Levels of the HIV entry inhibitor maraviroc (Selzentry) in vaginal and rectal tissues did not reach high enough levels with a single oral dose to confer protection against HIV in a laboratory study, researchers reported at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) last week in Seattle. Multiple doses, however, could still potentially be effective for pre-exposure prophylaxis, or PrEP.
People starting antiretroviral therapy containing raltegravir (Isentress) and those starting boosted atazanavir (Reyataz) or darunavir (Prezista) experienced significant increases in both abdominal and limb fat, with no evidence of greater fat gains among those taking HIV protease inhibitors, according to findings presented at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) last week in Seattle.
[Grace McComsey, CROI, February 26, 2015]
"We saw a significant increase in peripheral and central fat with all the regimens," McComsey said, describing results from the ACTG 5260s substudy at a CROI press conference. "We used to think protease inhibitors were associated with central fat accumulation, but here even an integrase inhibitor made patients gain as much fat."
She added, however, that people who started antiretroviral therapy before they experienced advanced immune suppression gained less fat, suggesting that this is another reason to start people on treatment "right away, regardless of CD4 count."
GA McComsey, C Moser, JS Currier, et al. Body Composition Changes After Initiation of Raltegravir or Protease Inhibitors . 2015 Conference on Retroviruses and Opportunistic Infections. Seattle, February 23-24, 2015. Abstract 140.
Tenofovir alafenamide (TAF), a new formulation that has lower concentrations in the blood but reaches higher levels in cells, is as effective as the older version, tenofovir disoproxil fumarate (TDF), according to a report at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) this week in Seattle. A second study showed that TAF has less detrimental effects on the kidneys and bones compared with TDF. TAF has been submitted for approval in the U.S. and Europe.
The burden of hepatitis C virus (HCV) infection is high in the U.S., with a nearly half of individuals born between 1945 and 1965 having severe fibrosis or cirrhosis and therefore being at high priority for treatment, according to a report presented at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) last week in Seattle.