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Issue No. 25 | June 17, 2011

News and Features

Updated Guide for HIV/AIDS Clinical Care Now Available

The Health Resources and Services Administration (HRSA) published an updated Guide for HIV/AIDS Clinical Care. This manual provides HIV/AIDS clinicians with practical medical information regarding the treatment of HIV/AIDS. The guide is organized into 10 sections that include information on HIV testing, prevention, treatment, coinfections and complications, medication interactions, neuropsychiatric disorders, and oral health. There is also a section that includes links to additional resources for clinicians and patients.

Printed copies of the manual can be ordered on the HRSA Web site.

CDC Updates “HIV and TB” Fact Sheet

The Centers for Disease Control and Prevention (CDC) recently updated the “HIV and TB” fact sheet. This fact sheet provides information and statistics on tuberculosis (TB) and how it affects people with HIV infection. Prevention challenges and actions the CDC is taking to prevent the further spread of TB are also detailed.

Study Examines Impact of Baseline HIV Tropism on Viral Response in HIV-Infected People Receiving First-Line Antiretroviral Therapy

“Viral tropism influences the natural history of human immunodeficiency type 1 (HIV-1) disease: X4 viruses are associated with faster decreases in CD4 cell count. There is scarce information about the influence of viral tropism on treatment outcomes. … Baseline plasma samples from patients recruited to the ArTEN (Atazanavir/[ritonavir] vs. Nevirapine on a background of Tenofovir and Emtricitabine) trial were retrospectively tested for HIV-1 tropism … . ArTEN compared nevirapine with atazanavir-ritonavir, both along with tenofovir-emtricitabine, in drug-naïve patients. … Of 569 ArTEN patients, 428 completed 48 weeks of therapy; 282 of these received nevirapine and 146 of these received atazanavir-ritonavir. Overall, non-B subtypes of HIV-1 were recognized in 96 patients (22%) and X4 viruses were detected in 55 patients (14%). At baseline, patients with X4 viruses had higher plasma HIV RNA levels (5.4 vs 5.2 log copies/mL, respectively; P = .044) and lower CD4 cell counts (145 vs 188 cells/μL, respectively; P < .001) than those with R5 strains. At week 48, virologic responses were lower in patients with X4 viruses than in patients with R5 viruses (77% vs 92%, respectively; P = .009). Multivariate analysis confirmed HIV-1 tropism as an independent predictor of virologic response at week 24 (P = .012). This association was extended to week 48 (P = .007) in clade B viruses. Conversely, CD4 cell count recovery was not influenced by baseline HIV-1 tropism. … HIV-1 tropism is an independent predictor of virologic response to first-line antiretroviral therapy. In contrast, it does not seem to influence CD4 cell count recovery.”

More information is available: