Positive Support Services in North Yorkshire and York
NYAA provides support for people in North Yorkshire and York who are living with or affected by HIV. From 1st July 2015, our support services will be delivered as part of our Partnership with York Teaching Hospital NHS under the recognised name YorSexualHealth.
On this website, you can find more information about who we are in the “About NYAA” section and what we do – what services we can provide – in the “Services” section. There is also an overview of information about HIV and HIV treatment in the “Information About HIV” section, with suggestions on where to find reliable, more detailed information. And there is also a “News” section, for news not only about NYAA, but also about things to do with HIV that might be of interest.
You can find our contact details here.
Topics on this page include the following: you can jump to them by clicking on the headings below:
Switching from Efavirenz Does Not Improve Cognitive Function
Despite effective antiretroviral therapy (ART), mild cognitive impairment (things like decreased attention span, poorer memory, worse problem-solving ability) remains common in people living with HIV. The reasons for this are poorly understood and little is known about the impact of specific anti-HIV drugs on neurological function. However, efavirenz – one of the most commonly used antiretrovirals (efavirnez is used in for example Truvada and Atripla) – has been associated with sleep disturbances and cognitive disturbances (vivid dreams, trouble sleeping, dizziness). Investigators in Newcastle designed a pilot study involving people taking efavirenz long-term, to see if changing from efavirenz to a different drug regimen would improve cognitive function.
Perhaps disappointly, changing treatment had no impact on cognitive function. Almost all the assessments performed before and after the switch from efavirenz to other drugs had comparable results. However, switching therapy did appear to improve sleep quality for some. Daytime sleepiness did not improve but some people reporting poor sleep quality on efavirenz did experience improvement after switching.
Although this is a small pilot study, it is a very detailed and thorough one, and suggests that despite the problems some people experience with efavirenz (estimated vary, but up to 25% of people taking efavirnez experience some neurological problems with efavirenz), it does not impact cognitive function.
The full article can be read here.
Life Expectancy Near Normal
A large study of 88,504 people with HIV on antiretroviral therapy (ART), published in the Lancet journal and reported widely in the news, has found substantial improvements in life expectancy in people with HIV who started ART after 2008, even in their first year of therapy. People who started ART in 2008-2010 and who had achieved CD4 counts over 350 cells/mm3 by the end of their first year of therapy had life expectancies approaching normal.
The researchers point out that this study only looks at mortality in people taking ART – “whereas most deaths in people with HIV infection occur in the untreated population.” They also comment that the life-expectancy benefits of ART “are not shared by all…Specifically, individuals who… have a history of injection drug use, or began ART with low CD4 cell counts have no reduction in mortality or improvements in life expectancy,” they say. They add that the uneven benefits of ART are not merely due to socioeconomic disadvantage or the effects of stigma but also to outdated perceptions of HIV treatment. “The previous era of inferior drugs and poor outcomes for patients has left a legacy that will be difficult to overcome,” they say. “Fear of medication-related side-effects is a leading psychosocial barrier to treatment initiation and has led to concerns that ART might actually make a patient sick. Interventions to increase awareness of the many positive benefits of early ART initiation and to allay fears of drug toxicity are needed, especially in individuals who feel healthy and might perceive ART as more of an immediate risk than a benefit,” they add.
The full article can be read here.