HIV and cancer

HIV and diabetes

Diabetes is an inability of the body to process sugars properly. It can lead to serious health problems.

Researchers have found that the factors most associated with the development of diabetes in people with HIV are similar to those seen in HIV-negative people.

American researchers compared two groups of patients, one HIV-positive, the other HIV-negative, to see what the risk factors were for the development of diabetes.

At the beginning of the study, diabetes was slightly less common in people with HIV than in HIV-negative people.

The factors most associated with diabetes in people with HIV were exactly the same as those seen in HIV-negative people: increasing age; being male; being black, Asian or from a minority ethnic group; and being overweight.

But they also found that HIV treatment slightly increased the risk of diabetes, and there was also very slight evidence that HIV-positive people with a higher CD4 cell count were more likely to have diabetes. They think that this could be because of the weight gain that many people experience after they start HIV treatment.

The March edition of HIV Treatment Update included a feature article on HIV and diabetes. This edition is now available to download from aidsmap.com.

HIV treatment and prevention

One of the hottest topics in HIV at the moment is the impact that HIV treatment has on the infectiousness of people taking it.

The debate was kick-started in early 2008 when senior HIV doctors in Switzerland issued a statement saying that in certain circumstances, people taking HIV treatment who had an undetectable viral load are not infectious to their sexual partners.

Few experts have gone as far as the Swiss and said that people taking treatment with an undetectable viral load are never infectious.

However, a general consensus seems to be emerging that taking HIV treatment and having an undetectable viral load does significantly reduce infectiousness. In April the French National AIDS Council issued a statement broadly supporting this position, but highlighting what they believe to be limitations in this approach and gaps in current knowledge.

Like many other experts, they noted limitations with treatment as a method of prevention. Even if a person has an undetectable viral load, there’s some evidence that there can still be a small risk of transmission. Furthermore, poor adherence and sexually transmitted infections can all increase viral load and increase the risk of infectiousness.

Treatment is not considered a replacement for condom use, and all the information about its impact on infectiousness comes from studies involving monogamous heterosexual couples.

But the French health ministry has now issued its own statement rejecting the idea of treatment as prevention. It states that consistent condom use offered maximum protection against HIV. It also highlights the lack of information about treatment as prevention and gay men, or about the use of treatment as a sole prevention strategy.