HIV treatment – treatment guidelines
HIV treatment is a very complex and fast-moving area of medicine. Guidelines are set by leading clinicians to ensure that doctors and patients make the best use of the available treatments.
Both European and US treatment guidelines have just been updated.
HIV and ageing
Effective HIV treatment means that people with HIV are living longer. Last week, a UK study showed that people who start HIV treatment when their CD4 cell count is around 350 can expect to live well into their 70s.
But ageing is associated with a number of illnesses – cardiovascular disease, kidney problems, neurocognitive impairment, bone disease and some cancers. There is also concern that the effects of HIV and the side-effects of some anti-HIV drugs could mean that people with HIV develop diseases of ageing earlier.
Several studies published in the last few weeks have provided further insights into this important issue.
HIV and hepatitis C
Current treatment for hepatitis C consists of pegylated interferon and ribavirin. It doesn’t always work, and can cause unpleasant side-effects.
There’s therefore a need for new anti-hepatitis C drugs. One of these is the protease inhibitor boceprevir (Victrelis). It has achieved good results in people who only have hepatitis C. Its safety and effectiveness are now being monitored in a clinical trial involving patients co-infected with HIV and hepatitis C.
Interim results from the study are now available. After 24 weeks, 70% of people taking boceprevir combined with pegylated interferon and ribavirin had an undetectable hepatitis C viral load, compared to 34% of people taking pegylated interferon and ribavirin with a placebo.
Some side-effects were more common in the people taking boceprevir compared to the placebo. These included neutropenia (low white blood cell count), unpleasant taste, vomiting, fever, headache, and poor appetite. However, rates of serious side-effects were lower in the boceprevir arm compared to the placebo arm (8 vs 21%).
Full results from the study are expected next year.