September 18, 2015
This week we read about a new broadly neutralizing antibody that can detect and attack HIV, even as the virus changes during infection. Another study reports that the histone deacetylase inhibitor romidepsin successfully reactivated latent HIV in a small group of patients. And we get new data on life expectancy for people over 50 living with HIV.
To beat HIV, you have to follow the science!
HIV contains three-part proteins on its envelope, also known as the HIV trimer or envelope spikes, which the virus uses to recognize and bind to CD4+ cells. The spikes are normally in a closed conformation, and change to an open conformation once the virus binds to CD4+ cells. Most bNAbs are able to recognize only the closed conformation. 8ANC195 recognizes both closed and open conformations, giving it potential as future HIV treatment.
Researchers in Denmark found that the histone deacetylase (HDAC) inhibitor romidepsin reactivated latent HIV in six HIV-positive patients, all of whom had undetectable viral loads for a median of nine years, according to a study published in PLOS Pathogens. The study included five men and one woman, all Caucasian and on antiretroviral therapy for a median 10.1 years. The median age was 56 and median CD4+ cell count at baseline was 645.
The participants received one four-hour romidepsin infusion per week for three consecutive weeks while maintaining antiretroviral treatment. After the second infusion, viral loads increased from below 20 copies/mL to levels that were easily detectable by standard tests (ranging from 46-103 copies/mL) in five of the six patients. Moreover, the drug appeared safe and did not alter T cell functions.
Although the arrival of highly active antiretroviral therapy dramatically increased life expectancy for people living with HIV, a Danish study found that average life expectancy for HIV-positive individuals over age 50 is still lower than the general population, according to an hivandhepatitis.com report. The study followed 2,440 HIV-positive individuals and 14,588 general population controls. Overall, 530 (21.7%) of the HIV-positive participants and 1,388 (9.5%) of the general population group died during the study period.
The estimated median survival time for people living with HIV at age 50 increased from 11.8 years during 1996-1999 to 22.8 years during 2006-2014, but is still significantly lower than the 30.2 year median of the general population. Moreover, even well-treated HIV-positive individuals over 50 with no comorbidities had a 70% higher likelihood of death than the general population.
HIV-positive women who received a brief alcoholic intervention (BI) were less likely to drink or have unprotected vaginal sex when compared to women receiving usual care, according to a study published in JAIDS. The study followed 148 women living with HIV and randomized them into two groups (intervention or usual care). The women in the intervention group were about 42% less likely to have a drinking day; however, heavy drinking days (defined as four or more drinks) and drinks per drinking day did not differ significantly. While the intervention group reported fewer instances of unprotected vaginal sex, there were no observed differences for treatment adherence, doctor's visits and viral suppression.
People living with HIV who inject drugs could benefit greatly from both opioid substitution treatment (OST) and highly active antiretroviral therapy when taken together, according to a study published in Clinical Infectious Diseases. The study analyzed data on 1,727 HIV-positive injection drug users. Overall, 493 (28.5%) died during a follow-up period of 5.1 years (18.7% due to drug-related causes, 55.8% due to HIV-related causes and 25.6% due to other causes). All-cause mortality was lowered by OST (adjusted hazard ratio [aHR] 0.34) and highly active antiretroviral therapy (aHR 0.39), but was lowest when both treatments were used together (aHR 0.16).
Is there a development this week in HIV research that you think we missed? Send us a tip mailto:firstname.lastname@example.org!
Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com.
Follow Warren on Twitter: @WarrenAtTheBody.
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