This week, we read a study that compares treatment regimens with and without nucleoside reverse transcriptase inhibitors (NRTIs) for treatment-experienced patients. We also see new data on life expectancy for HIV-positive adults in South Africa. And researchers have identified a new phase of HIV infection using a new imaging technique.
To beat HIV, you have to follow the science!
Omitting NRTIs from treatment regimens for treatment-experienced patients is safe and does not reduce treatment efficacy, according to a study published in the Annals of Internal Medicine.
The study randomized 360 treatment-experienced patients over 48 weeks to receive either a regimen with NRTIs (add-NRTIs) or one without NRTIs (omit-NRTIs).
Overall, the cumulative probability of treatment failure was 29.8% in the omit-NRTIs group versus 25.9% in the add-NRTIs group. Specifically, there were 53 treatment failures in the group without NRTIs versus 48 in the group with NRTIs. Furthermore, there were no deaths in the omit-NRTIs group versus 7 deaths in the add-NRTIs group.
"Treatment-experienced patients with HIV infection starting a new optimized regimen can safely omit NRTIs without compromising virologic efficacy. Omitting NRTIs will reduce pill burden, cost, and toxicity in this patient population," the authors concluded.
With increased availability of antiretroviral therapy in South Africa over the last decade, HIV mortality has decreased and life expectancy has increased, with greater improvements in women versus men, according to a study published in PLOS Medicine.
The study analyzed data from deaths between 2001 and2011 for about 100,000 individuals with HIV in South Africa. The researchers found that life expectancy increased 13.2 years for females, but only 9 years for males. This further raised the life expectancy gap between females and males from 4.4 years in 2003 to 8.6 years in 2011. Moreover, HIV-related mortality rates were similar for both men and women in 2003, but by 2011 women were 27% less likely to die from HIV than men.
"These results highlight the need for further research to understand why men are not as likely as women to seek and adhere to HIV care and treatment, and to design effective interventions to increase the uptake of HIV services among men," the authors concluded.
Using a new technique to take images of intact infected cells, researchers at UMass Medical School have identified a new phase of HIV infection called intra-nuclear migration, according to a study published in Cell Reports. The newly identified phase of infection relies on the human protein CPSF6 to guide HIV into the host cell's nucleus and potentially aid the virus's integration into active genes.
"This study reveals an important stage and mechanism in HIV infection that was previously unappreciated," said lead author Abraham L. Brass, M.D., Ph.D., according to the study press release. "It's important to know more about these early infection events so we can come up with ways to stop the virus from becoming part of our DNA and infecting us for life."
The new technique, called ViewHIV, was adapted from existing technologies and can generate images of the viral genome and protein capsid inside an infected host cell. Previously, researchers were unable to capture clear images of HIV inside the nucleus, according to the study press release. The researchers hope that ViewHIV will help better understand how HIV established itself and lead to new ways to prevent infection.
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