October 16, 2015
This week we read a study that identified three biomarkers that may predict HIV viral rebound after treatment interruption. We also see updated data on mortality risk after AIDS-defining opportunistic illnesses. And a study finds that HIV drugs may also protect against hepatitis B.
To beat HIV, you have to follow the science!
The study, which was published in Nature Communications, analyzed data from the SPARTAC trial, a study that treated individuals during acute infection. The researchers compared the CD4+ cells of 154 individuals who had their treatment interrupted after 12 or 48 weeks, and compared 18 different immune system biomarkers, according to the study press release.
The study investigators found three biomarkers in particular that were statistically significant predictors of when viral load would rebound after treatment interruption: PD-1, Tim-3 and Lag-3, all of which are associated with CD4+ cell exhaustion. High levels of these biomarkers before starting treatment predicted earlier viral rebound following treatment interruption -- leading the researchers to recommend further study of these biomarkers.
Five-year survival probability after an AIDS-defining opportunistic illness (AIDS-OI) has increased from 7% before antiretroviral therapy to 65% in the combination antiretroviral therapy era, according to a study published in the Journal of Infectious Diseases.
The study analyzed data from 20,858 individuals in San Francisco who were diagnosed with AIDS, from across three treatment eras: pre-antiretroviral therapy (1981-1986), mono/dual antiretroviral therapy (1987-1996), and combination antiretroviral therapy (1997-2012).
Overall, the most frequently diagnosed AIDS-OIs were Pneumocystis pneumonia (39.1%) and Kaposi sarcoma (20.1%). However, after adjusting for confounding factors, mortality rate was highest for brain lymphoma (hazard ratio [HR] 5.14; 95% confidence interval [CI]) and progressive multifocal leukoencephalopathy (HR 4.22; 95% CI).
"Better prevention and treatment strategies are still needed for AIDS-OIs occurring in the current HIV treatment era," the researchers concluded.
Hypogonadism, or low serum testosterone, affected more than one in 10 HIV-positive men, according to a preliminary single-center study in France. That rate was two times higher than similarly aged men in the general population.
The study, which was presented at ICAAC 2015, followed 113 men, all under 50 years old with a viral load below 50 copies/mL, for more than six months. Overall, 14 of the 113 men (12.4%) had hypogonadism. The researchers identified three independent predictors, including: total fat mass above 19%; more than 5.5 years of antiretroviral therapy; and more than two years of integrase inhibitor therapy.
For gay men living with HIV, being on treatment and having an undetectable viral load decreases the risk of contracting hepatitis B (HBV), according to a study publishing in the Annals of Internal Medicine.
The study followed 2,400 men who have sex with men (MSM) who were enrolled in the Multicenter AIDS Cohort Study (MACS). The researchers found that MSM on antiretroviral therapy with an undetectable viral load were 80% less likely to contract HBV, compared with MSM who were not on treatment or MSM on treatment but with a detectable viral load, according to the study press release. Moreover, for MSM on effective antiretroviral therapy, their risk of HBV infection was the same as MSM without HIV.
"What this means to us is that effective HIV therapy appears to restore an impairment in the immune response that protects someone with HIV from acquiring hepatitis B infection," said senior author Chloe Thio, M.D., according to the study press release. However, the researchers still urge men to get vaccinated for HBV.
Some women may have a stronger natural barrier against HIV and other sexually transmitted infections (STIs), according to a study from the University of North Carolina at Chapel Hill. The study researchers examined vaginal mucus from 31 women of reproductive age and found that a specific species of bacteria, known as lactobacillus crispatus, seems to be key in sustaining the barrier against HIV and other STIs, according to the study press release.
Higher levels of D-lactic acid were associated with blocking HIV, and since humans cannot make D-lactic acid, the lactobacillus bacteria may be responsible, the researchers suspect. The findings could lead to new developments in protecting women against HIV.
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.
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