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.

Plasma lopinavir concentrations predicted viral outcomes in HIV-infected children receiving lopinavir-based antiretroviral therapy, a recent study demonstrated. Investigators said their findings support a minimum target concentration of greater than and equal to 1 mg/L of lopinavir to ensure sustained viral suppression.

©alexskopje/ThinkStock.com

A real-world analysis of HIV-infected patients found no significant increase in the risk of cardiovascular events associated with exposure to atazanavir-containing treatment regimens.

Most antiretroviral-naive HIV-positive children experienced recovery of both weight for age and height for age over the 24 months following initiation of antiretroviral therapy (ART), according to results of a recent study. There was no significant difference between those receiving lopinavir/ritonavir and ART that was not based on nucleoside reverse transcriptase inhibitors (NNRTIs).

Even in an environment of easy access to antiretroviral therapy for HIV patients, many challenges still exist at the implementation stage of early ART, investigators for a study in AIDS Care reported. The authors said intense efforts in both patient and physician education will be required if the benefits of early ART are to be achieved at the individual and population level.

CD4+ and CD8+ T-cell immune activation and exhaustion are greater in HIV-infected youth, compared with matched controls, according to results of a recent study, while monocyte subpopulations are not changed even though there is a high soluble CD14 level.

The first documented HIV cure was based on a stem cell approach, and authors of a study in AIDS Research & Therapy say “there is reasonable hope that this unique case will not stand alone in the future.”

A study in HIV Clinical Trials found that telmisartan use is linked with an increase in circulating endothelial progenitor cells in older HIV-positive individuals who have cardiovascular disease risk factors.

The National Institutes of Health has given funding for a research network to promote the health and well-being of adolescents and young adults who are infected with HIV or at risk for HIV infection.

A study in the Lancet HIV found high levels of HIV pretreatment drug resistance in Mexico, and non-NNRTI pretreatment drug resistance significantly reduced the efficacy of first-line ART regimens that were based on these drugs.

The production of interleukin-1 beta by innate immune cells after stimulations of Toll-like receptors and bacillus Calmette-Guerin was correlated with different tuberculosis recurrence outcomes in ART-treated patients, according to a recent study.

Antiretroviral therapy during acute HIV infection, consisting of once daily emtricitabine/tenofovir/efavirenz, resulted in rapid and sustained viral suppression with high rates of patients staying in care and on ART, in a cohort including a large proportion of young men who have sex with men.

A recent study of cognitively impaired HIV-positive adults found that “higher self-efficacy, greater perception of treatment-related support, a stable medication regimen, stable stress levels, and absence of current stimulant use” predicted the best patient adherence to ART.

Viral suppression rates among HIV-infected children on ART in low- and middle-income countries were “low and were considerably poorer” than those previously found in adults in such countries and children in high-income countries, according to a recent study.

A study in Clinical Infectious Diseases found higher concentrations of inflammatory biomarkers among HIV RNA–suppressed men who reported less than 100% combination ART adherence, compared with more adherent men.

Any heavy alcohol consumption was associated with all-cause mortality among HIV-infected individuals, while only recent heavy consumption was associated with liver-related mortality, according to a study in HIV Medicine.

Family planning clinics, an important source of health care for young women, may be a natural setting for HIV preexposure prophylaxis discussion and roll-out, especially for women who have a history of intimate partner violence, according to a study in AIDS Care.

A relatively high rate of preliminary discontinuation of the antiretroviral dolutegravir (DGV) due to intolerability was detected in a recent study of combination ART. In particular, DGV was stopped more frequently if the regimen included abacavir.

Virologic failure rates in children and adolescents were high in a Tanzanian HIV study, with the majority of antiretroviral therapy–failing children harboring drug resistance–associated mutations (DRM) of HIV. The authors said viral load monitoring is urgently needed to maintain future treatment options for the millions of African children living with HIV.

In a recent study, virologically suppressed, HIV-infected adults with creatinine clearance 30-69 mL/min who switched from tenofovir disoproxil fumarate (TDF) to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF), had “stable creatinine clearance, significant and durable improvements in proteinuria, albuminuria, and tubular proteinuria, and significant increases in hip and spine bone mineral density.” It appears that the latter therapy is appropriate for HIV-infected individuals with mild to moderately impaired renal function.

Lower serum albumin and higher AST appear to be key mortality risk factors in HIV/HCV coinfection, but not as important in HIV-monoinfected individuals, according to a study in the journal AIDS.

A retrospective study of 11 European pediatric HIV cohorts found a high proportion of patients coinfected with hepatitis C virus who had progressive liver disease, which investigators said highlights the need for close monitoring and earlier and more efficacious hepatitis C virus therapy.

A study in Lancet Infectious Diseases confirmed that injecting drug use is a major contributor to the global burden of disease for HIV, hepatitis C, and hepatitis B. In 2013, an estimated 10 million disability-adjusted life-years were linked to exposure to HIV, hepatitis C, and hepatitis B via injecting drug use, the investigators reported.

rpizzi@frontlinemedcom.com

On Twitter @richpizzi

HIV research update: Late September 2016