News from the CROI2021 conference: Osteoporosis, mental health and more studies on HIV and Covid-19

CROI or Conference on Retroviruses and Opportunistic Infections has just ended. Like many other conferences, it became a virtual one. Here are some of the news presented at the March 6-10 conference.

Alendronate prevents osteoporosis

People who started treatment for HIV with the drugs TDF, emtracitabine and a third different drug, who also received Alendronate, showed fewer tendencies of osteoporosis.

Osteoporosis is a complication that mainly can affect older people living with HIV. Medicines, such as TDF, tenofovir disoproxil fumarate, which are found in Truvada as well as several other antiretrovirals, are also known to cause osteoporosis. Osteoporosis itself can lead to lower bone density and, in the worst case, bone fractures.

In a study of people who started HIV treatment, 70mg of alendronate was also given once a week in tablet form. The results showed, compared with a group not receiving alendronate, that the group receiving alendronate increased bone density (as opposed to osteoporosis) in the lumbar spine during the first 24 weeks and the first 48 weeks in the hip bones. The group that did not receive alendronate, on the other hand, showed signs of osteoporosis.

Comment:

Physical activity has previously been shown to increase bone density and proper diet and smoking cessation have also been shown to relieve osteoporosis. Because alendronate is already approved, it may be another tool to improve bone health, especially in the elderly living with HIV.

More info and a link to the study can be found here:

https://www.aidsmap.com/news/mar-2021/alendronate-can-prevent-bone-loss-people-starting-hiv-treatment

Digital mindfulness lessons help reduce depression and anxiety

Depression, anxiety and loneliness can affect anyone living with HIV, but older people are at increased risk. In the study, which was conducted in the United States, people living with HIV over the age of 50 participated in digital mindfulness lessons. The purpose was to find out if this type of intervention can reduce depression, anxiety and loneliness. In the pre-recorded lessons, the participants received, among other things, breathing and relaxation exercises aimed at reducing stress. Participants gained access to 14 lessons via mobile, computer or tablet.

The results showed after 25 days that both depression and anxiety decreased, compared to a group that did not participate in the lessons. However, the results were ambiguous when it comes to loneliness.

https://www.aidsmap.com/news/mar-2021/depression-anxiety-and-loneliness-can-be-improved-mindfulness-audio-lessons

Comment:

Especially during the Covid-19 pandemic, we need all types of interventions that can support and boost mental health. These results are interesting and shows that it is possible to make a difference digitally, perhaps not entirely unexpectedly that loneliness did not improve significantly, when you did not meet others.

HIV affects, but relatively marginally – Two large studies on HIV and Covid-19

Both the UK and the US provided studies targeting people living with hiv and Covid-19. Until now, there is no consensus on exactly what risk HIV poses in getting or becoming seriously ill in Covid-19.

The study from the UK was based on 69 cases of people with HIV who were admitted to a hospital due to Covid-19 last year. These people were compared with other equivalent patients, not living with hiv. The results showed that people with HIV who were hospitalized did not have a higher risk of dying, however, the time to recovery was longer.

Underlying diseases were found to play a greater role than HIV, and people with HIV who were hospitalized had more underlying diseases than those who did not live with HIV.

The study from the USA included 2,932 people with HIV whom tested positive for Covid-19. The study looked at the risk of being admitted to a hospital, which turned out to be higher for people living with HIV than people who did not live with HIV.

Here, too, underlying diseases played a major role, organ transplants, previous cardiovascular diseases and kidney disease all entailed an increased risk of being admitted. The researchers concluded that despite the role of the underlying diseases in being admitted, HIV was a risk factor for needing hospital care due to Covid-19.

Comment:

More time and more studies are probably needed to determine the risks for people living with HIV and how HIV affects the course of the disease with Covid-19. Regardless, I think many with me feel that it is nice that the risks are not sky high to become seriously ill in Covid-19 compared to people who do not live with HIV.

https://www.aidsmap.com/news/mar-2021/underlying-health-conditions-play-major-role-increased-risk-hospitalisation-covid-19