An intensive effort directed at improving the prevention and treatment of acquired immunodeficiency syndrome (AIDS)-associated opportunistic infections continues. A Phase I study of levofloxacin, an investigational quinolone, demonstrated that serum concentrations appropriate for the treatment of tuberculosis can be attained with safe, tolerable intermittent high-dose regimens. A study of pharmacokinetic drug interactions between stavudine, an anti-retroviral agent, and rifabutin or clarithromycin, drugs useful for the treatment or prevention of disease caused by Mycobacterium avium-intracellulare, has begun. An infrastructure for the collection of specimens from patients with tuberculosis has been established and assays for the detection and quantitation of M. tuberculosis in clinical specimens are being assessed. A study of the efficacy and pharmacokinetics of the investigational suspension formulation of atovaquone for the treatment of pneumocystis pneumonia has demonstrated a pharmacokinetic advantage of the suspension over the tablet formulation. A study of sulfasim, or CI-0694, a novel compound that can suppress and prevent antigen-specific antibody responses to sulfamethoxazole in animals, has just begun. This agent may prove useful in ameliorating the toxicity of trimethoprim- sulfamethoxazole and thus improve the treatment and prevention of pneumocystis pneumonia in some patients. A study of a ganciclovir- releasing intraocular implant with oral ganciclovir and an HIV-1 protease enzyme inhibitor is in the final stages of design. The assessment and follow-up of persons with idiopathic CD4+ T-lymphopenia (ICL) in order to investigate pathogenesis and natural history is continuing. Finally, an outreach effort for the enrollment of women and members of minority and medically under-served populations in clinical trials has begun which includes seeing patients in a local community health center as well as establishment of a city-wide AIDS clinical trials information center.
