Viral load and heart disease
There are higher rates of cardiovascular diseases like heart attack and stroke in people with HIV than in the general population.
A number of reasons have been suggested for this. It had been thought that HIV treatment was a cause. This is because some anti-HIV drugs can increase levels of blood fats.
However, it is now known that HIV-positive people who aren’t taking HIV treatment are more likely to have a heart attack than people who are taking anti-HIV drugs. This is because of the inflammation that HIV itself can cause.
The research involved people taking part in a treatment interruption study. Some people were taking their HIV treatment all the time, and others interrupted their treatment.
The researchers looked for subtle changes in the chemistry of the blood that can be a warning sign that a person has an increased risk of heart disease and they examined whether these were related to viral load.
In people taking and interrupting HIV treatment viral load was associated with inflammatory markers linked to an increased risk of heart disease.
It is currently recommended that HIV treatment should be started when your CD4 cell count is around 350. Starting treatment at this time reduces the risk of developing HIV-related illnesses as well as other health problems. The goal of HIV treatment is an undetectable viral load, and thanks to the availability of new, more powerful anti-HIV drugs, most people are able to achieve this outcome.Testosterone treatment for HIV-positive women – safe and effective
Testosterone is usually thought of as the male hormone, but it’s also present in women.
Many HIV-positive women have low levels of testosterone and this can lead to health problems, including reduced lean body mass, bone problems, and low mood.
It’s already known that taking testosterone in the short-term can lead to an improvement in these problems in HIV-positive women, without risking side-effects such as changes in hair patterns, acne, and alterations in the menstrual cycle.
The small study involved 25 HIV-positive women. They were divided into two groups, to take a low dose of testosterone or to take a placebo. The study lasted for 18 months and the researchers monitored levels of testosterone, body weight and lean body mass, and quality of life issues, for example depression and sexual function. They also monitored the women to see if the testosterone treatment was safe.
They found that the women who took testosterone experienced gains in their lean body mass and bone density. These all remained unchanged or became worse in women taking the placebo. What’s more, women taking testosterone reported less depression and fewer problems with sexual function. Women taking testosterone did not experience changes to hair patterns or menstrual cycles and were not at a greater risk of developing acne.
HIV treatment during pregnancy and development of the baby
HIV treatment taken during pregnancy can help reduce the risk of a mother passing on HIV to her baby to very low levels.
There has been some concern, however, that triple-drug HIV treatment taken during pregnancy, especially if it involves a protease inhibitor, could increase the risk of having a baby with a low birth weight.
But French researchers have found that this isn’t the case.
They looked at the weight of babies born to HIV-positive mothers between 1990 and 2006.
The type of HIV treatment used during pregnancy changed considerably over this period, from AZT by itself to triple-drug therapy after 2004.
Their first set of analysis showed that the average birth weight of babies did fall by about 100g.
But they also found that after 1996, babies were born about a week earlier, during the 38th week of pregnancy.
When they took this into account, they found that triple-drug HIV treatment was not associated with having a low weight baby.
Nor did the researchers find any evidence that the time HIV treatment was started during pregnancy, the duration of HIV treatment, or the type of HIV treatment taken increased the risk of having a low weight baby.
Sexual problems in gay men with HIV
Roughly 50% of HIV-positive gay men have multiple sexual problems, Australian researchers have found.
They conducted a study involving approximately 550 gay men. A total of 40% of these men were HIV-positive.
Men with HIV were much more likely than HIV-negative men to report a range of sexual problems, for example difficulty obtaining and maintaining an erection; premature or delayed ejaculation; loss of sexual desire; lack of pleasure from sex; anxiety over sexual performance; and pain during sex.
Overall 81% of HIV-positive gay men reported a single sexual problem (compared to 67% of HIV-negative men). Furthermore, 48% of men with HIV reported multiple problems (compared to a third of HIV-negative men).
Depression was associated with sexual problems for gay men regardless of their HIV status.
The researchers also found that taking antidepressants, poor coping strategies, and unprotected sex with casual partners were all associated with sexual problems for HIV-positive men.