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Issue No. 23 | May 22, 2009

News and Features

CDC: Guidance for H1N1 Virus in HIV-Infected Pregnant Women

"Pregnancy raises risk for complications related to seasonal as well as pandemic influenza infections such as those caused by the novel influenza A (H1N1) virus. The CDC has recently summarized information about novel H1N1 infection during pregnancy and. . . recommends that pregnant women with confirmed, probable, or suspected novel H1N1 infection receive antiviral therapy with oseltamivir (Tamiflu; preferred for its systemic absorption) for 5 days. Therapy should be initiated as soon as possible, even if more than 48 hours have elapsed since symptom onset."

Study: The Effect of Alcohol on HAART Outcomes

"Using a cohort study, differences in HAART effectiveness after 24 weeks of therapy were compared as a function of amount and preference for alcohol, drinking only liquor (LI, n = 55) or only wine or beer (BW, n = 110). Given the critical role of thymus on HAART response, changes in thymus size, CD4s, naïve lymphocytes and viral loads were assessed. . . . After HAART, positive increases in both CD4s (+12 cell counts/mm(3)) and thymus size (+0.7 mm(3)) were evident in the BW group. In contrast, the LI subgroup exhibited a decline in both parameters (-4 CD4 cells/mm(3) and -0.6 mm(3) in thymus size). Women in the LI group exhibited significantly lower CD4 (163.4 +/- 46.2) and naïve counts (178 +/- 69.5) than LI men (CD4: 281.6 +/- 203, P = 0.05; lymphocytes: 301.4 +/- 198, P = 0.04). . . . Liquor was associated with thymus deterioration and thus with poorer viro-immune outcomes after HAART. Subtyping participants by alcohol consumption patterns seems to be clinically relevant and needs to be accounted for in future studies."

Study: Early Antiretroviral Treatment Decreases Viral Load and Central Nervous System Dysfunction in SIV-Infected Rhesus Monkeys

"Neurocognitive disorders are devastating consequences of HIV infection. Although antiretroviral regimens have been efficacious in both improving life expectancy and decreasing dementia, there has not been an effect on the overall prevalence of HIV-associated neurocognitive disorders. . . . Using the simian immunodeficiency virus/macaque model, we investigated the hypothesis that early introduction of antiretroviral treatment can protect the brain. . . .  Early antiretroviral treatment prevents central nervous system dysfunction by decreasing brain viral load and interferon-alpha levels, which can have a profound impact over the course of infection."

Study: Comparative Metabolic Outcomes from NRTI-, NNRTI-, and PI-Sparing Initial Treatment Regimens

"Lipoatrophy was more frequent with efavirenz than lopinavir/r when combined with stavudine or zidovudine, and less frequent when either drug was combined with tenofovir. Lipoatrophy was least frequent with the NRTI-sparing regimen, but this benefit was offset by greater cholesterol elevations and the need for lipid-lowering agents."

Study: Artificial Antibodies Prevent SIV in Monkeys

"Researchers may have discovered a technique that will eventually lead to a way to vaccinate against the AIDS virus, by creating an artificial antibody carried into the body by a virus.

"This synthetic immune system molecule protected monkeys against an animal version of HIV called SIV. . . .

"While it will be years before the concept could be tested in humans, it opens up the possibility of protecting people against the fatal and incurable virus.

"`Six of nine immunized monkeys were protected against infection by the SIV challenge, and all nine were protected from AIDS,' Philip Johnson of Children's Hospital of Philadelphia and colleagues wrote."