CD4 counts only need to be done once a year
Annual CD4 count tests may be enough for people taking HIV treatment who have a suppressed viral load and a CD4 count above 250 cells/mm3, according to a new study. It showed that people in this situation had a very low risk of experiencing a drop in their CD4 count below 200 cells/mm3 or of developing a serious HIV-related illness.
The CD4 count is one of the key tests for people living with HIV. A consideration of the CD4 count is crucial in monitoring health before beginning HIV treatment and in making a decision about when to start it.
In contrast, when a person is taking HIV treatment, the viral load test is more important in monitoring health.
So how often should people taking treatment have their CD4 count monitored? Current UK guidelines suggests every six months, whereas American guidelines recommend every twelve months.
Researchers examined data on around 1500 people in twelve Asian countries. At the beginning of the four-year study, all had an undetectable viral load, a CD4 count above 200 cells/mm3 and were taking combination therapy.
Each year, fewer than 1% of participants saw their CD4 count drop to dangerous levels (below 200 cells/mm3). And only 0.5% had a serious HIV-related illness.
These rates were no different in those who had their CD4 count tested every six months, or every twelve months. In other words, more frequent CD4 counts did not help people stay in better health.
The researchers say there are two main benefits to less frequent CD4 counts. Firstly, the approach is less expensive. Secondly, some people with HIV become unnecessarily anxious when they see fluctuations in their CD4 count. Usually, the level returns to normal at the next test.
To find out more about CD4 counts, you can read our booklet ‘CD4, viral load & other tests’.
Insulin resistance, hepatitis C and cannabis
Insulin resistance means that the body is unable to use the hormone insulin and is unable to convert glucose in the bloodstream into energy. Insulin resistance can lead to type 2 diabetes.
There are high rates of insulin resistance and diabetes in people living with hepatitis C and also in people living with HIV. Not getting much exercise, being overweight and having an unhealthy diet increase the risk of developing diabetes
Now a study has shown that people who use cannabis have a lower risk of insulin resistance.
Researchers followed around 700 people with HIV and hepatitis C co-infection for up to five years. Just under half smoked or used cannabis and these individuals had a lower risk of developing insulin resistance, regardless of how often they used cannabis.
This may be due to the way in which the substances present in cannabis (cannabinoids) affect metabolism. The researchers say that forms of medical cannabis, such as pills or vaporisers, could be tested in clinical research.
Opioid substitution treatment boosts adherence
Opioid substitution treatment involves giving people who are addicted to heroin or other drugs alternative substances, such as methadone and buprenorphine. These relieve cravings for heroin, allow the person to avoid using heroin and to stop injecting. The treatment can help people have a more stable life and link them with healthcare.
The researchers looked at adherence rates in around 1800 people living with HIV who injected drugs over a five-year period. Around half the participants had used opioid substitution treatment at least once.
Adherence to HIV treatment was 68% better when individuals were receiving opioid substitution treatment.
Editors' picks from other sources
HIV and the general election – what we should be talking about
from NAT press release
The National AIDS Trust and HIV Scotland have joined together to identify the key priorities for the new Parliament which will reduce HIV transmission and improve the lives of people living with HIV across the UK.
We asked foreign-born British HIV patients about Nigel Farage's 'health tourist' comments
from Vice
Has Nigel Farage got a point? Can a few thousand foreign-born HIV patients be held responsible for the NHS's financial black hole? I went to meet some of these HIV-positive "health tourists" to find out how their holidays are going and ask whether it would be cheaper for everyone if they just went somewhere and died.
Nicola Sturgeon signs open letter condemning Farage over HIV comments
from BuzzFeed
The leaders of the SNP, the Green Party, and Plaid Cymru have signed an open letter organised by ACT UP London disputing claims made by Nigel Farage about HIV-positive immigrants.
Second parliamentary candidate reveals he is HIV-positive and accuses Farage of scaremongering
from Buzzfeed
The Liberal Democrat parliamentary candidate for Liverpool Riverside has told BuzzFeed News that he has been living with HIV for three years and is disgusted with Nigel Farage’s comments about the condition.
Six questions about HIV that deserve more attention
from Eurekalert Inf Dis
As HIV investigators work to control and eradicate the virus worldwide, certain myths or misconceptions about the disease have been embraced, whereas other concepts with merit have been left relatively unexplored, argues American HIV researcher Jay Levy, in a Trends in Molecular Medicine commentary. He calls on fellow researchers to continue questioning and not to lose sight of alternative strategies that could ultimately lead to a sustainable, long-term solution to HIV infection.