Sunday February 17, 2019

HIV Drug Is Not Linked to Depression: Study

A new study of a popular HIV drug could ease concerns about its link to depression

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HIV, Indonesia
A doctor draws blood from a man to check for HIV/AIDS at a mobile testing unit in Ndeeba, a suburb in Uganda's capital, Kampala. VOA

A new study of a popular HIV drug could ease concerns about its link to depression. Researchers in Uganda found that efavirenz, once feared to lead to depression and suicide, did not cause the expected negative side effects in their patients.

Efavirenz is an affordable, once-a-day pill used around the globe to treat and prevent HIV/AIDS. It’s “the treatment of choice” in most of the world, according to Africa Health Research Institute’s Mark Siedner, “especially [in] countries that depend on global aid to treat HIV.”

But some fear that efavirenz may come with a cost.

Some studies in the United States and Europe found the drug increased patients’ risk of depression or suicide, although other studies did not.

The mixed results prompted many doctors in the United States to prescribe more expensive but potentially safer drugs.

Siedner wanted to take another look at the risk of depression, this time in an African population. From 2005 until 2015, he and a team of Ugandan and U.S. doctors tracked 694 patients who took either efavirenz or another antiretroviral medication. They regularly asked the patients whether they experienced depression or suicidal thoughts.

No difference

Their analysis, published in the Annals of Internal Medicine, showed there was no difference between the two treatments. Siedner told VOA, “In other words, efavirenz was not associated with a risk of depression. If anything, there seems to be a signal that potentially it was associated with a decreased risk. But it wasn’t a strong enough [signal] for us to say that.”

The authors also reported that of the 17 participants who died in the course of the study, not a single death was a suicide.

Siedner has two possible explanations for why their findings differed from those in Western countries. “One potential cause is that every single ethnic group in the world, of course, is different, and different in many different ways — different socially, different environmentally, and in this case they may be different genetically.” His team is looking at whether the genes that control metabolism of the drug have a role to play in this story.

HIV Aids is a deadly disease.
HIV virus is Not Linked To Depression. Flickr

A second explanation could be the effectiveness of the drug. Because efavirenz is so potent, it could be keeping people healthier than they expected, so patients are less likely to report negative emotions.

The study is important, said Anthony Fauci, who heads the National Institute of Allergy and Infectious Diseases, because it pushes back against “the initial observation of suicidal ideation and suicide and depression” as caused by efavirenz. He told VOA, “I think now what you’re seeing is that with these conflicting reports, it’s likely someone will come in [with] the proposal to do a randomized study and take a look. So the story isn’t ended with this paper.”

As more research on the safety of efavirenz is conducted, new and cheaper drugs that might replace it are on the horizon. One of them, dolutegravir, might also pose a risk, however. A study in Botswana found dolutegravir was linked to neural tube defects in embryos, meaning it might not be safe for pregnant women. As always, further research is needed to confirm whether this is a common problem or specific to the population studied in Botswana.

Also read: UNAIDS : World Is At A “Defining Moment” In A Battle Against HIV/AIDS

“I think the whole field right now is in a bit of a holding pattern,” Siedner said when asked about dolutegravir and the future of HIV medication. (VOA)

Next Story

Novel Drug May Shorten Treatment Duration For Tuberculosis

Despite significant progress in combating tuberculosis, it remains the leading infectious cause of death worldwide, he said

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A new experimental antibiotic for tuberculosis (TB) has been shown to be more effective against TB than Isoniazid, a decades old drug which is currently one of the standard treatment for the disease, finds a study on mice.

The new drug, called AN12855, has several advantages over Isoniazid as Isoniazid requires conversion to its active form by a Mycobacterial enzyme, KatG, in order to kill the pathogen, which creates some problems.

In some M. tuberculosis, KatG is nonfunctional. That does not make M. tuberculosis any less pathogenic, but it prevents the drug from working. Consequently, this creates an easy avenue for the development of drug resistance.

In the study, the new drug showed a much lower tendency to develop resistance, and it remains in the tissues where the Mycobacterium tuberculosis bacteria reside for longer, killing them more effectively.

WHO will start working towards ending Tuberculosis
Dr. Simon Angelo (L) examines Iman Steven suffering from tuberculosis, held by her mother (R) at the hospital of Doctors Without Borders (MSF), June 15, 2016, at the Protection of Civilians (PoC) site in Malakal, South Sudan. VOA

The goal of TB drug development programmes is to develop universal treatment regimens that will shorten and simplify TB treatment in patients, which typically takes at least six months, and sometimes more than a year, said lead author Gregory T. Robertson, Assistant Professor at the Colorado State University in Fort Collins in the US.

For the study, the researchers used a new TB mouse model that develops these M. tuberculosis-containing granulomas to compare Isoniazid and AN12855.

Granuloma refers to a mass of granulation tissue, typically produced in response to infection, inflammation, or the presence of a foreign substance.

“We discovered that the drugs differed dramatically with respect to their abilities to kill the pathogen in highly diseased tissues,” said Robertson.

Tuberculosis
New TB drug may shorten treatment duration: Study. IANS

AN12855 proved more effective, “without selecting for appreciable drug resistance”, added Robertson in the study published in the journal Antimicrobial Agents and Chemotherapy.

Despite significant progress in combating tuberculosis, it remains the leading infectious cause of death worldwide, he said.

Also Read- Oscar Nominees Furious Over Exclusion From Telecast

“Multidrug resistance is a further challenge to the mission to control TB globally. Collectively, our group has pioneered the use of new TB mouse efficacy models to help advance innovative new therapies designed to shorten the length of TB treatment.” (IANS)