June 5, 2015
This week we look at results from a study analyzing 30 years of data on HIV-related mortality. We examine whether HIV's sweet tooth is its weakness, while another study explains why HIV has a "long tail." We also learn more about transmitted drug resistance, whether pre-exposure prophylaxis (PrEP) enhances HIV-specific immune responses, and how marijuana use affects successful aging for people living with HIV. To beat HIV, you have to follow the science!
Despite treatment advances, about a third of HIV-positive patients in the current treatment era who develop their first opportunistic illness die within five years, according to a study analyzing 30 years of data from over 20,000 patients in San Francisco.
A new approach taking advantage of HIV's sweet tooth may keep the virus from replicating in human cells, at least in vitro, according to a new study. In order to replicate, HIV identifies and takes over the sugar stored in activated CD4+ cells. Blocking activated CD4+ cells from storing sugar may deprive HIV of the nutrients it needs to survive.
A new study provides key insight into how HIV identifies and incorporates itself into other cells. A small section of HIV's envelope protein, located on what the researchers refer to as its "tail," is necessary for HIV to infect and replicate in other cells. The long tail may also help HIV dodge the immune system, according to the study. Figuring out how to manipulate the tail could help in developing effective vaccines.
Taking PrEP did not enhance the development of HIV-specific immune responses, according to a study following heterosexual African men and women who were at high risk of HIV. The researchers observed HIV-specific CD4+ and CD8+ cell responses in 10-20% of the participants, but the rate and magnitude of these responses did not differ significantly between PrEP and placebo groups.
Some drug-resistant HIV strains are very long-lived and appear to be primarily passed on by undiagnosed and untreated individuals living with HIV, according to a recent U.K. study. These strains from transmitted drug resistance (TDR) differ from drug resistance seen after failing treatment, and do not appear to be showing up in patients who are on treatment. Some of these TDR mutations are "fossil mutations" that developed in response to drugs that are no longer widely used, according to Aidsmap.
Smoking marijuana may decrease "successful aging" for patients living with HIV, according to a study from the University of Colorado Denver, which followed 359 virally suppressed patients, aged 45-65, on treatment. The researchers defined "successful aging" as absence of disease, adequate physical function, high quality of life (QOL), and social engagement. Patients who reported recent marijuana use (RMU) also reported more smoking and lower income than non-RMU patients. RMU patients also demonstrated lower mental QOL, increased odds of low social engagement, as well as unemployment or under-employment.
Mental health was strongly associated with treatment adherence, according to a large clinical trial on early antiretroviral therapy to prevent sexual transmission of HIV in serodiscordant couples. While adherence was high among individuals in stable relationships taking treatment for prevention (83.3% at one year), mental health and adherence covaried.
Among patients coinfected with HIV and hepatitis C (HCV), 70% could have moderate or severe drug-drug interactions with one of the four common direct-acting antiviral (DAA) regimens used to treat HCV, according to a Denver study presented at the 2015 International Workshop on Clinical Pharmacology of HIV and Hepatitis Therapy. In addition, the researchers estimated that 20% of patients who need to switch HIV regimens because of DAA interactions would not be able to because of HIV drug resistance.
"The continuing HIV epidemic is fuelled by the large number of people who are unaware of their HIV status," writes Amanda Castel, M.D., and Irene Kuo, Ph.D., M.P.H., of the Join Milken Institute School of Public Health. In this comment from the Lancet HIV, Castel and Kuo argue for more HIV testing in primary care settings, as well, "the continued use of combination approaches to HIV testing, including screening in emergency departments, home-based testing and targeted testing in hot spots of HIV transmission."
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.
No comments have been made.
The content on this page is free of advertiser influence and was produced by our editorial team. See our content and advertising policies.