June 12, 2015
This week we look at a study that once again shows reduction of inflammatory markers in HIV-positive patients who are treated with panobinostat. We examine the effect of country-level homophobia on HIV rates, while another study suggests that meeting through Craigslist increases HIV infections. We also hear about a new formulation of HIV treatment for children. To beat HIV, you have to follow the science!
Treatment with panobinostat (Farydak), a histone deacetylase (HDAC) inhibitor, led to significant reductions in multiple markers of inflammation among HIV-positive patients who were virally suppressed on treatment, according to a study published in the journal AIDS. At the same time, the researchers observed a decrease in the expression of genes related to cardiovascular risk, suggesting that panobinostat may have potential to reduce excess inflammation in HIV-positive patients.
In European countries with higher levels of stigma against homosexuality, measured by "a combination of national laws and policies affecting sexual minorities and a measure of attitudes held by the citizens of each country," men who have sex with men (MSM) are more likely to have undiagnosed HIV and more nonsteady sexual partners, according to a recent study by the Yale School of Public Health. Additionally, MSM in countries with higher levels of stigma are less likely to test for HIV, use HIV-prevention methods and discuss their sexuality HIV during testing.
In the year after Craigslist arrived in communities across Florida, an added 1,149 people became infected with HIV compared with the year before, according to estimates based on a 12-million person analysis. The 13.5% jump in HIV cases reflected new infections in traditionally high-risk as well as lower-risk populations.
In the U.S., those who identify as transgender women are significantly less likely to adhere to HIV medications and achieve an undetectable viral load, while also being more likely to have unmet needs for basic services, such as food and housing, than their nontransgender counterparts, according results of a three-year study published in the journal LGBT Health.
"The fact that, compared to other groups in treatment, transwomen had less [antiretroviral therapy] adherence and viral load suppression but more unmet needs for supportive services requires follow-up studies to inform remedial actions," says LGBT Health editor-in-chief William Byne, M.D., Ph.D., according to the study press release.
The U.S. Food and Drug Administration (FDA) recently approved a new children's formulation of lopinavir/ritonavir (Kaletra) that can be mixed with food so it is easier to take.
"Treatment innovations such as this that replace unpleasant and bad tasting medicines are a real breakthrough, accelerating access to treatment for children and keeping our youngest healthy," says Michel Sidibé, executive director of UNAIDS, according to the press release.
Long-term opioid use conferred a 40% higher death risk in a prospective study of U.S. veterans with or without HIV. The heightened risk ran to 46% in veterans with HIV compared with 25% in those without HIV. Long-term benzodiazepine use also inflated death risk in this population.
An HIV vaccine candidate appears safe and not toxic in a study following 48 HIV-positive individuals in France, according to the study press release. Results from the study will be published later this summer, but researchers presented preliminary data, which suggested proof of concept for the vaccine candidate.
The dendritic cells of elite controllers, who can live with HIV and maintain an undetectable viral load without treatment, may also be elite in that they are better able to detect HIV, thus better at generating T cells that specifically target HIV, according to a new study published in PLOS Pathogens.
"We are now focusing on fully understanding all the components required to trigger appropriate activation of dendritic cells in HIV infection, which may help to induce an elite-controller-like, drug-free remission of HIV in a broader patient population," says study co-author Xu Yu, M.D., according to the study press release.
A combination of access to newer direct-acting hepatitis C (HCV) treatment and behavioral interventions could reduce HCV transmissions in the U.K. by half over the next decade, according to a mathematical modeling analysis presented at the 2015 International Liver Congress.
Meanwhile, looking back, "Past treatment and risk reductions in the last 6 years may have averted an expanding HCV epidemic among HIV[-positive] MSM in the U.K.," the researchers noted.
The five-year probability of liver-related death (LRD) among HIV/HCV coinfected patients was substantially high in those with F2/F3 fibrosis (sub-distribution hazard ratio [sHR]: 10.3%, 95% confidence interval [CI]: 7.6-13.5), and even higher in those with F4 fibrosis (sHR: 14.0%, 95% CI: 10.3-18.3), according to a study published in the journal AIDS. Comparatively, LRD risk was low in patients with F0/F1 fibrosis (sHR: 2.2%, 95% CI: 1.7-2.9).
"Treatment with [directly acting antivirals] should be prioritized for those with at least F2 fibrosis. Early initiation of [combination antiretroviral therapy] with the aim of avoiding low CD4+ cell counts should be considered essential to decrease the risk of LRD and the need for HCV treatment," the researchers concluded.
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.
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