Welcome to HIV Weekly, a weekly email bulletin that provides people with, or affected by, HIV a concise, plain English digest of a selection of the very latest HIV news.

This new digest puts the latest HIV news stories into their context to equip you with the knowledge to understand what the latest research might mean for your HIV treatment and care.

Information on the latest NAM treatment information resources and those produced by other key organisations such as the UK Coalition and THT are also included.

HIV Weekly is edited by Michael Carter, NAM's patient information and news editor.

An HIV Weekly archive will be provided online.

There are four main sections to this edition of HIV Weekly:

• HIV and hepatitis: news from the Second International Workshop on HIV and Hepatitis Coinfection, held in Amsterdam January 12^th – 14^th. There were also two interesting studies published in journals and reported on aidsmap. One looked at the effectiveness of anti-HIV treatment in people coinfected with hepatitis C and the second looked at ability of a painless scan to assess liver damage in coinfected people.
• Illness: an interesting study was reported on aidsmap last week looking at why people with HIV get ill and die, even when HIV treatment is available. It found that infections and cancers are the biggest causes of death.
• Side-effects: starting treatment with a very low CD4 cell count increases the chances of an unpleasant group of symptoms called immune reconstitution syndrome occurring; and aidsmap reported a case of severe allergic reaction to abacavir (Ziagen) affecting the lungs.
• Mother-to-child transmission: if a pregnant woman has resistance to a lot of anti-HIV drugs, the fusion inhibitor T-20 (enfuvirtide, Fuzeon) can be used with drugs that still work to prevent her passing on HIV to her baby.

HIV and hepatitis

Many people with HIV are also infected with hepatitis B virus and/or hepatitis C virus. There viruses affect the liver and can make a person very ill. Over time, they can be fatal. Since effective anti-HIV treatment became available,  hepatitis B and hepatitis C has become a major cause of illness and death in people with HIV. Having hepatitis B and/or hepatitis C can also have implications for how and when HIV is treated.

Doctors, researchers, treatment activists and patients gathered in Amsterdam to share the latest research into HIV and hepatitis coinfection.

Illness

The amount of illness and death due to HIV fell significantly in the UK and similar countries with the widespread use of effective anti-HIV treatment from 1996 onwards. However, even when HIV treatment is available and used, people with HIV still get ill and die. Every year, approximately 400 new AIDS diagnoses are made in the UK and an equal number of people with HIV die, often this is because HIV is diagnosed so late that HIV treatment does not have an opportunity to work.

There is also concern that the side-effects of HIV treatment such as heart disease,  resistance to anti-HIV drugs, and infection with hepatitis B or hepatitis C may be involved in illness and deaths.  

An American study has confirmed that death amongst HIV-positive people fell dramatically with the introduction of effective HIV treatment and that survival time increased.

Infections caused almost 60% of deaths before 1996, but this fell to 24% after 2000. Nevertheless, infections remained the leading cause of death in people with HIV. Cancer was the second most common cause of death, accounting for 20% of all mortality before 1996 and 12% after 2000.

Before 1996, 80% of all deaths were due to AIDS, but by 2000, this had fallen to 65%. The researchers found that there was an increase in the proportion of non-AIDS deaths due to heart disease and diabetes. They also found that the percentage of deaths due to anal cancer increased slightly. The number of deaths due to hepatitis C was low, but also increased slightly.

Side-effects

Preventing mother-to-child transmission

The use of anti-HIV drugs can help prevent mother-to-child transmission of HIV. The way in which anti-HIV drugs are used depends on the stage at which HIV is diagnosed during pregnancy and the mothers health.

A growing concern is resistance to HIV drugs amongst pregnant women.

Doctors from a hospital in south London recently reported two cases involving pregnant women with resistance to lots of HIV drugs. The doctors used resistance tests to see which drugs would work best for the women and also treated them with the fusion inhibitor T-20 (enfuvirtide, Fuzeon). In both cases, these treatment combinations led to falls in the women’s viral load and both women had healthy, HIV-negative babies.

However, it was necessary for both women to have a caesarean section to deliver their babies as it is known that T-20 is not very good at suppressing levels of HIV in the genitals.