HIV research update: Late March 2016



A great volume of HIV and AIDS research enters the medical literature every month. It’s difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.

Investigators were able to maintain high rates of virologic suppression in HIV-infected patients when switching them from emtricitabine with tenofovir disoproxil fumarate to emtricitabine with tenofovir alafenamide. The researchers concluded that, with its safety advantages, fixed-dose emtricitabine with tenofovir alafenamide has the potential to become an important nucleoside reverse transcriptase inhibitor backbone.


Suppression of HIV-1 viremia is associated with changes in innate cellular function that may in part determine the restoration of protective immune responses, reported a study in JCI Insight. Researchers said plasma viral load had the strongest association with the change in innate functional capacity.

A study in PLOS Pathogens suggests that HIV infection dramatically increases the risk of Mycobacterium tuberculosis infection turning into active tuberculosis. Investigators discovered that HIV is associated with a failure to prevent harmful immune responses.

Because the efficacy of tenofovir-based pre-exposure prophylaxis (PrEP) for HIV-infected patients strongly depends on consistency of PrEP use, pill-taking patterns may have a substantial impact on the protection provided by PrEP, even when the same numbers of pills are taken, a recent study found.

Borderline personality disorder was strongly associated with STI/HIV risk in a cohort study of African American men being released from prison in North Carolina. The findings suggest borderline personality disorder, in addition to other mood disorders, may be an important risk factor for STI/HIV.

Poorly controlled HIV infection is an independent risk factor for liver fibrosis, according to a study in JAIDS. Investigators found that lower CD4 count and higher HIV viral load were significantly associated with progression to advanced hepatic fibrosis in a dose-dependent manner, independent of the risk associated with traditional factors: hepatitis C or hepatitis B virus coinfection, alcohol, and diabetes.

Food insecurity is associated with prevalent HIV, STIs, and illicit drug use among men in the U.S., according to a study published in JAIDS. The authors say further research is needed to establish whether and through what mechanisms improved food security may help prevent new HIV infections.

Using Medicaid claims data from 2006 to 2011, investigators found that the mean annual fee-for-service (FFS) payment for all HIV services was $47,434, while mean annual FFS payment for only medical services was $38,311. Estimated Medicaid payment amounts in this study are higher than some prior estimates, probably due to more complete capture of expensive inpatient hospitalizations in Medicaid data, the researchers said.

HIV-infected individuals may have poorer serologic responses to syphilis treatment and may be more likely to experience neurosyphilis, according to a study in the Journal of Infectious Diseases. Researchers found that serum T. pallidum–specific opsonic activity is significantly lower in HIV-infected individuals, and said impaired T. pallidum–specific immune responses could contribute to differences in the course of disease or treatment response.

The utilization of viral load monitoring may be necessary to truly assess the effectiveness of health facilities delivering antiretroviral therapy (ART) services to HIV-infected patients, reports a study in Tropical Medicine & International Health.

Among HIV-infected persons with median CD4+ count of approximately 500 cells/mm3, 3 months of weekly rifapentine plus isoniazid under direct observation was as effective and safe for treatment of latent M. tuberculosis infection as 9 months of daily isoniazid, and better tolerated, reported a recent study.

A study of the social consequences of early antiretroviral initiation in West Africa found that early ART does not carry detectable adverse social consequences that could impair its clinical and preventive benefits.

Research published in HIV & AIDS Review showed an association between national HIV prevalence values in Africa and the socioeconomic status of their albino populations. The investigators said poverty-stricken African albinos are apparently more likely to be HIV positive than their normal-pigmented counterparts.

A survey to assess Botswana’s progress toward achieving UNAIDS targets for 2020 found 83% of those infected with HIV knew their status; 95% of these people were receiving antiretroviral therapy; and 70% of HIV-infected people had virologic suppression. The authors conclude that UNAIDS 90-90-90 targets are achievable even in resource-constrained settings with high HIV burden.

A research review in Current Opinion in HIV & AIDS concluded that preantiretroviral levels of immune activation and inflammation have a consistently negative effect on bone mineral density, and suggest the immunocentric basis of bone loss in HIV. The findings support the benefits of earlier ART initiation.

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