HIV-Glasgow 2018 – Adverse effects of current ARVs: myths and realities


  • Allison Kirsop
  • Conference Reports
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People living with HIV (PLWH) are at increased risk of a number of comorbidities. However, there is insufficient data to determine if people are experiencing these at a much younger age than expected. Although anal and lung cancers appear to occur in excess in younger PLWH, Hodgkin’s Lymphoma is appearing at a later age than HIV negative patients.

Many studies have shown that PLWH have lower bone mineral density (BMD) than people without HIV. Long-term bone loss is associated with tenofovir disoproxil fumarate (TNF) but observations of reduced BMD may be a treatment effect which is limited to the first 12 months of treatment initiation. The HIV UPBEAT study revealed BMD loss of 0.2%-0.6% per year in PLWH.

Suggestions that abacavir contributes to increased risk of myocardial infarction has prompted investigations into platelet function as the underlying cause. There is now an accumulating wealth of translational research to support clinical observations that abacavir may be associated with myocardial infarction.

The Tsepamo observational study conducted in Africa reported data for an unexpected increase in neural tube defects in women taking dolutegravir at conception. Driven by four cases, this observation is at an early stage and the next analysis is eagerly awaited in March 2019.

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