PI Perspective #48

March 2009     View PDF     En español

News briefs from 2009 CROI ...

For complete coverage on these topics, go to www.projectinform.org/news/09_croi/index.shtml.

Smoking nearly triples the risk of death (http://www.projectinform.org/news/09_croi/022009.shtml)

It's well documented that HIV-positive people smoke more on average than HIV-negative individuals. Figures point anywhere from 47-70%, while the national average hovers around 20%. Results from the five-year FRAM study showed that current smoking, as well as older age, significantly increased the risk of death in people living with HIV. Although the study examined many factors related to disease progression and death, the one that was most notable was smoking. Smoking contributes to heart and lung disease and cancer, among many other conditions.

A common blood product called IVIG may help clear the HIV reservoir (www.projectinform.org/news/09_croi/022309.shtml)

Early findings detailed a small proof-of-concept study using high-dose IVIG to reduce the amount of HIV found in resting cells, sometimes call the latent reservoir. These reservoirs are compartments of HIV infection, seemingly untouched by conventional HIV therapy, that are believed to harbor the virus that eventually causes people to progress in their HIV disease. The small study enrolled 9 people on effective HIV therapy for 5 or more years who had undetectable viral loads for more than 1.5 years. They were given 30g IVIG daily for 5 days. Lab work, which included identifying the genetic types of HIV in latent reservoirs and blood, was done before and after the IVIG therapy. Seven out of the 9 showed lowered or undetectable virus particles in these reservoirs 8–12 weeks after IVIG. On average, latent HIV was reduced by 68% in the 7 patients who showed a response to the IVIG.

Successful therapy may still lead to loss of kidney function (www.projectinform.org/news/09_croi/021909.shtml)

The SCOPE study showed a loss of kidney function in people with HIV, even in those with well controlled HIV levels on potent HIV therapy (HAART). HAART helps control kidney function, more so than in those with uncontrolled HIV, but some still experience a higher rate of kidney dysfunction. Loss of kidney function was more associated with viral levels than with CD4 counts. The researchers offered that continued control of HIV levels without viral blips is key to maintaining good kidney function over time. However, they did not assess the impact of kidney-toxic drugs in HIV regimens on these findings. Those without HIV control, not on HIV therapy, fared worst among the four groups.

Cancer rate for Isentress similar to other HIV meds (www.projectinform.org/news/09_croi/022409.shtml)

Study data showed that people using the integrase inhibitor Isentress (raltegravir) developed similar rates of cancer as seen among people taking Sustiva or placebo. Cancer rates observed in 4 earlier studies of Isentress had raised concerns. A large analysis of 5 randomized, double-blind studies of the drug eases concern about cancer risks associated with its use.

Risk for invasive anal cancer high among HIV-positive people (www.projectinform.org/news/09_croi/021109.shtml)

More sobering news was presented on a serious HPV-related condition in men who have sex with men (MSM) that can lead to anal cancer. Unlike other diseases that have declined in incidence since the advent of HAART, the appearance of this condition (caused by human papillomavirus) has continued to increase. Incidence of anal cancer is 59-times higher among MSM and nearly 7-times higher in HIV-positive women. This reiterates and underscores the rise of cancers with infectious causes among people living with HIV. A great resource for information about these conditions is the website for the UCSF Anal Neoplasia Study at www.analcancerinfo.ucsf.edu/about/index.html.