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In this interview with AIDS Alert, Jorge A. Saavedra, MD, director general of the National Center for Prevention and Control of HIV/AIDS (CENSIDA), Ministry of Health in Mexico, discusses his nations HIV epidemic and response.
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Researchers have learned that multiple-resistant HIV is prevalent in genital tracts of women with long antiretroviral therapy histories, and resistant virus can persist even years after the therapy associated with the resistance has stopped.
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In a year that has seen waiting lists grow and funding fall short of increasing needs, the AIDS Drug Assistance Program (ADAP) has received one piece of good news: Up to 1,500 ADAP clients are eligible to enroll for free hepatitis C drug therapy during the next year.
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Less than half way into 2005, the Global Fund to Fight AIDS, Tuberculosis and Malaria is short by $950 million of the $2.3 billion needed to renew current grants and make new grants, according to Global Fund data.
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Post-surgical treatment of node-positive breast cancer with chemotherapy has been shown to reduce tumor recurrence and mortality, but the value of such therapy in geriatric populations has not been firmly established. In the current analysis of 4 large Cancer and Leukemia Group B trials spanning 25 years, there was no association between age and disease-free survival or cancer mortality. However, overall survival was significantly worse for older women, presumably from causes other than breast cancer.
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Radiofrequency ablation is a relatively new approach to the management of hepatocellular cancer. Tateishi and colleagues from the University of Tokyo describe their experience with this technique applied to 644 patients for a total of 1000 treatments. In their hands, RFA has proven safe and very effective, comparable in terms of 5-year overall survival to prior surgical series.
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In a phase I trial, the combination of capecitabine and irinotecan was explored in patients with upper and lower gastrointestinal cancers. Irinotecan was administered on day 1 by 90 minute intravenous infusion and capecitabine given orally twice a day on days 2-15 on a 21-day cycle. Important clinical responses were observed in several heavily pretreated patients. Dose limiting toxicities included diarrhea and neutropenia. The recommended doses for future investigation were irinotecan 250 mg/m2 and capecitabine 1000 mg/m2 twice daily.
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A rigorous operative and pathologic protocol for RRSO increases the detection rate of occult ovarian malignancy in BRCA mutation carriers nearly seven-fold. If confirmed, this finding will alter postoperative management because additional staging, chemotherapy, and follow-up may be necessary in affected women.
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Contradicting previous studies, no evidence was found in a large review of cancer patients that deaths were postponed relative to significant life events.
