Making the most of 2011
Welcome to the first HIV Weekly of 2011!
The Christmas and New Year holidays are over, and some of us are feeling the effects.
NAM’s information is available to help you recover from any mid-winter excesses – and to look after your health throughout 2011.
You may have put on weight over Christmas, or you may have decided that you want to improve your fitness this year. If so, information on starting and sustaining an exercise programme could be useful, and there’s some general information on the benefits of exercise and how to exercise safely here.
The idea of going on a diet is popular at this time of year. ‘Crash’ diets, and those involving very specific regimes, rarely lead to long-lasting reductions in weight, and can mean that you don’t get enough of some important nutrients. So it’s good sense to try to eat a good balanced diet, with a lot of fruit and vegetables and not too much fat. You can find some useful information on nutrition here, or in NAM’s patient information booklet Nutrition.
It can be easy to drink too much at Christmas, and drug use may be more common over the festive period as well. You can find out more about alcohol, safe drinking levels and advice and support available here. There’s also information, advice and support on drug use here, and information on reducing the risks associated with drug use here. If you’re worried about your use of alcohol or drugs, a good place to ask for help is your HIV clinic.
A lot of people spend more than they can afford at Christmas and the New Year and money worries are a major cause of the January blues. You’ll find some useful information on managing finances and dealing with debt here.
You may be experiencing the January blues for other reasons. Click here for information about looking after your mental health, or read our patient information booklet HIV, mental health and emotional wellbeing.
Not smoking has big benefits for your health, and there’s a lot of support available if you’re trying to quit. Again, talking to staff at your HIV clinic is a good place to start. You can read more about smoking, and giving up, in Off the hook: Smoking and how to give it up, an HIV Treatment Update feature article now available on aidsmap.
With the right treatment and care, many people with HIV can expect to live a near-normal lifespan. Throughout 2011, you’ll find reports on the most important news on HIV – and what it means for you – in HIV Weekly.
HIV treatment and undetectable viral load
The aim of HIV treatment is an undetectable viral load. This means that the tests used in routine HIV care cannot find any HIV in the blood. (This doesn’t necessarily mean that there’s no virus in your blood – these tests have a lower limit of detection of 40 or 50 ‘copies’ of HIV.)
Now researchers have found that people who are taking an HIV treatment combination that includes nevirapine (Viramune) are more likely to have a viral load of zero than those taking a combination based on efavirenz (Sustiva, also in the combination pill Atripla).
The research involved 165 patients, 75 of whom were taking nevirapine.
Overall, 81% of those taking nevirapine had a viral load of zero, compared to 55% of patients treated with efavirenz. The researchers think that nevirapine is better at reaching reservoirs of HIV in the internal organs.
It’s currently unclear if there are any benefits of having a viral load of zero. However, it’s known that even low levels of HIV can cause inflammation and that this can increase the risk of some serious illnesses, for example cardiovascular disease and some cancers.
HIV care – cancer screening
Cancer is a significant cause of death in people with HIV, but US researchers suggest that many of these may be preventable with better screening.
A low CD4 cell count, detectable viral load, late diagnosis of cancer, and not receiving cancer treatment were all associated with an increased risk of death.
Their research involved almost 21,000 patients who received HIV care across the US between 1996 and 2009.
Approximately 1500 patients were diagnosed with cancer. A total of 305 patients died.
But the researchers think that the risk of death from cancer may be reduced with some changes to screening and treatment for people with HIV.
“Our results support earlier initiation of combination antiretroviral therapy and aggressive cancer screening and treatment practices to maintain immunological function, obtain optimal viral suppression, control viral co-infections, detect cancer at an earlier stage, and provide appropriate cancer therapies,” they conclude.