Adolescents Have a Hard Time Doing Well in Adult HIV Care
HIV-positive adolescents and young adults are much less likely to start treatment, to achieve control of the virus while on treatment, and to stay on treatment or in care, according to two studies presented Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston. They may also do less well in adult care than in pediatric HIV clinics.

Are People Experiencing More Rapid HIV Disease Progression Now?
Compared with previous years, people who contract HIV today might experience a more rapid decline in CD4 counts, according to a new study presented Tuesday, March 1, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston. If confirmed in other studies, the results could ultimately influence decisions about when to start antiretroviral (ARV) therapy.

After 2 Years, Drug Regimen Works Well Among Treatment-Experienced
A drug regimen containing Isentress (raltegravir), Intelence (etravirine) and Norvir (ritonavir)?boosted Prezista (darunavir) continues to work well in a French clinical trial involving heavily treatment-experienced people living with HIV. About 88 percent of those using this potent regimen active against drug-resistant virus have undetectable viral loads after nearly two years of treatment, reported researchers on Wednesday, March 2, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

Isentress Has Long-Term HIV Efficacy and Safety, but Is Best Taken Twice Daily
The good news: Isentress (raltegravir)-based antiretroviral (ARV) therapy appears to work just as well as Sustiva (efavirenz)-inclusive regimens (such as Atripla), with fewer blood lipid problems, for at least three years in first-time HIV treatment takers. The not-so-good news: For best results using Isentress, twice-daily dosing is likely more effective than once-daily dosing in first-line drug regimens.

Risk of Virologic Failure 40 Percent Higher Among Blacks vs. Whites
There is a 40 percent higher risk of virologic failure among blacks, compared with whites, who are starting HIV treatment for the first time, according to a new AIDS Clinical Trials Group (ACTG) analysis reported by Heather Ribaudo, PhD, of Harvard University School of Public Health on Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston. Unfortunately, while one of the study’s goals was to explore the factors associated with this disparity, the researchers did not have adequate socioeconomic data to draw any firm conclusions.

Malaria Drug Plaquenil Calms Immune Activation
Plaquenil (hydrochloroquine), a drug used to treat malaria, lupus and rheumatoid arthritis, was able to significantly reduce immune activation in a small group of HIV-positive people. These data, reported Tuesday, March 1, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, offer hope of finding drugs that can reduce HIV-related immune activation, which is thought to contribute to poorer health, even in people whose virus is well controlled by antiretroviral (ARV) therapy.

New Version of Tenofovir Is Much More Potent and Hopefully Safer
A new formulation of the nucleotide reverse transcriptase inhibitor (NtRTI) tenofovir, currently dubbed GS-7340, achieves far higher concentrations inside of the cells targeted by HIV for infection than the current version of tenofovir (found in Viread, Truvada and Atripla). These data, which were presented Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, suggest that the drug could be simultaneously more potent and safer than the current prodrug formation of tenofovir (Viread).

ViiV Integrase Inhibitor Dolutegravir Is Better Twice-Daily for Treatment-Experienced People
ViiV Healthcare’s experimental integrase inhibitor, now called dolutegravir (S/GSK-572), works better when taken 50 milligrams (mg) twice-daily than when taken as 50 mg once-daily in people who have heavy resistance to other integrase inhibitors, notably Merck’s Isentress (raltegravir) and Gilead’s still-experimental elvitegravir. These data were presented Wednesday, March 2, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

Encouraging Results for BMS’s Oral HIV Attachment Inhibitor
Bristol-Myers Squibb reported encouraging preliminary results from a short study evaluating its oral version of a new class of antiretrovirals (ARVs): an attachment inhibitor currently dubbed BMS-663068 (BMS-068). The data were reported Monday, February 28, by Richard Nettles, MD, of BMS at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) at Boston.

CCR5 Gene Therapy Shows HIV Treatment Potential
SB-728-T, a gene therapy designed to knock out the CCR5 receptor on CD4 cells, protects and increases CD4s in patients experiencing poor immunologic recovery while on antiretroviral (ARV) therapy, according to preliminary Phase I study data reported on Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston. The new results, reported by Jay Lalezari, MD, are among the first from a human study illustrating the therapeutic—and curative—potential of this novel approach being developed by Sangamo BioSciences.

HIV Test and Treat: Challenges to Overcome
Several presentations at the 18th Conference on Retroviruses and Opportunistic Infections (CROI), which ran from February 27 to March 2 in Boston, documented the remaining challenges with the design, evaluation and implementation of HIV “test and treat” programs, whereby aggressive methods are employed to test and diagnose all people with HIV, link them to care and—when appropriate—get them on antiretroviral (ARV) treatment.

Test and Treat Success Stories: Community Viral Load Predicts HIV Transmission Declines
When the average viral load of people known to be HIV positive drops in a community, it can result in substantial and equal declines in new HIV diagnoses, according to a series of presentations Monday, February 28, and Wednesday, March 2, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

U.S. Women Prefer a Pill Over a Vaginal Gel for Prevention
U.S. women involved in a study comparing the safety, blood levels and acceptability of two methods of pre-exposure prophylaxis (PrEP) to prevent HIV transmission—an oral version of the antiretroviral (ARV) drug tenofovir and a vaginal gel version—strongly preferred the pill over the gel. These data were presented Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

First Rectal Gel Studies Show Real Promise
Microbicide researchers announced success with a new rectal gel designed to cut HIV transmission, saying that early data suggests it could work quite well provided that they can figure out how to make it more compatible with the fragile cells that line the rectum. Those important tweaks are already in the works and were also reported Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

Hep B Ups Death Risk Compared With Hep C, but Tenofovir Seems Protective
People with chronic hepatitis B virus (HBV) infection have twice the risk of dying from liver-related diseases as people with chronic hepatitis C virus (HCV)—including those also infected with HIV—according to a study presented Wednesday, March 2, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston. However, the introduction of tenofovir (found in Viread, Truvada and Atripla) as a common part of antiretroviral (ARV) therapy in 2003 has significantly reduced the risk of dying in people with HBV.

CD4s, Viral Load Not Enough to Predict Survival During HIV Treatment
As AIDS-related illnesses decline and non-AIDS complications become increasingly more common in the modern antiretroviral (ARV) therapy era, looking at six blood markers—not just CD4 cell counts and viral load—will be necessary to make accurate survival predictions. This is the conclusion of a study conducted by researchers at Yale and Harvard universities and reported on Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

HIV Non-Nuke Rilpivirine Less Likely Than Sustiva to Cause Vitamin D Drops
Sustiva (efavirenz) may have a greater negative effect on vitamin D levels than Tibotec Therapeutic’s experimental non-nucleoside reverse transcriptase inhibitor (NNRTI) rilpivirine (TMC278), according to results of a Phase III clinical trial comparing the two drugs and reported on Tuesday, March 1, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

The Effect of Antiretroviral Treatment on Cancer Risk
People who start antiretroviral (ARV) treatments at higher CD4 cell counts are less likely to develop non-AIDS-related cancers, and treatment with protease inhibitors (PIs) might be protective against prostate cancer. These and other findings were reported in two studies presented Tuesday, March 1, and Wednesday, March 2, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

Aging and HIV: Older HIV-Positive Men Are Frailer Than Similar HIV-Negative Men
HIV-positive men ages 50 and older are more likely to have symptoms of frailty than HIV-negative men of the same age, according to a study presented Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

Bone Loss During HIV Treatment: A Possible Side Effect of CD4 Cell Recovery
Bone loss may occur in people living with HIV during the first three months of therapy, according to new research involving humans and mice conducted at Emory University in Atlanta exploring the role of antiretroviral (ARV) therapy-induced immune activation on bone metabolism. These results, which suggest that early bone protection therapy may offset possible damage, were reported by Ighovwerha Ofotokun, MD, in an elegant presentation on Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections in Boston.

Non-AIDS-Related Cancers Are Now the Leading Cause of Death in People With HIV
A Swiss study found that non-AIDS-related cancers have become the leading cause of death among people with HIV, in general, but that liver-related diseases far outweigh all other causes of death for people coinfected with both HIV and hepatitis C virus (HCV). Meanwhile, a second study suggests that antiretroviral (ARV) drugs are not contributing to deaths from any cause. These studies were presented Tuesday, March 1, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

Study Says HIV and Inflammation, Not ARVs, Predict Cardiovascular Risk
The length of time (duration) that someone has been infected with HIV, as well as his or her markers of blood vessel and immune inflammation, is predictive of clogging of the arteries (atherosclerosis), but the use of antiretrovirals (ARVs) is not. These data were presented Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

Muscle Loss, Fat Gain Associated With Increased Risk of Death
HIV-positive individuals experiencing a loss of muscle mass and an increase in abdominal fat may face an increased risk of death, according to new data from the Fat Redistribution and Metabolic Change in HIV Infection (FRAM) study presented Tuesday, March 1, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

Previous Syphilis Infection Might Cause Poorer Brain Function for People With HIV
HIV-positive people who have been infected with syphilis (Treponema pallidum) in the past might have poorer brain function than HIV-positive people who have never had it. These data were presented Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

FDA Analysis: No Increased Heart Attack Risk While Using Abacavir
There is no association between the use of ViiV Healthcare’s nucleoside analogue abacavir—found in Ziagen, Epzicom and Trizivir—and heart attack risk, according to a new analysis conducted by the U.S. Food and Drug Administration (FDA), reported Monday, February 28, at the 18th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.