Conflicting Data on Bone Fracture Link to HIV Meds

Overall, use of antiretroviral therapy (ART) appears to be associated with a decreased likelihood of bone fractures among people with HIV, but whether specific drugs such as tenofovir increase the risk, reduce the risk, or have a variable effect over time remains unclear based on conflicting data reported in the February 1, 2012, advance online edition of AIDS.

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EACS 2011: Incidence of Non-AIDS Malignancies Stabilizes in D:A:D Study, but Prognosis Improves

Occurrence of non-AIDS-defining cancer has remained stable in recent years, according to an analysis of the large D:A:D observational cohort presented at the 13th European AIDS Conference (EACS 2011) last week in Belgrade. Prognosis for HIV positive people with such malignancies remains poor, but appears to have improved somewhat over time.

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Smoking, not Immune Deficiency is Major Cause of Lung Cancer for People with HIV

Lung cancer was strongly linked to smoking among participants in the Swiss HIV Cohort Study, but did not appear to be clearly associated with reduced CD4 cell levels, according to a report in the January 12, 2012, advance online edition of the British Journal of Cancer. Fortunately, another recent study showed that counseling by HIV care physicians can help patients stop smoking.

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EACS 2011: Neurocognitive Impairment in People with HIV

How much more common is brain impairment and dementia in people with HIV than in the general population? A study presented at the 13th European AIDS Conference (EACS 2011) this week in Belgrade showed that the answer could vary from "no more common" to "4 times as common," according to which group you studied, which sample of the HIV negative population you compared them with, and whether you averaged their neurocognitive (NC) performance over all domains or picked out specific areas of impairment.

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Vitamin D May Improve Bone Health in Young HIV+ People Taking Tenofovir

Taking vitamin D supplements may help prevent hormonal changes linked to bone loss among young adults whose antiretroviral regimen includes tenofovir (Viread, also in the Truvada and Atripla combination pills), according to a recent announcement from the National Institutes of Health (NIH).

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Elevated Triglycerides and Waist Circumference Predict Cardiovascular Risk for People with HIV

HIV positive people with high triglyceride levels and large girth were more likely to have other risk factors associated with cardiovascular disease and events such heart attacks, suggesting that these 2 simple measures may be used to distinguish high-risk versus low-risk individuals, according to a study in the September 22, 2011, edition of the open access journal PLoS ONE.

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Electrocautery Prevents Progression to Anal Cancer in HIV Positive and Negative Gay Men

Electrocautery ablation to remove abnormal tissue significantly reduced the likelihood of progression to anal cancer for both HIV positive and HIV negative gay men with high-grade anal intraepithelial neoplasia, according to a study described in the November 30, 2011, advance online edition of the Journal of Acquired Immune Deficiency Syndromes.

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Function Imaging Changes May Reflect Brain Impairment during Early HIV Infection

Functional magnetic resonance imaging during the early stages of HIV disease reveals changes in connectivity in the brain that may be due to high-level viral replication soon after infection, according to a study in the September 20, 2011, issue of Brain Connectivity. Researchers suggested this method may be useful as a non-invasive marker for future neurocognitive impairment.

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Immune Deficiency Linked to Non-AIDS Cancers in People with HIV

HIV positive people appear more likely than their HIV negative counterparts to develop several types of non-AIDS cancer, and the risk rises with declining immune function, according to a large study of Kaiser Permanente members published in the December 2011 issue of Cancer Epidemiology, Biomarkers, and Prevention.

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HIV+ People on ART Have Stable Bone Density after Short-term Loss

People with HIV tend to experience a loss of bone mineral density soon after starting antiretroviral therapy (ART), but the decline reaches a plateau after about 1 year and remains quite stable thereafter, according to a meta-analysis of nearly 40 studies described in the September 2011 Journal of Clinical Endocrinology and Metabolism.

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Premature Aging and Age-Related Conditions in People with HIV

Older HIV positive people were more likely to have multiple health problems at an earlier age, matching those of HIV negative individuals 10 years older, according to an Italian study described in the December 2011 issue of Clinical Infectious Diseases. A Swiss study in the same issue found that non-AIDS-related conditions including cardiovascular disease, cancer, bone loss, and diabetes are a growing concern as people with HIV survive to older ages due to effective antiretroviral treatment.

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FDA Considers Limits on Osteoporosis Drugs Due to Fracture Risk

An advisory committee of the U.S. Food and Drug Administration (FDA) last week weighed the risks and benefits of bisphosphonate drugs such as alendronate (Fosamax) for managing osteoporosis. The committee recommended limiting the duration of bisphosphonate use, but did not agree on a time frame.

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HIV and Aging Experts Release Guidelines for Managing Older People with HIV

As people with HIV live longer thanks to effective antiretroviral therapy (ART), managing conditions associated with aging has become a major aspect of HIV medicine.

In advance of World AIDS Day (December 1), the American Academy of HIV Medicine (AAHIVM), the American Geriatrics Society (AGS), and the AIDS Community Research Initiative of America (ACRIA) announced the release of a collaborative report offering "best practice" guidelines -- the first ever -- for managing co-existing conditions in older (age 50 and above) HIV positive patients.

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Cryptococcus May Be Misdiagnosed in People with AIDS

People with AIDS who contract cryptococcal infection may have a different organism than usually suspected, Cryptococcus gattii rather than Cryptococcus neoformans, according to a study in the September 1, 2011, online edition of PLoS Pathogens. Prevalence of C. gattii varies by region, and correct identification can help select the most effective treatment.

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IDSA 2011: Heart Problems Are Common Among People with HIV, but Largely Related to Modifiable Risk Factors

Structural and functional cardiac abnormalities were found in more than half of an HIV positive cohort in Washington, DC, according to a report at the 49th Annual Meeting of the Infectious Diseases Society of America (IDSA 2011) last month in Boston. Heart problems were often related to modifiable factors such as obesity and diabetes, suggesting that lifestyle changes may lower the risk.

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Age-Related Fractures Due to Reduced Bone Quality as well as Quantity

Bone loss is a growing concern as the HIV positive population ages. Age-associated bone problems including fractures have largely been attributed to loss of bone mineral density (osteopenia and osteoporosis), but changes in the quality of bone structure play a role as well, according to recent research described in the August 22, 2011, advance edition of Proceedings of the National Academy of Sciences.

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Hepatitis C Patients May Have Increased Risk of Stroke

People with chronic hepatitis C virus (HCV) infection appear to have a higher likelihood of dying from strokes than uninfected individuals, according to research reported in the December 2010 issue of Stroke. Over 17 years of follow-up, nearly 3% of HCV seropositive people dieddue to cerebrovascular events, compared with 1% of HCV negative people; furthermore, the risk of stroke death rose with increasing HCV viral load.

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Diet, Exercise, and Niacin/Fenofibrate Improves Blood Lipids in People with HIV

A combination approach including low-fat diet, exercise, and niacin plus fenofibrate increased HDL good cholesterol and reduced bad cholesterol and triglycerides in HIV positive people on antiretroviral therapy (ART) with abnormal blood lipid levels, researchers reported in the July 2011 Journal of Clinical Endocrinology and Metabolism.

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October 29 Is World Stroke Day

Saturday, October 29, has been designated World Stroke Day, an opportunity to raise awareness about how to prevent strokes -- which studies indicate occur more often among people with HIV and those with hepatitis C -- and how to recognize stroke symptoms to enable prompt treatment.

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Non-AIDS Cancers Linked to Lower CD4 Count in People with HIV

HIV positive people who spent more time with a CD4 cell count < 200 cells/mm³ had a higher risk of developing non-AIDS cancers, in particular those related to infectious causes, according to findings from the Dutch ATHENA cohort published in the June 15, 2011, issue of Clinical Infectious Diseases.

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