October 9, 2015
This week we read about a pair of proteins that can shut down HIV's ability to infect cells. We also read a study that finds higher rates of non-AIDS cancer among men living with HIV than those who are not. And a Virginia study finds that receiving health coverage through the Affordable Care Act (ACA) greatly improves outcomes for patients living with HIV.
To beat HIV, you have to follow the science!
"[T]he HIV-1 genome can't pass through the viral envelope when SERINC3 and SERINC5 are present. Somehow these proteins are blocking the release of the virus's genome, essentially keeping the virus from spreading," said Heinrich Gottlinger, M.D., Ph.D., lead author for one of the studies, according to the press release. These early findings offer a lot of potential for combating not only HIV, but other enveloped viruses as well.
Low-income HIV-positive patients enrolled in ACA health plans had a higher likelihood of achieving undetectable viral loads, according to a study presented at IDWeek 2015. The two-year study followed 3,933 ACA-eligible patients in Virginia who were already enrolled in the state's AIDS Drug Assistance Program (ADAP). About half were enrolled in ACA health plans, while the rest continued to receive medications through ADAP.
"We found patients fared better under ACA health plans, possibly due to broader access to medical care and medications beyond those that target HIV," said lead author Kathleen McManus, M.D., M.S., according to the study press release.
Undetectable viral loads were achieved by 85.5% of those who switched to ACA health plans versus 78.7% of those who stayed on ADAP. However, that is not to say one program is better than the other, because the researchers believe the cost-effectiveness of ACA insurance allowed Virginia to cover more patients.
"Moving patients to ACA insurance helps the Virginia ADAP use federal and state funds to cover a larger number of patients and help avoid wait lists for medications and services," McManus said.
Integrating addiction treatment into primary care for patients with or at risk for HIV can significantly reduce substance dependence and increase treatment adherence, according to a study published in the Journal of Substance Abuse Treatment. The study highlights a program developed at Boston Medical Center (BMC) called the Facilitated Access to Substance Abuse Treatment with Prevention and Treatment for HIV (FAST PATH) program. From 2008 to 2012, FAST PATH enrolled 265 participants who were dependent on drugs or alcohol for at least one year, and who were either living with HIV or at high risk of contracting the virus, according to the study press release.
Patients were given a multidisciplinary assessment and offered weekly addiction counseling, HIV risk reduction and overdose prevention counseling. Patients who needed medication-assisted treatment were prescribed buprenorphine, a medication used to combat opioid addiction. After six months, substance dependence dropped to 49%. The researchers also reported that buprenorphine treatment was associated with higher engagement, while depression was associated with substance dependence.
"Given depression's association with adverse outcomes in this clinical population, including mental health treatment as part of integrated care holds potential to improve addiction treatment outcomes," the study authors concluded.
HIV-positive men had a higher incidence of both virus-related and virus-unrelated non-AIDS cancers than HIV-negative men in a 30-year Multicenter AIDS Cohort Study (MACS) analysis, according to a NATAP report. The study analyzed data from 7137 men who have sex with men (MSM) who were enrolled in MACS between 1984 and 2014. Men with HIV had significantly higher incidence of non-AIDS cancers than those without HIV, among men both younger and older than 55. The researchers suggested four factors that may contribute to the increased non-AIDS cancer risk, including: coinfection with cancer-causing viruses, HIV itself, chronic inflammation and a weakened immune system, according to the NATAP report.
Infants born to mothers who take HIV regimens containing tenofovir (Viread) to prevent mother-to-child HIV transmission were more likely to have lower bone mineral content than infants exposed to other HIV drugs, according to a National Institutes of Health (NIH) study. The study found that pregnant women who received tenofovir in their third trimester gave birth to babies whose bone mineral content was 12% lower than other babies who were not exposed to tenofovir, according to the study press release.
"At this point, we can say that those who care for pregnant women with HIV and their children should be aware that prescribing tenofovir to pregnant women could be a concern for their infants' bones," said George K. Siberry, M.D., lead author of the study. At the same time, the researchers cautioned against any immediate changes against the use of tenofovir in pregnant women, but called for additional studies to better understand the relationship between tenofovir and infant bone health.
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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