Study to analyze seizures in HIV patients, explore drug interactions

February 22, 2011

EAST LANSING, Mich. -- A Michigan State University researcher is looking to uncover the risks of treating seizures in HIV-positive patients, providing much-needed data on possible interactions between antiepileptic drugs and antiretroviral medicines that potentially could make HIV drugs less effective or the disease itself drug resistant.

Despite seizures being one of the most common neurologic symptoms among HIV-positive patients, little is known to guide physicians looking to treat the attacks with antiepileptic drugs, said Gretchen Birbeck, an associate professor of neurology and ophthalmology in MSU's College of Osteopathic Medicine.

To that end, Birbeck has been awarded a $244,750 grant from the National Institute of Neurological Disorders and Stroke to create a cohort study in Zambia, where rates of epilepsy and AIDS are both high.

"We will be identifying people who are HIV positive and who have had their first seizure," Birbeck said. "We then will follow them over time through the clinics where they receive HIV treatment. At each visit, we will reassess whether they have had further seizures, whether they require seizure medications chronically and if they are also taking HIV medications."

A critical part of the study, Birbeck said, is to determine whether the dual burden of treating seizures and HIV at the same time affects the efficacy of antiretroviral drugs or makes HIV resistant to medications.

The issue, Birbeck explains, is the antiepileptic drugs used in Zambia (where epilepsy rates are about 10 times what they are in the United States) and across much of the developing world belong to a class of drugs known as enzyme inducers.

"Taking enzyme-inducing drugs causes the body to speed up its metabolism of some other drugs," Birbeck said. "Among the drugs potentially affected are critical antiretrovirals.

"So a patient taking both medicines may be taking a dose of antiretroviral that is getting metabolized too rapidly, putting them at risk of drug failure, developing AIDS and even death."

The interaction also may increase the risk that in a HIV-positive person taking antiepileptic drugs, the virus develops resistance to the drugs that are now present in doses too low to kill it. If that occurred, Birbeck said, a form of HIV could be transmitted to uninfected people who now will not respond to available medications.

"This study is vital to assist clinicians in determining if and when to initiate chronic treatment for seizures in people with HIV and to determine if using the medications for HIV and epilepsy routinely available in resource-limited settings may be leading to problematic drug interactions," Birbeck said.

Birbeck, who also serves as director for MSU's International Neurologic & Psychiatric Epidemiology Program, has been studying in Zambia and sub-Saharan Africa since the early 1990s. Her work also focuses on the link between epilepsy and cerebral malaria in the region.
Michigan State University has been working to advance the common good in uncommon ways for more than 150 years. One of the top research universities in the world, MSU focuses its vast resources on creating solutions to some of the world's most pressing challenges, while providing life-changing opportunities to a diverse and inclusive academic community through more than 200 programs of study in 17 degree-granting colleges.

Michigan State University

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to