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CROI 2015 - Metabolics / Aging, Senescence / Comorbidities / Inflammation - 3 Exercise Studies / Heart Disease / Statins / Cancers / The Kidney / Bone / TAF / The Brain - neurologic function
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from Jules: This was one of the major themes at CROI 2015......
......here are links to 70 reports from CROi on these key topics. Heart disease is perhaps the leading killer at this time in HIV amongst the comorbidities and there were several statin studies at CROI reporting improvements in heart disease associated with taking statins. Below is a link to a plenary talk on heart disease along with link to webcast delivered by Steve Grinspoon warning about subclinical heart disease, which appears to be an important concern because subclinical means there are no clear indications - lipids may be normal - but underneath the surface problems may be brewing and non calcified plaque appears to be a unique problem in HIV+ regarding the risk for heart disease. These metabolic problems - brain/neurologic function bone, heart disease, kidney, cancers etc - are all linked by inflammation & immune activation; HIV causes inflammation & immune activation, some studies at CROI 2015 showed improved inflammation with very early ART .....here is a link to a bunch of studies at CROI finding numerous improvements & benefits with early ART including regarding HIV DNA, inflammation, neurocognitive protection, improved CD4 recovery and mortality.....CROI: THE EARLIER cART IS INITIATED DURING PHI, THE MORE INTRACELLULAR HIV-DNA DECREASES - (03/23/15)
CROI: Premature Aging and Immune Senescence in HIV-1-Infected Children - (03/16/15)
CROI: Chronic HIV Infection Exacerbates Cellular Aging Markers in Isolated T cell Subsets - (03/06/15)
CROI: Geriatric Syndromes are Common Among Older HIV-Infected Adults - (03/16/15)
CROI: Age-Related Morbidities Among HIV-Infected Adults From 2000 to 2010...high comorbidities rate among older >60 & among Blacks....rates increase with age >40 through >60 - (03/16/15)
CROI: Body Composition Changes after Initiation of Raltegravir or Protease Inhibitors..... - (03/16/15)
CROI: Frailty and Cause-Specific Hospitalization among Aging HIV-Infected and Uninfected Persons - (03/06/15)
CROI: Impact of Antiretroviral Drugs on Hypertension in HIV-positive Persons: D:A:D Study ......Hypertension in HIV+....not the ARTs...But Established/Tradional Risk Factors....age, ethnicity/Black, lipids, diabetes, lipodystrophy, BMI, eGFR, IDU - (03/16/15)
CROI: Impaired Cardiac Strain and Biomarkers of Immune Activation in HIV - (03/11/15).......HIV-infected subjects demonstrate subclinical impairment in systolic function and this is associated with markers of chronic immune activation, inflammation and tissue remodeling.......Our findings indicate that subclinical impairment in cardiac strain tracks with markers of chronic inflammation and immune activation, which may serve as targets for future therapeutic strategies to optimize long-term cardiovascular health in persons living with HIV.
CROI: Cerebral Vasoreactivity is Impaired in Virally Suppressed HIV-infected Individuals - (03/11/15)
CROI: Asymptomatic genital CMV replication in MSM linked to T-cell exhaustion
CROI: Chronic HIV Infection Exacerbates Cellular Aging Markers in Isolated T cell Subsets - (03/06/15)
CROI: Poor balance confidence--not physical function--predicts falls in older men with HIV -
LIPIDS New LDL Drug - CROI: PCSK9 is Elevated in HIV+ Patients And May Mediate HIV-Associated Dyslipidemia - (03/11/15)
CROI: Avoiding smoking could prevent 37% of non-AIDS cancers in adults with HIV - Mark Mascolini - (03/11/15)
CROI: Impact of SVR on Liver Decompensation and Hepatic Fibrosis Markers in HIV/HCV ...... "SVR Associated with reduced risks of decompensation and death..... No decompensations were observed in HIV/HCV patients who achieved SVR" - (03/06/15)
BONE
CROI: Fracture incidence is increased in aging HIV-infected women (WIHS) - (03/02/15)
CROI: Immunologic Predictors of Bone Loss in a Contemporary HIV Cohort - (03/11/15)
CROI: Modified FRAX tool underestimates fracture rates in older men with HIV - (03/02/15)
ART / Non-AIDS /Mortality / Inflammation/CD4 Tied to Mortality
CROI: Impact of Specific Antiretroviral Drugs on Non-AIDS Mortality; the D:A:D Study -
CROI: IL-6 Partially Mediates the Effect of HIV Status on Survival....Inflammation & HIV Associated with Mortality in HIV+ Vets...HIV+ with >500 viral load have 33-100% greater mortality in VA Cohort - (03/16/15)
EXERCISE
CROI: The impact of physical activity on cognition in men with and without HIV - (03/11/15)
CROI: The Effect of Physical Activity on Cardiometabolic Health and Inflammation in HIV - (03/09/15)
CROI: Aerobic Exercise Attenuates Cognitive Decline and Brain Volume Loss Associated With HIV.....from Jules: real-world exercise/diet intervention studies are need - (03/09/15)
HEART DISEASE / Statins
CROI: Cardiovascular Disease in HIV Patients: An Emerging Paradigm and Call to Action - (03/02/15)
CROI: Statin Therapy Reduces Coronary Noncalcified Plaque Volume in HIV-infected Patients: a Randomized Controlled Trial - (03/02/15)
CROI: Rosuvastatin halts carotid artery wall thickening in placebo-controlled trial -
CROI: Calcified Plaque Burden is Associated with Serum Gut Microbiota-Generated Trimethylamine in HIV - (03/02/15)
CROI: Smoking and heavy drinking tied to atherosclerosis in MACS men with HIV - written by Mark Mascolini - (03/02/15)
CROI: Cardiovascular Disease Risk Prediction in the HIV Outpatient Study (HOPS)..... "Among participants with any length of follow-up, the four risk prediction equations underestimated the 10-year risk of CVD" - (03/02/15)
CROI: Confirmed kidney deficit tied to rising cardiovascular disease incidence in D:A:D......."need intensified monitoring for all types of emerging cardiovascular disease, in particular in older individuals with continuously low eGFR levels, and cincreased focus on applying different renal and cardiovascular preventive measures in HIV-positive persons" - (03/11/15)
CROI: T-Cell Activation and E-Selectin Associated with Coronary Plaque in HIV-Infected Youth: early predictors of potential heart disease found in HIV+ youth 22 YO - (03/11/15)
CROI: Incidence and Risk of Myocardial Infarction (MI) by Type in the NA-ACCORD - (03/23/15)
CROI: Abacavir Use and Risk for Myocardial Infarction in the NA-ACCORD - (03/23/15)
CANCERS
Excess Cancers Among HIV-Infected People in the United States - (03/06/15)
CROI: High cancer risk among the HIV-infected elderly in the United States - (03/02/15)
CROI: CD4 Measures as Predictors of Lung Cancer Risk and Prognosis in HIV Infection.....cd4 <500 & CD4/CD8 ratio <0.4 associated with increased lung cancer risk - (03/09/15)
SMOKING
CROI: Varenicline (Chantix) helps French with HIV quit smoking in 48-week placebo trial - (03/02/15)
The Brain / Neurologic Function
Efavirenz...
CROI/2015: Neurocognitive Decline is Associated with Antiretroviral Concentrations in Cerebral Spinal Fluid and Blood (EFV, TDF) - (03/13/15) - "TLE (EFV regimen) was associated with greater risk of incident NCI over 96 weeks than ZLN (nevirapine regimen)"
CROI: Efavirenz Use Is Not Associated With Increased Risk of Neuropsychological Impairment - (03/16/15)
CROI: Suppressive ART is Key to Reduce Neurocognitive Impairment in Aging HIV+ Individuals - (03/16/15)
CROI: Microbial Translocation is associated with Neuroinflammation in HIV-infected subjects on ART - (03/16/15)
CROI: HIV induces astrocyte [brain] senescence and is reversed by ß-catenin induction - (03/16/15)
CROI: PREDICTORS OF NEUROCOGNITIVE DECLINE AMONG AVIREMIC INDIVIDUALS IN THE CHARTER COHORT - (03/13/15)
CROI: Similar neurocognitive performance in patients on ATV/r monotherapy vs triple therapy - (03/27/15)
CROI: Maraviroc-Enhanced cART Improves Cognition in Virally-Suppressed HAND: A Pilot Study - (03/27/15)
CROI: HIV DNA and Neurocognitive Impairment in Older and Younger Subjects on Suppressive ART - (03/27/15)
CROI: Antiretroviral Concentrations in Brain Tissue Are Similar to or Exceed Those in CSF - (03/23/15)
Inflammation
CROI: The Kidney: TAF, Inflammation, Neurocognitive decline associated with renal/CVD markers, integrate inhibitors, early ART/inflammation - (03/23/15)
CROI: Inflammation Persists Despite Early ART in Acute HIV - (03/16/15)
CROI: ART in Acute Infection, Inflammation/Activation "Largely Disappear" - (03/18/15)
CROI: Inflammatory Biomarkers Decline but Do Not Normalize after 10 Years of cART - (03/16/15)
CROI: Kidney Dysfunction and Markers of Inflammation in the Multicenter AIDS Cohort Study - (03/06/15)
CROI: Elvitegravir Reduces Monocyte Activation and Vascular Inflammation More than Efavirenz - (03/16/15)
CROI: IL-21 Reduces Inflammation and Virus Persistence in ART-Treated SIV-Infected Macaques - (03/18/15)
CROI: IL-6 Partially Mediates the Effect of HIV Status on Survival....Inflammation & HIV Associated with Mortality in HIV+ Vets...HIV+ with >500 viral load have 33-100% greater mortality in VA Cohort - (03/16/15)
Statins
CROI: Statins Improve SVR, Reduce Fibrosis Progression and HCC Among HCV+ Persons. Statins Reduce Plaque/Halt Carotid Artery Wall Thickening/Improve Kidney - (03/23/15)
CROI: Statin Therapy Reduces Coronary Noncalcified Plaque Volume in HIV-infected Patients: a Randomized Controlled Trial - (03/02/15)
CROI: Rosuvastatin halts carotid artery wall thickening in placebo-controlled trial -
HCV & Kidney/Diabetes/CVD
CROI: INCIDENCE OF EXTRAHEPATIC COMPLICATIONS IN HIV/HCV PATIENTS WHO ACHIEVED SVR - (03/27/15)
KIDNEY
TAF
CROI: Tenofovir Alafenamide (TAF) in a Single-Tablet Regimen in Initial HIV-1 Therapy - (02/26/15)
CROI: Safety of Tenofovir Alafenamide in Renal Impairment - (02/27/15)
CROI: Renal and Bone Safety of Tenofovir Alafenamide vs Tenofovir Disoproxil Fumarate - (02/27/15)
CROI: Gilead Announces Phase 3 Results for Investigational Once-Daily Single Tablet HIV Regimen Containing Tenofovir Alafenamide (TAF) - (02/27/15)
CROI: Exposure to antiretrovirals and development of chronic kidney disease - D:A:D Study Group
CROI: Kidney Dysfunction and Markers of Inflammation in the Multicenter AIDS Cohort Study - (03/06/15)
CROI: The Kidney at CROI 2015 - - Written by Lene Ryom PhD CHIP, Department of Infectious Diseases and Rheumatology, Section 2100, Rigshospitalet - University of Copenhagen, Denmark Christina Wyatt MD Associate Professor, Medicine/ Nephrology Icahn School of Medicine at Mount Sinai New York, NY - (03/06/15)
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