HIV services in the UK – future plans
Funding and co-ordination of HIV testing, treatment and care services may remain at a national level, new NHS plans reveal.
The Conservative-Liberal Democrat coalition government is planning some big changes to the NHS. This includes GPs being given more power to decide how funding is spent and on which services.
However, it has now been proposed that the funding and co-ordination of HIV medicine could continue to be organised on a national level. HIV organisations welcomed this.
A range of sexual health services may be planned and funded locally by local authorities, as part of their public health budget.
These proposals are open for consultation. You can read the full story on our website, which also contains links to the proposal documents.
Flu vaccination – effective and recommended for people with HIV
People with HIV are one of the groups recommended to have an annual flu jab. Swine flu (also called H1N1 flu) hasn’t gone away, and H1N1 is included in the flu vaccine being given to patients this winter.
Vaccination produced protective antibodies against flu – but there was some evidence that better levels of protection were provided when patients had an additional dose of the vaccine.
Receiving the vaccine had ‘real world’ benefits – rates of flu were much lower among patients who had a flu jab than those who didn’t.
In addition, flu vaccination didn’t reduce CD4 cell count or increase viral load.
Researchers therefore concluded that recommendations that patients with HIV should be vaccinated against flu are “justified” and they strongly recommend that patients should seek vaccination.
In the UK flu jabs are available from GPs. HIV clinics can provide advice on dealing with swine flu and being vaccinated.
The NHS Choices website provides a searchable database of GPs.
HIV treatment – tests to predict side-effects
Testing for specific genes could reduce the risk of side-effects for some patients taking HIV treatment, new research suggests.
Like any medicine, the drugs used to treat HIV can cause side-effects.
It’s already known that a gene is associated with an allergic reaction to the drug abacavir (Ziagen, also in the combination pills Kivexa and Trizivir). Patients should be tested for this gene before they start treatment with the drug. If you are tested and your result is positive, you shouldn’t take abacavir.
Now researchers have found that some genes increase the risk of side-effects caused by other anti-HIV drugs.
They tested 577 patients starting HIV treatment for the first time to see if they had variations in particular genes that could be associated with certain side-effects. These were mood and sleep problems caused by efavirenz (Sustiva, also in the combination pill Atripla) and a non-dangerous yellowing of the skin and eyes caused by atazanavir (Reyataz).
For patients taking efavirenz, the presence of a specific genetic make-up increased the risk of mood and sleep problems three-fold. The risk of atazanavir-related side-effects was increased nine-fold.
The researchers called for more research into the questions raised by their study.
For more information on the side-effects of HIV treatment, you can read our Side-effects booklet on our website.
Copies of this booklet are available free to clinics and organisations in the UK – contact us on 020 7837 6988 or info@nam.org.uk.
For more information on genetics and HIV treatment, visit our website.
HIV and cardiovascular health
Because HIV treatment is now so effective, many people with the virus can expect to live a long life.
However, there’s evidence that people with HIV have an increased risk of developing cardiovascular disease.
Now researchers have found that about two-thirds of patients have asymptomatic abnormalities in the function or structure of their heart, a much higher rate than would be detected in the general population.
Their research involved 656 patients who had the health of their heart monitored using echocardiography.
Factors associated with heart irregularities were often modifiable, and included smoking and being overweight.
Cardiovascular health should be monitored as part of your routine care, and the researchers conclude that patients should be supported so they can change their lifestyle to reduce their risk of cardiovascular illness.
Visit our free online archive for feature articles on giving up smoking and exercise and HIV.
HIV and pregnancy – outcomes and circumstances among teenagers in London
Mother-to-baby transmission of HIV is rare among HIV-positive teenagers in London, new research has shown.
The study looked at 58 HIV-positive teenagers who had 67 pregnancies. There were 66 live births, and only one baby was infected with HIV. This was probably because the mother’s HIV was diagnosed late.
But the research showed that many of the young women were coping with very difficult circumstances, and many had housing and money problems. In addition, only a minority were using condoms and 25% had a repeat pregnancy within a year of delivery.
HIV-positive pregnant women should be able to access a range of support and advice, and specialist health care is often provided by a team that includes an HIV doctor, a paediatrician, an obstetrician and a specialist midwife.
However, the researchers think that their study showed young people may need some additional support as well – especially concerning their sexual and reproductive health.
A feature article written by an HIV specialist midwife in the UK, Happy Families, is now available on our website. This feature first appeared in HIV treatment update.