May 12, 2017
This week, a study finds that a new maturation inhibitor in development, GSK3532795, shows activity against HIV that is resistant to protease inhibitors. Another study finds that using sofosbuvir plus ribavirin for acute hepatitis C (HCV) in HIV/HCV -coinfected men led to high relapse rates. And current CDC guidelines for cervical cancer screening in women with HIV are mostly adequate, a study suggests. To beat HIV, you have to follow the science!
A new maturation inhibitor in development, GSK3532795, showed antiviral activity in vitro against protease inhibitor-resistant isolates, study authors reported in Journal of Acquired Immune Deficiency Syndrome.
The experiments were supported by Bristol-Myers Squibb, the original developer of the drug . Maturation inhibitors work similarly to protease inhibitors (PIs), hence cross-resistance between these two types of antiretrovirals is a concern. Researchers tested isolates from 22 people for phenotypic sensitivity to the new drug. All participants had been previously treated with a PI. HIV mutations in protease and Gag genes that are associated with PI resistance did not reduce the susceptibility of the virus to GSK3532795. Conversely, isolates that were less responsive to the new drug still reacted to currently approved PIs.
Results "support the continued development of GSK3532795 in treatment-experienced patients," study authors concluded. The compound is currently in a phase-2b trial, conducted by ViiV Healthcare, among treatment-naive adults.
Hepatitis C (HCV) relapsed in 41% of HIV/HCV co-infected participants in a small trial evaluating sofosbuvir plus ribavirin to treat HCV, Clinical Infectious Diseases reported.
The 17 men enrolled in the study had acute HCV and chronic HIV infection, and represent cohort 1 of a 2-cohort open-label clinical trial. Participants received the study drugs for 12 weeks, at which point their HCV levels were undetectable. Four weeks later, HCV had returned to detectable levels in seven participants. At the end of treatment, ribavirin levels were more than 50% higher in those who achieved a sustained virologic response (SVR) than in those whose virus relapsed.
Researchers do not know the cause of this discrepancy. The study "did not achieve noninferiority compared to the study-defined historical SVR rate of 60%," study authors conceded. Cohort 2 of this trial, which is evaluating eight weeks of lepidasvir and sofosbuvir in participants co-infected with HIV and HCV, is ongoing.
U.S. Centers for Disease Control (CDC) guidelines on the frequency of cervical cancer screenings for women living with HIV (WLHIV) mostly match the risk for developing that cancer among various groups of WLHIV, an evaluation of cervical cancer screening strategies that was published in AIDS found.
The study suggested that women with CD4+ cell counts of 500 cells/μL or more and negative cytology could wait two years between screenings (current guidelines call for 1 year). It also recommended colposcopies for those with low CD4+ cell counts (< 350 cells/μL) and atypical squamous cell of undetermined significance cytology (CDC recommends rescreening in six to 12 months).
The study compared cervical cancer risk benchmarks for participants in the Women's Interagency HIV Study with those in the general population. Researchers developed novel methods for applying these benchmarks to arrive at screening interval recommendations. They believe this approach could be helpful in evaluating screening strategies as HIV treatment and cancer assessments change.
Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com. Follow Warren on Twitter: @WarrenAtTheBody.
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