[Viva] Fwd: TreatmentUpdate 230

[shelly tognazzini]

😊☕

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From: CATIE <mailer at catie.ca>
Date: Tue, Mar 12, 2019, 8:28 AM
Subject: TreatmentUpdate 230
To: <shetognazzini at gmail.com>


Anti-HIV drugs and substance use
Issue 230
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Anti-HIV drugs

*Can high-dose dolutegravir be a rescue therapy?*
<https://catie.us16.list-manage.com/track/click?u=89abcbccf295c7b8d9a92cf09&id=bb17a3f04c&e=3006f90030>
A small study in Italy found that high doses of the powerful integrase
inhibitor dolutegravir (Tivicay, and also found in Juluca and Triumeq) can
be used as a key part of rescue therapy for people with HIV that has
extensive drug resistance to treatment. When doctors doubled the dose
typically prescribed for treatment-experienced people to 100 mg twice
daily, they found that high-dose dolutegravir was well absorbed with no
occurrence of neuropsychiatric or serious side effects.

*Large French study examines neuropsychiatric side effects with integrase
inhibitors*
<https://catie.us16.list-manage.com/track/click?u=89abcbccf295c7b8d9a92cf09&id=70c6759387&e=3006f90030>
The largest prospective study to date on integrase inhibitors and their
potential for being associated with neuropsychiatric side effects was
conducted in France. With more than 21,000 HIV-positive participants, the
study found that the proportion of people who stopped taking integrase
inhibitors due to neuropsychiatric side effects was generally very low
(between 1% and 3%). Of particular note is the fact that before starting
treatment with an integrase-inhibitor-containing regimen, between 3% and
10% of participants had previously reported neuropsychiatric side effects
with other classes of HIV treatment.

*Higher levels of dolutegravir in older people not linked to side effects*
<https://catie.us16.list-manage.com/track/click?u=89abcbccf295c7b8d9a92cf09&id=1e16826584&e=3006f90030>
A study in England with people aged 60 to 79 found that the maximum levels
of dolutegravir (Tivicay, and also found in Juluca and Triumeq) in the
blood were significantly greater (by about 25%) in these people compared to
people aged 50 and younger. Although this occurred, there were no
significant side effects or intensified side effects—particularly related
to sleep and cognition—in the older patients.
Substance use

*Quitting smoking – impact on cancer risk*
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Rates of tobacco use are relatively high among HIV-positive people and
studies in the current era have shown that HIV-positive smokers who take
ART (HIV treatment) tend to have a diminished life expectancy from
smoking-related complications, not from HIV. Scientists with a large
database called DAD focused on data from 35,442 people and compared rates
of cancers between people who smoked and subsequently quit and people who
never smoked. They found that the risk for all cancers, including
smoking-related ones, was greatest in the first year after quitting.
Subsequent risk for some cancers declined, though the risk of lung cancer
remained elevated five years after people had quit. Further monitoring is
needed to find out the long-term risk of lung cancer among HIV-positive
people who quit smoking.
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