African Institute AISD is looking at HIV, Aging and other health conditions linked to HIV from our NAM updates Jan 2011
Thanks to treatment, many people with HIV can expect to live well into old age.
But there is concern that some people with HIV are developing diseases associated with older age sooner than would be expected in the general population.
The causes aren’t clear, but they could include damage caused by HIV, lifestyle factors such as smoking, and the side-effects of some anti-HIV drugs.
Now US researchers have found that ‘ageing’ of the immune system may increase the risk of cardiovascular disease for HIV-positive women.
The immune system deteriorates as we age. For this study, doctors in New York compared the immune function of HIV-positive and HIV-negative women. They found that women with HIV were more likely to have an ‘aged’ immune system.
This was linked to changes to the carotid artery that can increase the long-term risk of cardiovascular disease.
Separate research has also shown that some diseases of old age meant that people with HIV were less able to perform daily tasks.
But overall the study showed that differences in physical function between HIV-positive and HIV-negative people were small.
Staying active and exercising regularly were associated with an improved ability to perform daily tasks.
The December edition of HIV Treatment Update includes a report (‘The prescription for old age’) on the recent British HIV Association community symposium on ageing.
HIV Treatment Update is available free to anyone affected by HIV – and paid subscriptions are available to professionals. Contact us on 020 7840 0050 or info@nam.org.uk for more information, or browse the online archive for a flavour of the content.
Cost of HIV care in the UK
The annual cost of HIV treatment and care in the UK could be over £750 million by 2013, a new study suggests.
The National Health Service (NHS) provides some of the best quality HIV treatment and care in the world. Taxation funds the NHS. All the services and treatment provided by NHS clinics are free at the point of delivery to people who are entitled to use the NHS for free.
Annual HIV costs increased substantially between 1996 and 2007, and researchers think they’ll increase still further, reaching around £750 million by 2013.
The increases in cost are because treatment means that people with HIV are living longer and treatment is lifelong. They are also due to high levels of new diagnoses.
Analysis conducted by the researchers showed that early HIV treatment, and therefore reducing levels of HIV-related illness, was cost-effective – the cost of HIV treatment and care increased as patients became sicker.
But they think that the only real way to reduce costs is to cut the number of new infections. They call for increased emphasis on HIV prevention. and AISD director, Mr Amdani Juma, stressed this as it is the good deal for our communities who represent the real future active population who contribute into the UK economy and form an important source of income for their large and needy families in Africa
Once-daily darunavir approved for treatment-experienced patients
The boosted protease inhibitor darunavir (Prezista) is an important treatment option for people who have been on other anti-HIV drugs.
This powerful drug usually works against HIV that is resistant to other protease inhibitors.
It’s now been approved for once-daily dosing for treatment-experienced adults, as long as they don’t have any resistance to the drug.
The once-daily dose is 800mg, taken as two 400mg tablets, with 100mg of ritonavir (Norvir).
But treatment-experienced patients are recommended only to take the once-daily dose if their CD4 cell count is above 100 and their viral load below 100,000 copies/ml.
Patients with a lower CD4 cell count or a higher viral load should take the twice-daily dose – 600mg darunavir with 100mg ritonavir.
HIV and cardiovascular disease – stroke
The proportion of HIV-positive patients in the US hospitalised because of stroke has increased, new research shows.
Researchers looked at admissions to hospitals because of stroke between 1997 and 2006.
Stroke can occur when arteries are damaged by factors such as smoking or the build-up of cholesterol.
In 1996, just 0.09% of stroke patients were HIV-positive. This had increased by 67% to 0.15% in 2006.
The number of people with HIV admitted to hospital because of stroke increased from 888 in 1997 to 1425 in 2006.
The researchers also noticed that it was only strokes caused by blocked blood vessels in the brain that were increasing.
Stroke occurred at a younger age in HIV-positive patients than HIV-negative individuals.
Reasons for the increase in stroke may include the inflammatory effects of HIV, or increases in cholesterol caused by some anti-HIV drugs.
Screening for the early warning signs of cardiovascular disease is an increasingly important component of HIV care.
Fatty liver disease and hardening of the arteries
US researchers have found a possible early warning sign of future heart problems.
Research involving 223 adults showed that hardening of the coronary artery was associated with fatty liver disease.
Just over a third of patients had some evidence of hardening of the coronary artery, and 13% had fatty liver disease.
Overall, 59% of patients who had a fatty liver also had hardening of the arteries.
The researchers conclude, “Fatty liver disease is associated with underlying cardiovascular disease and should be considered as a novel marker for risk stratification among HIV-infected persons.”
Predicting the success of HIV treatment
Researchers have developed an online computer programme that can help doctors choose the best possible combination of anti-HIV drugs for patients who’ve taken a lot of treatment in the past (‘treatment experienced’).
The programme considers factors such as resistance, treatment history, CD4 cell count and viral load and then suggests the five most appropriate drug combinations.
Two studies showed that doctors found the programme useful, but they sometimes changed the combinations suggested by the programme to take into consideration the preferences of their patients.
The programme is still in development, and its researchers have emphasised that it’s intended to be used by doctors. It should not be considered a replacement for proper consultations between doctors and patients.
The online programme is available on the HIV Treatment Response Prediction System website. To use the system you have to register for an account, confirming you are a healthcare professional or research scientist.
Thanks to treatment, many people with HIV can expect to live well into old age.
But there is concern that some people with HIV are developing diseases associated with older age sooner than would be expected in the general population.
The causes aren’t clear, but they could include damage caused by HIV, lifestyle factors such as smoking, and the side-effects of some anti-HIV drugs.
Now US researchers have found that ‘ageing’ of the immune system may increase the risk of cardiovascular disease for HIV-positive women.
The immune system deteriorates as we age. For this study, doctors in New York compared the immune function of HIV-positive and HIV-negative women. They found that women with HIV were more likely to have an ‘aged’ immune system.
This was linked to changes to the carotid artery that can increase the long-term risk of cardiovascular disease.
Separate research has also shown that some diseases of old age meant that people with HIV were less able to perform daily tasks.
But overall the study showed that differences in physical function between HIV-positive and HIV-negative people were small.
Staying active and exercising regularly were associated with an improved ability to perform daily tasks.
The December edition of HIV Treatment Update includes a report (‘The prescription for old age’) on the recent British HIV Association community symposium on ageing.
HIV Treatment Update is available free to anyone affected by HIV – and paid subscriptions are available to professionals. Contact us on 020 7840 0050 or info@nam.org.uk for more information, or browse the online archive for a flavour of the content.
Cost of HIV care in the UK
The annual cost of HIV treatment and care in the UK could be over £750 million by 2013, a new study suggests.
The National Health Service (NHS) provides some of the best quality HIV treatment and care in the world. Taxation funds the NHS. All the services and treatment provided by NHS clinics are free at the point of delivery to people who are entitled to use the NHS for free.
Annual HIV costs increased substantially between 1996 and 2007, and researchers think they’ll increase still further, reaching around £750 million by 2013.
The increases in cost are because treatment means that people with HIV are living longer and treatment is lifelong. They are also due to high levels of new diagnoses.
Analysis conducted by the researchers showed that early HIV treatment, and therefore reducing levels of HIV-related illness, was cost-effective – the cost of HIV treatment and care increased as patients became sicker.
But they think that the only real way to reduce costs is to cut the number of new infections. They call for increased emphasis on HIV prevention. and AISD director, Mr Amdani Juma, stressed this as it is the good deal for our communities who represent the real future active population who contribute into the UK economy and form an important source of income for their large and needy families in Africa
Once-daily darunavir approved for treatment-experienced patients
The boosted protease inhibitor darunavir (Prezista) is an important treatment option for people who have been on other anti-HIV drugs.
This powerful drug usually works against HIV that is resistant to other protease inhibitors.
It’s now been approved for once-daily dosing for treatment-experienced adults, as long as they don’t have any resistance to the drug.
The once-daily dose is 800mg, taken as two 400mg tablets, with 100mg of ritonavir (Norvir).
But treatment-experienced patients are recommended only to take the once-daily dose if their CD4 cell count is above 100 and their viral load below 100,000 copies/ml.
Patients with a lower CD4 cell count or a higher viral load should take the twice-daily dose – 600mg darunavir with 100mg ritonavir.
HIV and cardiovascular disease – stroke
The proportion of HIV-positive patients in the US hospitalised because of stroke has increased, new research shows.
Researchers looked at admissions to hospitals because of stroke between 1997 and 2006.
Stroke can occur when arteries are damaged by factors such as smoking or the build-up of cholesterol.
In 1996, just 0.09% of stroke patients were HIV-positive. This had increased by 67% to 0.15% in 2006.
The number of people with HIV admitted to hospital because of stroke increased from 888 in 1997 to 1425 in 2006.
The researchers also noticed that it was only strokes caused by blocked blood vessels in the brain that were increasing.
Stroke occurred at a younger age in HIV-positive patients than HIV-negative individuals.
Reasons for the increase in stroke may include the inflammatory effects of HIV, or increases in cholesterol caused by some anti-HIV drugs.
Screening for the early warning signs of cardiovascular disease is an increasingly important component of HIV care.
Fatty liver disease and hardening of the arteries
US researchers have found a possible early warning sign of future heart problems.
Research involving 223 adults showed that hardening of the coronary artery was associated with fatty liver disease.
Just over a third of patients had some evidence of hardening of the coronary artery, and 13% had fatty liver disease.
Overall, 59% of patients who had a fatty liver also had hardening of the arteries.
The researchers conclude, “Fatty liver disease is associated with underlying cardiovascular disease and should be considered as a novel marker for risk stratification among HIV-infected persons.”
Predicting the success of HIV treatment
Researchers have developed an online computer programme that can help doctors choose the best possible combination of anti-HIV drugs for patients who’ve taken a lot of treatment in the past (‘treatment experienced’).
The programme considers factors such as resistance, treatment history, CD4 cell count and viral load and then suggests the five most appropriate drug combinations.
Two studies showed that doctors found the programme useful, but they sometimes changed the combinations suggested by the programme to take into consideration the preferences of their patients.
The programme is still in development, and its researchers have emphasised that it’s intended to be used by doctors. It should not be considered a replacement for proper consultations between doctors and patients.
The online programme is available on the HIV Treatment Response Prediction System website. To use the system you have to register for an account, confirming you are a healthcare professional or research scientist.
