Pneumococcal disease
People living with HIV continue to be at increased risk of invasive pneumococcal disease, according to a study in Denmark. Even in the era of modern combination HIV treatment, the risk of infection was 19-fold higher among people living with HIV than in the general population.
Infection with Streptococcus pneumoniae can cause a range of bacterial diseases, from relatively mild illness to much more serious conditions. Non-invasive pneumococcal infections include ear and sinus infections, and bronchitis. Invasive pneumococcal infections include infections of the joints, bones, lungs, and blood.
People who have a weakened immune system are most at risk from infection with pneumococcal bacteria. Investigators in Denmark wanted to find out whether the availability of effective HIV treatment and the introduction of a childhood vaccine in 2007 had reduced rates of invasive pneumococcal disease in people living with HIV.
They compared rates of the disease between people living with HIV and people in the general population (controls) at different time periods – 1995-96; 1997-99 and 2000-12. Each person living with HIV was matched with 19 controls.
The research found that overall risk of invasive pneumococcal disease was around 24-fold higher among people living with HIV. Risk became lower as HIV treatment improved, but even in the latest time period the risk was significantly higher for people living with HIV.
Smoking and injecting drugs were associated with an increased risk of pneumococcal disease. Detectable viral load and low CD4 count also increased risk.
Moreover, the risk of the disease remained unchanged throughout the study for people living with HIV who inject drugs. The researchers comment that people who inject drugs, “have a remarkably high risk of invasive pneumococcal disease that hasn’t declined over time, and remain an obvious group for targeted immunization”.
HIV superinfection
HIV superinfection involves someone living with HIV acquiring another strain of HIV at a later time. It had been thought to be rare, but research in Kenya found an annual superinfection incidence of 3% among a group of women at high risk.
The impact of superinfection on HIV disease progression is not clear. The team of researchers in Kenya therefore followed-up women in the group and compared changes in viral load, CD4 count, and clinical disease progression between women with superinfection and women with a single virus.
They found that there was a significantly faster increase in viral load among the women with superinfection, but only a modest impact on CD4 cell loss and this did not translate into faster disease progression.
Editors' picks from other sources
Intimacy a strong motivator for PrEP HIV prevention
from Eurekalert Inf Dis
Many HIV-negative gay or bisexual men in steady relationships with other HIV-negative men don't always use condoms out of a desire for intimacy. That same desire, according to a new study, makes such men more inclined to use antiretroviral medications to prevent getting HIV, a recommended practice known as PrEP.
Britain has no problem paying for expensive hepatitis C drugs
from Businessweek
The UK’s decision to recommend Sovaldi was far from a sure thing. But once the National Institute for Health and Care Excellence (NICE) was convinced that Sovaldi is cost-effective, the decision to pay for it is simple, because one entity pays for all the medical care in the UK. If treating a patient with costly drugs now prevents a more expensive liver transplant in 15 years, that savings accrues to the National Health Service – and ultimately to British taxpayers.
From HIV to Ebola: How to protect health workers in West Africa
from Devex
What can we learn from the global response to HIV and AIDS that can be applied now to aid workers dealing with the Ebola outbreak in West Africa? Mead Over, a senior fellow at the Center for Global Development, urges donors to help affected governments protect health workers in Ebola-affected areas.
Passengers with HIV sue China's Spring Airlines
from BBC News
Two passengers with HIV are suing a budget Chinese airline for refusing to let them board a plane. Local media reports say the two men and a friend – who does not have HIV – were prevented from boarding a Spring Airlines plane at Shenyang airport.
NICE consults on further draft guidance on the drug sofosbuvir (Sovaldi) for treating hepatitis C
from NICE
In further draft guidance NICE has recommended sofosbuvir (Sovaldi, Gilead Sciences) as a treatment option for some people with chronic hepatitis C. The positive recommendation follows receipt of additional information about the drug’s cost effectiveness from the manufacturer.
AIDS 2014: Disappointing HIV cure news leads to new questions
from HIVandhepatitis.com
The fourth IAS Towards an HIV Cure symposium – an initiative of the International AIDS Society – took place July 19-20, prior to the 20th International AIDS Conference in Melbourne.
AIDS activist takes up a new fight: Defending FDA
from ABC
As an AIDS activist in the early 1990s, Gregg Gonsalves travelled to Washington to challenge the Food and Drug Administration (FDA). Gonsalves was part of the confrontational group AIDS Coalition to Unleash Power, which staged protests outside the FDA's headquarters, disrupted its public meetings and pressured its leaders into speeding up the approval of experimental drugs for patients dying of AIDS. A quarter century later, Gonsalves still travels to Washington, but with a different agenda: to defend the FDA.