November 13, 2015
This week, a study reports the potential of interleukin-21 to reduce inflammation and limit viral persistence, when taken in combination with antiretroviral drugs. Another study reports that human papillomavirus (HPV) vaccination in HIV-positive gay men after anal intraepithelial neoplasia treatment may reduce the risk of anal cancer. Plus, we read a study examining the risk factors of acute exacerbation of chronic obstructive pulmonary disease (COPD) in people living with HIV.
To beat HIV, you have to follow the science!
Interleukin-21 (IL-21) given in combination with antiretroviral therapy may help control HIV and reduce inflammation, according to a nonhuman primate study at Emory University.
Researchers at Yerkes National Primate Research Center, Emory University, tested the IL-21 combination in SIV-infected rhesus macaques two months after infection. Eight of 16 macaques were given the IL-21 combination, while the other eight were given only antiretroviral therapy. After seven months, treatment was discontinued.
The researchers found that for the monkeys treated with IL-21, SIV RNA in the blood was five times less than the controls, and remained that way up to eight months later. This effect was also seen in viral DNA levels in the intestinal tissues and CD4+ cells. Additionally, the IL-21 combination was associated with reduced immune activation (indicators of inflammation) and improvements in antimicrobial immunity.
"This was an important test of the concept that an intervention that reduces immune activation during antiretroviral therapy can also limit viral persistence. Our data provide a rationale for additional preclinical studies on IL-21 as part of a novel combination strategy aimed at limiting the size of the latent viral reservoir and contributing to a remission or functional cure," said senior author Mirko Paiardini, Ph.D., according to the study press release.
For men over 27 years old who have sex with men and have been treated for high-grade anal intraepithelial neoplasia (HGAIN), quadrivalent human papillomavirus (qHPV) vaccination could reduce the lifetime risk of anal cancer by 63%, according to a study published in Clinical Infectious Diseases.
In addition, the researchers deemed qHPV vaccination cost saving, estimating lifetime costs decrease of $419, as well as increasing quality-adjusted life years (QALY) of 0.16.
Currently, the practice is to not vaccinate after treatment for HGAIN, therefore, "expansion of current vaccination guidelines to include this population should be a high priority," the study authors conclude.
Having HIV, especially with a lower CD4+ cell count, was found to be an independent risk factor for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), according to a study published in the journal AIDS. Smoking and unhealthy alcohol use in patients living with HIV were also associated with greater risk of AECOPD. The study adds to a growing focus on COPD in individuals living with HIV, who are more susceptible to the disease.
A letter from the Obama Administration tells U.S. states that Medicaid must allow more people access to costly drugs that can cure their hep C. It also sends a message about treatments for HIV and other diseases, Carmel Shachar writes.
The Medicaid notice on hep C treatment -- one of the most important documents for access to care from the Centers for Medicare and Medicaid Services (CMS) since guidance on HIV treatment in the 1990s -- is an important tool for clinicians and other advocates.
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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