August 28, 2015
Ebola. Hodgkin's lymphoma. Mother-to-child transmission. Sure, they might sound like old topics from an HIV clinical science standpoint, but in the same way that the epidemic is ever-evolving, so is our understanding of many long-since identified facets of this epidemic. This week, we learn new, valuable information on a number of these issues -- and we see the latest sign that HIV's precursors may date back as many as 16 million years.
To beat HIV, you have to follow the science!
Indications regarding the use of rilpivirine (Edurant) by HIV-positive patients between the ages of 12 and 18 have been added to the product labeling, according to a bulletin issued by the U.S. Food and Drug Administration on Aug. 27. Information has also been added to the label regarding the association of rilpivirine use with depressive disorders and adrenal dysfunction.
Conversations around the widespread use of methamphetamine, poppers and erectile dysfunction drugs (among other so-called "party drugs"), particularly among HIV-positive men who have sex with men, often tend to focus on HIV transmission risk. But there's another side to recreational drug use that deserves attention, researchers contend: potentially significant interactions with antiretroviral treatment, particularly the booster drugs ritonavir (Norvir) and cobicistat (Tybost).
As Ebola raged in West Africa during the latter half of 2014, HIV-related services suffered -- but not all of them suffered similarly, according to the results of an observational, single-facility study in Guinea. Researchers observed massive reductions in HIV testing rates and linkage to care for newly infected patients during the outbreak, but significantly less impact on patient attendance at the facility's HIV follow-up clinic, leading the researchers to conclude that "HIV care in such circumstances is challenging, but not impossible."
The first point in the timeline of the ultimate evolution of HIV seems to keep snaking further backward in history. The latest such evidence comes from a study published in PLoS Pathogens, which used genetic analyses of Old World primates to find signs that lentiviruses that existed as many as 16 million years ago bore very similar characteristics to modern-day simian immunodeficiency virus (SIV).
In the latest episode of the "Why All People With HIV Should Be on Antiretroviral Therapy" show, we learn about findings from a massive, prospective French cohort finding that the earlier an HIV-positive woman begins treatment prior to having a baby, the less likely the infant is to be born with HIV. The data indicate that the odds of perinatal transmission increase from a nadir of 0.2% among women who commence therapy before pregnancy to a zenith of 2.2% among women who begin therapy during their third trimester.
Given that a number of recent studies have focused on the continued incidence of AIDS-defining illnesses among people with HIV (even those with high CD4 counts), it can be helpful to periodically get a reality check about just how much better clinical outcomes have become for patients who develop these illnesses. The latest evidence comes from a French study published online in Clinical Infectious Diseases (and reported by Aidsmap) that found a continued high risk for classic Hodgkin's lymphoma among people with HIV in the combination antiretroviral treatment era -- but that also found survival rates among such patients to be similar to their HIV-negative counterparts.
Is there a development this week in HIV research that you think we missed? Send us a tip!
Myles Helfand is the editorial director of TheBody.com and TheBodyPRO.com.
Follow Myles on Twitter: @MylesatTheBody.
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