A lot happened in the HIV world in 2006. Old topics were revisited and guidelines were updated. New medications were in the works and the development of others were stopped in their tracks. Here is a list of the top 10 HIV stories of 2006.
The SMART study, one of the largest HIV studies ever conducted, determined that treatment interruptions, whether structured or unstructured, were a very bad idea. The study made it clear that interrupted treatment strategies were worse for a person's health than was a continuous treatment approach.
2. Kaletra vs. Sustiva - Is One Drug Better than Another?
For the first time, these two popular and potent HIV medications were pitted against one another in a study by the AIDS Clinical Trials Groups (ACTG). The study resulted in an interesting finding. People on
Sustiva were more likely to have undetectable viral loads while those on
Kaletra had higher CD4 counts. Simply put, doctors and patients will have to decide what's more important; a higher CD4 or an undetectable viral load.
3. HIV Treatment Studies Help Doctors Decide Which Regimen is Best
The year 2006 saw many head-to-head clinical trials in an effort to clarify which regimens are best for which circumstances. Some combinations are better as first-time regimens, and others are better for those patients who have been on treatment in the past. Shedding some light on specific combinations of drugs makes these studies a very important story indeed.
For years, observational studies suggested that circumcision offered some protection against HIV infection. Now, controlled trials conducted in Africa has proven that circumcision can reduce the HIV infection rate. Could this be an effective means to slow the epidemic throughout Africa?
The first question I hear when telling someone they are HIV infected is how long will they live. My answer has always been that there is no answer; life expectancy varies from person to person and is impacted by a myriad of factors. But now researchers at Emory University's Center for AIDS Research says their studies indicate people live on average 24 years after being diagnosed with HIV. Since 1993 the average life span after diagnosis has more than tripled from 7 years to 24 years, a testament to more effective treatments and better HIV care.
6. Viral Load Measurements Can Predict Declines in CD4 Counts ... Sometimes
It was commonly held that high viral load counts are predictors of declining CD4 counts. A study in 2006 disproved that belief ... sort of. Simply put, higher viral loads can predict that the CD4 count will decline, but not in everyone. As a result, doctors should be flexible in their treatment decisions, realizing that a high viral load may not signal an impending disaster.
For years, lipodystrophy has been a problems for many HIV patients on treatment regimens. "Crixi-belly", "Protease Paunch" and "Buffalo Hump" have been linked to a few meds like
Zerit,
Retrovir, and the protease inhibitor
Crixivan. Studies in 2006 proved that these drugs aren't the only culprits. More work needs to be done to better understand this continuing problem, but 2006 saw a positive step in the process of understanding.
The Centers for Disease Control and Prevention has recommended that HIV testing and HIV screening be part of routine clinical care in all health care settings. The CDC also suggests that the patient's right to refuse be preserved in order to facilitate a good working relationship between patient and doctor.
Every six months or so, the U.S. Department of Health and Human Services releases updated guidelines on how health care providers should treat people with HIV. The latest version includes a recommendation that HIV drug-resistance testing be routinely done before people start taking HIV meds.
In 2006, only one new HIV medication was approved in the United States: the protease inhibitor
Prezista (darunavir). But the story of 2006 was the abundance of promising HIV medications right around the corner. Not only are new drugs on the way, but some are the first ones of brand new drug classes.
