Abacavir and high viral load

Abacavir (Ziagen) showed itself to be just as effective as tenofovir (Viread) in patients starting HIV treatment in the UK with a high viral load.

(Abacavir is also in the combination pills Kivexa  and Trizivir  and tenofovir is also in the combination pills Truvada   and Atripla .)

UK researchers compared changes in viral load in people starting triple-drug HIV treatment that included abacavir or tenofovir. They found that falls in viral load were similar in the patients taking both drugs. Furthermore, between six months and a year after starting HIV treatment, equal proportions of people taking these drugs had an undetectable viral load. It didn’t matter what a person’s viral load was when they started treatment.

The findings of this study contradict those of earlier US research that showed patients with a viral load above 100,000 who started HIV treatment with abacavir were less likely to achieve an undetectable viral load than those starting treatment that included tenofovir.

Because of this preceding research, British HIV treatment guidelines say that abacavir may not be a good option for people who have a high viral load when they start HIV treatment. The latest research contradicts this and it will be interesting to see if future studies have similar findings.

For more information on starting treatment, you may find our information booklets useful. They are available free to people with HIV in the UK , as well as on our website .

More evidence of changing causes of death in people with HIV

The amount of illness and death in people with HIV fell dramatically when effective HIV treatment became available in 1996.

There have been further improvements in life-expectancy since then because HIV treatment and care has become even better. In fact, doctors are now hopeful that many people with HIV will live a near-normal lifespan.

Researchers have also noticed a change in the illnesses causing death in people with HIV. Before 1996 the main causes of death in people with HIV were AIDS-defining illnesses.

But several studies have shown that these are now causing less death and that diseases that are not considered to be related to immune damage, such as heart, kidney and liver disease, as well as certain cancers, are increasingly important causes of death.

Now research conducted in Rio de Janeiro has shown that between 1999 and 2006 non-AIDS-related diseases were the main cause of death in people with HIV.

The most important causes of death were infectious diseases, followed by accident or violence, and cardiovascular disease.

Starting HIV treatment when your CD4 cell count is around 350 reduces your risk of becoming ill with both HIV and non-HIV-related serious illnesses.

Stigma and access to HIV care

People who feel stigmatised because they have HIV don’t go to their clinic as often as they should, American researchers have found.

The study showed that 77% of people had poor access to healthcare and 43% didn’t take their HIV treatment properly.

People who reported feeling stigmatised were much less likely to visit their HIV clinic regularly than people who did not report feelings of stigma.

The research also showed that poor mental health was associated with not taking HIV treatment properly.

NAM produces booklets on HIV & Stigma and HIV & Mental Health. They are available free to people with HIV in the UK , as well as on our website and through HIV clinics and organisations in the UK.

Support NAM’s work

On Saturday 1st August, three of NAM’s bravest staff - Tom (our Web Developer), Kieran (our Graphic Designer) and Caspar (our Director) -teamed up and took on the London Triathlon Team Relay Challenge.

These guys really went the extra mile (or even 50km and a dip in the Thames!) to raise money for NAM.

Please help us to raise vital funds to support NAM’s work by donating today at www.aidsmap.com/triathlon.

NAM works hard to support people living with HIV with clear, up-to-date and impartial information resources – resources just like www.aidsmap.com and HIV Weekly. The donations we receive from individuals play a vital role in making sure this work continues.

Read more and see the pictures of the day here.