Archive for April 2014

Are long-acting HIV medications the key to better adherence?

April 28, 2014

By Mathew Rodriguez

If you haven’t heard of “GSK744,” it has the potential to become the first HIV medication that need only be taken once a month.

GSK744 (short for S/GSK1265744) is an investigational integrase inhibitor; it is a long-acting version of the U.S. FDA-approved HIV medication Tivicay (dolutegravir). What’s the big difference? Well, this new drug is being developed specifically to have a very long “half-life,” which refers to the time it takes to break down inside the body — GSK744 takes a lot longer to break down in the body than currently approved HIV meds. As a result, early studies suggest that — although the drug will need to be injected by a clinician — it may only need to be taken once every 30 days, or even longer.

The idea is that therapies like GSK744 could address adherence concerns because the regimen is only once-a-month instead of once-a-day, and the treatment would be administered and directly observed by a health care professional. (It’s also being investigated for possible use in pre-exposure prophylaxis for the same reason.)

That said, when it comes to adherence, what works for some will not work for others. Taking a daily pill gives some people the freedom to make their own travel schedules, to take their medication on their own terms and in comfortable settings. Some people won’t want to go to their doctor (and pay to see the doctor!) every month to get their medication, while some people may struggle with taking a daily reminder of their HIV status and might welcome a less-frequent dose.

Research on this drug — as well as other ones like it — is still in its early stages, and even if further studies prove successful, it will likely be years before any long-acting antiretrovirals are approved by the U.S. Food and Drug Administration. But still, excitement about long-acting regimens is on the rise. What do you think? Would you take advantage of long-acting injectables? Or do you prefer to take your medications on your own time in pill form? What would make you switch?

 

Marking a scientific milestone in the HIV epidemic

April 24, 2014

From Huffington Post
by John-Manuel Andriote
Journalist and author, ‘Victory Deferred: How AIDS Changed Gay Life in America’

Thirty years ago, in an April 23, 1984 press conference in Washington, D.C., the world learned that American microbiologist Robert C. Gallo and his colleagues at the National Cancer Institute had proved that a retrovirus first seen by their counterparts at Institut Pasteur in Paris was the cause of AIDS.

Secretary of Health and Human Services Margaret Heckler also announced that day that the Gallo team had created a blood test to detect antibodies produced by the body to fight infection. With it we finally had the ability to know who was infected, to screen donated blood and to track the spread of the virus.

By the time of the announcement, 4,177 AIDS cases had been reported in the United States across 45 states. New York City alone accounted for more than 1,600 cases. San Francisco, far smaller than the nation’s largest city and the East Coast’s biggest gay mecca, had more than 500 cases. The majority of these cases were among gay men of all skin tones.

Although the HIV test was originally intended to screen the blood supply, it became available to the public in early 1985. After early uncertainty about what, exactly, a positive test meant, it became clear it meant that a microbial time-bomb was ticking inside you, set to explode at some unpredictable time in a nightmare that would eventually lead to your death from the cancers, dementia, brain infections and other horrors that attack a body when HIV has destroyed the immune system.

Continue reading on the Huffington Post.

HIV-infected men at increased risk for heart disease, MACS-related study finds

April 1, 2014

From the National Institutes of Health

NIAID and NHLBI funded the study with additional support from the National Center for Advancing Translational Sciences, part of NIH. Past studies of the association between heart disease and HIV infection have reached

Plaque buildup in the arteries that nourish the heart, a condition called coronary atherosclerosis, narrows the arteries and increases the risk for heart attack.

Plaque buildup in the arteries that nourish the heart, a condition called coronary atherosclerosis, narrows the arteries and increases the risk for heart attack.

inconsistent conclusions. To help clarify whether an association exists, the current investigation drew participants from the Multicenter AIDS Cohort Study (MACS), a study of HIV/AIDS in gay and bisexual men established by NIAID nearly 30 years ago. “One advantage of the MACS is that it includes HIV-uninfected men who are similar to the HIV-infected men in the study in their sexual orientation, lifestyle, socioeconomic status and risk behavior, which makes for a good comparison group,” said Wendy S. Post, M.D., who led the study. Dr. Post is a professor of medicine and epidemiology at the Johns Hopkins School of Medicine and the Johns Hopkins Bloomberg School of Public Health in Baltimore.The buildup of soft plaque in arteries that nourish the heart is more common and extensive in HIV-infected men than HIV-uninfected men, independent of established cardiovascular disease risk factors, according to a new study by National

Institutes of Health grantees. The findings suggest that HIV-infected men are at greater risk for a heart attack than their HIV-uninfected peers, the researchers write in Annals of Internal Medicine. In addition, blockage in a coronary artery was most common among HIV-infected men whose immune health had declined the most over the course of their infection and who had taken anti-HIV drugs the longest, the scientists found, placing these men at even higher risk for a heart attack. “These findings from the largest study of its kind tell us that men with HIV infection are at increased risk for the development of coronary artery disease and should discuss with a care provider the potential need for cardiovascular risk factor screening and appropriate risk reduction strategies,” said Gary H. Gibbons, M.D., director of the National Heart, Lung, and Blood Institute (NHLBI), part of NIH. “Thanks to effective treatments, many people with HIV infection are living into their 50s and well beyond and are dying of non-AIDS-related causes¬—frequently, heart disease,” said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), also part of NIH. “Consequently, the prevention and treatment of non-infectious chronic diseases in people with HIV infection has become an increasingly important focus of our research.”

Another advantage was the MACS’ size, with nearly 7,000 men cumulatively enrolled, 1,001 of whom participated in the new study. The participants included 618 men who were HIV-infected and 383 who were not. All were 40 to 70 years of age, weighed less than 200 pounds, and had had no prior surgery to restore blood flow to the coronary arteries. Dr. Post and colleagues investigated whether the prevalence and extent of plaque buildup in coronary arteries, a condition called coronary atherosclerosis, is greater in HIV-infected men than HIV-uninfected men and whether that plaque is soft or hard. Coronary atherosclerosis, especially soft plaque, is more likely to be a precursor of heart attack than hard plaque.

The scientists found coronary atherosclerosis due to soft plaque in 63 percent of the HIV-infected men and 53 percent of the HIV-uninfected men. After adjusting for cardiovascular disease risk factors, including high blood pressure, diabetes, high cholesterol, high body mass index and smoking, the presence of soft plaque and the cumulative size of individual soft plaques were significantly greater in men with HIV infection.

In addition, by examining a subgroup of HIV-infected men, the scientists discovered two predictors of advanced atherosclerosis in this population. The first predictor deals with white blood cells called CD4+ T cells, which are the primary target of HIV and whose level, or count, is a measure of immune health. The researchers found that for every 100 cells per cubic millimeter decrease in a man’s lowest CD4+ T cell count, his risk of coronary artery blockage rose by 20 percent. The scientists also found that for every year a man had taken anti-HIV drugs, his risk of coronary artery blockage rose by 9 percent.

Because the investigators examined coronary artery plaque at a single point in time, further research is needed to determine whether coronary artery plaque in HIV-infected men is less likely to harden over time, or whether these men simply develop greater amounts of soft plaque, according to Dr. Post. In addition, she said, studies on therapies and behavioral changes to reduce risk for cardiovascular disease in men and women infected with HIV are needed to determine how best to prevent progression of atherosclerosis in this population.

Find out more at the National Institutes of Health.

Pitt Men’s Study HIV educational forum April 16th

April 1, 2014

The Pitt Men’s Study will be hosting its annual HIV Educational Forum on Wednesday, April 16th. The forum is an opportunity for Pitt Men’s Study participants to hear talks from researchers and ask questions about important HIV and research matters.

The event starts at 6:30pm and is held at the Hilton Garden Inn, 3454 Forbes Ave, in Oakland. It is a free event and includes a dinner served at 7pm, but you must register by April 7.

To register, email Jessica McGuinness at pitteventrsvp@gmail.com (or call 412-383-1674). When registering, specify your meal choice: Stuffed Chicken Breast, Cheese Tortellini, or Vegetable Napoleon (Cheese Tortellini and Vegetable Napoleon can be served as vegan on request).

Take a look at the flyer here