Friday 15 April 2011
At the MRC Clinical Trials Unit, 222 Euston Road, London, NW1
|09:30-09:50||Registration, refreshments and expenses|
|09:50-10:00||Welcome, introductions, UKCAB updates|
|10:00-11:00||HIV and brain function – Dr Tristan Barber|
|11:10-11.30||Pre-Meeting for Abbott – Ben Cromarty|
|11:45-12:45||HIV, antiretroviral therapy and the brain – Dr Sam Nightingale|
|14:00-15:30||Company meeting: Abbott|
|15:35-16:00||Changes to HIV prescribing in London and what implications this could have for the rest of the UK, UKCAB AOB|
The meeting will be looking at how HIV affects the brain.
This is an area where there are lots of questions and so far very few answers.
HIV causes inflammation in other organs, so perhaps also in the brain. How much virus gets to the brain in the cerebrospinal fluid (CSF)? Is this important? Can it be measured? Is the choice of treatment likely to be important for everyone? Or just some people?
HAART has changed the treatment of HIV so that many of us can now lead long and productive lives. However the brain is a very sensitive organ and the body keeps it protected from substances it does not recognise. As a result HIV drugs have difficultly entering the brain and are often pumped back out if they do enter. This means that the level of drugs in brain fluid can be as little as 1% of that in blood. Lots of studies show that for different reasons these low levels may be enough – but do we need this from one, two or all three drugs.
In some people HIV can be found in the brain despite it being undetectable in blood. Sometimes the reverse is true. Does this matter?
Other studies looking a symptoms have shown that up to half of HIV positive people can have minor problems with thinking and memory, despite treatment.
We hope to discuss questions such as:
- What tests can I have for brain impairment?
- What can and can’t the doctor measure in the brain?
- Are there any tools to improve brain impairment?
- What drugs best penetrate the CSF?
- What studies are being done on HIV and the brain?
HIV and the Brain – The Body
Covers a variety of issues from brain impairment to the role of HAART. You can easily jump to the areas of interest using the hyperlinks. A long but easy to read document.
Controlling HIV in the Brain – amFAR AIDS Research
Steve Deeks’ work on elite controllers is interesting, the article looks at comparisons of brain inflammation of the elite controllers with three groups – HIV negative, HIV positive with detectable, HIV positive with undetectable viral load.
This article focuses on neurological brain function while on HAART. Looks at CSF viral load and drug penetration into the brain. Needs to be read a few times to be understood as it is quite technical.
Article reports on studies about whether HAART improves brain impairment. It is fairly easy to read and to understand and not lengthy.
Report on studies looking at how much virus escapes into the brain through the CSF, participants were all on HAART with undetectable viral loads. 10% had detectable viral loads in their CSF, which was associated with increased inflammation the brain.