Starting treatment

Starting treatment features

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  Treatment as prevention: Experts in the UK agree it works

  Roger Pebody summarises the statement released in January that should now guide how our doctors talk to us about treatment as prevention. ...

  From:  HIV treatment update

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  HIV and TB in Practice for nurses: Starting ART for treatment and prevention in people with active TB and HIV

  This article provides information for nurses on starting HIV treatment for people with HIV and active TB....

  From:  HIV & AIDS treatment in practice

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  The generic generation

  In the next few years, some of the most widely used HIV drugs will come off patent in the UK. Gus Cairns asks: what are the...

  From:  HIV treatment update

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  Treatment: what really works best?

  The new edition of the HIV treatment guidelines from the British HIV Association (BHIVA) is now out for public consultation. HTU editor Gus Cairns was one of the...

  From:  HIV treatment update

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  What do treatment as prevention study results mean for treatment?

  The findings of HPTN 052, the randomised study that recently demonstrated that providing early antiretroviral therapy (ART) to HIV positive individuals reduced transmission of the virus to their...

  From:  HIV & AIDS treatment in practice

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  HIV drug prescribing in London: changes from this month

  From April 2011, the preferred first- and second-line drug regimens for HIV-positive people in London are changing. The change in prescribing practice will not initially affect people...

  From:  HIV treatment update

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  START… and why the time is now

  Simon Collins of HIV i-Base looks at an important and exciting new study of when to start HIV therapy, which needs your help....

  From:  HIV treatment update

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  Switching from efavirenz to nevirapine in women with higher CD4 counts

  This issue provides an overview of the risks and benefits, and real-life experiences, of switching from efavirenz to nevirapine in women with higher CD4 counts,...

  From:  HIV & AIDS treatment in practice

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  Universal testing and immediate treatment could cut HIV infections by 95% in 10 years

  This issues looks at  WHO's modelling study proposing universal testing and immediate treatment could cut HIV infections by 95% in 10 years in a generalised...

  From:  HIV & AIDS treatment in practice

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  First-line antiretroviral therapy: not as simple as we'd like it to be

  This issues looks at questions surrounding first-line treatment in resource-limited settings, including use of tenofovir, monitoring requirements and when to start treatment....

  From:  HIV & AIDS treatment in practice

Starting treatment in your own words

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  A senior moment: sero-conversion late in life

  I’m a senior citizen and a gay man living with HIV. I’m not the only gay HIVer of my generation, of course, but I’m perhaps different from...

  From:In your own words

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  Starting treatment wasn't as scary as I thought!

  I started learning about HIV treatment soon after I was first diagnosed. I had ‘the chat’ with someone, after I got my results – I...

  From:In your own words

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  'I just take the tablets and get on with my life'

  I was diagnosed HIV-positive in 1997. I'm now 65. It was a bit of a shock. It could never happen to me, after all. I...

  From:In your own words

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  Starting treatment

  Following my HIV diagnosis in August 2001, my doctor estimated that I would be looking to start therapy in around six years. But following a...

  From:In your own words

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  My life with HIV

  I was born in Zambia in 1973 and came to England in April 1994 to live with my cousin to help her look after her...

  From:In your own words

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  Time will tell

  I was devastated when I got the news that I was HIV-positive. But I was lucky to have such a supportive GP. It was thanks...

  From:In your own words

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  My journey

  When I was diagnosed HIV-positive it was only a year after a serious heart operation, and I really felt my health was broken, that I’d...

  From:In your own words

Starting treatment news from aidsmap

• Self-testing and home treatment initiation triples uptake of HIV treatment in Malawi

  Offering people the opportunity to self-test at home and then start antiretroviral therapy after counselling at home, together with home delivery of antiretroviral drugs, increased the number of people linked to care after testing and started on treatment almost ...

  11 hours ago | Keith Alcorn

• In resource-rich countries, migrants have a higher risk of progressing to AIDS in the first year of HIV therapy

  Rates of AIDS-defining illnesses in the first year of antiretroviral therapy are significantly higher among migrant than non-migrant populations in resource-rich countries, investigators report in the online edition of AIDS. The difference was mainly driven by higher rates of tuberculosis ...

  01 March 2013 | Michael Carter

• Meta-analysis shows superiority of integrase inhibitors in first-line HIV therapy and benefits for people changing treatment due to resistance

  Antiretroviral combinations based on an integrase inhibitor are superior to other first-line HIV treatment regimens, according to the results of a meta-analysis published in the open access journal PLoS One. The study also showed the benefits of integrase inhibitor-containing regimens ...

  26 February 2013 | Michael Carter

• Earlier treatment in South African cohort did not increase loss to follow-up

  Implementation of South Africa’s 2011 expansion of treatment guidelines – starting antiretroviral therapy (ART) at or below 350 cells/mm3 – will not increase patient loss to follow-up, researchers report in this first study from a routine clinical setting published in ...

  21 February 2013 | Carole Leach-Lemens

• AIDS-defining illnesses, especially TB, more frequent at high CD4 counts in Africa and Asia

  Rates of death and illness remained 'substantial' even at higher CD4 cell counts among people receiving antiretroviral therapy in lower-income settings, and much greater efforts to get people onto treatment earlier will be needed to reduce this burden in people ...

  07 February 2013 | Carole Leach-Lemens

• Nigeria: Drug resistance data show merits of using tenofovir in first-line ART regimens

  People living with HIV in Nigeria, at high risk for virological failure, on a tenofovir (TDF)-based first-line regimen, had fewer nucleoside reverse transcriptase inhibitor (NRTI) drug-resistant mutations and more fully active NRTI drug options for second-line treatment, researchers report ...

  23 January 2013 | Carole Leach-Lemens

• Australian researchers project that many HIV-positive people will run out of treatment options

  Running out of antiretroviral treatment options may severely curtail the life expectancy of people with HIV in resource-rich countries, according to Australian research published in the online edition of AIDS. The research expands upon a study ...

  22 January 2013 | Michael Carter

• Out-of-clinic adherence club for delivery of ARVs shows better retention than standard of care

  An out-of-clinic model of HIV treatment delivery in South Africa has shown superior results to the standard in-clinic delivery of antiretrovirals (ARVs), according to results of an evaluation presented by Dr Gilles Van Cutsem at the Southern African ...

  03 December 2012 | Lesley Odendal

• Starting HIV therapy with a viral load above 100,000 is associated with a lower chance of achieving an undetectable viral load

  Starting HIV treatment with a viral load above 100,000 copies/ml is associated with a reduced chance of achieving an undetectable viral load within 48 weeks regardless of the combination of drugs used, according to the results of a meta-analysis ...

  28 November 2012 | Michael Carter

• Abacavir: new studies challenge the evidence of reduced potency when viral load is high

  An analysis of two studies of the new HIV integrase inhibitor dolutegravir presented at the Eleventh International Congress on Drug Therapy in HIV Infection in Glasgow had the incidental effect of bringing into question evidence from a previous study ...

  26 November 2012 | Gus Cairns

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Starting treatment news selected from other sources

• When to Start ART in Africa — An Urgent Research Priority

  We believe that a randomized, controlled trial should be undertaken immediately to determine when to initiate ART in Africa for maximal individual health benefit. It is feasible to conduct a large, simple trial to assess the risks and benefits of immediate ART versus deferral until a CD4+ count of 350 cells per cubic millimeter is reached.

  23 February 2013 | New England Journal of Medicine

• Why no one is helped by dumbing down the “when to start” debate: a response to Dr Myron Cohen

  This article was prompted by contributions to the “when to start” debate that avoid both it’s complexity and the lack of evidence for benefits at higher CD4 counts. This issue has broad concern for HIV positive people, doctors and health workers, and public health policy.

  23 February 2013 | HIV i-Base

• Updated HIV Treatment Guidelines Include Stronger Recommendation for Acute Infection

  Among the key changes are additional information about the most recently approved antiretroviral agents and a recommendation that newly infected people with HIV should be offered combination ART. The guidelines continue to recommend treatment for all people with HIV, both to reduce the risk of disease progressionand for the prevention of HIV transmission.

  15 February 2013 | HIVandHepatitis.com

• Updated U.S. DHHS guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents

  New recommendations on drug-resistance testing, genotypic tropism assays, starting treatment, acute infection, pregnancy and interactions.

  15 February 2013 | AIDSinfo

• HIV Treatment During Primary Infection Raises CD4s - and Further Questions

  Two new studies, each published in The New England Journal of Medicine (NEJM), suggest that treating HIV with antiretrovirals (ARVs) within four to six months after infection helps raise CD4 counts, but neither study was able to make an overwhelming argument for starting therapy so early.

  23 January 2013 | AIDSMeds

• BHIVA and EAGA position statement on the use of antiretroviral therapy to reduce HIV transmission: January 2013

  The UK Department of Health, in collaboration with the Expert Advisory Group on AIDS and the British HIV Association, has issued a definitive statement on the potential of antiretroviral therapy to reduce HIV infectiousness and transmission. It says that the risk of transmission from a person with a fully-suppressed viral load in the absence of STIs is "extremely low" and advises physicians to discuss this with all patients.

  22 January 2013 | Department of Health

• Early HIV drugs 'slow virus down'

  Giving a patient HIV drugs as soon as they are diagnosed could be the future of treatment, say researchers.

  17 January 2013 | BBC Health

• FDA approves prescribing information update for EDURANT® (rilpivirine)

  On December 7, 2012, FDA approved changes to the Edurant (rilpivirine) package insert. The major changes include restricting the indication to treatment-naïve adult patients with HIV-1 RNA less than or equal to 100,000 copies/mL, updating the package insert with the 96 week results from the Phase 3 trials and adding a new Warning and Precaution for hepatotoxicity.

  11 December 2012 | Janssen press release

• Antiretroviral treatment for HIV reduces food insecurity, study finds

  Can treatment with modern anti-HIV drugs help fight hunger for HIV-infected patients in Africa? Starting antiretroviral therapy for HIV reduces "food insecurity" among patients in Uganda, suggests a new study.

  06 December 2012 | Science Daily

• Nigeria: MSD Introduces New HIV Drug, Atripla

  AS part of the efforts to meet the Anti-Retroviral, ARV, drugs requirements of Nigerians living with HIV, MSD, one of the world’s healthcare leaders, weekend launched into the Nigerian market its innovative antiretroviral, ARV, drug – Atripla – a prescription medication used to treat HIV-1 infection in adults and children of at least 12 years of age.

  05 December 2012 | AllAfrica

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