Prevention of the future
A successful vaccine is still a long way off and will unlikely be 100% successful. Prevention strategies of the future will most likely combine current methods with a vaccine plus topical microbicides.
The most successful Pre-Exposure Prophylaxis (PREP) strategy trailed to date appears to be Truvada (tenofovir + emtricitabine) taken 24 hours before and two hours after exposure.
USA catches up
Jim Pickett from AIDS Research in Chicago endorsed America’s first ever national HIV/AIDS Strategy and remarked that he particularly liked the way it has prioritised key populations at risk, rather than taking a blanket approach towards prevention. Prioritising MSM in the strategy was a gratifying step forward, he said.
He also welcomed the prospect of rectal microbicides (douches and lubes) as they will sit quite comfortably as safe sex interventions for men in their pursuit of pleasure.
The benefits of not smoking
It didn’t come as any surprise to learn that the risk of developing cardiovascular disease drops significantly after someone with HIV stops smoking. Results from the D.A.D study show by just how much. While people are still two to three times as likely to develop the disease in the first year after stopping, the risk drops to one to two times after three years
Anal cancer is now the most common non-AIDS-related cancer. Smoking emerged (again) as a major risk factor for the disease, as it is for the other top cancers: lung and cervical.
Abacavir v tenofovir
For those at risk of cardiovascular diseases, there was further proof that changing from abacavir to tenofovir can improve arterial stiffness and reduce cholesterolAn essential component of cell membranes and nerve fibre insulation, cholesterol is important for the metabolism and transport of fatty acids and the production of hormones and Vitamin D. Cholesterol is manufactured by the liver, and is also present in certain foods. High blood cholesterol levels have been linked to heart disease and may be a side effect of some anti-HIV medications..
Abacavir didn’t fare particularly well in results from the ALTAIR study, either, with people on the abacavir/AZT armAny of the treatment groups in a randomised trial. Most randomised trials have two "arms," but some have three "arms," or even more. showing raised lipidA fat. levels and therefore changing treatment after 48 weeks.
Tenofovir’s link to kidney damage appears to be more prevalent when the drug is prescribed in a combination that also includes ritonavir as a boosting agent.
What to start
In a session on the best combination to start with, Truvada (tenofovir/emtricitabine) + efavirenz (TDF/FTC + EFV) emerged as the marginally most effective overall. However, the combination is now just one of four preferred starting regimens.
The others are: ritonavir-boosted atavanavir + Truvada (ATV/r + TDF/FTC), ritonavir-boosted darunavir + Truvada (DRV/r + TDF/FTC) and raltegravir + Truvada (RAL +TDF/FTC).
If you’re interested in checking out the current AntiretroviralA medication or other substance which is active against retroviruses such as HIV. Guidelines for Australia, you can view them at www.ashmAustralasian Society for HIV Medicine. The peak Australasian organisation representing the medical and health sector in HIV/AIDS and related areas. .org.au
Results from the MERIT study indicate that maraviroc appears to have a role to play in systemic inflammation as well as reducing immune activation. It is currently being considered by Australian authorities for first line treatment. Maraviroc is currently available on the PBS[Pharmaceutical Benefits Scheme] The federal government program which subsidises medication costs in Australia. Anti-HIV drugs are part of a special part of the PBS called Section 100 (S100) which is used for expensive, highly specialised drugs. for treatment experienced patients, providing of course that they have CCR5-topic virusA small infective organism which is incapable of reproducing outside a host cell..