Latest Drug Regimens Provide 'Lazarus Effect' for HIV Patients

Frailty related to HIV infection is rapidly becoming a thing of the past, according to a perspective article authored by a clinical team at the UA College of Medicine – Tucson.
March 12, 2019
Dr. Stephen Klotz
Dr. Stephen Klotz

Remarkable advancements in HIV/AIDS treatments have made the infection almost undetectable in patients who strictly comply with their medication therapy, according to a recently published article authored by a clinical team at the University of Arizona College of Medicine – Tucson.

Lead author Stephen A. Klotz, M.D., professor in the Division of Infectious Diseases in the UA Department of Medicine, said that in the past, HIV/AIDS patients often suffered from extreme frailty, aging 10-15 years in appearance and function. Now, frailty related to HIV infection is "rapidly becoming a specter of the past," Klotz and his co-authors noted in the article, HIV Infection-Associated Frailty: The Solution for Now is Antiretroviral Drugs, published Feb. 25 in the Journal of the International Association of AIDS Care Providers.

Thanks to new treatments, disfiguring lipodystrophy – changes in body fat that affect some patients – is “a grim historical footnote to the HIV epidemic in the United States,” the authors added.

“We have shown that years of anti-retroviral therapy can return patients to a non-frail state. In addition, prolonged anti-retroviral therapy restores cellular function and numbers of cells adversely affected by HIV,” Klotz said. “Recently, we demonstrated a marked improvement in aging markers in HIV patients on long-term anti-retroviral drug therapy.”

In the early 1980s, patients with HIV might have taken nearly 20 pills a day, with many suffering severe side effects. Today, patients take a single anti-retroviral pill containing three medications once a day, “with virtually no side effects,” Klotz said.

The team employed another major advancement in the treatment of HIV/AIDS: a “frailty meter,” developed by Bijan Najafi when he was a faculty member in the UA Department of Surgery and director of the Interdisciplinary Consortium on Advanced Motion Performance. The device now allows clinicians to measure HIV/AIDS patients’ frailty in a matter of seconds, rather than requiring several clinic visits.

The frailty meter detects frailty through a small, Bluetooth-supported motion sensor that attaches to the subject’s wrist. In about 20 seconds, it measures subjects’ elbow flexes to accurately determine their frailty.

Another major clinical advancement is the ability to cure the hepatitis C virus infection, which was commonly associated with HIV/AIDS infection.

“This other viral scourge is decreasing in prevalence, not only in the general public, but in our HIV patients as well,”Klotz noted.

In related research led by co-authors Nicole Bradley, a postdoctoral research associate in the UA Department of Immunobiology and Nafees Ahmad, a professor in the UA Department of Immunobiology and member of the UA Cancer Center, the team is studying specific immune aging markers in HIV patients and “once again is finding improvement in infected patients on continuous long-term anti-retroviral therapy,” the article stated.

Co-author Shannon Smith manages the Petersen Clinics, part of the UA Department of Medicine’s Division of Infectious Diseases. In collaboration with Banner – University Medicine, the Petersen Clinics provide clinical care for people living with, or at risk for, HIV. The Petersen Clinics comprises infectious disease specialists, pharmacists, clinical coordinators, medical case managers and early interventionists to provide patients comprehensive HIV specialty care.

“We’re very proud of the scope of services we provide,” Smith said. “We’re very creative in ensuring our patients and families obtain the care they need.”

A version of this article originally appeared on the UA Health Sciences website: https://opa.uahs.arizona.edu/newsroom/news/2019/latest-anti-retroviral-drug-regimens-provide-lazarus-effect-hiv-patients

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