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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.

European Medical Journal news storyPeople living with HIV may experience subtle changes in heart muscle function even when conventional measures of cardiac performance remain normal, according to findings from a systematic review and meta-analysis. Researchers identified significantly impaired global longitudinal strain (GLS) among people with HIV compared with HIV-uninfected individuals, despite preserved left ventricular ejection fraction (LVEF) in both groups. The findings suggest that speckle-tracking echocardiography (STE) could provide additional information about early myocardial dysfunction in this population. Read the full news story here.

Among cancer patients, the high financial cost of cancer care is a prevalent problem. This financial burden is also associated with potentially harmful behavioral strategies that patients might use to cope with costs, such as delaying or forgoing treatment and skipping medications. Collectively, researchers refer to this impact as financial toxicity.

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.

Wits University news releaseIn a landmark HIV prevention trial, an antibody blocked viruses most vulnerable to it, but others broke through. Now researchers have uncovered how HIV evolved after those infections – and why the amount of antibody in the body is an essential part of the story. The Antibody-Mediated Prevention (AMP) trials enrolled more than 4,600 volunteers across Africa, the Americas, and Europe to test VRC01, a laboratory-made broadly neutralising antibody (bnAb). In the AMP trial, VRC01 did not significantly reduce HIV infections overall, although it reduced infections caused by highly sensitive strains by about 75%.  This study showed that HIV requires high antibody titers, and it illustrates the importance of maintaining those titers throughout the dosing cycle. A new study published in Nature Microbiology has now examined what happened after infection in people who received VRC01. The findings show how a virus can respond to antibody pressure – and offer clues for improving future antibodies and vaccines. Read the full news release here.

Continuous glucose monitors (CGMs) could transform diabetes management for millions of Americans with type 2 diabetes who don't take insulin, according to findings published in the New England Journal of Medicine. The clinical trial found that adults using CGMs spent approximately five additional hours each day within their target blood sugar range compared with those receiving routine care. Nearly twice as many CGM users also achieved an A1c level below 7%, a common treatment goal for people with diabetes.