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Treatments & health news from CROI 2016

Researchers presented promising news on a range of HIV-related health conditions at the recent Conference on Retroviruses and Opportunistic Infections (CROI 2016).

Injectable treatments

32 week results from LATTE study of cabotegravir and rilpivirine found that injected treatment was as effective as oral treatment, with a low rate of serious adverse effects, and acceptable to trial participants.

309 people were randomised to receive injections once every 4-8 weeks or remain on their oral therapy. Follow up will continue to 96 weeks and larger studies are planned.

More info: Long-acting injectable cabotegravir + rilpivirine works well as HIV maintenance therapy (AIDSMap)

Cancer

Analysis of cancer rates in the START study provide yet more evidence for the health benefits of early treatment.

The cancer risk for people on the early treatment arm of this trial was reduced by by 75% for infection-related cancers (such as cervical or anal cancer or Epstein-Barr virus). The rate of non-infectious cancers was halved.

Source: Early antiretroviral therapy reduces the risk of infection-related cancers (AIDSMap)

Neurological health

Individualised therapy is the way forward for some cases of neurological disease among people with HIV, suggested several researchers at a symposium on brain health.

The use of biomarkers, such as those for inflammation in cerebrospinal fluid, and brain imaging technologies will help clinicians determine the source of neurocognitive impairment and tailor treatments for the individual.

More info: HIV in the brain: new tools and treatment to keep your mind beautiful (AIDSMap)

In a small, placebo-controlled clinical trial, Johns Hopkins physicians report that the antidepressant paroxetine modestly improves decision-making and reaction time, and suppresses inflammation in people with HIV-associated cognitive impairment.

The researchers say they believe this is the first time that a SSRI (selective serotonin reuptake inhibitor) has been shown to improve key measures of cognition in people with HIV in a controlled study.

Source: Antidepressant May Improve Cognitive Symptoms in People with HIV (Johns Hopkins Media release)

Cardiovascular disease

Findings from a sub-study of the START trial support earlier studies suggesting that early treatment does not reduce the risk of heart disease.

The study looked specifically at the elasticity of major artery walls - loss of elasticity is an early warning of heart disease. The investigators did not find any evidence for a decline in elasticity among those on the early treatment arm, after controlling for other contributors for heart disease (such as smoking).

More info: Early antiretroviral therapy has no impact on marker of early cardiovascular disease (AIDSMap)

Bone health

Analysis of bone health risk factors in the EuroSIDA cohort confirmed the association between fractures and use of tenofovir, although it does not appear that the risk increases with prolonged use. This may because the bone mineral loss only occurs in the first year.

Zoledronic acid, a drug used to treat osteoporosis and bone-related cancer, has been shown to help reduce bone loss among people with HIV by up to 74%, in a small US trial. The drug was administered as a single infusion to people starting treatment for the first time.

The 63 trial participants were followed up for 48 weeks. Those on the arm receiving Zoledronic acid showed no serious side effects and similar rates of viral suppression to those not receiving it. The researchers called for a larger trial to confirm these promising findings.

More info: Tenofovir treatment raises the risk of broken bones (AIDSMap)

 

 

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This page was published on 26 February, 2016