Bioengineer.org | Switching HIV drugs or adding zoledronic acid rebuilds bone lost to tenofovir - European AIDS Treatment Group

TheBodyPro clinical overviewAs we more frequently prescribe injectables, two-drug therapies, and other novel antiretroviral regimens, a growing proportion of those regimens lack tenofovir. Because tenofovir is used to treat hepatitis B virus (HBV) and is partially protective against new HBV infection, providers need to consider the risk of new or reactivated HBV before switching a patient to a tenofovir-sparing regimen. “I think we are very much in, and entering, an era where increasingly more therapeutic options for antiretroviral therapy and PrEP are going to be without tenofovir,” said H. Nina Kim, M. D., M. Sc., a professor of medicine at University of Washington’s Division of Allergy and Infectious Diseases. Kim co-authored a viewpoint paper this May in Clinical Infectious Diseases highlighting the issue so that clinicians can protect patients against potentially harmful reactivations and new HBV infections. “Many of these reactivations may be subclinical with mild rise in liver enzymes,” Kim said.

Bioengineer.org news storyFor people living with HIV, modern antiretroviral therapy can suppress the virus to levels below what standard laboratory tests can detect. Yet some patients on long-term treatment experience a curious phenomenon: a single test result showing a small, transient amount of virus in the blood, followed by an immediate return to undetectable levels. These events, known as viral blips, have puzzled clinicians and researchers for years, raising questions about whether they represent harmless statistical noise, brief bursts of viral production from hidden reservoirs, or early warnings of impending treatment failure. A new nationwide Swedish study, published in BMC Infectious Diseases, offers one of the most comprehensive answers to date. Drawing on the Swedish national InfCareHIV cohort, researchers analyzed data from 4,210 treatment-naïve adults who began antiretroviral therapy from 1 January 2007 onward, with follow-up data extracted through 30 September 2020. The median observation time was 5.5 years, with some individuals followed for as long as 13.7 years.

The new treatment kills off a sub-group of fat cells. (Jian Fan/iStockphoto/Getty Images) Early clinical trials into a new fat reduction treatment have reported promising results, and the treatment takes a more unusual approach: Rather than shrinking fat cells, as most weight loss strategies do, it safely and naturally kills them off. The drug here is CBL-514, which is administered via injection. As well as proving effective at reducing subcutaneous fat (just below the skin), there's evidence it can also reduce visceral fat (stored deeper around the organs). According to the team behind the trials, CBL-514 and its unconventional strategy have the potential to reduce fat in key areas of the body – with further benefits that come with weight loss likely to follow. "We expect that patients will be pleased by the cosmetic effects, such as the flatter stomach that can come with subcutaneous fat loss," says endocrinologist Timothy Garvey, from the University of Alabama at Birmingham, who headed up the trial.