August 7, 2015
This week we look at a study that found HIV continues to grow despite years of effective antiretroviral therapy. We read an essay looking at the risk of drug-drug interactions among HIV-positive individuals on treatment who also use so-called "party drugs." And we examine whether an end to AIDS by 2030 is likely and ask what it will take. To beat HIV, you have to follow the science!
Previous modeling studies have theorized that HIV could potentially be eradicated with antiretroviral therapy after decades of ongoing treatment. However, despite suppressive antiretroviral therapy, HIV can continue to grow, according to research by the University of Liverpool.
A recent paper in the journal AIDS raises the concern about the increasing recreational drug use among men who have sex with men (MSM) living with HIV. In particular, this includes the use of party drugs in the context of "ChemSex," which is the use of three specific drugs (methamphetamine, mephedroneand and GHB/GBL) in a sexual context. For MSM living with HIV, use of these drugs could lead to drug-drug interactions with their antiretrovirals, according to the paper authors.
An essay in The Lancet HIV examines the latest UNAIDS goal of reaching an end of AIDS by 2030. "Malaria, tuberculosis, and antibiotic resistant infections have taught us that even when tried and tested measures are working, innovation must continue. New HIV treatments are in the pipeline, and this must remain to be the case," the essay explains.
One in four female sex workers in two Mexican cities on the U.S. border enter the sex trade before age 18, and one in eight before age 16, according to a study published in the Journal of the American Medical Association. These young women have a three times greater risk of contracting HIV compared to those who start sex work after age 18. The younger women are also more likely to be forced into sex with male clients and seven times less likely to use a condom during their first month.
A new hepatitis C (HCV) regimen consisting of two investigational drugs, grazoprevir (MK-5172) and elbasvir (MK-8742), was found to be effective and well tolerated in a cohort of 218 patients coinfected with HIV and HCV, with or without cirrhosis, according to a study published in The Lancet HIV. Sustained virological response 12 weeks after ending therapy (SVR12) was achieved by 210 (96%) of the 218 patients. Common adverse events included fatigue in 13% of patients, headache in 12%, and nausea in 9%. However, no patient discontinued treatment because of an adverse event. This new regimen will continue to be studied in phase-3 trials.
In this paper published in The Lancet HIV, Lydia Tang, M.D., and Shyam Kottilil, M.D., Ph.D., discuss how to best provide hepatitis C (HCV) treatment for patients coinfected with HCV and HIV -- pointing out the major restriction of drug interactions between HIV antiretroviral therapy and HCV direct-acting antivirals (DAAs). Despite the high rates of HCV cure using these newer regimens, clinicians face the unresolved challenge of how to best treat their patients on different HIV regimens. Tang and Kottilil wonder whether clinicians should consider starting HCV treatment for newly diagnosed patients even before starting HIV treatment.
Having HIV is associated with greater increases in focal carotid artery plaque, according to a study published in the journal Clinical Infectious Diseases. The study followed 1011 women (74% living with HIV) and 811 men (65% living with HIV) to compare common carotid artery intima-media thickness (CCA-IMT) and new focal carotid artery plaque formation. The researchers did not find a statistically significant difference in CCA-IMT progression based on HIV status, either in combined or sex-specific comparisons. However, patients living with HIV had a 1.6-fold greater risk of new plaque formation compared to the HIV-uninfected control patients. HIV-infected patients with a baseline CD4+ cell count above 500 had plaque formation risk similar to HIV-uninfected controls.
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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