February 10, 2017
This week, a study finds that people living with HIV are more likely to develop diabetes than the general population. Another study finds that an 8-week course of hepatitis C (HCV) treatment is highly effective in individuals with HIV/HCV coinfection. And the lower tenofovir efficacy rates observed among those with HIV subtype C may be explained by demographics, another study finds. To beat HIV, you have to follow the science!
People living with HIV may be more likely to develop diabetes than HIV-negative individuals, according to a study published in the January 2017 issue of BMJ Open Diabetes Research & Care.
The study found that 1 in 10 HIV-positive adults receiving care also had diabetes, a rate nearly 4% higher than adults in the general population. The researchers also found that HIV-positive individuals were more likely to develop diabetes at earlier ages, even when controlling for obesity.
Factors associated with developing diabetes for HIV-positive individuals included older age, length of time with HIV, mean CD4 count, and obesity.
An 8-week course of sofosbuvir and ledipasvir (Harvoni) was highly effective among selected HCV-infected and HIV/HCV coinfected patients in a German study of real-world data published in Clinical Infectious Diseases.
The sustained HCV viral response rate 12 weeks after the end of treatment was 93.5% overall, and the medication was well tolerated. That rate was similar between those infected only with HCV and those living with HIV and HCV, although study authors caution that coinfected participants were on stable antiretroviral treatment for HIV and had relatively low HCV viral loads.
The researchers also note that the data was collected from a white population and may not be transferable to other groups. HCV genotypes differ among regions of the world and the study medication is only active against genotype 1, which is less common in Africa and South Asia, for example. The study also showed very good response rates among those who had been previously unsuccessfully treated with interferon-based medications.
Virologic failure of tenofovir-containing antiretroviral therapy among people living with HIV subtype C can be explained by demographic differences rather than the subtype's propensity for developing a tenofovir-resistant mutation, a study published in The Journal of Infectious Diseases found.
Researchers analyzed data from 8,746 participants in the UK Collaborative HIV Cohort who were on a tenofovir-based first-line regimen. In line with worldwide prevalence, about 70% had subtype C. Raw data showed twice the virologic failure rate for subtype C compared to subtype B. However, most study participants with subtype B where white men who have sex with men, while those with subtype C were black and heterosexual. After adjusting for these and other potentially cofounding factors, researchers did not find a difference in virologic failure rates based on subtypes.
An editorial commentary noted that these results show the worse response rate among people with subtype C in some studies primarily because of the difference in treatment conditions between resource-rich and resource-limited settings, rather than the mutation itself.
Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com. Follow Warren on Twitter: @WarrenAtTheBody.
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