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Side Effects - HIV

HIV Glasgow: HIV Treatment Benefits Outweigh Clinical Impact of Lipodystrophy

Over a 20-year period, people who suffered lipodystrophy (abnormal fat distribution) and especially lipoatrophy (fat loss) when they started antiretroviral therapy (ART) actually had better health outcomes than people who did not suffer from it, according to a report at the 2016 International Congress on Drug Therapy in HIV Infection (HIV Glasgow) last week.

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CROI 2015: Similar Fat Gain Seen with Different Antiretroviral Regimens [VIDEO]

People starting antiretroviral therapy containing raltegravir (Isentress) and those starting boosted atazanavir (Reyataz) or darunavir (Prezista) experienced significant increases in both abdominal and limb fat, with no evidence of greater fat gains among those taking HIV protease inhibitors, according to findings presented at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) last week in Seattle.

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[Grace McComsey, CROI, February 26, 2015]

"We saw a significant increase in peripheral and central fat with all the regimens," McComsey said, describing results from the ACTG 5260s substudy at a CROI press conference. "We used to think protease inhibitors were associated with central fat accumulation, but here even an integrase inhibitor made patients gain as much fat."

She added, however, that people who started antiretroviral therapy before they experienced advanced immune suppression gained less fat, suggesting that this is another reason to start people on treatment "right away, regardless of CD4 count."

3/3/15

Reference

GA McComsey, C Moser, JS Currier, et al. Body Composition Changes After Initiation of Raltegravir or Protease Inhibitors
. 2015 Conference on Retroviruses and Opportunistic Infections. Seattle, February 23-24, 2015. Abstract 140.

CROI 2012: ART Liver Toxicity is Lower with Modern Regimens, but Still a Risk for HIV/HCV Coinfected

Liver toxicity related to antiretroviral therapy (ART) has become less common in recent years thanks to development of better tolerated drugs and improved understanding of how to use them. But HIV positive people coinfected with hepatitis C remain at higher risk, researchers reported at the 19th Conference on Retroviruses and Opportunistic Infections (CROI 2012) this month in Seattle.

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Crofelemer Improves Diarrhea in People with HIV

Crofelemer (brand name Fulyzaq) was well-tolerated and significantly reduced non-infectious diarrhea among HIV positive people taking antiretroviral drugs, according to a study published in the November-December 2013 issue of HIV Clinical Trials.

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FDA Committee Rejects Capsaicin Patch for HIV Neuropathy Pain

An advisory committee of the U.S. Food and Drug Administration (FDA) last week unanimously voted against approval of a capsaicin patch for relief of HIV-related neuropathy pain, due to insufficient evidence of its effectiveness.alt

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IAS 2013: Kidney Problems Linked to Tenofovir Use, Improve with Switch to Abacavir

Indian people with HIV who took tenofovir had a higher rate of kidney impairment than westerners, according to a study presented at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) this month in Kuala Lumpur. A related study found that switching from tenofovir to abacavir reduced kidney risk.

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UCSF Answers Patient and Provider Questions about Tenofovir Kidney Study

The University of California at San Francisco (UCSF) has issued a set of frequently asked question and answers for patients and clinicians regarding a study in this week's issue of AIDS finding a link between tenofovir (Viread, also in the Truvada and Atripla combination pills) and kidney impairment.alt

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IAS 2013: Genetic Testing Lowers Risk of Nevirapine Skin Rash

Screening for genetic mutations could substantially reduce the risk of hypersensitivity reactions involving skin rash among people starting nevirapine, according to a late-breaker report at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) this month in Kuala Lumpur.

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Large Study Finds Tenofovir Linked to Increased Kidney Risk

HIV positive people who took tenofovir (Viread, also in the Truvada and Atripla combination pills) were more likely to show signs of impaired kidney function, according to an observational study of more than 10,000 people described in the February 4, 2012, advance online edition of AIDS.

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Raltegravir (Isentress) Can Cause Central Nervous System Side Effects for People with HIV

The HIV integrase inhibitor raltegravir (brand name Isentress) is generally safe and well-tolerated, but it can cause central nervous system (CNS) symptoms such as insomnia, dizziness, and mood changes, especially when used with other drugs that raise its levels in the body, researchers reported in the October 1, 2012, advance online edition of AIDS. alt

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IDSA 2011: Capsaicin Patch Reduces Pain Due to HIV-Associated Neuropathy

A patch containing 8% capsaicin -- a compound derived from chili peppers -- significantly relieved the pain of nerve damage related to HIV or its treatment, investigators reported at the 49th Annual Meeting of the Infectious Diseases Society of America (IDSA 2011) last month in Boston.alt

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1 in 5 People on Atripla Switch, Usually Due to Central Nervous System Side Effects

One-fifth of all people who start the Atripla (efavirenz/tenofovir/emtricitabine) combination pill eventually may need to change to a different regimen, most often due to neuropsychiatric symptoms such as insomnia, abnormal dreams, dizziness, anxiety, or depression, according to a study described in the July 17, 2012, issue of AIDS. alt

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IDSA 2011: Tenofovir Not Linked to Increased Kidney Risk in HIV+ Veterans Study

Use of tenofovir (Viread, also in the Truvada and Atripla coformulations) was not associated with a higher risk of kidney toxicity compared with other antiretroviral agents, according to a study presented at the 49th Annual Meeting of the Infectious Diseases Society of America (IDSA 2011) last month in Boston.

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NIH Offers Free Database of Drugs Associated with Liver Injury

The National Institutes of Health (NIH) last week launched the new LiverTox database of drugs known to have the potential to cause liver toxicity -- the leading cause of acute liver failure in the U.S. In addition to prescription drugs, it also includes over-the-counter medications, herbal remedies, and supplements. A number of antiretroviral drugs used to treat HIV appear on the list. alt

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Peripheral Neuropathy Still Common, Capsaicin Patch Can Help

Nerve damage in the feet remains common among people with HIV in the ART era, though is often asymptomatic. A patch containing capsaicin -- derived from hot peppers -- relieved pain in people with HIV-associated neuropathy, researchers reported at a recent pain conference.

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Researchers Uncover Mechanism for Abacavir Hypersensitivity

As described in the May 19, 2012, advance online edition of AIDS, scientists have revealed how the nucleoside reverse transcriptase inhibitor abacavir (Ziagen, also in the Epzicom combination pill) can cause hypersensitivity in the small proportion of individuals with the HLA-B*5701 gene variation.alt

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CROI 2011: Reduced Limb Muscle, More Belly Fat Linked to Higher Mortality

HIV positive people who lose muscle in their arms and legs while gaining abdominal fat are at increased risk of death, according to findings from the FRAM study presented at CROI 2011. alt

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Pfizer Halts Phase 3 Trial of Pregabalin (Lyrica) for HIV Neuropathy Pain

Pfizer last week announced that it is halting late-stage clinical studies of pregabalin (brand name Lyrica) after an interim analysis showed that the drug did not relieve HIV-related neuropathy pain more than placebo.alt

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Tesamorelin (Egrifta) Now Available to Manage HIV-related Lipodystrophy

Tesamorelin, the recently approved treatment for lipodystrophy, is now commercially available under the brand name Egrifta, according to a recent announcement from EMD Serono. The company will offer a patient assistance program for low-income individuals and a co-pay assistance program for people with insurance, as well as patient training on how to inject the new medication.

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CROI 2012: Crofelemer Reduces Diarrhea in People with HIV; FDA Grants Priority Review

A plant compound known as crofelemer significantly decreased the frequency of secretory diarrhea in HIV positive patients, researchers reported at the 19th Conference on Retroviruses and Opportunistic Infections (CROI 2012) last month in Seattle. The U.S. Food and Drug Administration (FDA) has given crofelemer priority review status and is expected to take action by early June.alt

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NIH Scientists Shed Light on Immune Reconstitution Inflammatory Syndrome (IRIS)

Newly published research by scientists at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), sheds light on a poorly understood, acute illness called Immune Reconstitution Inflammatory Syndrome (IRIS) that develops in some HIV-infected individuals soon after they begin antiretroviral therapy. IRIS is a significant problem in the treatment of HIV patients. Following is an announcement from the NIH about the results of the new study.

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