HIV Update 28th October
Posted by: admin | Posted on: October 28th, 2009 | 0 Comments
Warning of rare etravirine side-effects
HIV healthcare providers have been warned that the non-nucleoside reverse transcriptase inhibitor etravirine (Intelence) can cause rare, but potentially very serious allergic reactions.
The warning was issued after severe skin rashes were reported in a very small number of people taking etravirine. One of the cases was fatal.
Etravirine is considered to be a very safe drug – its main side-effect is a mild rash in the first few weeks of treatment.
However, more serious rashes have developed in a few patients between three and six weeks after treatment with etravirine was started.
In addition to rash, symptoms included fever, tiredness, aching muscles and joints, blistering, oral lesions, hepatitis, conjunctivitis, a general feeling of being unwell, and blood abnormalities.
In most cases, the symptoms disappeared and the patients made a full recovery. After treatment with etravirine was stopped and steroids were provided, all but one of the patients made a complete recovery.
If you are taking etravirine and develop a severe rash, you should contact your HIV doctor immediately. If your clinic is closed, then go to accident and emergency at your local hospital.
You can find out more about ways of dealing with side-effects in NAM’s booklet Side-effects; you can download it here, or order it from our online bookshop.
Less resistance being transmitted in Europe
A team of researchers from 20 European countries and Israel looked at blood samples taken from people newly diagnosed with HIV between 2002 and 2006. They monitored the number of people infected with resistant virus.
It’s possible for strains of HIV to develop resistance to anti-HIV drugs and this resistant virus can be passed on.
Overall, about 8% of patients in the study were infected with resistant virus.
The researchers found that the proportion of patients infected with virus that was resistant to nucleoside/nucleotide reverse transcriptase inhibitors remained stable.
However, the number of patients infected with virus resistant to protease inhibitors fell.
In addition, after 2004, there was a fall in the proportion of patients infected with HIV that was resistant to non-nucleoside reverse transcriptase inhibitors.
HIV treatment improved significantly during the four years of the study. This meant that for more people their viral load could be reduced to an undetectable level – and maintained at that low level. As a result their infectiousness was reduced and they were less likely to pass on HIV to others.
It’s also important to note that HIV treatment has got even better since 2006. Several important new drugs have become available that mean nearly everybody taking HIV treatment can obtain an undetectable viral load. It will therefore be interesting to see if rates of transmitted resistance fall even further.
There is more information on HIV drug resistance in NAM’s new patient information booklet Adherence & resistance. You can download it here, or order it from our online bookshop.
HIV treatment and infectiousness
A new study has found more evidence that people with low viral loads are less infectious.
US researchers found that very few HIV transmissions originated from people with a viral load below 1000 copies/ml. Moreover, the rate of transmission was over twice as high for patients with a viral load of around 10,000 copies/ml compared to those with a viral load of 1000 copies/ml or below.
There’s been a lot of debate about HIV treatment, viral load and infectiousness. Evidence seems to be accumulating that successful HIV treatment does significantly reduce infectiousness.
Viral load is often calculated on a logarithmic scale. A ‘one log increase’ means that viral load has increased by a factor of ten. This means that a viral load of 10,000 copies/ml is one log higher than a viral load of 1000 copies/ml. Similarly, a viral load of 1,000,000 copies/ml is one log higher than a viral load of 10,000 copies/ml and so on.
Researchers found that a fall in viral load of 0.74 log reduced the risk of HIV transmission by 50%.
It’s hoped that the findings of this study will assist further research into the use of HIV treatment in prevention.
There is more information on viral load in NAM’s new patient information booklet CD4, viral load & other tests. You can download it here, or order it from our online bookshop.
Transmission of hepatitis C in gay men
The findings of this research are in contrast to evidence from the UK and several other European countries which has found evidence of the sexual transmission of hepatitis C in HIV-positive gay men. In these studies fisting, unprotected sex, recreational drug use, and group sex have all been linked to the transmission of hepatitis C in men with HIV.
Australian researchers monitored the rate of hepatitis C co-infection in HIV-positive and HIV-negative men in Sydney between 2005 and 2007. At the start of the study 9% of men were co-infected with hepatitis C.
There were no new hepatitis C infections in the HIV-positive men during the course of the study. Of the men co-infected with hepatitis C, 16 reported a history of injecting drug use.
The researchers also found that about 1% of HIV-negative men were infected with hepatitis C. This is similar to the proportion of the general Australian population infected with the virus.
Injecting drug use, tattooing and body piercing were associated with infection with hepatitis C. There were a small number of new hepatitis C infections in the HIV-negative men during the study.
Two of these were possibly linked to sex. Both of the men reported sex with HIV-positive gay men and they also had a history of sexually transmitted infections that cause genital ulcers.
The April edition of HIV Treatment Update included a feature article on HIV and hepatitis C infection in gay men. This edition can be downloaded as a PDF from aidsmap.com.
HIV and stigma
Stigma can mean that people don’t get the HIV care that they need.
In a recent article in a medical journal, researchers outlined how stigma can deter people from seeking HIV testing or going to a clinic for treatment and care.
They outline ways in which healthcare staff, clinic managers and others can recognise and act upon stigma.
You can find out more about stigma and discrimination in NAM’s booklet HIV and stigma, which can be downloaded as a PDF from aidsmap.com. There is also information on how you can respond to stigma and discrimination, and about organisations that can help you.
The June edition of HIV Treatment Update included the first of a series of feature articles on HIV and stigma. This edition can be downloaded as a PDF from aidsmap.com.
Swine flu and HIV
There are two new factsheets on swine flu available on aidsmap.com (Key facts and Dealing with infection). They can be read online, or downloaded as PDFs – we are happy for you to print and distribute them.
Visit www.aidsmap.com/swineflu.
The August/September edition of HIV Treatment Update also included a Q&A article about swine flu. HIV Treatment Update is available free to people living with HIV in the UK, or subscriptions can be bought. Visit our online bookshop for more information, or contact us at info@nam.org.uk or 020 7840 0050.
South London: First Point
The new First Point service is open to anyone living with HIV in south London. The ‘First Point’ of contact for the South London HIV Partnership, the team can talk to you about your situation and help you choose the support, advice or information services you need.
They can make referrals on your behalf.
The partnership brings together services in south London including counselling, health support, advice and advocacy, and peer support. Whatever your situation, First Point is a good place to start.
To make an appointment or find out more, contact the team on 020 7160 0949, text your name to 07889 168 455, email the First Point team, or visit the South London HIV Partnership website for more information.
