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This Week In HIV Research

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This Week in HIV Research: Smoking Increases Viral Load and Risk of Heart Attack; and Men With HIV Need Fewer Drinks to "Feel a Buzz"

April 24, 2015

This week we look at a handful of studies that ultimately point out the obvious: Smoking is bad for your health. We also look at a study that found HIV-positive men with detectable viral loads need fewer drinks to feel the effects of alcohol. Additionally, a large study set out to determine whether being gay was actually a risk factor when donating blood, and whether current blood ban policies were necessary. And a super algorithm could help us analyze electronic adherence data and implement selective viral load testing to save us some money. That and much more. To beat HIV, you have to follow the science!


Comorbidities/Complications

Smoking Increases Viral Load and Oxidative Stress in HIV-Positive Individuals

We know that smoking is common among people living with HIV, and that even mild smoking increases HIV progression. This study further elucidated that by showing an increase in viral load for HIV-positive patients who were mild-to-moderate smokers compared to those who did not smoke. Moreover, although the researchers were unable to observe significant changes in most inflammatory markers, their findings did suggest an association between smoking and oxidative stress, as well as cytochrome P450 (CYP) enzymes.

Smoking Associated With 75% of Heart Attacks in People Living With HIV

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Smoking was associated with 75% of all heart attacks among HIV-positive individuals, compared to only 25% in the general population, according to a recent, large Danish study. The researchers suggested that smoking cessation be a primary focus in modern HIV care, particularly since quitting smoking could prevent more than 40% of heart attacks among HIV-positive individuals. The study was featured in the current print issue of Clinical Infectious Diseases, but was published online, ahead of print, in January.

Having HIV Associated With Increased Risk of Lung Cancer

Pulmonary damage and inflammation associated with HIV infection is linked to an increased risk of lung cancer, based on long-term data from the Women's Interagency HIV Study (WIHS) and the Multicenter AIDS Cohort Study (MACS). "Encouraging and assisting younger HIV-infected smokers to quit and to sustain cessation of smoking is imperative to reduce the lung cancer burden in this population," the researchers noted.

HIV Infection Associated With Increased Risk of Acute Exacerbation of COPD

More and more studies are finding an association between HIV and chronic obstructive pulmonary disease (COPD). This latest study found that HIV was independently associated with increased risk of acute exacerbations of COPD (AECOPD), which is a major contributor to morbidity and mortality.

HIV-Positive Men Need Fewer Drinks to "Feel a Buzz"

HIV-positive men with detectable viral loads needed fewer drinks to "feel a buzz" than those with undetectable viral loads or HIV-negative men, according to a recent study.


In the Clinic

Electronic Adherence Data May Provide Strategies for Selective Viral Load Monitoring

Regular viral load testing for patients on treatment is expensive and can be unnecessary since most of these patients have undetectable viral loads. Using a machine-learning algorithm (Super Learner) to evaluate long-term adherence data, researchers in the U.S. were able to build a model to classify virological failure and potentially inform a selective viral load testing strategy. Their results suggest that, "25%-31% of viral load tests could be avoided while maintaining sensitivity for failure detection at or above 95%, for a cost savings of $16-$29 per person-month."

Untreated Pain Lowers Treatment Adherence Among HIV-Positive Patients

Patients living with HIV who experienced pain that was left untreated were less likely to achieve 95% treatment adherence when compared to those who were pain free or had their pain treated, according to a U.S. study. The findings, which were published online last year but featured in the latest print issue of AIDS Patient Care and STDs, suggest that pain management is critical for patients living with HIV.


Epidemiology and Prevention

Is Being Gay a Risk Factor When Donating Blood?

Researchers from the Belgian Red Cross set out to analyze whether being MSM (men who have sex with men) posed a risk of transfusion-transmissible infections, including HIV, when donating blood. After combing through 18,987 research papers, they were able to find only 14 relevant studies -- and further, only three of those had enough data on gay men to warrant inclusion.

While the researchers noted, "The available evidence suggests a link between MSM blood donors and HIV-1 infection," they also stressed there is not enough data to clearly recommend a specific blood donor deferral policy or change existing policies.

Pilot Partner-Notification Program Identifies New HIV Cases in Barcelona, Spain

A pilot partner-notification program in Barcelona was able to identify and test 141 individuals who were previous partners of patients living with HIV. Of those 141 partners, 26 were newly diagnosed when tested, giving the program a case-finding effectiveness of 18.4%. Not only was the program effective, it was feasible and acceptable to the user.

Sexual Relationships Outside Primary Partnerships and Abstinence Associated With Lower PrEP Adherence

This Ugandan study found that HIV-negative individuals who reported having sex outside their primary relationship and less-than-100% condom use were more likely to have low adherence to pre-exposure prophylaxis (PrEP), when compared to those who reported having sex with only their primary partner and 100% condom use. Additionally, those who reported abstaining from sex also had lower adherence to PrEP.


Commentary

Ebola: The Real Lessons From HIV Scale-Up

Wafaa M. El-Sadr, M.D., M.P.H., and Miriam Rabkin, M.D., M.P.H., sum up the four lessons that they think can be learned from HIV efforts and applied to the Ebola response, including: engaging affected communities, the need for innovative approaches, the importance of investing in data for decision making, and the effect of vertical programming on health systems.


In Memoriam

Martin Fisher, R.I.P.

On a sad note, professor Martin Fisher passed away on April 20. Fisher was the first professor of HIV medicine at Brighton and Sussex Medical School in England. He was a leading HIV physician and researcher, as well as an active member of the British HIV association (BHIVA) since its inception.

Is there a development this week in HIV research that you think we missed? Send us a tip!

Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com.

Follow Warren on Twitter: @WarrenAtTheBody.


Copyright © 2015 Remedy Health Media, LLC. All rights reserved.




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