HIV care
Frequent check-ups are an important part of HIV care. These allow you and your doctor to monitor how HIV is affecting your health.
Blood tests form an important part of this. Two key tests are CD4 cell count and viral load. CD4 cell counts are used to monitor the health of your immune system. A viral load test shows how active HIV is in your body.
The frequency of monitoring varies between individuals, but most people will need to go to their clinic for a check-up every three to four months, and usually no less than twice a year.
However, the latest US research showed that only 45% of HIV-positive people were receiving regular medical monitoring.
The study included over 100,000 people. Results showed that 55% of patients were not receiving the minimum standard of care outlined in US treatment guidelines – two CD4/viral load tests, at least three months apart, over a year.
The researchers also found that a third of people in the study were not being linked to care within a year of their diagnosis with HIV.
These are worrying findings. It’s known that people who don’t have regular monitoring have an increased risk of HIV disease progression. A major reason for this is likely to be because they aren’t taking HIV treatment.
This also has implications for the use of HIV treatment as prevention.
In the UK, nearly all HIV care is provided through specialist clinics. If you are entitled to NHS care then all your HIV treatment and care will be free.
Lost touch with your clinic and worried about going back? Chances are they’ll be pleased you’ve got back in touch. Why not call them up, make an appointment and spend some time preparing before you go? Our Talking points tool is designed to help you prepare for appointments with your healthcare team.
Vitamin D
A study suggests that vitamin D supplements may have benefits for the bone metabolism of younger people taking HIV treatment combinations that include tenofovir (Viread, also in the combination pills Truvada, Atripla and Eviplera).
Thinning of the bones is now a well-recognised complication of HIV infection.
The exact causes are uncertain. However, they could include the direct effects of infection with HIV as well as the side-effects of some anti-HIV drugs, especially tenofovir. Vitamin D also plays an important role in bone metabolism, and many HIV-positive people have low levels of this vitamin. Once again, the reasons for this aren’t known for sure.
The impact of tenofovir on bone metabolism could be because of its impact on a parathyroid hormone – this plays an important role in bone formation.
Research conducted in HIV-negative people showed that treatment with vitamin D supplements had a beneficial impact on this hormone.
US researchers therefore designed a study involving approximately 200 HIV-positive 18 to 25 year olds. Half were randomised to receive vitamin D supplements, with the other group taking a matching placebo.
Results showed that people treated with vitamin D who were taking tenofovir had significant improvements in levels of parathyroid hormone. The supplement did not have this benefit for people taking other anti-HIV drugs.
The study only lasted twelve weeks, so the researchers were unable to say if the vitamin D supplement had any long-term benefits. The researchers therefore suggest that further studies are needed.
If you’re generally in good health and want to guard against bone loss, there are several steps you can take – eating a balanced diet, stopping smoking, not drinking too much alcohol, and taking exercise, particularly weight-bearing exercise such as running, walking, weight-training or aerobics. For more information see Skeleton key from the HIV treatment update archive.