in South and sub-Saharan Africa, where new infections increasingly overwhelm local health services," says study co-author Neil Martinson, M.P.H., research associate, The Johns Hopkins University School of Medicine and Johns Hopkins Bloomberg School of Public Health.

While the costs associated with secondary therapy -- using antiretroviral medications -- are significant and well-known, little information has to date been available about the other costs associated with care. On average, there is a three-month period of primary care, such as laboratory tests, for people who are HIV-infected, before they can start anti-retroviral therapy.

The six-month study looked at the costs associated with providing primary care to nearly 2,000 patients. Actual costs ranged from $25 for a basic visit to $50 per visit when screening tests were performed. Included in the $30 average figure are costs for staff (35 percent, primarily a nurse supported by a community doctor), plus laboratory tests (26 percent), drugs (11 percent), and X-rays (5 percent). Remaining costs were associated with overhead.

Real costs of providing primary care to HIV-infected people in Soweto, South Africa. Neil A. Martinson, D. Bakos, Glenda Gray, James McIntyre.