||Ever Upward: "When to Start" Debate Turns to CD4+ Cell Count of 500|
Dueling studies -- one presented by Mari Kitahata, M.D., the other by Jonathan Sterne, M.D. -- offer strikingly different views on the benefits of HAART initiation at a CD4+ threshold of 500. However, both appear to solidify the wisdom of starting therapy before CD4+ cell count drops below 350.
More Top Stories:
- Which CROI 2009 Studies Are Most Likely to Impact Clinical Care?
Tune in as Joel Gallant, M.D., M.P.H., one of the United States' foremost HIV experts, walks us through some of the most important findings regarding HIV treatment strategies presented at CROI 2009.
- The Next Generation of Boosters: Promising Data on Potential Alternatives to Ritonavir
Brian Kearney, Pharm.D., of Gilead Sciences Inc., and Robert Guttendorf, Ph.D., of Sequoia Pharmaceuticals discuss encouraging findings from early human trials on a pair of pharmacokinetic enhancers whose utility could potentially extend far beyond protease inhibitor boosting.
- The Next Stage of HIV Eradication: Finding the Secret Reservoirs
In adherent patients on fully suppressive HAART, viral replication has completely stopped, says Robert Siliciano, M.D., Ph.D. But the virus still lurks persistently in reservoirs -- one whose identity is known, and at least one whose identity remains a mystery.
- High Adherence May Become Less Essential the Longer a Patient Maintains Viral Suppression on HAART, Findings Suggest
Maximum adherence should always remain a goal when taking HAART. However, patients with sustained viral suppression on HAART are highly likely to maintain that viral suppression even in the face of adherence rates much lower than 95 percent, reports David Bangsberg, M.D., M.P.H.
- Antidepressants Can Significantly Reduce Viral Load by Improving Adherence Among Homeless or Marginally Housed Patients, Study Says
Antidepressant use had a small (.8 log) but statistically significant effect on viral load reduction among 418 homeless and marginally housed adults who had initiated HAART, found Alexander Tsai, M.D., Ph.D., et al. However, that benefit vanished after adjusting for adherence, suggesting that improved adherence was the reason behind the viral load reduction, not a biological effect of antidepressant use.
- 5% or More of Perinatally HIV-Infected Adolescents May Be Long-Term Nonprogressors, U.S. Study Suggests
In what may be the first study of its kind, Rohan Hazra, M.D., offers data suggesting that a significant proportion of HIV-infected U.S. adolescents, all of whom were infected with HIV at birth, were able to remain off antiretroviral therapy for at least six months without experiencing any noticeable degree of disease progression.
- High-Dose Intravenous Immunoglobulin May Reduce Latent HIV Reservoir in Resting CD4+ Cells, Study Suggests
A five-day course of high-dose intravenous immunoglobulin appears to somehow activate replication-competent HIV in the resting CD4+ cells of patients on HAART, ultimately leading to a reduction in those patients' latent HIV reservoirs, according to the results of a nine-patient study presented by Magnus Gisslén, M.D., Ph.D.
- Despite CD4+ Boost, Interleukin-2 Provides No Discernible Long-Term Health Benefits to Patients on HAART, ESPRIT/SILCAAT Studies Find
The use of interleukin-2 (IL-2) alongside antiretroviral therapy does not further reduce an HIV-infected patient's risk of developing an opportunistic infection or dying, according to findings from a pair of large, long-term, international studies. The findings provide a fresh -- and possibly final -- blow to the use of IL-2 as an immune-based therapy for HIV-infected patients receiving combination antiretroviral therapy.
- An Update on the Present -- and Future -- of HIV Eradication
Robert Siliciano, M.D., is one of the world's foremost researchers on the topic of HIV eradication. We caught up with him at CROI 2009 to discuss recent developments in the field, which has suddenly experienced somewhat of a renaissance of late.
- A Common Blood Product Called IVIG May Help Clear the HIV Reservoir
- Two Studies Show Kaletra and Isentress Similarly Suppress HIV, Yet Have Different Side Effects
- More Monotherapy Data Underscore Its Potential to Harm
- Truvada and Epizcom are Similar in Their Ability to Suppress HIV
- Thin Pipeline Reveals Three Possible HIV Drugs
- Isentress Equal to Sustiva in First Line Therapy
- Acyclovir: The Next New HIV Drug?
- Gilead Announces Data Demonstrating Pharmacokinetic Boosting Activity of GS 9350
- Kaletra Superior to Nevirapine-Based ART for Women Already Exposed to Single-Dose Nevirapine
- Maternal Resistance to Nevirapine Following Single Dose Reduced by AZT/ddI or One Month's ART
Please note: Knowledge about HIV changes rapidly. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. For a complete listing of our most recent conference coverage, click here.