Welcome to HIV Weekly, a weekly email bulletin that provides people with, or affected by, HIV a concise, plain English digest of a selection of the very latest HIV news.
This new digest puts the latest HIV news stories into their context to equip you with the knowledge to understand what the latest research might mean for your HIV treatment and care.
Information on the latest NAM treatment information resources and those produced by other key organisations such as the UK Coalition and THT are also included.
HIV Weekly is edited by Michael Carter, NAM's patient information and news editor.
There are four main sections to this week’s edition:
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Early HIV treatment: Disappearance of HIV antibodies can occur in HIV-positive people who receive HIV treatment soon after their infection with the virus. However, even when this occurs, infection with HIV has not been cleared.
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HIV treatment in children: A long-term undetectable viral load after starting HIV treatment means a better immune system. But even children with a detectable viral load can benefit from HIV treatment.
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HIV and hepatitis: Hepatitis B genotype can influence the amount of liver damage a person coinfected with HIV and hepatitis B experiences; an experimental hepatitis C protease inhibitor is to be fast-tracked through approval by US drug regulatory authorities.
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Drug interactions: Statins – drugs that lower fats in the blood – may not cause a drop in the immune system.
Early HIV treatment
There is no cure for HIV. However, potent HIV treatment can mean a much longer and healthier life.
Current UK treatment guidelines recommend that HIV treatment should be started by anyone who is ill because of HIV or who has a CD4 cell count between 200 – 250, a level which indicates that they have a considerable risk of becoming ill due to HIV in the near future.
The value of treatment at higher CD4 cell counts is less certain. Some researchers think that the short-term use of anti-HIV treatment soon after a person becomes infected with the virus may offer a unique opportunity to achieve long-term control of HIV. There have even been case reports of people losing their HIV antibodies and consequently prompting press reports that they have been “cured” of HIV.
Doctors in San Francisco conducted a study involving 87 people who had their HIV infection identified in the very earliest stage (often called the acute stage) and started anti-HIV treatment.
HIV antibody tests were conducted when people were first identified and again after 48 weeks of anti-HIV treatment. Twelve people did not have HIV antibodies (their HIV infection was initially diagnosed using viral load testing) at the start of the study. However, after 48 weeks, all but one had developed antibodies to HIV.
Five people who had HIV antibodies to start with lost them after taking HIV treatment. Four of these people decided to stop taking HIV treatment, but in each case HIV viral load increased and HIV antibodies reappeared.HIV treatment in children
The course of HIV infection in children can be much faster than that seen in adults. In addition, special care is needed when interpreting key tests to monitor the immune systems of HIV-positive children.
Anti-HIV treatment can mean that HIV-positive children live longer and healthier lives.
However, less is known about treatment in children and making sure that children have good adherence to their HIV treatment. Taking it at the right time and in the right way can be difficult.
Doctors wanted to see if long term changes in the strength the immune systems (as measured by CD4 cell percentage) of children taking anti-HIV treatment were associated with a constantly undetectable viral load. They found that children who always had an undetectable viral load had higher CD4 cell percentages than children who never had an undetectable viral load or only had one some of the time.
Nevertheless, treatment was very valuable for children who had a detectable viral load. The strength of the immune systems improved and the disease progression rate was very low.
The researchers found that children who always had an undetectable viral load were much more likely to take their treatment properly.
HIV and hepatitis
The infections hepatitis B virus and hepatitis C virus are now major causes of illness and even death in HIV-positive people.Drug side-effects
Anti-HIV treatment can have side-effects. These can include an increase in blood fats which can increase the long-term risk of heart disease, diabetes and stroke.
Lifestyle changes, such as alterations in diet, stopping smoking and regular exercise can all help lower blood fats.
Drugs called statins and fibrates can also lower blood fats. However, some doctors have expressed concerns about the safety of statins in HIV-positive people pointing to evidence that they might prevent CD4 cell count from increasing.
A small Italian study has found, however, that CD4 cell counts were comparable between people given statins, fibrates or advice about diet or exercise to control their high blood fats.
However, the study only included 267 people so confirmatory studies would be needed involving more people.