(Press-News.org) Globally, around 2.6 million children and adolescents are currently living with HIV, the majority of them in Africa. These young people are much more likely to experience treatment failure than adults. Experts long assumed that testing for viral drug resistance could improve treatment in cases where treatment has failed. However, a research team led by the University of Basel, Switzerland, now shows that it is much more important to support patients in taking their medication regularly.
The fight against HIV has made great strides over the past few decades. Antiretroviral drugs keep the virus at bay, preventing it from reproducing in the body and from being transmissible to others. However, there are variants of the virus that have become resistant to these medications. In high-income countries, doctors therefore test the virus for resistance mutations if a particular antiretroviral therapy is failing to take effect.
In resource-limited regions, however, such tests for viral mutations are not so readily available. If the treatment does not work as hoped, all the attending physicians can do is guess, and decide on further treatment steps on that basis: In order to circumvent a possible resistance of the virus, the treatment should be switched to other medication. However, if the reason for the treatment failure is that the medication was not taken daily as intended, the medication should not be changed.
In light of limited funding for HIV programs in a number of African countries, discussions are ongoing among experts on whether treatment success could be improved by providing more resistance tests, particularly for children and adolescents.
Researchers led by Professor Niklaus Labhardt at the University of Basel and University Hospital Basel have therefore got together with various international partners to investigate whether these cost- and labor-intensive tests are actually an effective lever for better HIV management. The results of their study, entitled “GIVE MOVE”, appear in the scientific journal The Lancet Global Health.
Resistance tests are ineffective alone
The study took place in 10 clinical centers in Lesotho and Tanzania and gathered data from 284 participants between the ages of six months and 19 years. The children and adolescents were all receiving antiretroviral therapy, but were still showing a high concentration of the HIV virus in blood samples.
The researchers divided the patients at random into two groups. One group underwent tests by specialist staff for viral mutations that confer resistance. The second group received the usual care, with repeated viral load testing and empirical treatment.
The results indicated that the genetic tests for resistance did not significantly improve treatment. Thirty-six weeks after the starting point of the study, there were no significant differences in viral load between the two groups. “This contradicts the assumption that treatment supported by resistance tests would meaningfully improve clinical and virological outcomes,” summarizes Dr Jennifer Brown, lead author of the study.
Adherence to therapy is crucial
The main reason for the continued high viral load despite antiretroviral medications seems to be that the drugs are not being taken every day as intended, according to study leader Niklaus Labhardt. “Improving adherence to therapy would be more effective than introducing resistance tests more broadly. The reason that this result is so important is that it helps us prioritize where we want to put the limited funding for HIV programs.”
The researchers hope that the study results will lead to more resources being made available to programs that take into account the specific needs of children and adolescents and that thereby improve their adherence to treatment. At the same time, it will be important to better understand which individuals are at the highest risk for viral resistance, so that costly resistance testing can be provided in a more targeted manner.
Working alongside researchers from the University of Basel and University Hospital Basel were also experts from the Swiss Tropical and Public Health Institute, the non-profit organization SolidarMed, the Baylor College of Medicine Children’s Foundation, and the Seboche Mission Hospital in Lesotho, as well as the Ifakara Health Institute and the Management and Development for Health organization in Tanzania. The study was financed by three foundations: the Fondation Botnar, the Swiss National Science Foundation and the Gottfried und Julia Bangerter-Rhyner-Stiftung.
END
Improving HIV treatment in children and adolescents – the right way
2024-07-18
[Attachments] See images for this press release:
ELSE PRESS RELEASES FROM THIS DATE:
Substantial rise in adults vaping for longer than 6 months, especially in young adults
2024-07-18
The number of adults in England who report vaping for more than six months has increased substantially from around one in 80 in 2013 to one in 10 in 2023, finds a study published by The BMJ today.
Much of this increase has occurred since 2021, coinciding with the rapid rise in popularity of disposable e-cigarettes, especially among young adults, including those who had never regularly smoked, the results show.
It was already established that vaping rates have increased substantially in England since new disposable e-cigarettes became ...
No increased risk of birth defects after covid-19 infection or vaccination in early pregnancy
2024-07-18
Neither covid-19 infection nor vaccination during the first trimester of pregnancy is associated with increased risk of major birth defects, finds a study from Scandinavia published by The BMJ today.
It’s well known that women who experience covid-19 infection during pregnancy are at increased risk of severe illness and have a higher risk of complications, including preterm birth and stillbirth.
Less clear is the risk of birth defects (congenital anomalies) after infection with or vaccination against covid-19 as it has only recently become ...
Trusted TV doctors “deepfaked” to promote health scams on social media
2024-07-18
Some of the UK’s most recognisable TV doctors are increasingly being “deepfaked” in videos to sell scam products across social media, finds The BMJ today.
Trusted names including Hilary Jones, Michael Mosley and Rangan Chatterjee are being used to promote products claiming to fix high blood pressure and diabetes, and to sell hemp gummies, explains journalist Chris Stokel-Walker.
Deepfaking is the use of artificial intelligence (AI) to map a digital likeness of a real-life human being onto a video of a body that isn’t theirs. Reliable evidence on how ...
Singing the science: Using karaoke to examine blushing
2024-07-18
A new collaboration between researchers from the Netherlands Institute for Neuroscience, the University of Amsterdam and the University of Chieti explores the neural substrates of blushing in a MRI scanner.
Most of us know what it feels like to blush. The face becomes warm and red, and we experience self-conscious emotions, such as embarrassment, shyness, shame, and pride. It is perhaps no wonder that Charles Darwin referred to it as “the most peculiar and the most human of all expressions”. But why do we blush, and what ...
Data protection laws reduced breaches but affected firms’ value
2024-07-18
The introduction of new data protection rules significantly reduced breaches by firms but negatively impacted their market value, according to new research by the University of East Anglia (UEA) and University of Texas.
Researchers looked at what happened when the European Union’s General Data Protection Regulation (GDPR) started being enforced in 2018. Using its extraterritorial reach, the authors explore variation in US firms’ exposure to the EU GDPR to see how stricter data privacy laws affected their value, ...
Landmark study shows elevated cancer risk for women with endometriosis
2024-07-17
A landmark study from researchers at Huntsman Cancer Institute at the University of Utah (the U), the Spencer Fox Eccles School of Medicine at the U, and Boston University Chobanian & Avedisian School of Medicine found that women with severe endometriosis are 10 times more likely to get ovarian cancer, compared to women who do not have the disease.
Prior studies have shown a causal connection between endometriosis and ovarian cancer. But in using the Utah Population Database—a repository of linked health records housed at Huntsman ...
Lichtenberg earns GSA’s 2024 Donald P. Kent Award
2024-07-17
The Gerontological Society of America (GSA) — the nation’s largest interdisciplinary organization devoted to the field of aging — has chosen Peter Lichtenberg, PhD, ABPP, FGSA, of Wayne State University as the 2024 recipient of the Donald P. Kent Award.
This distinguished honor is given annually to a GSA member who best exemplifies the highest standards for professional leadership in gerontology through teaching, service, and interpretation of gerontology to the larger society. It was established in 1973 in memory of Donald P. Kent, PhD, for his outstanding leadership in translating research findings ...
Does the type of workstation you use make a difference in your health and productivity?
2024-07-17
It might be an exaggeration to claim that “sitting is the new smoking,” but significant research indicates that people who are sedentary face more health challenges than their active counterparts.
Office workers who spend most of their eight-hour workdays seated, for example, more often experience symptoms such as daytime exhaustion, hypertension and musculoskeletal discomfort than those who are less sedentary. Although devices such as standing desks have been found to alleviate physical symptoms and increase worker productivity, questions remain regarding the best use of the primary types of workstations—stand-biased, ...
Why the most prescribed chemotherapy drug can cause serious heart damage
2024-07-17
There’s still much to learn about how doxorubicin, a 50-year-old chemotherapy drug, causes its most concerning side effects. While responsible for saving many lives, this treatment sometimes causes cardiac damage that stiffens the heart and puts a subset of patients at risk for future heart failure. To better understand and potentially control such complications, Tufts University School of Medicine and Tufts Graduate School of Biomedical Sciences researchers have isolated the immune cells that become overactive when patients take doxorubicin. The team’s findings appear July 17 in the journal Nature Cardiovascular Research.
Doxorubicin ...
Cohen-Mansfield earns GSA’s 2024 Robert W. Kleemeier Award
2024-07-17
The Gerontological Society of America (GSA) — the nation’s largest interdisciplinary organization devoted to the field of aging — has chosen Jiska Cohen-Mansfield, PhD, FGSA, of Tel Aviv University as the 2024 recipient of the Robert W. Kleemeier Award.
This distinguished honor is given annually to a GSA member in recognition for outstanding research in the field of gerontology. It was established in 1965 in memory of Robert W. Kleemeier, PhD, a former president of the Society whose contributions to the quality of life through research in aging were exemplary.
The award presentation will take place at GSA’s ...