July 9, 2015
This week we look at a study that reaffirms that starting treatment early reduces mortality risk for people living with HIV, especially for individuals over 45. We read an essay that examines the complex relationship between HIV, aging and comorbidities. And we see how spending $1 on prevention can translate into saving $5 on treatment. To beat HIV, you have to follow the science!
The landmark START study recently found that [[starting treatment as soon as possible, even at higher CD4 counts, helped reduce mortality risk for people living with HIV]]. Now, another study is finding that this may be especially true for those over the age of 45.
For patients who entered care between the ages of 45 and 65, "Delaying [antiretroviral therapy] until CD4 count dropped below 200 cells/mm3 increased 10-year mortality from 19% (had patients initiated [antiretroviral therapy] when CD4 counts first dropped below 500 cells/mm3) to 28%," the authors wrote, according to a report by aidsmapcom.
HIV-related comorbidities may not be associated with aging, according to a paper published in The Lancet HIV. Studies have found that risk of morbidities, such as myocardial infarction, cardiovascular disease, renal disease and non-AIDS-defining cancers, increased at similar rates between age-matched HIV-positive and HIV-negative individuals.
"The causes of these long-term clinical outcomes in HIV-positive individuals are a complex mix of HIV infection, antiretroviral treatment, coinfections such as hepatitis B and hepatitis C virus, and lifestyle factors such as cigarette smoking and use of alcohol and other drugs, which are much more prevalent in people with HIV than in those without," the researchers wrote.
An Ontario study found that, from 1987 to 2011, community-based prevention programs in the province helped prevent 16,672 HIV infections, which translates into Ontario health care savings of approximately 6.5 billion Canadian dollars (USD$5.11 billion). Put into context, from 2005 to 2011, every Canadian dollar invested in these programs saved about CAD$5 in treatment costs, the study found.
A new study published in Clinical Infectious Diseases confirms that having syphilis increases the risk of acquiring HIV. Following 2,805 men with syphilis in New York City, study investigators found that 423 participants (15.1%) contracted HIV. The overall annual HIV incidence for men with syphilis was 3.61%, which was higher among men who have sex with men (MSM) at 5.56%; males with secondary compared with primary syphilis at 4.10% versus 2.64%; and highest among males diagnosed with another sexually transmitted bacterial infection after syphilis at 7.89%.
Low health literacy may be one of the key contributing factors to the HIV epidemic in the Southern U.S., but it is overlooked, according to a paper published in The Lancet HIV. Defined as, "The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions," low health literacy is a silent epidemic that exacerbates health inequity, according to the paper.
Two studies published in PLOS Pathogens show results on neutralizing antibodies (NAbs) that could provide insight into vaccine research and design. The first study found that "exposure to diverse HIV subtypes following superinfection may drive a broad and potent Nab [sic] response," according to the study press release. The second study examined the role of NAbs in cell-cell 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.
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