June 2004

Focus on infectious diseases research

New cardio-vascular research at the Victorian HIV/AIDS Service, part of the Alfred’s Infectious Diseases Unit, is investigating the cause of an increase in heart disease and other major complications of life-saving drugs.

Advances in treatment have meant many people living with HIV/AIDS can now expect to live close to normal life spans.

The very drugs that are keeping them alive, however, are also slowly poisoning them.

HIV patients suffer significant side-effects from modern anti-retro viral therapies, including a 26 per cent increase in the risk of heart disease.

The study is among a raft of research being undertaken in the new Alfred Infectious Diseases Unit opened by Minister for Health Bronwyn Pike.

The new facility will be a centre of excellence for HIV and other infectious diseases research in Victoria, bringing together state-of-the-art research facilities in the newly-developed Burnet Institute and the leading clinical practice at the Alfred.

The State Government provided more than $19 million in dedicated funding for the HIV Service in 2003—04.

The cardio-vascular research was undertaken as part of a large international study coordinated by the DAD study group (Data collection on Adverse events of anti-HIV Drugs).

The Alfred Infectious Diseases Unit studied the incidence of heart disease and risk factors, including smoking and family history, in a case-controlled study involving HIV patients to determine whether they had an increased risk on top of existing factors.

The study demonstrated that on top of the usual risks for cardiovascular disease there was a 26 per cent increase in relative risk in HIV-infected individuals taking anti-HIV drugs.

Further work is now needed to understand the change in heart disease rates over time, the nature and process of this disease and how the increase in heart disease is linked to patients’ anti-retro viral treatments.

This is one of many studies undertaken in recent years, typical of the focus shift for HIV researchers, who are not only actively seeking cures for the disease but trying to improve the quality of life for HIV survivors.

People living with HIV/AIDS can live long, productive lives but must contend with major side effects including heart disease, liver problems, body deformities, nerve problems and dementia.

Research undertaken in the new centre of excellence includes the associations between depression and neuropsychiatric disease, problems with co-morbidities including hepatitis B and C and treatments for facial deformities and fat wasting.

Researchers are also looking at how HIV destroys the immune system, why anti-HIV drugs cannot eradicate HIV infection, the interaction between HIV and the hepatitis B virus and how HIV causes dementia.

The new centre includes laboratories dedicated to both research and patient care.

The diagnostic laboratory uses new state-of-the-art techniques that can rapidly diagnose infections.

These tests are critical for the successful management of people following bone marrow or organ transplantation.

The Alfred Infectious Diseases unit is the biggest in Victoria and is the State HIV Service treating 80 per cent of HIV-infected Victorians.