Mortality in HIV+ immunosuppressed adults is increasing. Therefore, to reduce mortality scientists have designed two innovative strategies, where intensive screening is equivalent to preventive treatment.
Immediate Antiretroviral Therapy After HIV Improves Retention Rates
Antiretroviral therapy (ART) immediately after a HIV diagnosis dramatically improves retention in clinical HIV care.
Antiretroviral therapy (ART) immediately after a HIV diagnosis dramatically improves retention in clinical HIV care.
‘The intensive, systematic initiation of antituberculosis treatment is equivalent to preventive therapy in reducing mortality in severely immunosuppressed HIV-infected adults.’
The results were presented at the Conference on Retroviruses and Opportunistic Infections held in Boston. Despite increased access to HIV screening and antiretroviral therapy, many HIV-infected people still enter healthcare systems very late, by which time severe immunosuppression complicates management.
Mortality is high in these patients, notably because of tuberculosis, the leading cause of death in HIV-infected people. Patients who initiate antiretroviral therapy late are currently offered simple tuberculosis screening.
Antiretroviral Therapy for 4 Days a Week Shows Positive Results
The four-day antiretroviral regimen had the same treatment efficacy as patients on everyday regimen. But patients on the four-day regimen experienced fewer side effects.
The four-day antiretroviral regimen had the same treatment efficacy as patients on everyday regimen. But patients on the four-day regimen experienced fewer side effects.
The first results of this study, which is conducted by Professors François-Xavier Blanc (CHU de Nantes) and Serge Domoua (Programme PAC-CI, CHU de Treichville, Abidjan) and their colleagues in Cambodia, Côte d'Ivoire, Uganda, and Vietnam, will be disclosed in an oral presentation at the Conference on Retroviruses and Opportunistic Infections (CROI 2018).
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Antiretroviral Therapy Reduces Food Insecurity
Contributing to the disruption of a lethal syndemic, starting HIV-infected patients are treated with antiretroviral therapy which reduces food insecurity and improves physical health.
Contributing to the disruption of a lethal syndemic, starting HIV-infected patients are treated with antiretroviral therapy which reduces food insecurity and improves physical health.
In the first arm, the patients underwent tuberculosis screening comprising an Xpert MTB/RIF test and a urine lipoarabinomannan assay.
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Regular Antiretroviral Therapy Reduces HIV in the Female Reproductive Tract
For the first time, investigators have determined how ART affects the way HIV disseminates and establishes infection in the female reproductive tract.
For the first time, investigators have determined how ART affects the way HIV disseminates and establishes infection in the female reproductive tract.
In the second arm, all patients received systematic antituberculosis therapy.
The success rates of these two strategies, as a function of the number of deaths or of invasive bacterial infections during the first 24 weeks of follow-up, were higher than that previously reported in the literature for simple tuberculosis screening.
There was no significant difference between the two strategies.
ANRS STATIS therefore shows that systematic initiation of antituberculosis treatment is no superior than intensive tuberculosis screening in reducing mortality in severely immunosuppressed HIV-infected adults when they enter the healthcare system.
The study is still ongoing and new analyses will be performed for each patient after 48 weeks of follow-up. The two strategies compared in this study are particularly suited to resource-limited settings.
Source-Eurekalert
