Janis Kelly

A surprisingly high percentage of women with breast cancer who start adjuvant therapy with an aromatase inhibitor stop taking these drugs because of associated musculo-skeletal side effects

;Breast cancer patients who skip 30% of their tamoxifen doses increase their risk of death from breast cancer by 16%, Scottish researchers reported at the first annual ASCO Breast Cancer Symposium

GENEVA--Highly active antiretroviral therapy (HAART), usually including a protease inhibitor, can suppress human immunodeficiency virus (HIV) so much that the immune system actually begins to heal, according to work presented at the 12th World Conference on AIDS. In patients who respond well to HAART, CD4+ and CD8+ cell counts move toward normal, and the risk of opportunistic infections decreases (see Oncology News International, August, 1998, pp 1 and 20).

VANCOUVER, BC--The new understanding of the importance of viral dynamics in the progression of HIV infection (see "New Thinking on HIV Progression Leads to New Strategies") has led to new guidelines for deploying drugs now available to treat HIV (a list of available agents is on page 13). Experts now recommend reducing viral load to below detectable limits, as an indication that viral replication has been curtailed as much as possible.

VANCOUVER, BC--Treatment for AIDS is beginning to resemble cancer therapy: Some studies suggest that best results occur when disease burden is reduced early by aggressive use of combination therapy. Previous thinking has been to hold effective antiviral agents in reserve until disease progression.Presentations at the 11th International Conference on AIDS showed that combination treatment, especially with regimens that include one of the new protease inhibitor drugs, can reduce the virus to undetectable levels in the blood. Reduced viral load decreases the risk of disease progression and is often followed by clinical and immunological improvement.Speaking at the meeting, Scott Hammer, MD, of New England Deaconess Hospital, Boston, pointed out that the ability of combination therapy to reduce viral load to undetectable levels means that "eradication of virus has become an acceptable hypothesis to be tested."Researchers at the Aaron Diamond AIDS Research Center are testing that hypothesis using aggressive combination treatment during primary infection.