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Tesamorelin Growth Hormone-releasing Factor Reduces Visceral Fat in Diverse Patient Groups

Tesamorelin (TH9507, brand name Egrifta), a recombinant form of human growth hormone-releasing factor, decreased the amount of visceral abdominal fat over 1 year in a variety of sub-populations of HIV patients with lipodystrophy, according to research presented at the recent 50th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2010). A related study found that fat loss measured by CT scans was reflected in reduced waist size and improved patient-reported body image.

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HIV Infection Linked to Increased Cardiovascular Risk Even in Long-term Non-progressors

Markers of endothelial dysfunction -- an early indicator of cardiovascular disease -- were elevated in HIV positive people who maintained a stable viral load and CD4 cell count without antiretroviral therapy (ART), and even among "elite controllers," according to a study presented at the 50th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2010) this week in Boston. This finding adds further evidence that factors other than waning CD4 T-cell function -- for example, persistent inflammation -- contribute to non-AIDS conditions in the ART era.

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AIDS 2010: Majority of HIV Positive People on Antiretroviral Therapy May Have Reduced Bone Density

About half of people with HIV taking antiretroviral therapy (ART) in a Spanish study had low bone mineral density, and another quarter had more severe bone loss, researchers reported at the XVIII International AIDS Conference (AIDS 2010) last month in Vienna. This study found that bone loss was associated with use of tenofovir and protease inhibitors, a finding also supported by results of the ACTG 5142 trial in the U.S.

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Updated Recommendations for Prevention of Invasive Pneumococcal Disease

This new report from the U.S. Centers for Disease Control and Prevention (CDC) provides updated recommendations for prevention of invasive pneumococcal disease (IPD), which affects a broad spectrum of the U.S. population. The risk for IPD is highest among individuals who are immunocompromised, such as those with HIV infection or asplenia (e.g., sickle cell disease or congenital or surgical asplenia). Recommendations for revaccination among persons with immunocompromising conditions remain unchanged since the report issued in 1997. The indications for which vaccination is recommended now include smoking and asthma.

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Can Morphine Help Protect the Brain against HIV Neurotoxicity and Cognitive Impairment?

Morphine, a drug derived from opium poppies that relieves pain and often triggers addiction, may help protect the brain from damage due to HIV by interfering with the virus' ability to enter cells, according to a study in mice reported last week at the annual meeting of the Society of NeuroImmune Pharmacology. The researchers emphasized that people should not use morphine or similar drugs like heroin to protect the brain, but suggested these findings may offer clues for designing future therapies to prevent neurocognitive impairment in people with HIV.

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People with CD4 Counts below 200 May Stop Pneumocystis Pneumonia Prophylaxis if Viral Load Is Undetectable

HIV positive people with a CD4 T-cell count between 100 and 200 cells/mm3 may be able to safely discontinue preventive medications for Pneumocystis jiroveci (formerly P. carinii) pneumonia, or PCP, if they maintain undetectable HIV RNA on combination antiretroviral therapy (ART), according to a report in the September 15, 2010 issue of Clinical Infectious Diseases.

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CROI 2010: Risk Factors for Neurocognitive Impairment among People with HIV

People with higher blood and cerebrospinal fluid viral load and lower CD4 cell count are more likely to develop neurocognitive impairment, according to studies presented in February at the 17th Conference on Retroviruses and Opportunistic Infections (CROI 2010) in San Francisco. In addition, researchers with the SMART study reported that cardiovascular risk factors predict poorer neurocognitive performance. But conflicting findings emphasize the need for further research. 

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AIDS 2010: CHARTER Study Finds Neurocognitive Impairment Still Common in ART Era, Linked to Lowest CD4 Cell Count

Neurocognitive impairment ranging from subtle to severe remains common among people with HIV despite widespread use of effective combination antiretroviral therapy (ART), according to findings from the large CHARTER study presented at the XVIII International AIDS Conference (AIDS 2010) last month in Vienna. Impairment was associated with nadir or lowest-ever CD4 cell count, even among individuals whose immune function has since recovered on ART.

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CROI 2010: HIV/HCV Coinfected Patients Demonstrate Poorer Neurocognitive Performance, but No Difference in Neural Imaging

HIV/HCV coinfected individuals with good HIV suppression on performed more poorly than HIV monoinfected people on neurocognitive tests, but the 2 groups showed no significant differences in neural imaging measures, according to a study presented at the recent 17th Conference on Retroviruses and Opportunistic Infections in San Francisco (CROI 2010).

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