Fwd: e-Newsletter for Tuesday, May 25, 2010

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e-Newsletter for Tuesday, May 25, 2010

Niacin May Improve Blood Vessel Function

in People with HIV

By Liz Highleyman

SUMMARY: HIV positive people treated with extended-release niacin for 12 weeks demonstrated improved ability of the endothelial lining of blood vessels to expand and contract, a sign of good function that is lost with the development of atherosclerosis, according to a study described in the April 24, 2010 issue of AIDS.

Research indicates that people with HIV are more prone to cardiovascular disease, which may be associated with antiretroviral therapy (ART), inflammation due to ongoing viral replication, or other factors that are not yet fully understood. Impaired endothelial function is an early stage in the progression of atherosclerosis, or "hardening of the arteries."

Dominic Chow from the University of Hawaii and colleagues conducted a study to assess the short-term effects of extended-release niacin on endothelial function in HIV positive people with low high-density lipoprotein (HDL) "good" cholesterol levels. HDL removes lipids from blood vessels and therefore has a protective effect, while low-density lipoprotein (LDL) "bad" cholesterol deposits fats on artery walls and increases the risk of heart disease.

This small controlled study included 19 HIV positive participants; most (89%) were men, the median age was 50 years, and about half were white. All were on stable ART, 95% had HIV viral load < 50 copies/mL, and the median CD4 cell count was high at 493 cells/mm3. Participants had HDL < 40 mg/dL and LDL < 130 mg/dL. None were taking lipid-lowering medications. Full Article...

Hepatitis B and C - Top New Articles

Less than Half of Drug Addiction Treatment Programs Screen for Infectious Diseases such as HIV and Hepatitis B or C

SUMMARY› Just under 50% of U.S. substance abuse and addiction treatment facilities incorporate screening for infectious diseases that occur more often among drug users, according to a survey from the Substance Abuse and Mental Health Services Administration (SAMHSA). Such diseases include blood-borne infections like HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) that can be transmitted through shared needles. Testing was more common, however, in programs focused on treatment for opiate use, for example those providing methadone or buprenorphine maintenance.

People Receiving Buprenorphine instead of Methadone for Addiction Treatment Are More Likely to Respond to Hepatitis C Therapy

SUMMARY› Evidence continues to confirm that current and former injection drug users can benefit from hepatitis C treatment if they are able to maintain good adherence. About two-thirds of drug users who concurrently received interferon-based therapy and underwent opiate substitution addiction treatment achieved sustained virological response, according to a Greek study presented at the Digestive Disease Week conference (DDW 2010) this month in New Orleans. The study also found that people on buprenorphine substitution were about 3 times more likely to adhere to hepatitis C therapy than those on methadone.

HCV Main Section HBV Main Section

HIV and AIDS - Top New Articles

Niacin May Improve Blood Vessel Function in People with HIV

SUMMARY› HIV positive people treated with extended-release niacin for 12 weeks demonstrated improved ability of the endothelial lining of blood vessels to expand and contract, a sign of good function that is lost with the development of atherosclerosis, according to a study described in the April 24, 2010 issue of AIDS.

Cholesterol Crystals Trigger Inflammation Leading to Atherosclerosis

SUMMARY› People with HIV have a higher risk of cardiovascular disease compared with the general population, which may be attributable in part to elevated low-density lipoprotein (LDL) cholesterol related to antiretroviral drugs and inflammation due to ongoing low-level viral replication. Now, as reported in the April 29, 2010 issue of Nature, researchers have determined how cholesterol crystals contribute to atherosclerosis, or "hardening of the arteries," a progressive inflammatory condition that can lead to heart attacks and strokes.

Project Inform Clarifies Position on Early Treatment for HIV

SUMMARY› When to start antiretroviral therapy (ART) for HIV continues to be a controversial issue. As previously reported, San Francisco General Hospital and the city's Department of Public Health recently changed their policy to offer everyone diagnosed with HIV the option to start treatment, regardless of CD4 cell count. The HIV/AIDS advocacy group Project Inform issued a statement supporting this change and outlining an approach dubbed TLC+, or Testing and Linkage to Care Plus. Now, Project Inform has put out a new statement clarifying its position and providing more information about the benefits of prompt HIV testing, linkage to care, and -- if appropriate and desired -- early ART initiation.

Less than Half of Drug Addiction Treatment Programs Screen for Infectious Diseases such as HIV and Hepatitis B or C

SUMMARY› Just under 50% of U.S. substance abuse and addiction treatment facilities incorporate screening for infectious diseases that occur more often among drug users, according to a survey from the Substance Abuse and Mental Health Services Administration (SAMHSA). Such diseases include blood-borne infections like HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) that can be transmitted through shared needles. Testing was more common, however, in programs focused on treatment for opiate use, for example those providing methadone or buprenorphine maintenance.

CDC Reports U.S. H1N1 Flu Activity Falls to Normal Low Summer Level

SUMMARY› H1N1 "swine flu" activity has fallen to a low level typically observed for seasonal influenza during the summer months in the U.S., according to the latest update from the Centers for Disease Control and Prevention (CDC). During the week of May 9-15, doctor visits for flu-like symptoms decreased, flu-related hospitalizations leveled off, and the number of deaths attributed to influenza or pneumonia remained stable. Globally, the most active areas of H1N1 flu transmission are in the tropical regions of the Caribbean, South America, and Southeast Asia.

HIV and AIDS Main Section

HIV/HCV and HIV/HBV Coinfection - Top New Articles

Some HIV Elite Controllers Can also Naturally Control Hepatitis C Virus

SUMMARY› About one-quarter of people who are naturally able to suppress HIV replication without antiretroviral therapy (ART) may also be able to spontaneously control hepatitis C virus (HCV), according to a small study described in the May 12, 2010 advance online edition of AIDS. However HIV/HCV coinfected elite controllers had a significant lower average CD4 cell count, CD4 percentage, and CD4/CD8 cell ratio than HIV suppressors without chronic hepatitis C, suggesting that HCV has a detrimental effect on immune function.

IL28 Gene Variation Has Less Influence on Interferon Response in HIV/HCV Coinfected Patients

SUMMARY› Variations in the IL28B gene, which last year was shown to be strongly associated with response to interferon-based therapy for hepatitis C, appears to have less influence on treatment response in HIV/HCV coinfected patients that it does in people with hepatitis C virus (HCV) alone, according to a study presented at the 45th Annual Meeting of the European Association for the Study of the Liver (EASL 2010) last month in Vienna.

HIV/HCV Coinfection Main Section HIV/HBV Coinfection Main Section

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