Fluctuating Symptoms Have A Major Impact On The Lives Of Many People With HIV

Tiredness, depression, diarrhoea and nerve pain were widely reported and were often associated with difficulties performing day-to-day tasks or working.

People with HIV in the UK were invited to participate in an online survey about their recent experiences of five symptoms commonly seen in people with HIV.

Many people receiving state health-related benefits are currently having their eligibility assessed. There is concern that these assessments are not adequately able to take into account the effect of fluctuating or variable symptoms.

About 250 people participated in the study, and the majority reported at least one symptom. The most common was tiredness, which was experienced by over 50% of people, and nerve pain – the least common – was reported by a third of participants.

Significantly, many people said their symptoms fluctuated – they didn’t have them all the time – and were unpredictable.

Most people reported having multiple symptoms – for example, three quarters of patients with depression also had fatigue and 57% also reported difficulty sleeping.

Fluctuating symptoms affected the ability of some people to work.

One participant said: “How do you work round this kind of thing unless you work for yourself or for an extremely understanding employer?”

The research was conducted by UK HIV organisation NAT, which says the findings have implications for the work assessment tests that people claiming health-related benefits have to undergo.

“Assessment should consider the impact of fluctuation and the cumulative impact of multiple, lower-level symptoms on people living with HIV,” they comment.

For more information on changes to the benefits system in the UK, visit our website to read the feature ‘What’s happening to benefits?’. You can download the NAT report ‘Fluctuating symptoms of HIV’ (PDF) from the NAT website.

HIV treatment – new drug does well in people starting treatment
HIV treatment that includes a once-daily dose of the new NNRTI etravirine (Intelence) appears to be safe and effective in people starting antiretroviral therapy.

An NNRTI is a type of antiretroviral drug, commonly used in HIV treatment. It stands for non-nucleoside reverse transcriptase inhibitor.

Etravirine is a powerful NNRTI. It works against most strains of HIV that have resistance to the older NNRTIs – efavirenz and nevirapine (Viramune).

The drug is licensed to be taken twice daily, and is approved for use by people with previous experience of HIV treatment.

But researchers wanted to see if a once-daily dose was safe and effective in people starting antiretroviral therapy for the first time.

Researchers compared etravirine to the widely used NNRTI efavirenz (Sustiva, also in the combination pill Atripla).

Equal proportions of people experienced a sustained fall in their viral load to undetectable levels. But etravirine was less likely to cause the mood and sleep problems often associated with efavirenz.

Their research involved 157 people. They were randomised to receive either etravirine or efavirenz, which was taken in combination with two NRTIs (nucleoside reverse transcriptase inhibitors, another type of antiretroviral drug).

After a year of treatment, 76% of people taking etravirine had an undetectable viral load compared to 75% of those taking efavirenz.

Four of the people taking etravirine had a detectable viral load – in most cases this was below 200 copies/ml, and none developed drug-resistant virus. However, three of the seven people taking efavirenz who had a detectable viral load developed resistance.

Only 6% of patients taking etravirine had mood or sleep problems after a year of therapy compared to 22% of patients treated with efavirenz.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.

TOGETHER WE REMAIN STRONG!