Posts tagged HIV treatment
Genetics May Account for Some HIV Drug Failures
9 years ago
When anti-HIV drugs fail to suppress the condition or prevent transmission, the situation is usually blamed on a patient who does not take the treatment as is needed for it to work correctly. Recent research, however, shows that some individuals, and even some parts of the body may be genetically predisposed to treatment failure.
Consider the drug Tenofovir. It is on the market under the brand name Viread, and the FDA approved this medication back in 2001 as an HIV treatment. Then in 2012 approval was given for use as an oral prophylactic, this time with the goal of preventing HIV transmission.
Unfortunately, some people, and also some parts of the body, have enzymes that take the active Tenofovir and return it to an inactive state that does not combat HIV. The research showed different enzymes to be at work in the vagina and rectum causing the treatment to have different results depending on where it was used on the body. But even when used in the same manner, results still varied.
That is because the location of the treatment was not the only determining factor. About one in 12 women who were part of the study suffered from a genetic variation that rendered the medication inert regardless of how it was used.
Learning this is a big step for researchers since it was previously just assumed that human error was involved when the drug didn’t work. Now the realization is that genetics may be involved. The next stage of research may reveal that genetic testing can determine in advance if Tenofovir is a viable treatment option or not for a particular individual.
The next step is a clinical trial. It is hoped that such continued research will determine how anti-HIV drugs function and what variants definitely affect how successful the treatment will be from person to person.
Consistent HIV Treatment Reduces Heterosexual Transmission
9 years ago
by ADMIN
in HIV Management
Recent studies show that HIV treatment that is effective in suppressing the disease works well at preventing the spread of the disease between heterosexual partners. These Canadian findings were the result of a trial funded by NIAID.
The idea of lessening HIV transmission with treatment is not entirely new. In fact, one study from 2011 revealed that the risk of spreading HIV to a partner is reduced by 96 percent when treatment starts early and is taken consistently. The study focused specifically on heterosexual couples in which only one partner was HIV positive.
More than 1,700 heterosexual couples across four continents signed up to be a part of the clinical trial. As a part of the study, all of the couples received training on how to avoid transmission of HIV. Infected individuals were assigned at random to either begin immediate antiretroviral treatment or to delay starting treatment until immunocompromised. Approximately 600 couples did not complete the entire trial, but the data from the other 1,100+ was sufficient to get results. What was learned?
The healthy partner was 93 percent less likely to contract HIV if the infected partner began treatment immediately. In the case of couples where the treatment was begun early on, only eight partners ended up being infected. In fact, four of those individuals were diagnosed early on, showing that the longer treatment went on, the less likely the health partner was to be infected.
It is also important to note that in all four individuals who were infected later on, the partner receiving treatment had not had the disease fully suppressed for one reason or another. In the case of those for whom the treatment worked, there was no transmission after the early part of the study. Another important discovery was that, for those who waited to start treatment, it took longer to suppress the virus, thus leaving a longer window where transmission risk was higher.
The moral of the story: to protect your partner, start treatment early and stick with it to ensure suppression.
Deadly Lymphoma Now Has Potential Treatment for HIV Patients
9 years ago
by ADMIN
in HIV Management
Primary effusion lymphoma (PEL) is a deadly and incurable form of lymphoma that is specific to those with HIV/AIDS. A researcher, however, has recently determined that a drug already approved by the FDA and on the market for treatment of multiple myeloma may actually be more effective at treating PEL as part of the HIV treatment.
Once the researchers discovered that existing medications can help fight PEL, the search was on to see what other existing cancer treatments would also be effective. That is when they decided to look into BRD4 inhibitors. These inhibitors, when combined with the immunomodulatory drugs (IMiDs) for multiple myeloma worked exceptionally well in the lab as anti-PEL treatment.
The problem with PEL is that there have been no treatment options up to this point. Combine this with the fact that the disease is very fast moving, and most patients do not survive half a year after diagnosis. Current attempts at treatment are all IV drugs and are very toxic to the patient. These drugs are expensive and very difficult to administer in remote parts of Africa where the condition is the most prevalent.
The research, however, does not mean that patients can go out and get multiple myeloma treatment if they currently have PEL. It means that clinical testing will now begin to see if this combination of medications could, in fact, be effective. The fact that all of the drugs involved have already been approved by the FDA should help things move along rather quickly in the testing phase.
While this is not one of the more common diseases on earth and is even rare among HIV treatments, it is certainly one that has a high mortality rate. It is satisfying to see research going on that helps a very select group of individuals, even though the need for such medication will not drive the same earnings as treatment for a more common condition.
Lack of HIV Prevention Threatens to Increase
9 years ago
by ADMIN
in HIV Management
UNAIDS has released a report showing that the next five years are critical in slowing the spread of HIV. Now that major advances in treatment have been made, HIV prevention seems to be less of a topic. The stark fact is that treatment alone will not stop the spread of HIV. To halt the continuing spread of this condition, prevention efforts need to be revamped, especially when it comes to high-risk groups.
Treatment Costs on the Rise
One of the amazing things about modern HIV treatment is that most people who are infected with the disease can expect to live to the average lifespan. This fact, however, also makes prevention a necessity. With HIV positive individuals living longer and the infection rate growing in many countries, costs of providing treatment are skyrocketing for governments around the world. In fact, in several African nations it has been calculated that more than one-third of government spending on health must target HIV, and that this translates into as much as 2% of the gross domestic product of some nations.
A Reachable yet Difficult Goal
UNAIDS sees the next five years as an opportunity to strike a major blow against HIV. With the funds to provide treatment globally and greater prevention encouragement for at-risk individuals, the organization is seeking to eliminate transmission from mother to child by 2030. The difficulty is encouraging the haves to share with the have-nots since many of the nations facing such crises simply do not have the funds to enact the needed programs.
First World Problem: Complacency
HIV prevention is not just an issue in Africa. In advanced nations such as in Europe and North America, evidence reveals that among homosexual men, infection rates have started to rise. This negative shift is blamed on complacency due to treatment methods and their accessibility in these nations. Rather than on treatment, the focus needs to be on prevention if infection rates in countries such as the US are going to decrease as they should.
In Africa, Traditional Healers Can Undermine Efforts of Modern HIV Treatments
9 years ago
Imagine you start to show signs of possible HIV infection: your skin color changes, your immune system is visibly weaker than ever before, and a flu-like feeling just won’t go away. You go to your trusted healer, the traditional healer your family has seen for years, decades, possibly generations. Now, imagine this traditional healer tells you that these symptoms are not due to a blood-borne virus infecting your body, but by a curse a neighbor has placed upon you and your family. His or her treatment will not recommend antiretroviral medications, but to chant incantations and rub medical herbs into an open cut made from a razor. Although this is not heard of as a practice in any area of the United States, no matter how rural, this type of traditional healing is still very common in rural areas of Mozambique and other sub-Saharan African countries. When these traditional healers speak of curses and angered ancestors as the causes for the HIV symptoms, there is an inevitable delay between the first signs of symptoms and the administration of the first antiretroviral medicines. Prolonging this crucial timeframe shows that these traditional healers can undermine efforts of modern HIV treatments, which can harm the patient in irreparable ways, possibly causing the individual to develop AIDS before receiving the medicine he or she needs.
A study led by Carolyn Audet, Ph.D., an assistant professor of Health Policy, focused on sub-Saharan African countries. Over 60% of the rural residents in this study who started showing symptoms of HIV infection visited at least one traditional healer before consulting a trained medical professional, sometimes seeing several healers before any doctors. This caused, on average, a two-and-a-half-time longer delay for receiving the needed medicine, as over 50% of those who saw traditional healers first were initially diagnosed with having a curse placed upon them. With countries like Mozambique having over ten percent of its population infected with HIV (in the US it is roughly 0.6%), mistreatment has become an epidemic of serious concern. These delays can undermine efforts of modern HIV treatments, as many traditional healers are resistant to incorporating Western medicine into their religious and healing practices, which can seriously harm or even cause the preventable death of patients before receiving life-saving antiretroviral medicines.
