AIDS Treatment News

New Life for Treatment Interruptions?

2009-07-10T21:18:00.002-04:00

"Newly unearthed data from the SMART study may reawaken interest in the possibility of safely interrupting HIV treatment in at least some people.

"Emerging data from a study that came to a grinding halt more than three years ago may reopen a door that most people assumed was firmly closed: the possibility of HIV treatment interruptions. The latest report has at least one activist questioning whether the death knell of treatment interruption research was sounded too soon."

Read more in POZ HIV/AIDS Special Reports, July 10, 2009.

Comment: We are waiting for more information, especially the unpublished letter from the SMART term.

Isentress (raltegravir) indication extended for the treatment of HIV-1 infection in treatment-naïve patients

2009-07-10T21:02:00.001-04:00

"On July 8, 2009, FDA granted approval to Isentress (raltegravir), for the treatment of HIV-1 infection in treatment-naïve patients. The recommended dose for treatment-naïve adult patients is Isentress 400 mg twice daily, with or without food.

"The use of Isentress in treatment-naïve patients is based on a 48-week randomized, double-blind, active control trial to evaluate the safety and efficacy of Isentress 400 mg twice daily + emtricitabine + tenofovir versus Sustiva (efavirenz) 600 mg + emtricitabine + tenofovir. The proportion of patients with HIV RNA < 50 copies/mL was 87% for the Isentress group compared to 82% for the Sustiva group."

Read more in FDA.gov, July 8, 2009.

Renal Function in Patients with Preexisting Renal Disease Receiving Tenofovir-Containing Highly Active Antiretroviral Therapy in the HIV Outpatient...

2009-07-10T21:00:00.001-04:00

"We observed confirmed worsening of kidney disease stage in 5 of the 19 patients during follow-up. TDF use can be considered in patients with preexisting or current renal dysfunction who have limited antiretroviral treatment options, require TDF for fully active antiretroviral regimen, and can be closely monitored for incident worsening of renal function."

Read more in AIDS Patient Care and STDs, July 10, 2009.

HIV Ravages Antibody-Producing Cells Days After Infection

2009-07-10T00:06:00.001-04:00

"Researchers may have figured out why the body is so slow in producing effective antibodies against HIV. According to study details published in the July 2009 online issue of PLoS Medicine, HIV cripples the production of antibody-producing B cells within just 17 days after infection."

Read more in POZ, July 9, 2009.

Text from the keynote speech by Charles King, president and CEO of Housing Works, at the 10th Annual Prevention and Outreach Summit in Philadelphia...

2009-07-09T23:56:00.002-04:00

"... Imagine what would happen if we were offering housing or rental assistance to every single HIV+ person who needed it, and offering every single person who is HIV+ access to ARV’s. Just with those two structural interventions, plus one other, you could bring the epidemic to a screeching halt even before we had a vaccine or a cure. Why, because the vast majority of people who go on ARV’s before their immune systems are destroyed and are reasonably adherent…not perfectly, just reasonably…the viral load is reduced to an undetectable level.

"What does that mean? Well, it means that particularly in sexual interactions, even without condoms, it becomes very difficult to transmit the virus. We would have dramatically reduced the viral pool, making reliance on changing individual behaviors in moments of passion and ecstasy, whether natural or chemically induced, no longer the principle vehicle for preventing transmission. Couple that with clean needles for IV drug users, Medicaid or insurance-funded hormones for transgender folk, and treatment for HIV+ pregnant women, particularly at time of delivery, and we would have cut off just about every means of viral transmission. Now that is prevention that follows science!"

Read more in POZ HIV/AIDS Special Reports, July 9, 2009.

Immune suppression increases risk of death from non-AIDS-defining illnesses

2009-07-09T23:54:00.000-04:00

"'The consistent finding of a raised risk of non-AIDS-defining death and cumulative time spent with a CD4 cell count less than 350 cells/mm3 reveals clinically important information and provides a strong argument that HIV-infected patients may benefit from early initiation of antiretroviral treatment to reduce the risk of AIDS and non-AIDS-related causes of death.'"

Read more in Aidsmap, July 9, 2009.

NGOs to file petition against Anti-Counterfeit Act in Kenya

2009-07-08T17:15:00.002-04:00

"Generic medicines are legitimate exact copies of their brand-name original. They are not counterfeits. They should not be confused with counterfeits. The manufacturing of generic medicines is not a criminal offence. We can only afford generic medicines because they cost up to 90 per cent less than the originals, the NGOs added."

Read more in PHARMABIZ.com (India), July 8, 2009.

Nitazoxanide: Beyond Parasites Toward a Novel Agent for Hepatitis C

2009-07-07T22:59:00.002-04:00

"Although there is substantial literature on NTZ as a safe and effective antiparasitic agent, the initial report of its antiviral properties in HCV-infected patients came in 2008 from Rossignol et al. This study was a double-blind, placebo-controlled trial of 50 patients with HCV genotype 4 treated with NTZ monotherapy (500 mg twice daily) for 24 weeks. Remarkably, 7 of 23 patients (30%) had an end-of-treatment response and 4 of 23 (17%) had a sustained virologic response (SVR) compared with none in the placebo arm. Of note, all patients attaining an SVR had a baseline HCV RNA < 400,000 IU/mL.

"In this issue of Gastroenterology, Rossignol et al present the results of a randomized, controlled trial evaluating the efficacy of NTZ in combination with peginterferon and ribavirin. ... The authors conclude that NTZ with peginterferon and ribavirin increases RVR and SVR rates compared with standard therapy without increasing adverse events."

Read more in Gastroenterology, March, 2009.

Note: This inexpensive treatment, FDA-approved for a different use, is now being tested as an addition to standard treatment for hepatitis C genotype 1.

HIV treatment and traditional risk factors causing hardening of the arteries

2009-07-07T22:57:00.001-04:00

"Treatment with antiretroviral drugs can cause hardening of the arteries, Greek investigators report in the online edition of the American Journal of Hypertension. Traditional risk factors for hardening of the arteries, also known as atherosclerosis, such as cholesterol and high blood pressure, were also shown to be important."

Read more in Aidsmap, July 6, 2009.

Long-term Testosterone Therapy Is Safe and Improves Body Composition in Women with HIV

2009-07-02T21:53:00.001-04:00

"These findings led the researchers to conclude, 'Long-term testosterone administration was well tolerated in HIV-infected women and resulted in significant improvements in body composition, bone mineral density, and quality of life indices.'"

Read more in HIVandHepatitis.com, July 3, 2009.

Evolution of SIV toward RANTES resistance in macaques rapidly progressing to AIDS upon coinfection with HHV-6A

2009-07-02T21:43:00.000-04:00

"Conclusions: These results provide in vivo evidence of SIV evolution toward RANTES resistance in macaques rapidly progressing to AIDS. RANTES resistance may represent a common virulence factor allowing primate immunodeficiency retroviruses to evade a critical mechanism of host antiviral defense."

Read more in Retrovirology, July 2, 2009.

Youth Who Believe They Will Die Young More Likely To Be Diagnosed With HIV/AIDS, Study Finds

2009-07-02T21:40:00.001-04:00

"Teenagers who believe that they will die at a young age are seven times more likely than optimistic teenagers to be diagnosed with HIV/AIDS in early adulthood, according to a study released on Monday and published in the July issue of Pediatrics, the AP/Los Angeles Times reports (AP/Los Angeles Times, 6/29)."

Read more in Kaiser Daily HIV/AIDS Report, July 1, 2009.

Politico Examines Retraction, Resubmission Of Proposed HIV Travel Ban Rule

2009-07-02T21:37:00.002-04:00

"Politico's blog "Under the Radar" explores HHS' recent decision to revise documents submitted to the Federal Register regarding a change in HIV-related immigration policy. The blog looks at differences between the original document sent to the Federal Register on Monday compared to the version slated to be resubmitted by HHS Thursday, noting that while "the proposed rule was pulled from publication in Tuesday’s edition at the request of HHS Secretary Kathleen Sebelius" late Monday because it was "'incomplete,' it was actually 12 pages longer than the replacement," with "different data than the original" that "could ease sticker shock." Politico compares the two proposals – one which estimates the number of immigrants living in the U.S. with HIV after five years; the other which estimates the number after 20 years."

Read more in Kaiser Daily HIV/AIDS Report, July 2, 2009.

Preventing HIV transmission with antiretrovirals

2009-07-02T18:56:00.004-04:00

"Three of the most extraordinary events in global health over the past 30 years have been the emergence of the pandemic of HIV/AIDS, the development of antiretroviral therapy (ART) capable of arresting HIV progression and reducing mortality, and scale-up of therapy in low- and middle-income countries. By the end of 2007, approximately 3 million people were accessing ART in resource-constrained settings, an unimaginable achievement a few years previously, yet one whose expansion and sustainability are threatened by resource constraints and competing priorities. ...

"Their paper reported that in an HIV/AIDS epidemic of southern African severity, universal voluntary HIV testing on an annual basis followed by immediate ART could
reduce HIV incidence by about 95% within a decade..."

Read more in Bulletin of the World Health Organization, July, 2009. Also available in Chinese, French, and Russian.

HIV and ARV Therapy Accelerate Bone Loss

2009-07-01T23:58:00.001-04:00

"Bone loss is common among people living with HIV before they begin antiretroviral (ARV) therapy, and it worsens upon starting treatment, especially if the regimen contains Combivir (zidovudine plus lamivudine), according to a new report published in the July 17 issue of AIDS. Though severe bone loss is associated with an increased risk of serious bone fractures, the Dutch study authors remind readers that this might be less of a concern among young people living with HIV. "

Read more in POZ, June 30, 2009.

Unexpected Finding: Penetration of ARVs Into Nervous System Doesn’t Protect the Brain

2009-07-01T23:52:00.003-04:00

"While antiretroviral (ARV) drugs known to penetrate into the cerebrospinal fluid (CSF)—and thus possibly the brain—do lower HIV levels in the brain, they do not appear to protect against detrimental changes in thinking, memory and physical coordination. This is the conclusion of a study published in the July 17 issue of AIDS."

Read more in Poz, July 1, 2009.

Menopause does not affect response to HIV treatment

2009-06-30T22:48:00.001-04:00

"Menopausal status does not affect responses to HIV treatment, US investigators report in the August 1st edition of Clinical Infectious Diseases. In the largest ever study into the impact of menopause on the effectiveness of HIV treatment, the researchers found that CD4 cell counts and viral loads were comparable in pre- and post-menopausal women two years after initiating potent HIV therapy.

“Women respond equally well to antiretroviral therapy in the short and long term regardless of menopausal status,” comment the investigators."

Read more in Aidsmap, June 30, 2009.

Adherence to HIV treatment in US gay men differs by race and ethnicity

2009-06-30T22:46:00.001-04:00

"Levels of adherence to HIV treatment differ significantly between racial groups, US investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes. They also found that the factors affecting adherence differed between racial groups. Furthermore, different levels of adherence were seen within racial groups according to ethnicity."

Read more in Aidsmap, June 30, 2009.

WHO HIV boss warns against two-tier global system of treatment

2009-06-30T22:44:00.001-04:00

"The world cannot allow a permanently two tiered system of global AIDS treatment with late initiation of outmoded drugs reserved for the South. Nor can we hide behind lack of knowledge or the attitude of 'let's wait and see', he told the meeting in a plenary address."

Read more in Aidsmap, June 30, 2009.

Patients returning after interrupting HIV care have a high risk of short-term illness and death

2009-06-30T00:37:00.001-04:00

"HIV-positive patients who return to care after being lost to follow-up are five times more likely to die in the short term than patients who remain in HIV care, French investigators report in the online edition of AIDS.

'Increased efforts are needed to reduce loss to follow-up and encourage those patients who no longer attend clinic to return to care,' recommend the authors."

Read more in Aidsmap, June 29, 2009.

Low-Abundance HIV Drug-Resistant Viral Variants in Treatment-Experienced Persons Correlate with Historical Antiretroviral Use

2009-06-28T23:51:00.001-04:00

"Low-abundance HIV drug-resistant mutations in antiretroviral-experienced subjects at time of virologic failure can increase a subject's overall burden of resistance, yet commonly go unrecognized by conventional genotyping. The majority of unrecognized resistant mutations correlate with historical antiretroviral use. Ultra-deep sequencing can provide important historical resistance information for clinicians when planning subsequent antiretroviral regimens for highly treatment-experienced patients, particularly when their prior treatment histories and longitudinal genotypes are not available."

Read more in PLoS One, June 29, 2009.

International Association of Physicians in AIDS Care Partners With Healthy Interactions(R) to Advance HIV/AIDS Education Across Diverse Cultures, Pati

2009-06-28T23:49:00.001-04:00

"The International Association of Physicians in AIDS Care (IAPAC) today announced that it is entering into a partnership with global patient education innovator Healthy Interactions. The partnership will address the rising incidence of HIV/AIDS in both developed and developing world nations via culturally relevant education programs that speak to diverse patient populations and enhance global HIV literacy.

'The collaboration will leverage Healthy Interactions' Conversation Map(R) education tools to enhance the quality of care, treatment, and support provided to people living with HIV and related co-infectious diseases. The Conversation Map tools utilize the power of small group dialogue and collaborative learning to improve health by providing groups of patients a method for engaging in a discussion about a disease or subject that enables them to recognize how their beliefs or attitudes affect their perceptions and discover ways they can change behavior and improve their personal health management. First introduced in 2005, the Conversation Map tools now have a presence in over 50 countries and are being used to help people living with diabetes. "

Read more in Aegis, June 24, 2009.

National HIV Testing Day - A message from President Obama

2009-06-27T23:32:00.002-04:00

"Today, in recognition of National HIV Testing Day, President Obama released a special video message about the importance of HIV testing and his own experiences getting an HIV test in Kenya."

Read more in AIDS.gov, June 27, 2009.

Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study

2009-06-27T11:20:00.003-04:00

"Conclusion: The dominant components of the Mediterranean diet score as a predictor of lower mortality are moderate consumption of ethanol, low consumption of meat and meat products, and high consumption of vegetables, fruits and nuts, olive oil, and legumes. Minimal contributions were found for cereals and dairy products, possibly because they are heterogeneous categories of foods with differential health effects, and for fish and seafood, the intake of which is low in this population."

Read more in British Medical Journal, June 23, 2009.

Comment: Though not HIV-related, this study may be worth noting re healthy diets. Obviously many other factors can affect the pros and cons of moderate alcohol use (which in this case was generally wine with meals).

Very high level of late diagnosis in US: 38% develop AIDS within one year

2009-06-26T23:55:00.000-04:00

"A substantial proportion of HIV-positive individuals in the US are diagnosed late, according to an article in the June 26th edition of Morbidity and Mortality Weekly Report. An analysis of data from 34 US states revealed that 38% of patients progressed to AIDS within a year of their HIV diagnosis.

"The report was published ahead of the US National HIV Testing Day on June 27th. 'To reduce late testing for HIV infection, health-care providers should fully implement both routine and risk-based HIV testing', comment the investigators."

Read more in Aidsmap, June 26, 2009.