August 12, 2016
This week, a study of a new drug that effectively prevents vaginal and oral HIV transmission among humanized mice investigates a new pre-exposure prophylaxis (PrEP) option for women and children. Another study shows the promise of using prime-boost strategies in developing an HIV vaccine. Meanwhile, for toddlers living with HIV, short treatment interruptions were not found to be detrimental. Finally, for women living with HIV and hepatitis C, marijuana use did not increase the risk of liver fibrosis. To beat HIV, you have to follow the science!
A new compound, known as EFdA (4'-Ethynyl-2-fluoro-2'deoxyadenosine), was effective in preventing vaginal and oral transmission of HIV in humanized mice, according to a study published in the Journal of Antimicrobial Chemotherapy.
EFdA was also found to bepotent against drug-resistant HIV strains, and had relatively low toxicity. Should this new drug be shown to work in humans, as well, it could be used to prevent HIV transmission to women before and during pregnancy, as well as to infants during breast-feeding.
Such a medication would be particularly helpful in resource-limited settings, where it could be used both for mothers and their babies, said study co-author Angela Wahl, Ph.D., according to the study press release.
In this study, the drug was administered once daily. The next step is to lower the dose of EFdA and to reduce the frequency with which it is given in order to determine the minimum effective dosage, co-author Martina Kovarova, Ph.D., said in the press release.
"The most intriguing finding is detection of neutralizing antibody to heterologous, CCR5-tropic HIV," write the authors of the proof-of-concept vaccine study involving 19 and 72 study participants in its two parts. The phase-1 results were published in The Journal of Infectious Diseases.
Part A of the study evaluated polyphosphazene (pP), also known as alum, as a vaccine adjuvant (the "boost") to oligomeric glycoprotein 160 (ogp160; the "prime"). Part B of the study tested recombinant canarypox virus expressing HIV antigens (ALVAC-HIV) with ogp160 and either adjuvant against a placebo.
About 10% of all study participants who received a prime-boosted vaccine developed antibodies that can neutralize CCR5-tropic HIV. That response was slightly better in those who received the vaccine boosted with pP, 12% of whom developed serum that neutralizes tier-2 viruses, than in those whose vaccine had been boosted with alum. None of the study participants experienced serious adverse events relating to the vaccines.
Brief treatment interruptions for infants who start antiretroviral therapy during their first year of life and continue treatment for two years do not affect viral load control, growth, change in CD4 count over 18 months (CD4%), or morbidity, according to a study published in AIDS.
The study randomized 42 young children living with HIV in Kenya to interrupt antiretroviral therapy after 24 months of treatment until they met World Health Organization (WHO) criteria for treatment or to continue antiretrovirals uninterrupted. Every participant in the treatment interruption arm met the WHO criteria within three months of stopping treatment and was restarted on medication.
A follow-up evaluation 18 months after the randomization showed no difference in CD4% and other markers between the two study arms. Study authors cautioned that these results cannot necessarily be extrapolated to adults because of the potential for transmitting the virus during the treatment interruption and the fact that adults are less likely to start antiretroviral therapy during acute infection.
Using marijuana does not increase the risk of developing significant liver fibrosis in women who are coinfected with HIV and hepatitis C (HCV), a study reported in Clinical Infectious Diseases found.
Researchers analyzed data from 575 participants in the Women's Interagency HIV Study who were HIV/HCV coinfected and had been followed for a median of 11 years. Fewer than 50% of them reported any marijuana use during the study.
The majority of the 251 who did report marijuana use said they did so less than once a week. The use of marijuana did not affect the likelihood of progressing to significant liver fibrosis (FIB-4 score > 3.25), even among those who used the substance for long periods of time or very frequently.
Women who had some liver fibrosis when starting the study, had lower CD4 counts, or were heavy drinkers were more likely to develop a high FIB-4 score than those without these characteristics. However, African-American women with any of these characteristics were less likely to progress to significant liver fibrosis than participants of other ethnicities with the same risk factor.
Barbara Jungwirth is a freelance writer and translator based in New York.
Follow Barbara on Twitter: @reliabletran.
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