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.

This edition of HIV Weekly provides further analysis of news from the 45^th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), a major annual HIV conference, that was held in Washington DC just before Christmas as well as all the other latest HIV news.

This week’s news is divided into five sections:

• Major treatment strategy trial halted early: The SMART study is stopped after only two years after more AIDS illnesses than expected were seen in people taking a treatment break.

• New drugs: Once-daily HIV treatment consisting of just one pill may be a reality by the summer of this year; a medicine from a new class of anti-HIV drugs make progress in clinical trials; and switching from Combivir to Truvada has benefits for treatment experienced people.

• Side-effects: Being infected with hepatitis C virus may be the only reason why people who start HIV treatment develop liver problems, and a new analysis comparing drugs in the non-nucleoside analogue class -  efavirenz (Sustiva) and nevirapine (Viramune) – suggests that nevirapine may be less likely to cause liver problems then previously thought.

• Illness: Having a high viral load for a long period of time seems to be a risk factor for the development of the AIDS-defining cancer, non-Hodgkin’s lymphoma.

• Sexual health: Women who are shedding the genital herpes virus are more likely to have high levels of HIV replication in their genitals.

Major treatment strategy trial halted early

The SMART study, a major international treatment strategy trial has been halted early. Read the full aidsmap.com news report here.

The study was designed to compare two HIV treatment strategies: one group of people would take a treatment break on the basis of their CD4 cell count; the second group of people would take HIV treatment all the time.

The study was stopped early because a higher than expected number of people in the treatment interruption arm developed an AIDS-defining illness.

No more people will be recruited to the study and people who were in the group taking breaks from treatment will be told that they need to take their HIV drugs all the time.

New drugs

Side-effects

Illness

The number of people dying of AIDS has fallen dramatically since effective anti-HIV treatment became available in the mid/late 1990s. However, even in the UK and other European countries where there is widespread use of anti-HIV drugs people still die of AIDS. The cancer non-Hodgkin’s lymphoma has become a lot rarer in HIV-positive people due to HIV treatment, but it accounts for about a quarter of AIDS cases in countries like the UK. HIV-positive people who develop non-Hodgkin’s lymphoma normally have very low CD4 cell counts.

A French study has now found that having a high viral load for a long period may be a risk factor for the development of non-Hodgkin’s lymphoma.  Unlike other studies, the French doctors did not find that the lowest ever CD4 cell count or CD8 cell count were risk factors for developing lymphoma.

The French doctors suggest that their findings could have important implications about when HIV treatment should be started. It is currently recommended that HIV treatment should be started when a person’s CD4 cell count is between 200 – 250 cells. A CD4 cell count of this level indicates that a person has a risk of becoming ill due to HIV. However, the French doctors suggest that a high viral load before this could be a risk factor for developing non-Hodgkin’s lymphoma.

Sexual health