HIV and swine flu

There was a lot of concern last year about swine flu (H1N1). People with serious underlying health conditions – including those caused by immune suppression – seemed to be more likely to develop complications when they contracted swine flu. Therefore people with HIV were recommended to be vaccinated against swine flu.

Now Spanish investigators have published a study showing that the consequences of swine flu were no more serious for people with HIV than for HIV-negative patients.

The researchers reviewed the medical records of 585 patients who were admitted to hospital because of swine flu. Twenty-six  of these people were HIV-positive.

Most of the HIV-positive patients were taking HIV treatment. Their average CD4 cell count was over 500 and 84% had an undetectable viral load.

There were no differences in the types of swine flu symptoms between the HIV-positive and HIV-negative patients.

Both groups of individuals started to get better two-and-a-half days after they were admitted to hospital, and there was no difference in the length of their stay in hospital.

Similar rates of complications were seen in the two groups of patients. Three of the HIV-negative patients died, but all the HIV-positive patients made a full recovery.

The researchers describe these results as “remarkable”.

CD4 cell count and Kaposi’s sarcoma

Rates of the AIDS-defining cancer, Kaposi’s sarcoma, fell dramatically after the introduction of effective HIV treatment, US research has shown.

But the same study showed that the cancer is now being found more frequently at higher CD4 cell counts. The researchers think that is another reason why patients should start HIV treatment promptly.

Researchers from the US military looked at rates of Kaposi’s sarcoma in HIV-positive military personal between 1985 and 2008.

Compared to the period before 1990, those receiving care after 2002 had a 72% reduction in their risk of developing the cancer.

However, Kaposi’s sarcoma appeared to be occurring at higher CD4 cell counts. Before 1990, only 18% of patients had a CD4 cell count above 350 when the cancer developed. However, after 2002 this had increased to 35%.

Nevertheless, the researchers found that a higher CD4 cell count reduced the risk of the cancer.

In addition, patients with a CD4 cell count below 350 were about eight times more likely to develop Kaposi’s sarcoma than those with a CD4 cell count above this level.

The researchers found some evidence that, among patients with a CD4 cell count above 350, those taking HIV treatment were less likely to be diagnosed with the cancer.

HIV and kidney problems

Few HIV-positive patients in Europe have end-stage kidney disease, researchers have found.

Over 60,000 patients were included in the study, but just 122 patients had kidney disease that was so serious it required dialysis or a transplant.

Nearly all the patients were taking HIV treatment, 88% had a viral load below 500 copies/ml, and average CD4 cell count was around 350.

Most of the patients with serious kidney problems were men, and the majority were of black race.

HIV-related kidney disease was the biggest single cause of serious renal problems.

A total of 26 patients had had a kidney transplant. Eight of these had experienced organ rejection, but all the patients were still alive.