HIV Weekly 21 April 2010
Posted by: admin | Posted on: April 28th, 2010 | 0 Comments
Advice for people stranded because of volcano-related travel ban
A cloud of volcanic ash has caused serious problems for people trying to travel to or within large areas of Europe for several days now. Some people may be experiencing problems because they are not at home and running out of supplies of antiretroviral drugs.
You can find more detailed advice on how to get hold of anti-HIV drugs here, or search for an HIV clinic for help and advice on finding emergency drug supplies here.
HIV treatment as prevention
One of the hottest topics in HIV at the moment is the use of treatment as prevention.
Taking HIV treatment reduces the amount of virus, not only in the blood, but also in sexual fluids. The levels of viral load in blood and genital secretions are related.
Very few HIV transmissions are thought to originate in people who are on HIV treatment and whose blood viral load is undetectable.
Most of the research looking at the link between treatment, viral load and infectiousness has so far been conducted in heterosexual people.
These conditions are:
- The HIV-positive partner has been on stable HIV treatment, with an undetectable viral load, for at least six months.
- They have good adherence to treatment, with no missed, late or incorrectly taken doses.
- They have no other sexually transmitted infections.
The doctors studied the virus in a group of gay men recently infected with HIV to see if it could be placed within clusters of HIV transmissions.
All the men took HIV treatment soon after their infection with HIV, but stopped after a year or so.
The researchers traced six transmission clusters, involving 28 men.
None of the men who transmitted HIV to a sexual partner had an undetectable viral load.
Most of the men those who passed on HIV were in the “chronic” phase of HIV infection, having had HIV for at least one year.
This surprised the researchers. Viral load is highest soon after a person is first infected with HIV, and some researchers have argued that as many as half of all new HIV infections originate in people who have only recently been infected themselves.
In the Swiss research, the viral load in people transmitting the virus ranged from as low as 300 to over 1 million copies/ml.
The researchers think that their findings could have major implications, suggesting that gay men should take early and continuous HIV treatment as a way of reducing transmissions.
However, Swiss HIV doctors have previously pointed out that treatment is not a replacement for safer sex.
The use of treatment as prevention is a highly controversial and rapidly evolving subject. Further developments will be reported in HIV Weekly.
HIV and TB
New international TB treatment guidelines
Tuberculosis (TB) is the single biggest cause of serious illness and death in people with HIV.
Treatment with combinations of antibiotics can cure TB in people with HIV, and there are guidelines about how these should be used.
The new guidelines recommend that treatment should include the key anti-TB drug rifampicin (one of the drug group called rifamycins) for the duration of treatment.
They also say that treatment should be provided daily.
Antiretroviral treatment is endorsed for all HIV-positive patients with active TB.
Coinciding with the release of the guidelines was the publication of a paper which reviewed the studies looking at TB treatment for people with HIV.
This paper found that rifamycin treatment for eight months had the best results. The researchers also found evidence supporting the new recommendation that treatment should be taken daily, and that TB was more likely to be cured if a person took HIV treatment as well.
You can find out more about TB treatment in NAM’s information booklet, HIV and TB.
Preventing TB: a new vaccine being tested in people with HIV
Although a vaccine for TB already exists, it doesn’t always work.
The candidate vaccine, which is called AERAS-402/Crucell Ad35, is being studied in HIV-positive patients in South Africa.
Treatment with the anti-TB drug isoniazid is recommended by the World Health Organization for people who have latent TB (TB that isn’t causing them to be ill at present).
But despite this recommendation, many of those with latent TB do not receive this treatment.
One reason is that some doctors fear it could lead to the development of drug-resistant TB.
However, researchers in South Africa have found that these fears may be unfounded.
They looked at the sensitivity of TB to the antibiotics used to treat people who developed active TB.
Most of the people in the study were also HIV-positive.
HIV Treatment Update – free to people with HIV
HIV Treatment Update is NAM’s regular newsletter, bringing you the latest HIV news and developments.
Recent editions have included features on insurance, clinical trials, life expectancy, crystal meth, HIV services after the election, smoking, exercise and treatment guidelines, as well as regular updates on news and conferences around the world. An archive is available on our website.
HIV Treatment Update is available free to people living with HIV, or subscriptions can be bought. Visit our online bookshop for more information, or contact us at info@nam.org.uk or 020 7840 0050.
Looking for information on HIV transmission?
Clear and comprehensive information on HIV transmission can be hard to find.
Visit the HIV transmission section of our website for detailed information on subjects including co-factors that affect transmission, viral load and risk of transmission and protective measures.
We also produce a book covering these topics, HIV Transmission & Testing, which is available to buy from our online bookshop.
Women and HIV:
Inner strengths
A study is investigating the inner strengths women use in coping with HIV. If you are an HIV-positive woman in the UK, you can help by visiting the research team’s website and filling in an online questionnaire. You do not have to give your name.
