UK-CAB 5 – Access to treatment – TB and HIV
2 May 2003
Notes for the meeting
Introduction to meeting and speakers
Reading Material
Background information – Roche
Venue Details
Transcriptions from the meeting
Summary Report from the meeting
Report: Issues of working with HIV positive refugees and asylum seekersBadru Male and Linda McDonald
Report: TB and HIV coinfectionDr Anton Pozniak
PowerPoint Slides from the meeting
Access to HIV treatment
Linda McDonald MA MSc RN
UK-CAB_Access_McDonald.ppt [61k]
TB and HIV
Dr A.L. Pozniak
UK-CAB_TB_Pozniak.ppt [880k]
Enfuvirtide (T-20) Roche
Leroy Benons
Medical Advisor / HIV
UK-CAB_Roche_T-20.ppt [5MB]
1. Introduction to meeting and speaker
Access to treatment in the UK – Linda McDonald and Badru Male
Linda McDonald is an HIV Clinical Nurse Specialist at Central Middlesex Hospital and she is also a lawyer and very conversant with immigration law and how it affects positive people, especially asylum seekers.
The discussion will include differences between the GU regulations and NHS access to treatment regulations.
Badru Male is a UK-CAB member who has extensive experience from advocacy work with Blackliners and many other African organisations and will introduce the session.
There was a lot of interest in the group for this subject. The attached case studies collected by the THT show some of the major difficulties and often illegal and improper ways that people are treated.
TB and coinfection with HIV – Dr Anton Pozniak
Anton Pozniak is a consultant physician at the Chelsea and Westminster Hospital and as chair of the writing committee for the BHIVA treatment guidelines. He has a specialist interest in TB and coinfection and is an internationally recognised expert in this area. He is also author for the UK TB/HIV coinfection guidelines.
The training will provide an overview of TB and the many complications of treatment and coinfection.
2. Reading material
ACCESS TO TREATMENT FOR VISITORS
THT CASE STUDIES
Access To Treatment For Visitors
WHAT IS TB – Basic Fact sheet
The New Mexico Aids InfoNet
Simple introductory factsheet to TB and HIV
Treating TB in coinfected – technical overview
The following is a comprehensive overview of treatment from HIV-insite Knowledge Base:
Tuberculosis and HIV
HIV InSite Knowledge Base Chapter, March 2001
http://hivinsite.ucsf.edu/InSite.jsp?page=kb-05&doc=kb-05-01-06
This issue of GMHC Treatment Issues also includes related articles to T-20, such as pricing, the development programme as well as this summary of results.
T-20 after launch in the US
ConFuzeon Reigns By Bob Huff, GMHC
T-20 has finally been launched and Roche is struggling to get it into orbit.
http://www.gmhc.org/living/treatment/ti1704/ti1704.html#5
3. Background information – Roche
T-20 is close to receiving marketing authorisation in Europe and is already approved in the US, and through clinical trials and the expanded access programme, people in the UK are already using this new drug.
* T-20 is the first drug of a new class which works outside of the cell (all other HIV drugs only work once HIV is inside a cell) – and so could minimise side effects such as mitochondrial toxicity and lipodystrophy… but, it has to be taken by twice daily subcutaneous injection.
* T-20 is sensitive to all currently resistant virus… but also needs to be supported by other active treatments, so cant just be used as a last option.
* It is also the most complicated HIV drug to produce – and costs over 20,000 euros a year – three times the price of the most expensive current drug. It has also been one of the most demanded drugs for expanded access programmes, but manufacturing difficulties have made supply one of the most limited.
* Current guidelines are not clear about how and when T-20 should be used and there is a concern that cost could limit access to HIV treatment for the first time in the UK.
Financial support
The UK-CAB receives unrestricted funding from some pharmaceutical companies towards the direct costs of holding four meetings each year. This funding supports the travel and accommodation costs for members to attend from outside London, plus the cost of catering.
The content, programme and agenda for meetings is decided by the UK-CAB steering group in consultation with the wider membership. Funding is unconnected to meeting content.
We believe that manufacturers who currently develop and market medicines have a responsibility to actively engage with advocacy organisations and that HIV positive people and their advocates should be able to directly question manufacturers about the safety and efficacy of their products and proposals for future research.
For a list of companies that support the UK-CAB please see the “about us” page.