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Liver, Kidney & Bone Toxicity

IAS 2017: People with HIV Are at Risk for Liver Fibrosis and Steatosis

Metabolic syndrome, type 2 diabetes, and obesity are risk factors for the development of liver fibrosis and steatosis (liver fat accumulation) in people living with HIV, including those who do not have viral hepatitis coinfection, according to research presentedat the 9th International AIDS Society Conference on HIV Science (IAS 2017) last month in Paris.alt

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Truvada PrEP Causes Only Minimal Bone Loss, Raltegravir Easier on Bones than PIs

Use of tenofovir/emtricitabine (Truvada) for HIV pre-exposure prophylaxis (PrEP) was associated with a small decrease in bone mineral density that stabilized after the first 6 months, according to study findings reported in the April 23 edition of Clinical Infectious Diseases. Related research showed that HIV-positive people starting an antiretroviral regimen containing the integrase inhibitor raltegravir (Isentress) experienced less bone loss than those taking protease inhibitors.

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ICAAC 2013: Dolutegravir Shows Good Efficacy Across Patient Groups

The new integrase inhibitor dolutegravir (Tivicay) worked better than boosted darunavir for people starting HIV treatment for the first time, researchers reported at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2013) last week in Denver. Another study found that dolutegravir worked well across sex, race/ethnicity, and age groups.

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IDWeek 2014: Earlier Treatment, NNRTI Use Predict Slower HIV Rebound After Stopping ART

HIV viral load usually begins to rise again within 4 to 8 weeks after stopping antiretroviral therapy (ART), though starting treatment earlier in the course of infection and using a non-nucleoside reverse transcriptase inhibitor (NNRTI) may delay viral rebound, according to study findings presented at IDWeek 2014 last week in Philadelphia.

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ICAAC 2013: New Tenofovir Formulation Has Less Effect on Kidneys and Bones

Tenofovir alafenamide (TAF), a new formulation that reaches higher levels in cells but allows for lower dosing, was as effective as the current tenofovir disoproxil fumarate (TDF) formulation but had less impact on markers of kidney function and bone turnover, researchers reported at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2013) this week in Denver.

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IDWeek 2014: Longer Use, Age, Low Body Weight Raise Risk of Tenofovir Kidney Problems

Abnormal kidney biomarkers are common but rarely progress to serious kidney dysfunction in HIV positive people taking tenofovir, and longer duration of use, older age, and having diabetes or high blood pressure raise the risk, researchers reported at IDWeek 2014 last week in Philadelphia. A related study found that people with low body weight experienced progressive kidney function decline while taking tenofovir.

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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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HIV Positive Stimulant Users Benefit from Antiretroviral Therapy

People with HIV who use methamphetamine or other stimulant drugs do well on antiretroviral therapy (ART) and appear not to be at greater risk than non-users for AIDS-related or all-cause death overall, but those who use stimulants more than half the time did have a higher risk of progression to AIDS or death, according to a study published in the September 30 Journal of Acquired Immune Deficiency Syndromes.

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Bone Loss and Fracture Risk are 'Modest' among HIV+ People, Linked to Tenofovir, Smoking, and HCV

Continued bone loss among HIV positive men with osteopenia was modest overall, but about 25% of those taking tenofovir (Viread, also in 4 antiretroviral coformulations) experienced significant loss, according to a recent study. A related meta-analysis found that HIV infection is associated with a modest likelihood of new fractures, with smoking and hepatitis C virus (HCV) coinfection further increasing the risk.

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ICAAC 2013: Researchers Present Data on New NNRTIs AIC292 and MK-1439

A pair of next-generation HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs) demonstrated promising activity in early studies, researchers reported last week at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2013) in Denver. AIC292 showed good antiviral activity in early laboratory, animal and human studies. MK-1439, now in Phase 2b, is likely to interact with ritonavir, but not tenofovir.

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