New Publications in HIV : Archive

16 September 2009

Primary care guidelines for the management of persons infected with human immunodeficiency virus: 2009 update by the HIV medicine association of the infectious diseases society of America.

Aberg JA, Kaplan JE, Libman H et al. Clin Infect Dis 2009;49:651–81. • These updated evidence-based guidelines were prepared by an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America and replace those published in 2004.
• The guidelines are intended for use by healthcare providers who care for HIV patients or patients who may be at risk for acquiring HIV infection.
• With fewer complications and increased survival, HIV patients are increasingly developing common health problems that also affect the general population.
• HIV patients should be managed and monitored for all relevant age- and gender-specific health problems.
Link 22 October 2009

Small-molecule screening using a human primary cell model of HIV latency identifies compounds that reverse latency without cellular activation

Yang HC, Xing S, Shan L et al. J Clin Invest 2009 doi: 10.1172/JCI39199. • The latent viral reservoir in resting CD4+ T-cells is a major barrier to virus eradication and elimination of this reservoir requires reactivation of the latent virus.
• This paper reports the development of a novel in-vitro model of HIV-1 latency that was used to screen small-molecule libraries for compounds that can reverse latency.
• The model identified a compound that reactivated latent HIV-1 without inducing global T-cell activation: 5-hydroxynaphthalene-1,4-dione (5HN).
• Conclusions: This study increases the number of classes of latency-reversing agents and demonstrates the utility of the in-vitro model for investigating strategies to eradicate HIV-1 infection.
Link 22 October 2009

Interleukin-2 cycling causes transient increases in high-sensitivity C-reactive protein and D-dimer that are not associated with plasma HIV-RNA levels.

Porter BO, Shen J, Kovacs JA et al. AIDS 2009;23:2015–9. • This study investigated the effects of interleukin (IL)-2 treatment on inflammatory and thrombotic biomarkers in chronically HIV-infected adults receiving ART.
• Cryopreserved plasma was evaluated retrospectively for C-reactive protein (CRP) and D-dimer at baseline, end of an IL-2 cycle and long-term follow up from two randomized, controlled studies.
• Significant increases in CRP (study 1: 138.6 mg/L; study 2: 58.9 mg/L) and D-dimer (study 1: 3.1 mg/L; study 2: 0.4 mg/L; all p<0.0001) occurred by the end of the initial IL-2 cycle, returning to baseline by the end of study.
• No thrombotic or cardiovascular serious adverse events occurred.
• Conclusions: IL-2 caused transient increases in plasma CRP and D-dimer levels, irrespective of HIV-RNA VL, indicating the possibility of an increased risk for thrombotic events.
Link 22 March 2010

Impact of antiretroviral therapy on incidence of pregnancy among HIV-infected women in Sub-Saharan Africa: a cohort study.

Myer L et al. PLoS Med 2010;7:e1000229. • This study investigated whether ART influences pregnancy rates by analyzing data from 11 Mother-to-Child Transmission-Plus (MTCT-Plus) Initiative programs in seven African countries.
• In total, 589 pregnancies were observed among 4,531 women (incidence: 7.8/100 person-years).
• The rate of new pregnancies was significantly higher among women receiving ART (9.0/100 person-years) than those not on ART (6.5/100 person-years) (adjusted HR: 1.74; 95% CI: 1.19–2.54).
• Conclusions: ART was associated with a significantly higher pregnancy rate among HIV+ women in sub-Saharan Africa. The results indicate the importance of pregnancy planning and management as a component of HIV care services
Link 07 June 2010

Pretreatment levels of soluble cellular receptors and interleukin-6 are associated with HIV disease progression in subjects treated with highly active antiretroviral therapy.

Kalayjian RC et al. J Infect Dis 2010;201:1796–805. • This study investigated associations between AIDS or death and different inflammatory markers, including selected soluble tumor necrosis factor superfamily receptors (sTNFRs) and ligands, IL-6 and CD8 T-cell activation, in patients treated with HAART to identify inflammatory pathways that may contribute to the pathogenesis of HIV.
• Higher pre-treatment concentrations of sTNFR-1, sCD27, sCD40L and plasma IL-6 were associated with a new AIDS-defining illness or death in separate models adjusted for age, sex, haemoglobin and the latest CD4 cell counts.
• Conclusions: The results are compatible with a model in which soluble inflammatory markers identify pathways that may contribute to the pathogenesis of HIV.
Link 07 June 2010

Inflammation and complications of HIV disease.

Dubé MP, Sattler FR. J Infect Dis 2010;201:1783–5. • This study investigated associations between AIDS or death and different inflammatory markers, including selected soluble tumor necrosis factor superfamily receptors (sTNFRs) and ligands, IL-6 and CD8 T-cell activation, in patients treated with HAART to identify inflammatory pathways that may contribute to the pathogenesis of HIV.
• Higher pre-treatment concentrations of sTNFR-1, sCD27, sCD40L and plasma IL-6 were associated with a new AIDS-defining illness or death in separate models adjusted for age, sex, haemoglobin and the latest CD4 cell counts.
• Conclusions: The results are compatible with a model in which soluble inflammatory markers identify pathways that may contribute to the pathogenesis of HIV.
Link 07 June 2010

Markers of inflammation, coagulation, and renal function are elevated in adults with HIV infection.

Neuhaus J et al. J Infect Dis 2010;201:1788–95. • This study compared the inflammation and coagulation biomarkers high-sensitivity C-reactive protein (hsCRP), IL-6, D-dimer, and cystatin C in people with and without HIV in different trials.
• In one trial, the levels of hsCRP and IL-6 were 55% and 62% (both p<0.001) in people with versus those without HIV and in another trial, hsCRP, IL-6, D-dimer and cystatin C levels were 50%, 152%, 94% and 27% higher, respectively (all p<0.001).
• Conclusions: hsCRP, IL-6, D-dimer and cystatin C levels are increased in HIV+ individuals and remain so after suppression of HIV RNA levels with ART.
Link 07 June 2010

Inflammation and complications of HIV disease.

Dubé MP, Sattler FR. J Infect Dis 2010;201:1783–5. • This study compared the inflammation and coagulation biomarkers high-sensitivity C-reactive protein (hsCRP), IL-6, D-dimer, and cystatin C in people with and without HIV in different trials.
• In one trial, the levels of hsCRP and IL-6 were 55% and 62% (both p<0.001) in people with versus those without HIV and in another trial, hsCRP, IL-6, D-dimer and cystatin C levels were 50%, 152%, 94% and 27% higher, respectively (all p<0.001).
• Conclusions: hsCRP, IL-6, D-dimer and cystatin C levels are increased in HIV+ individuals and remain so after suppression of HIV RNA levels with ART.
Link 07 June 2010

Alcohol use accelerates HIV disease progression.

AIDS Res Hum Retroviruses 2010;26:511–8. • The study investigated the effects of alcohol abuse on HIV disease progression.
• Frequent alcohol users (two or more drinks daily) were 2.91 times (95% CI: 1.23–6.85; p=0.015) more likely to have a decline in CD4 cell count to ≤200 cells/mm3, which was independent of baseline CD4 cell count and VL, ARV use, time since HIV diagnosis, age and gender.
• Frequent alcohol users who were not on ART also increased their risk of a decline in CD4 cells to ≤200 cells/mm3 (HR: 7.76; 95% CI: 1.2–49.2; p=0.03).
• Combined frequent alcohol use with crack-cocaine also showed a significant risk of CD4 cell decline (HR: 3.57: 95% CI: 1.24–10.31; p=0.018). Frequent alcohol intake was associated with higher VL over time.
• Conclusions: Frequent alcohol use and its combination with crack-cocaine accelerate HIV disease progression. Alcohol appears to have a direct effect on CD4+ cells that is independent of ART, whereas its effect on VL appears to be due to reduced adherence to ART.
Link 29 July 2010

Rational design of envelope identifies broadly neutralizing human monoclonal antibodies to HIV-1.

Wu X et al. Science. 2010 Jul 8. • In this study, antigenically resurfaced glycoproteins specific for the structurally conserved site of CD4 receptor binding were developed.
• These probes were used to identify sera with neutralising antibodies to the CD4-binding site and to isolate individual B-cells from the HIV-1-infected donor.
• Three monoclonal antibodies, including a pair of somatic variants, which neutralised >90% of circulating HIV-1 isolates, were identified.
• Conclusions: Exceptionally broad HIV-1 neutralisation can be achieved with individual antibodies targeted to the functionally conserved CD4-binding site of gp120, providing an important insight for the future design of an HIV-1 vaccine.
Link