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In addition to the results of the placebocontrolled trial discussed above, Dr. Lori also presented new virologic and immunologic data for 12 of the original 57 patients who remained on the study drugs for an average of 2.5 years. "These 12 patients told us that they did not want to start triple-drug therapy, at a time when everyone else was starting protease inhibitors, " Dr. Lori explained. "We called these patients `pandas, ' as they were a very rare population of patients." The median viral load for the "pandas" at baseline was approximately 50, 000 copies mL. At week 40, the median viral load lingered at approximately 2, 000 copies mL. Yet, at week 122, the average viral load for the 12 pandas was 184 copies mL, 11 12 patients having unquantifiable levels of hiv-rna. "When you compare these data to those of other dual-combination studies, " explained Dr. Lori, "you can see that hydroxyurea and ddI appear to offer an advantage. To my knowledge, no other dual combination has been shown to suppress viral load for 2.5 years. If viral resistance could turn out not to be a real threat, we would not even need to worry about complete suppression. However, controlled, randomized trials need to be performed to confirm these initial results." In terms of CD4 + count increases, the 3 median average was + 30 cells mm. However, as Dr. Lori is quick to point out, hydroxyurea is a cytostatic compound associated with myelosuppression. "This may not necessarily be a bad thing, as immune suppression in hiv likely has several positive outcomes.

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Fig. 4. Comparison of a subgroup of patients with right-sided trigeminal pain TR, n 5 ; and a subgroup with left-sided pain in the distal limb LL, n 5 ; against the healthy control group. Shown are LORETA images for the frequency ranges of maximal overactivation. In the 6 9 Hz range in both subgroups, activity was enhanced for a large regions of cortex. Furthermore, peak activations were localized to the IC and piPC cortices ipsilateral to the pain side in both TR and LL group. Distinct involvement of rACC, midCC, but not cuneal areas is visible for TR, but not for LL. In the low beta range 12 16 Hz ; , both subgroups show activations in a medial frontal area involving rACC BA 24, 32 ; and medial prefrontal cortex BA 9, 10 ; , as well as in the left DLPFC. The medial frontal activation was broader in LL and more focal in TR. TR patients showed a distinct midCC activation BA 24V ; and a bilateral involvement of the insulae that was not found in LL.

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