BMD Correlates with Number of HIV Regimens (CME/CE)

BMD Correlates with Number of HIV Regimens (CME/CE)

The number of HIV treatment regimens a patient undergoes appears to correlate with loss of bone mineral density (BMD), researchers reported here at the International Aids Society Conference on HIV Pathogenesis, Treatment, and Prevention.

Blood Test May Flag Impending COPD Flares (CME/CE)

Blood Test May Flag Impending COPD Flares (CME/CE)

Easily measured biomarkers of inflammation could give advance warning of chronic obstructive pulmonary disease (COPD) exacerbations, researchers said.

When COPD patients in a prospective Danish study had high levels of C-reactive protein (CRP), serum fibrinogen, and leukocyte count, their risk of experiencing a disease flare during the following year was increased by a factor of 2.5 (95% CI 1.8-3.4) compared with patients who did not have high values for any of these measures, according to Børge Nordestgaard, DMSc, of Copenhagen University Hospital in Denmark, and colleagues.

Switch to Quad Pill Maintained HIV Suppression (CME/CE)

Switch to Quad Pill Maintained HIV Suppression (CME/CE)

HIV patients can be successfully switched from a twice-daily integrase inhibitor regimen to a once-daily, single-tablet regimen without loss of viral suppression, researchers reported here.

At 48 weeks, all 46 patients who switched from a raltegravir-based (Isentress) regimen to the four-drug, elvitegravir-cobicistat-tenofovir-emtricitabine (Stribild) pill were able to maintain undetectable viral load using the 50 copies/ml assay, said Gordon Crofoot, MD, a Houston-based HIV researcher in private practice.

Quad Pill for HIV Appears Safe in Renal Disease (CME/CE)

Quad Pill for HIV Appears Safe in Renal Disease (CME/CE)

HIV patients with mild to moderate renal impairment appear to tolerate treatment with a combination tablet that contains drugs known to impact kidney function, a phase III, open-label, two-cohort study found.

The treatment group receiving the four-drug combination of elvitegravir, cobicistat, tenofovir DF, and emtricitabine, branded as Stribild, saw a small impact on estimated creatinine clearance (eCCr), but the change rapidly plateaued and may not be clinically meaningful, Frank Post, MD, a reader in HIV at Kings College Hospital in London, told MedPage Today

Single HIV Pill Not Always Best (CME/CE)

Single HIV Pill Not Always Best (CME/CE)

HIV patients taking single pills containing three drugs are thought to be less likely to stop taking their medications than those on more complicated regimens, but that may not be completely accurate, researchers said here.
In a retrospective, observational study, people taking the most widely used single pill were just as likely to switch therapies as were those on multipill regimens, according to Benoit Trottier, MD, of Clinique Medicale L'Actuel in Montreal, and colleagues at the AIDS Society Conference on HIV Pathogenesis, Treatment, and Prevention.

Quad Pill Works Over 2 Years (CME/CE)

Quad Pill Works Over 2 Years (CME/CE)

In pooled results from two randomized clinical trials, treatment with the four-drug, once-daily single tablet (Stribild) continued to show efficacy comparable with other anti-HIV regimens out to 96 weeks, researchers said here.

After 96 weeks, 84% of patients on the 'quad' achieved undetectable suppression of HIV using the 50 copies/mm3 assay compared with viral suppression in 82% of patients on the combination of efavirenz-emtricitabine-tenofovir (Atripla), said David Cooper, MD, professor of medicine at the Kirby Institute, University of New South Wales, Sydney.

Prezista Extends HIV Suppression in Children (CME/CE)

Prezista Extends HIV Suppression in Children (CME/CE)

Children with human immunodeficiency virus (HIV) maintain viral control for 48 weeks when treated with the protease inhibitor darunavir/ritonavir (Prezista) along with an optimized background regimen, researchers reported here.

In the Darunavir in Treatment Experienced Pediatric Population (ARIEL) study, 81% of the 21 children ages 3 to 5 years were able to achieve viral suppression to undetectable limits using the 50 copies/ml assay, an increase from the 57% viral suppression rate at 24 weeks, said Avy Violari, MD, deputy executive director of the Perinatal HIV Research Unit at Chris Hani Baragwaneth Hospital, Soweto, South Africa.

Etravirine Good Tx Switch Option in HIV (CME/CE)

Etravirine Good Tx Switch Option in HIV (CME/CE)
The non-nucleoside reverse transcriptase inhibitor etravirine (Intelence) is a good option for HIV patients who can't or don't want to tolerate their current drug regimen, a researcher said here.

In a retrospective cohort analysis, patients switching with an undetectable HIV viral load -- usually because of adverse effects -- were able to maintain viral suppression, according to Lauren Bull, MD, of Chelsea and Westminster Hospital in London.

Investigational HIV Treatment Promising (CME/CE)

Investigational HIV Treatment Promising (CME/CE)
The investigational anti-HIV drug dolutegravir outperformed raltegravir (Isentress) in a randomized trial among patients needing salvage therapy, a researcher said here.

After 48 weeks of therapy, HIV patients who had failed earlier regimens were significantly more likely to control their virus if they were taking dolutegravir, according to Pedro Cahn, MD, of Fundación Huesped in Buenos Aires.

Low-Dose Drug Combo Safe in Kids with HIV (CME/CE)

Low-Dose Drug Combo Safe in Kids with HIV (CME/CE)
A low-dose treatment regimen with lopinavir/ritonavir antiretroviral therapy appears to have similar efficacy with fewer adverse events than standard dosing in HIV-infected children, researchers said here.

In the intention-to-treat analysis, 89 of 101 children (88.1%) on the low-dose regimen achieved undetectable viral loads using the 50 copies/ml assay (P
=0.38) compared with 90 of 98 children treated with the standard dose of lopinavir/ritonavir (Kaletra), said Thanyawee Puthanakit, MD, from Chulalongkorn University in Bangkok, and colleagues.
"This study demonstrated non-inferiority in virologic efficacy of low dose compared to standard dose lopinavir/ritonavir tablets as maintenance therapy," she reported at the International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention.

Early Therapy May Lead to HIV Remission (CME/CE)

Early Therapy May Lead to HIV Remission (CME/CE)

Preliminary data from a French randomized trial suggest that early HIV treatment might be a step toward so-called post-treatment control, a researcher said here.

Post-treatment control is what investigators are calling the ability to stop HIV therapy -- after some time on treatment -- without having the virus resume replication within the body.

Some 14 patients -- known as the Visconti cohort and all treated within weeks of their infection -- have been shown to have such control, some for several years, according to Antoine Cheret, MD, of Sorbonne-Paris-Cite University in Paris.

Early HIV Treatment Restores Immune System (CME/CE)

Early HIV Treatment Restores Immune System (CME/CE)

Antiretroviral therapy can restore aspects of a normal immune system in some patients with chronic HIV, as well as reduce the size of the viral reservoir, a researcher said here.

The catch is they have to start with a relatively intact immune system, with at least 500 CD4-positive T cells per microliter of blood, according to Laurent Hocqueloux, MD, of the Centre Hospitalier Régional in Orleans, France.

Blood Tests May Aid Alzheimer's Diagnosis (CME/CE)

Blood Tests May Aid Alzheimer's Diagnosis (CME/CE)

Several novel markers detectable in blood could prove to be useful adjuncts in diagnosis and management of patients with Alzheimer's disease and other dementias, researchers suggested here.

In separate studies, researchers found significant associations between fragments of tau protein, metabolites of thiamine, and apolipoprotein J (also known as clusterin) in blood products such as serum with clinical diagnoses and/or results of neurocognitive tests, according to presentations at the Alzheimer's Association International Conference.

HIV Drugs Getting Better (CME/CE)

HIV Drugs Getting Better (CME/CE)

The efficacy of HIV drugs in clinical trials has increased markedly over time, according to a meta-analysis of 144 studies with more than 40,000 participants.

Efficacy -- defined as the proportion of patients able to suppress HIV to undetectable levels -- was about 47% in trials conducted before 2000, according to Frederick Lee, MD, of the St. Vincent's Centre for Applied Medical Research, Sydney, in Australia.

Link Seen in Age at Retirement and Risk of Alzheimer's (CME/CE)

Link Seen in Age at Retirement and Risk of Alzheimer's (CME/CE)

French retirees who had stopped working relatively late in life were less likely to develop Alzheimer's disease, a researcher reported here.

Analysis of a French healthcare insurer's records indicated that, for each year after age 60 at which a person retired, the risk of subsequently developing Alzheimer's disease was lower by 3.2% (HR 0.968, 95% CI 0.962-0.973), said Carole Dufouil, PhD, of INSERM in Bordeaux, France.

Statin On-Board May Cut Cancer Risk in HIV Infection (CME/CE)

Individuals infected with human immunodeficiency virus (HIV) who are on statin therapy are significantly less likely to develop cancer, researchers said here at the International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention.

In a retrospective analysis, Vincenzo Spagnuolo, MD, a resident in infectious diseases at Ospedale San Raffaele, Milan, observed that 363 individuals out of 4617 who were not on statins (7.9%) were diagnosed with cancer compared with 12 of 740 patients on statins (1.3%).

Gene Test Gives Clues to Asthma Persistence (CME/CE)

Genetic risk assessment can provide useful information about whether childhood asthma will remit or persist, but a clinically meaningful test based on identified gene variants is likely many years away, researchers found.

Analysis of data from a four-decade longitudinal study involving almost 1,000 people revealed that those with higher genetic risk scores were more than a third more likely to continue to suffer from asthma as adults than were those with lower scores, based on the 15-variant prediction model (RR 1.36, 95% CI 1.14-1.63).

Mom's Worrying Linked to Kid's Asthma (CME/CE)

Adolescents with asthma reported worse symptoms of breathlessness when they had anxious mothers, and the link may have more to do with genes than environment, researchers suggested.

Findings from a Swedish twin study shows that maternal anxiety was significantly associated with adolescent asthma (odds ratio 2.02, 95% CI 1.15-3.55) reported by the mother on one anxiety measure, and it was significantly associated with breathlessness (OR 1.74, CI 1.04-2.91) reported by the adolescent on several anxiety measures, according to Catarina Almqvist, MD, PhD, from the Karolinska Institutet in Stockholm, and colleagues.

Sleep May Ease Asthma in Teens (CME/CE)

A pilot sleep extension program for teens with asthma was associated with improved daytime lung function and fewer nighttime symptoms, researchers reported here.

Teens with asthma who got more sleep during an experimental sleep extension program had significantly fewer nocturnal asthma symptoms (P
=0.001) and less variability in objective daily lung function (P=0.05), according to Lisa Meltzer, MD, of the National Jewish Health Center in Denver, Colo., and colleagues.
Longer sleep among teens with asthma was also associated with moderate effects on executive functioning, Meltzer said during an oral presentation at the Associated Professional Sleep Societies meeting.