Omega 3 to lower triglycerides and inflammation
As people living with HIV get older, it makes sense to pay attention to heart health. Triglycerides and LDL cholesterol are two types of blood fats – raised levels are associated with an increased risk of heart disease.
A randomised study shows that people living with HIV who already have very high levels of triglycerides can reduce them with supplements of omega 3 fatty acids (extracted from fish oils). The supplement used was not one you can buy commercially but has a high dose and is only available on prescription (brand name Omacor in Europe and Lovaza in the United States).
People in the study took the supplement for two years, and also attempted to improve their diet and lose weight.
People taking omega 3 had significant reductions in triglycerides (but not in cholesterol).
They also had significantly lower levels of a biomarker of inflammation. In people living with HIV, the long-term activation of the immune system in response to HIV (chronic inflammation) may contribute to the earlier onset of heart disease and other illnesses.
New form of tenofovir has good results for people aged 50+
One of the most widely used anti-HIV drugs is tenofovir disoproxil fumarate (DF) – it is included in the tablets Viread, Truvada, Atripla, Eviplera and Stribild. Tenofovir DF is highly effective and generally safe and well-tolerated, but can cause kidney and bone problems for a few people.
Tenofovir alafenamide (AF) is a new form of the drug that is delivered more efficiently to cells. This means that a lower dose is needed, which lowers the risk of side-effects. This new form of the drug, tenofovir AF, is included in the tablets Descovy, Odefsey and Genvoya.
While cheaper, generic versions of tenofovir DF will be available soon, tenofovir AF is a new drug exclusive to the pharmaceutical company Gilead – it is more expensive.
Access to tablets containing tenofovir AF is most important for people who need to pay attention to their kidney or bone health. Such problems are more likely to occur as we get older.
A new analysis compares people continuing to take tablets containing tenofovir DF with people switched to tablets containing tenofovir AF. They were aged between 50 and 79 (average age 55) and most were men.
Both forms of the drug were as effective as each other in reducing HIV to undetectable levels. People taking the newer tenofovir AF had improved levels of protein in urine and glomerular filtration rate (both are measures of kidney function) as well as improved bone mineral density at the spine and hip.
For more information on this issue, see an article from the American website BETA: ‘Ask A Pharmacist: With a new tenofovir, should you switch to Descovy, Genvoya or Odefsey?’
Drugs for all hepatitis C genotypes
A hepatitis conference last week heard excellent results from several studies of drug combinations which can treat all genotypes of hepatitis C. Until now, the treatment of hepatitis C has varied according to which of the six genotypes a person has.
Each genotype reflects a different genetic composition of the virus. At the moment, genotype testing is essential before getting treatment. But treating the virus may become simpler to manage with ‘pangenotypic’ drugs which are able to treat hepatitis C of all genotypes.
A single-tablet combination of a protease inhibitor called glecapravir and a NS5A inhibitor called pibrentasvir cured at least 98% of people with hepatitis C who had genotypes 1, 2, 4, 5 or 6. The drugs were taken as once-daily tablets for 8 or 12 weeks.
The same tablet was also tested against genotype 3 (which is often harder to treat) in a smaller, earlier phase study. Some of the people taking part had cirrhosis while others had already tried treatment but it had not worked. Over 96% of people were cured, although some needed to take the tablets for 16 weeks.
Other studies tested a different tablet, which combined three drugs: the nucleotide polymerase inhibitor sofosbuvir, the NS5A inhibitor velpatasvir and the protease inhibitor voxilaprevir. In people of all genotypes who had never taken treatment, it cured 95% of people after 8 weeks. In people who had previously tried treatment but it had not worked, it cured over 96% of people after 12 weeks.
For more information on hepatitis, read NAM’s booklet ‘HIV & hepatitis’.
Editors' picks from other sources
The AIDS fight: Andrew Sullivan on a history of the movement
from New York Times
A question has always hung over the reaction of gay men to the plague that terrorised and decimated them in the 1980s and 1990s: Why did they not surrender? David France’s remarkable book tries to answer that question.
One man’s story of what it is like to find out he has HIV and how it’s not a death sentence
from Metro
Alex, 27, a marketing account director, has given a candid interview about his experience with HIV. He was diagnosed at the age of 23 and gave us this frank and emotional account of life before HIV, that dreadful day of diagnosis, and how he’s now living a normal life.
Stopping a silent killer: know the facts about heart disease and HIV
from Positively Aware
Heart disease rates among people living with HIV are elevated compared to the general population. If you add to that the fact that heart disease is often a silent killer with atypical symptoms, it is easy to understand why more research needs to be conducted on this subject.
What's at stake in Trump's America? HIV community leaders share their opinions
from The Body
By Election Day, 8 November, after an eventful primary season and a noxious election cycle, it seemed that most HIV advocates were ready to get to work with a soon-to-be President-elect Hillary Clinton's soon-to-be administration, to continue the pioneering work activists forged under President Obama in addressing HIV in the US. Then the unthinkable happened. In the wee hours of 9 November, Donald J. Trump was declared the president-elect of the United States.
Prince Harry proves powers of persuasion as he meets people with HIV
from Telegraph
His brief was to help break down the stigma around HIV, and Prince Harry proved that he has inherited his mother’s remarkable powers of persuasion today when he met a group of people living with the virus.