When to start HIV treatment: cohort studies disagree on how early

Two major analyses of the risk of death or AIDS-related illness in people who started treatment at different CD4 counts have produced conflicting evidence about the benefit of starting treatment substantially earlier than current guidelines recommend, the Sixteenth Conference on Retroviruses and Opportunistic Infections heard on Monday.

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HIV infection has similar impact on hardening of arteries as smoking, diabetes

HIV infection independently increases the severity of atherosclerosis as much as traditional cardiovascular risk factors such as smoking and diabetes, researchers reported on Wednesday at the Sixteenth Conference on Retroviruses and Opportunistic Infections in Montreal.

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Rosiglitazone improves fat loss and insulin resistance in people with lipoatrophy

The diabetes drug rosiglitazone (Avandia) improved limb lipoatrophy in HIV-positive people taking antiretroviral therapy, researchers reported Wednesday at the Sixteenth Conference on Retroviruses and Opportunistic Infections in Montréal. However the researchers did not study the drug's effect on facial fat loss.

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Diabetes, high blood pressure and smoking raise risk of death for all people with HIV

A number of modifiable or preventable medical conditions can nearly double the risk of death in people with HIV, a large cohort study has found, and can double the risk of death due to specific causes. Colette Smith of University College Medical School, London, presented the latest analysis of the D:A:D study to the Sixteenth Conference on Retroviruses and Opportunistic Infections in Montreal on Wednesday.

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Certain protease inhibitors and abacavir linked to heart attacks in two large cohort studies

The latest follow-up data from two large cohort studies, presented on Monday at the Sixteenth Conference on Retroviruses and Opportunistic Infections in Montreal, adds further evidence that specific protease inhibitors (PIs) and nucleos(t)ide reverse transcriptase inhibitors (N(t)RTIs) are associated with a higher risk of cardiovascular problems in people with HIV.

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Treatment switches on basis of CD4 declines often unnecessary, Uganda research shows

Switching people to second-line antiretroviral treatment on the basis of CD4 declines, without information from viral load tests, could result in a large numbers of unnecessary switches to more expensive second-line regimens in resource-limited settings, a study in Uganda has found.

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Disadvantage of late treatment start in Africa may persist for years, studies find

Starting antiretroviral therapy earlier, before the development of symptoms, is the most likely way to reduce the high death rates after treatment initiation seen in people with HIV in resource-limited settings, two large cohort analyses show. The studies also show that the major disadvantage of starting treatment late - an increased risk of death - may persist for some years, burdening already overstretched health systems with illness that could be avoided by earlier treatment.

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Double-dose lopinavir/ritonavir provides insufficient lopinavir exposure in children on rifampicin-based TB treatment

Doubling the dose of lopinavir/ritonavir (Kaletra) in children with HIV on rifampicin-based TB treatment fails to provide adequate lopinavir concentrations according to a drug interaction study presented this week at the Sixteenth Conference on Retrovirus and Opportunistic Infections in Montréal

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