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Premature Aging of CD4 Cells May Accelerate HIV Disease Progression

Despite extensive research over the past 3 decades, the mechanisms underlying HIV disease progression are still not fully understood. But a report in the January 7, 2009 Journal of Acquired Immune Deficiency Syndromes adds another piece to the puzzle.

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HIV Mutations Can both Reduce and Enhance Virological Response to Boosted Darunavir (Prezista)

Development of viral resistance to anti-HIV drugs is a potential barrier to long-term treatment success. In the current study, published ahead of print in the January 15, 2009 online edition of the Journal of Antimicrobial Chemotherapy, French researchers sought to identify a pattern of HIV protease gene mutations associated with virological response to regimens containing ritonavir-boosted darunavir (Prezista).

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Adherence Is Reduced in Patients Who Don't Think They Need Antiretroviral Treatment

Adherence is a key contributor to optimal response to antiretroviral therapy. Many factors influence good or poor adherence, including an individual's perceived need for treatment, according to a study published in the December 1, 2008 Journal of Acquired Immune Deficiency Syndromes.

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Longer Exposure to NRTIs, especially Stavudine, Increases the Risk of Insulin Resistance in Women with HIV

As people with HIV live longer thanks to effective antiretroviral therapy (ART), cardiovascular disease and long-term metabolic problems are a growing concern, leading researchers to focus on the relationship between these conditions, HIV infection itself, and antiretroviral treatment. As reported in the December 1, 2008 Journal of Acquired Immune Deficiency Syndromes, Phyllis Tien and colleagues looked at factors associated with insulin resistance, which may progress to diabetes and can increase the risk of cardiovascular disease.

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Latino HIV Patients Starting Antiretroviral Therapy Are Most Likely, and Blacks Are Least Likely, to Develop Lipodystrophy

Body shape changes and metabolic abnormalities -- collectively known as lipodystrophy syndrome -- is common in people with HIV, but it is not yet fully understood whether this is an effect of HIV infection itself, a side effect of antiretroviral therapy, or due to some combination of factors. It is also unclear whether race/ethnicity influences lipodystrophy among HIV positive patients, though it is recognized that metabolic disorders such as diabetes are more common among certain groups in the general HIV negative population.

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Changes in Darunavir (Prezista) Resistance Score after Previous Failure of Boosted Tipranavir (Aptivus) in Multidrug-resistant HIV Patients

Darunavir (Prezista) and tipranavir (Aptivus) are the most recently-approved protease inhibitors. Boosted with low-dose ritonavir (Norvir), they both exhibit activity against multidrug-resistant strains of HIV. However, researchers have not yet clearly defined the optimal sequencing of these 2 antiretroviral agents when used in salvage regimens for highly treatment-experienced patients [1,2].

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Gilead Plans Clinical Trial of 4-in-1 Antiretroviral Combination Pill Containing Experimental Integrase Inhibitor Elvitegravir

The development of combination pills containing 2 or more antiretroviral drugs has reduced the "pill burden" and improved the convenience of HIV treatment. As reported last week by the Bloomberg financial news serviceGilead is now planning studies of a new all-in-one "quad" antiretroviral pill containing the NRTIs tenofovir and emtricitabine (the same ones in Atripla and Truvada) plus the company's experimental integrase inhibitor elvitegravir and a boosting agent, making it the first-ever 4-drug antiretroviral coformulation.

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Antiretroviral Treatment Interruption Is Associated with Evidence of Kidney Dysfunction in SMART Study

Evidence continues to accumulate showing that antiretroviral treatment interruption, as evaluated in the large SMART trial, is a potentially risky strategy. A new study, published in the January 2, 2009 issue of AIDS, sheds further light on kidney dysfunction in this setting.

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Zoledronate Improves Bone Loss in People with HIV

Research indicates that people with HIV are more susceptible to bone loss -- osteopenia or the more severe osteoporosis -- compared with HIV negative individuals. Some studies have reported rates as high as 50%-70%, but it is not yet clear whether this is due to HIV infection itself, immune dysfunction, systemic inflammation, antiretroviral therapy, or some combination of factors.

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