Women respond differently to AIDS

[Guest guest]

Women respond differently to AIDS

REUTERS

CHICAGO: AIDS physician Jerry Cade says his patients are different from the

subjects in the research studies. Cade's patients are women.

Women have been excluded from clinical trials in the past because the

majority of AIDS patients have been men. But now women make up more than

half of the 36.1 million adults infected with HIV worldwide.

The percentage of newly diagnosed U.S. women has doubled over the last 10

years, making women the fastest growing HIV-infected population in the

United States. Countries across Europe are reporting similar increases as

transmission of the virus through heterosexual sexual contact becomes more

prevalent, said Witek, a MCP Hahnemann University AIDS researcher in

Philadelphia.

As a growing number of women become infected, including more women in

research studies becomes increasingly important because female patients

respond differently to the disease and to treatment, Witek said.

" The disease doesn't necessarily behave the same way in both genders, " said

Judy Delmar, a physician treating AIDS patients in San , Texas.

''It's just a different disease in women.''

Delmar, Witek and Cade were among 50 AIDS physicians and advocates who

gathered recently in Chicago to discuss the latest developments in

treatment. The need for more women subjects in AIDS research was a concern

repeated throughout the two-day conference.

Arboleda, another attendee, said the differences between men and

women start with detection.

" One of the main differences is that women are diagnosed later in the

disease than men because they do not perceive themselves as at risk, " said

Arboleda, treatment director at the National Minority AIDS Council in

Washington.

Once a patient is diagnosed, the next step is balancing effective treatment

with minimizing side effects, an especially tough task for doctors treating

female patients, said Christeller, executive director for the Chicago

Women's AIDS project.

" If the doctors don't know how to fine-tune treatment for gender, it makes

it difficult, " Christeller said. " We're trying to educate women that there

are really good treatments available, but we're kind of handicapped. "

Determining an appropriate treatment option for women can be difficult

because women generally weigh less and have lower viral loads than men who

are just as sick, Christeller said.

Viral loads count the number of HIV-infected cd4 cells, which normally

orchestrate the immune system's response to disease by signaling to other

cells to attack unwanted invaders. AIDS disables the body's immune system.

Counting a patient's infected cd4 cells can give doctors a picture of how

far the HIV infection has progressed and whether treatment has been

successful.

If doctors do not have an accurate gauge of how a woman's viral load differs

from a man's, treatment could be compromised, Witek said.

Women need to be their own advocates, learn about the disease and the

treatment options that are available, said Freddie Oaks, a counselor at

project inform, a San Francisco AIDS help center.

" Women are having a rough time of it, " Oaks said. " We live in a society

where men's health is more important than women's health. "

Even when new treatments, like protease inhibitors and other anti-viral

medications successfully keep the disease at bay, many patients go off of

the drugs because of the painful and disfiguring side effects, including

lipodystrophy, Christeller said.

Lipodystrophy, a syndrome where fat cells leave the face causing a gaunt

appearance and collect in unsightly deposits around the stomach, neck and

back, causes many of cade's patients to abandon the same medications that

have extended their lives.

" The differences between men and women and lipodystrophy is cleary an

issue, " Christeller said. " We just don't have the information. There has to

be more research. "

Researchers are making an effort to include more women in AIDS studies,

Witek said.

" There is a push to try and include women in clinical trials, " said Witek.

" Some of the trials now consider things like providing money for child care

and other expenses. "

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" Dr. E. Mohamed Rafique " <emrafi@...>