HIV-positive people with a certain mutation in the gene that makes interleukin-28B are more likely to respond to standard HCV therapy than people without the mutation, according to a study just published online in the journal Clinical Infectious Diseases. Testing for the gene could help identify those most - and least - likely to benefit from HCV treatment. The investigators suggested that a test for this IL-28B gene should be incorporated into daily clinical care of co-infected HCV/HIV patients. Vitamin A and beta-carotene supplements are unsafe for HIV-positive women who breastfeed because they may boost the excretion of HIV in breast milk -- thereby increasing the chances of transmitting the infection to the child, according to a study published in the American Journal of Clinical Nutrition. This may be partly because these nutrients raise the risk of developing subclinical mastitis, an inflammatory condition that causes blood plasma to leak into the mammary gland and viral particles to leak into the milk.
HIV-related fatigue has a high prevalence (up to 88% in some studies) and is strongly associated with depression and anxiety. There is a need for intervention studies comparing the effect of medication (antidepressants, anxiolytics) and behavioral interventions to determine the best treatment for fatigue, which is associated with unemployment, social isolation, reduced self-care activities, impaired quality of life, and lower survival. Treatment of HIV-related fatigue is important for HIV-infected patients and requires a multidisciplinary approach.
Source: Jong E, Oudhoff LA, Epskamp E, et al. Predictors and treatment strategies of HIV-related fatigue in the combined antiretroviral therapy era. AIDS 2010:24:1387-405.
A Swedish study of patients with undetectable plasma viral loads on ART found that 10% showed traces of HIV in spinal fluid. This suggests that the CNS may be a place where HIV can hide and that some ART cannot entirely suppress the virus there. It remains unclear, since data conflict, whether residual inflammation or small quantities of virus in the spinal fluid pose a risk of future complications. Still, the investigators concluded that future research should consider the effects in the CNS when developing new drugs.
Source: University of Gothenburg Press Release. August 23, 2010.
Researchers at Sangamo BioSciences testing a gene therapy approach for attacking HIV have reported in Nature Biotechnology that it has prevented HIV infection in mice. The key is introducing stem cells that lack the CCR5 gene. Because this receptor allows HIV to infect immune cells, those who lack this receptor are resistent to HIV-1 infection. The next step is to investigate this approach in clinical trials on HIV-infected patients, to see if this approach can slow or prevent HIV progression.
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