Do HIV patients recover completely after long term treatment?

“When HIV began, people were worried about dying. But with ARVs [anti-retroviral drugs], people are living longer and science is discovering other challenges brought by the disease,” says Damalie Nakanjako, a group leader at Makerere University and UVRI (MUII-plus) programme in Uganda, funded by DELTAS Africa.

The Developing Excellence in Leadership, Training and Science (DELTAS) Africa is a US$100 million programme supporting the Africa-led development of world-class researchers and scientific leaders in Africa.

An estimated 24.7 million people in sub-Saharan Africa are living with HIV, accounting for 71% of the global total.

HIV in ageing

Nakanjako has dedicated the past 12 years to HIV research. She has found that while people with HIV are living much longer than in the past, they tend to develop hypertension and heart conditions, among other age-related diseases, at a younger age on average than those who are HIV-negative.

She and her team are now “studying the clinical and biological differences between HIV patients receiving ARV treatment and people who don’t have the disease to establish if there are any persistent abnormalities and complications caused by HIV and treatment over a long term.”

Clinical studies on HIV in ageing

These observations were made from a 12-year-old clinical study of 559 HIV-infected individuals, initiated in 2004, to offer and monitor HIV treatment in a research setting. In this group of patients, we demonstrated that antiretroviral drugs improve the survival rates of people with HIV – 492 people were still living at the end of the study period – but that survivors face other medical challenges at a higher rate than the general population.

The impact

Nakanjako’s studies have shown that HIV-associated inflammation persists despite using ARVs, and increases the incidence of diseases of aging at an earlier age. Among her research findings was that HIV-infected patients got cataracts 20 years earlier on average than HIV-negative individuals.

Nakanjako’s research group is testing the effect of statins, which are used for treating high cholesterol, to reduce inflammation in patients being treated for HIV. “There are currently no drugs on the market to specifically treat persistent inflammation during HIV treatment. So we are testing statins like atorvastatin (commonly known as Lipitor) to see their effects on long term complications of ‘treated’ HIV disease,” she says.

Nakanjako’s research group is testing the effect of statins, which are used for treating high cholesterol, to reduce inflammation in patients being treated for HIV.

“There are currently no drugs on the market to specifically treat persistent inflammation during HIV treatment. So we are testing statins like atorvastatin (commonly known as Lipitor) to see their effects on long term complications of ‘treated’ HIV disease,” she says.

Nakanjako’s important research has earned a number of awards, including the Merle A. Sande  Health Leadership Award for emerging African scientists and the MUII-plus Group Leader Award, which funds her laboratory to train young researchers.

Inspired by the need to make a difference, Nakanjanko joined MUII in 2012 as a post-doctoral fellow, where she advanced to develop her own research group in 2013. Her team is training three PhD, and five master’s students, who in turn promise to make significant contributions as they establish their own independent careers.