November 17, 2011

November 17, 2011
HIV Treatment as Prevention

Welcome to another day in my life. Today is Thursday and I hope you are having a safe and great week so far. It is another busy and stressful week for Dab the AIDS Bear and me.

I read some recent responses that the US has committed itself to using HIV treatment to reduce the number of new HIV infections and the disease caused by the virus.

Secretary of State, Hillary Clinton, said the aim was an “AIDS free generation”.

Clinton said: “Treatment does not take away from prevention, it adds to it. So let us end the old debate over treatment versus prevention and embrace treatment as prevention.”

A combination approach to HIV prevention was advocated by Clinton. She highlighted three measures shown to reduce the risk of infections:

Testing and treatment to prevent mother to child transmission.
Voluntary male circumcision.
Treatment as prevention.

The HPTN 052 study showed that earlier treatment reduced the risk of HIV transmission by 96%, and another US funded study has confirmed that treatment before the onset of serious AIDS defining illness or immune deficiency substantially reduces the risk of developing AIDS or dying.

HIV treatment – side effects

Product information for raltegravir (Isentress) has been updated in the US to warn of a potentially dangerous side effect and allergic reaction.

Raltegravir is a type of anti-HIV drug called an integrase inhibitor and it generally only causes mild side effects.

However, the Warnings and Precautions section of the drug’s information leaflet now cautions that rare cases of Stevens Johnson syndrome, a severe and potentially life threatening skin reaction, have been associated with the drug, as have severe allergic reactions, or hypersensitivity reactions.

People taking raltegravir are therefore advised to contact their doctor immediately if they develop a rash.

People should stop taking raltegravir at once and seek medical attention if this rash is accompanied by any of the following symptoms: fever; feeling generally unwell; extreme tiredness; aching in muscles or joints; blistering; mouth ulcers or lesions; inflammation of the eyes; swelling of the eyes, lips or mouth; facial swelling; breathing difficulties; yellowing of the skin or eyes; dark urine; pale stools; nausea; vomiting; loss of appetite; pain, aching or sensitivity on the right hand side, below the ribs.

For more information on raltegravir, visit our A to Z of antiretroviral drugs at HIV treatment – resistance

Modern HIV treatment combinations that include tenofovir (Viread) have a low risk of resistance, new research suggests.

The aim of HIV treatment is an undetectable viral load. However, if HIV is not fully suppressed then the virus can develop resistance to the drugs used to treat it.

Modern HIV drugs are generally very powerful, easy to take and cause only mild side effects. They are therefore associated with a lower risk of resistance than earlier generations of anti-HIV drugs.

Swiss researchers wanted to establish the risk of resistance associated with individual combinations of drugs.

All the combinations they looked at were based on either 3TC (lamivudine, Epivir) or FTC (emtricitabine, Emtriva). They were then grouped according to the other drugs taken in the combination.

Over six years, 16% of people who were taking a combination that included both AZT (zidovudine, Retrovir) and efavirenz (Sustiva) developed resistance. This compared to between 5 and 9% of patients treated with other combinations.

Two thirds of all cases of resistance developed when patients had a viral load between 50 and 500 copies/ml.

The researchers think this finding is remarkable and suggest that people who experience a low rebound in their viral load when taking treatment should be closely monitored for resistance.

The research underlines the effectiveness of modern HIV treatment. AZT is no longer recommended for routine long term use in countries like the UK. But the findings of this study are important for low and middle income countries where AZT is a backbone of HIV treatment.

Access to health care

Our information on provision of NHS health care to non-UK citizens has been updated to reflect recent changes in regulations.

The changes include better access to care for refused asylum seekers.

HIV psychology workshop

The British Psychological Society Faculty for HIV & Sexual Health is holding an event for community sector and healthcare workers, psychologists and people with HIV.

The workshop is themed Beyond the therapy room and will focus on innovative psychological and community level approaches when working with communities affected by HIV.

The event will be held in London on Friday 2nd December.

So while most of this news pertain to the friends in England of Dab the AIDS Bear and me, I thought you would be interested.

Hope you have a great Thursday!

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,

Daddy Dab