Antiretroviral drugs

NAIROBI, 27 June 2011 (PlusNews) - Certain antiretroviral (ARV) drugs commonly used in the developing world may be responsible for premature ageing, according to the authors of a new study published in the journal, Nature Genetics. Newer, less toxic but more expensive ARVs are more commonly used in the Western world.

Nucleoside analogue reverse-transcriptase inhibitors (NRTIs) - including Zidovudine, Lamivudine and Abacavir - have enabled millions of people living with HIV to prolong their lives. The UN World Health Organization has recommended that countries phase out Stavudine, an NRTI commonly used in Africa, due to long-term, irreversible side effects.

"We noticed that people in their 40s who had been on NRTIs for the past several years had signatures of ageing in their muscles commonly found in healthy people in their 70s and 80s," said Prof Patrick Chinnery of the University of Newcastle in the UK, one of the study's lead authors.

The researchers studied skeletal muscle from 33 HIV-infected adults, all aged 50 years or under, and 10 uninfected control subjects of comparable age. They found that in patients on NRTI treatment there was an expansion in mutations of mitochondrial DNA - the energy-producing part of the cell - similar to the mutations found in healthy older individuals.

"What we saw in our study is similar to patterns described by people who have been on ART [antiretroviral therapy] for a long time," said Chinnery.

Studies have found that despite a significant drop in mortality, people living with HIV are often affected by an increased risk of non-AIDS complications, including osteoporosis and heart attacks, which undermine their life-expectancy.

"The findings suggest that we need to look carefully at the effects of these drugs because some of the diseases caused by the abnormalities - diabetes, heart failure and so on - are serious and can cause progressive disability," Chinnery noted.

"But at the same time, clearly the patients need their drugs in order to keep them alive... but our study suggests that it may be beneficial to move to newer classes of drugs."

Chinnery said there was a need to conduct prospective studies on the likely effects of long-term use of different ARVs in order to catch and address potentially harmful side effects.

The initial CD4 cell counts of patients newly infected with HIV fell significantly between 1985 and 2001, US research published in the May 1st edition of Clinical Infectious Diseases has shown. This suggests that the virus may have evolved to become more virulent during this time period, which could have clinical implications, shortening the interval between infection with HIV and the need to start HIV treatment. In people with HIV, CD4 cell counts provide an important indication of the strength of the immune system, of HIV disease progression and of when to start antiretroviral treatment.

A DURBAN hospital has cut the transmission of HIV from pregnant mothers to their babies to less than 3% with dual therapy. The study started with all 2 624 pregnant women who attended McCord's antenatal clinic during the 18 months from March 2004 to August 2005.

A commonly used AIDS drug appears to nearly double the risk of a heart attack, researchers said Tuesday. In a study published online by the medical journal Lancet, the researchers also said another less frequently used AIDS drug increased the chances of a heart attack by 50 percent.

A new generation of HIV drugs is so promising that researchers are talking about eradicating the virus, an international Aids conference will be told in Sydney next week. The International Aids Society (IAS) conference from July 22-25 will bring together more than 5 000 experts from around the world to hear presentations on the cutting edge of HIV/Aids research.

A combination of two experimental AIDS drugs can help control the deadly virus in people who are infected with highly resistant forms, an international team of researchers reported on Thursday.

African countries are facing serious financial and practical dilemmas over implementing recent World Health Organization (WHO) guidelines urging a shift away from d4T-based combinations for first-line antiretroviral treatment, the 2007 HIV Implementers' Meeting heard last week in Kigali, Rwanda.

The South African Public Sector strike has meant that many public sector patients with HIV may or already have had their treatment interrupted. This applies to antiretrovirals, as well as opportunistic illness treatment.

Women can take the anti-AIDS drug nevirapine to protect their unborn children without endangering their ability to undergo life-saving antiretroviral treatment later on, a new study has found.

CAPE TOWN - The health department moved this weekend to correct figures it released last week on the number of HIV patients receiving AIDS drugs at state facilities, saying it had accidentally doubled the number of children on treatment.