New York, Dec 17, 2016: Antiretroviral drugs have been life-changing therapies for HIV patients, but they can have significant side effects including neuronal degeneration, which can be manifested as forgetfulness, confusion and behavioural and motor changes, says a study.
Certain protease inhibitors, among the most effective HIV drugs, lead to the production of the peptide beta amyloid, often associated with Alzheimer’s disease, the study found.
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“Protease inhibitors are very effective antiviral therapies, but they do have inherent toxicities,” said senior author on the study Kelly Jordan-Sciutto, Professor at University of Pennsylvania School of Dental Medicine in the US.
The drugs prompt an increase in levels of the enzyme that cleaves the amyloid precursor protein, APP, to produce beta amyloid, which is responsible for the damage to neurons.
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Notably, inhibiting that enzyme, called BACE1, protected human and rodent brain cells from harm, suggesting that targetting this mechanism with a new drug could minimise damage to neurons in patients on antiretroviral therapies.
“Our findings may cause us to rethink how we’re using these drugs and even consider developing an adjunctive therapy to reduce some of these negative effects,” Jordan-Sciutto noted.
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To determine whether and how neuronal damage arises from drug treatment and to ascertain the enzyme BACE1’s role, the team investigated the effects of protease inhibitors in two animal models, then probed the mechanism of action in cells in culture.
The findings appeared in the American Journal of Pathology. (IANS)
Pakistan is registering approximately 20,000 new HIV infections annually, the highest rate of increase among all countries in the region, warns the World Health Organization (WHO).
The international body says mortality among Pakistanis living with the virus, which causes the deadly AIDS disease, is also rising, in spite of the availability of lifesaving antiretroviral therapy.
The latest government figures show that only 16 percent of the estimated 150,000 people living with HIV had been tested and only 9 percent have access to lifesaving treatment.
“The remaining 135,000 people are walking around in the communities as carriers of (HIV) infection who are ready to transmit infections to those who are not infected, even to their unborn babies,” Dr. Saima Paracha of the National AIDS Control Program, told VOA.
Officials say the HIV epidemic in Pakistan remains largely concentrated among the key populations, including people who inject drugs, the transgender community, sex workers and their clients and men who have sex with men.
“The drivers of infection are now the sexual networks and they are ready to spill the infection into the general public,” Dr. Paracha cautioned.
Paracha says the Pakistani government offers free HIV testing and treatment, but she notes the marginalized key populations continue face widespread stigma and discrimination in the society.
The fear of maltreatment, and punitive actions by law enforcers impacts the willingness of these populations to pursue testing, which remains a major challenge facing national efforts to treat and prevent the spread of HIV, she lamented.
Official estimates show that Pakistan has seen a 45 percent increase in new HIV infections since 2010.
“The number of new HIV infections will continue to increase dramatically if implementation rates of intervention remain at current levels,” said Dr. Nima Saeed Abid, country head of WHO.
An official statement issued in connection with World AIDS Day quoted him as saying that Pakistan has the lowest rate of all regional countries in diagnosing people who are infected and linking them to care and treatment.
Naila Bashir, who heads the HIV treatment center at Islamabad’s Pakistan Institute of Medical Sciences (PIMS), told VOA the facility receives up to 40 new HIV patients every month, underscoring the alarming increase in the number of infections.
The center was established in 2005 and the number of patients has since increased from 22 to more than 3,000, including men, women and children of all ages, said Dr. Bashir.
HIV has never been a priority program in the national health system and the recent abolition of the federal health ministry and the devolution of its functions to the provinces, which lacked preparedness and capacity, have led to the increase in infections, say WHO experts in the country. However, they acknowledge the new government of Prime Minister Imran Khan is giving priority to tackling health emergencies in Pakistan, including HIV.
Federal Minister for National Health Services Regulation and Coordination, Aamir Mehmood Kiyani, says the government is working on a strategy to remove barriers and challenges in protecting people from HIV infections.
Kiyani told a seminar in Islamabad that since taking office three months ago, the government has moved to established 12 new HIV treatment centers while overall 33 such facilities have been working throughout Pakistan.
U.N. officials say the Pakistan government urgently needs to redouble efforts to “de-stigmatize HIV testing, advocate for confidential, non-discriminatory, community based care models and raise awareness about disease transmission, prevention treatment” to achieve reductions in new infections in affected populations. (VOA)