{"id":5419,"date":"2008-02-28T23:37:49","date_gmt":"2008-02-28T22:37:49","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=5419"},"modified":"2013-08-30T10:51:31","modified_gmt":"2013-08-30T10:51:31","slug":"volume-9-number-12-januaryfebruary-2008","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/5419","title":{"rendered":"Volume 9 Number 1\/2 January\/February 2008"},"content":{"rendered":"<p><strong>Welcome to the first issue of HTB for 2008. Every new year it is always a little sobering to find that we are still producing HTB &#8211; and that this year we are startng volume 9.<\/strong><\/p>\n<p>HIV in Western countries should be a problem that is largely solved. The January update to the US treatment guidelines (see Antiretrovirals) paints the broadest picture with a Table on page 106. Three-yeart risk of progression to AIDS in the pre-HAART era is shown by columns getting progressively higher as baseline viral load increases and CD4 declines. In the post-HAART era the columns barely leave the ground, apart from patients with CD4 counts &lt;200 cells\/mm<sup>3<\/sup> \u0096 generally the result of late diagnosis. Another sobering point is that in most industrial countries a third of new diagnosis are with a CD4 count &lt;200 cells\/mm<sup>3<\/sup>.<\/p>\n<p>A French cohort (also covered in our Antiretorviral section) calculates that after six years of HAART, patients with CD4 counts over 500 cells\/mm<sup>3<\/sup> have a similar life expectancy to age and sex-matched HIV-negative people in the general population.<\/p>\n<p>Through 2007, we reported on the availability of new drugs \u0096 raltegravir, darunavir, etravirine, maraviroc \u0096 which together with tipranavir and\/or T-20 should enable most patients with even extensive resistance to suppress viral load to below 50 copies\/mL, and consequently achieve long-term durable responses.<\/p>\n<p>But this optimism, even in a Western setting, is tempered by an aging HIV-positive population, with the potential for complications with morbidities that are still likely to be higher than the general population including cardiovascular disease.<\/p>\n<p>We have included two reports from the 15th Retrovirus Conference held in Boston as this issue went to press &#8211; and will of course include more coverage in the next two issues.<\/p>\n<p>The leading report links abacavir and ddI to an increased risk of cardiovascular events.<\/p>\n<p>These results were unexpected, and have most significance for patients who have high underlying risk of cardiovascular events. They generated a lot of dicsussion and interest at the meeting, and we therefore have also printed a statement from the research group that explain the findings in more detail.<\/p>\n<p>Howver, this shows the importance of large safety studies that can detect signals or side effects that occur at too low and incidence to have been found in registrational studies.<\/p>\n<p>So for all the optimism of new treatment, and there has never been a better time to be optimistic about HIV treatment for poeple living in countries with good ARV access, the importance of post-marketing safety studies should not be forgotton.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Welcome to the first issue of HTB for 2008. Every new year it is always a little sobering to find that we are still producing HTB &#8211; and that this year we are startng volume 9. HIV in Western countries &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-5419","post","type-post","status-publish","format-standard","hentry","category-editorial"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/5419","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=5419"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/5419\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=5419"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=5419"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=5419"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}