Christmas and New Year
Don't forget that HIV clinics and other services may be closed over the Christmas and New Year period.
If you know you will need more supplies of medication or want to talk to someone at your clinic, it's a good idea to get in touch with them now.
Read the NAM factsheet on Christmas services.
NAM wishes all its readers a merry Christmas and a happy and healthy 2013.
There will be no HIV Weekly on 26 December or 2 January.
We'd like to say a big thank you to everyone who has supported us this year. Visit our website to read more about how your support makes a difference.
HIV and cardiovascular disease
Research conducted in the United States has shown that the early warning signs of cardiovascular disease (CVD, or heart disease) in people with HIV are more strongly associated with traditional risk factors, such as smoking or high cholesterol, than HIV-related factors or the damage the virus can cause.
HIV is associated with an increased risk of cardiovascular disease. The exact reasons for this aren’t known for certain. However, it’s thought that a number of factors are important, including traditional CVD risk factors, the inflammation caused by untreated HIV infection, and the side-effects of some anti-HIV drugs.
The latest research involved 331 people who were about to start HIV treatment. They had ultrasound examinations to monitor the health of their arteries. None of the participants had a history of cardiovascular disease or diabetes. However, 60% had a history of smoking.
Results showed that damage to the arteries was associated with well-known risk factors such as older age, smoking and higher levels of blood fats and sugars.
There was no evidence that HIV-related factors such as a low CD4 cell count or a high viral load increased the risk of vascular damage, and there was little evidence of an association with the inflammatory effects of HIV.
The researchers believe their findings show the importance of encouraging HIV-positive people to make lifestyle changes, such as eating a healthy, balanced diet, exercising regularly, and stopping smoking, to lower their risk of cardiovascular disease.
For more news and features on cardiovascular disease, visit the topics pages of our website.
HIV and hepatitis
Many people with HIV are co-infected with hepatitis B or hepatitis C. Liver disease caused by viral hepatitis is now an important cause of death in co-infected people.
Infection with hepatitis B or C increases the risk of liver cancer, especially a form called hepatocellular carcinoma.
Their study involved patients who developed liver cancer between 2003 and 2010. They were matched with HIV-negative patients who also developed liver cancer and their characteristics were compared.
The people with HIV developed cancer at an earlier age (46 vs 58 years).
Comparison between HIV-positive and HIV-negative people with hepatitis C who were diagnosed with cancer showed that those with HIV were less likely to have undergone a course of treatment for hepatitis C (44 vs 77%).
Six co-infected people were candidates for a liver transplant, but only three individuals underwent the procedure.
The 24-month survival was poorer for people with HIV, especially if they were co-infected with hepatitis B.
The researchers believe that their results show the importance of careful monitoring for the early signs of liver cancer during routine HIV care.
HIV treatment during pregnancy
With the right treatment and care, the risk of an HIV-positive mother passing on HIV to her baby is very low. For women on effective HIV treatment and who have an undetectable viral load it is reduced to 0.1%.
Combination HIV therapy is recommended for the duration of pregnancy for women who need it for their own health.
This treatment is essential to protect the health of both the mother and her unborn child. Some research has suggested that it can increase the risk of having either a premature delivery, or a baby with a low birth weight. However, the benefits of HIV treatment outweigh the potential risks in this situation.
US researchers looked at rates of pre-term delivery among 1869 infants of 1506 HIV-positive mothers. None of the infants were infected with HIV.
Overall, 19% of babies were born pre-term (before the end of week 36 of pregnancy), and 55% of these premature births were spontaneous.
Most of the mothers (89%) took HIV treatment during pregnancy, with 40% treated during the first trimester.
The researchers found that taking antiretroviral therapy based on a protease inhibitor during the first trimester increased the risk of having a premature delivery by approximately 50%. They didn’t find an association between these drugs and birth weight.
Individual protease inhibitors associated with a pre-term birth were saquinavir (Invirase), ritonavir (Norvir) and lopinavir/ritonavir (Kaletra).
“The mechanism of first trimester effect is unclear but could be related to changes in immune and inflammatory mediators,” the researchers conclude. “Further studies are needed to elucidate the specific drug effects and the interaction of the many factors that determine pregnancy outcome.”
You can read the recommendations for HIV treatment during pregnancy on the BHIVA website. Find out more about preventing mother-to-child transmission by visiting our topics pages.
Editors' picks from other sources
Dr Steve Taylor: How HIV Stigma Still Kills
from Huffington Post UK
A quarter of those with HIV in the UK are entirely unaware of their status, and it's in large part because people are scared to take the simple test that could allay their fears or get them on life-saving treatment. People are still dying of HIV - and it's because stigma is preventing us diagnosing them in time.
We never thought we could get HIV. We were wrong.
from Daily Mail
Rachel Dilly, 48, contracted HIV after unprotected sex with a new partner. A further seven heterosexual British women have spoken out about their condition for a photographic exhibition.
HIV11: Lipid Levels Are Higher among HIV+ People on ART, Immune Suppression May Play a Role
from HIVandhepatitis.com
People with HIV on suppressive antiretroviral therapy (ART) have "considerably higher" blood lipid levels relative to untreated individuals or those on less effective treatment, researchers reported at the 11th International Congress on Drug Therapy in HIV Infection (HIV11) last month in Glasgow. They also found that greater immune deficiency, as indicated by lowest-ever CD4 count, was associated with lipid elevations.
Brighton university cancels screening of AIDS denialist film
from Pink News
The University of Brighton has cancelled the screening of a film which claims the HIV virus does not cause AIDS after a student backlash.
UK team receives funding to develop HIV detection device
from The Engineer
A British team is developing a handheld device for detecting HIV in the early stages of infection. The researchers claim that this will combine the speed of existing point-of-care testing devices.
New NICE public health guidance aims to ensure more people at increased risk of hepatitis B and C infection are tested
from NICE
New guidance published today (12 December) by healthcare guidance body NICE highlights the need to tackle ignorance about the risk factors and causes of hepatitis B and C, and misconceptions about its treatment if barriers to effective testing of those at increased risk of infection are to be overcome.
Six Promising HIV Drugs in the Pipeline
from The Body Pro
What new HIV medications do we have to look forward to over the next few years? How will these newer drugs improve upon the older ones? To shed some light on these questions, Roy Gulick, M.D., provided an overview at ID Week 2012 of drugs in development.