Gene therapy advances
For the first time, researchers have used a gene-editing technique to target HIV-infected cells and remove HIV genes completely from them.
In the lab, the therapy produced significant reductions in viral production by CD4 cells taken from four people with HIV. The therapy also made uninfected cells more resistant to infection and 100% resistant to one of the two strains of HIV tested.
The next step is to see if the gene-editing therapy will remove the HIV genes from cells that are already being treated with antiretroviral therapy (ART).
This is a remarkable advance but some considerable challenges remain before the approach can be tested in humans.
Tuberculosis advances
People with advanced HIV disease, especially if they have not received HIV treatment, are at great risk of tuberculosis (TB), especially in some African and Asian countries. Around the world, one third of deaths in HIV-positive people are due to TB. Two recent studies show progress in reducing the burden of tuberculosis on people living with HIV.
One found that a new way of diagnosing TB, testing a sample of urine, speeded up diagnosis of TB. This meant that people who had both TB and HIV could start TB treatment quicker, often preventing their death.
The other found that for people with a very low CD4 count, below 50, a single drug to prevent the development of tuberculosis was as effective as the four-drug treatment that is usually given. The single drug also has fewer side-effects.
England’s PrEP policy in disarray after NHS U-turn
Activists, individuals at risk of HIV, and clinicians have reacted with anger to an official U-turn on provision of HIV pre-exposure prophylaxis (PrEP). NHS England officials have refused to allow a draft policy on PrEP to go forward for further consideration.
“The UK once had a reputation for being a leader in HIV prevention and that reputation now lays in tatters,” said Will Nutland of activist group Prepster. “NHS England has turned its back on a process that could have significantly contributed to turning the tide of HIV in this country. The decision is ill-conceived, is not based on evidence, and will directly contribute to the on-going sexual ill health of the nation.”
The argument advanced by NHS England for the U-turn is that they shouldn’t have been considering commissioning PrEP in the first place, as HIV prevention services are the responsibility of local authorities. While many think these arguments to be disingenuous, PrEP appears to be a victim of the split of commissioning responsibilities between the NHS and local authorities.
People who are concerned about PrEP and the state of HIV prevention in the UK are urged to write to their MP and ask them to raise the issue with the Secretary of State for Health and also to sign a parliamentary petition.
HIV treatment improves liver function
People who start HIV treatment usually see long-term improvements in their liver function, especially if their viral load is suppressed, a new study shows. The researchers included data on liver function four years before treatment, one year before, two years after, and five years after.
The study lends support to the idea that immune deficiency or HIV replication can damage the liver. (There are many other additional causes of serious liver damage, including infection with hepatitis B or C and alcohol abuse). When people’s HIV treatment reduced viral load to undetectable levels, liver function improved.
This was the case even though much of this data concerns people beginning HIV treatment in the late 1990s, when several anti-HIV drugs which can themselves be harmful for the liver were commonly used. These drugs, such as didanosine (ddI) and stavudine (d4T) are now rarely used in western countries.
In the study, liver function improved both in people who had HIV only and also in people with HIV and hepatitis co-infection.
Editors' picks from other sources
Older people with HIV face different long-term health challenges
from CATIE
Canadian researchers collaborated on a massive data analysis project that collected health-related information from more than one million people, a small fraction of whom (less than 1%) had HIV. Overall, HIV-positive people had “more co-infections but fewer chronic diseases” compared to HIV-negative people. Furthermore, they found that HIV-positive people were generally more likely to have experienced “depression and social isolation and the use of psychotropic medicines.”
Decision to withhold PrEP shows the government and health bodies are contributing to HIV epidemic
from Attitude Magazine
In a judgement as irrational as it is infuriating, NHS England have announced it would be abandoning its decision to make highly effective HIV prevention drugs, otherwise known as ‘PrEP’, available to those most at risk of HIV. In what has become a recurring theme, authorities have once again met the opportunity to tackle rising HIV transmission rates with complacency and disregard.
Poppers 'will remain legal' despite ban on legal highs
from Telegraph
A review by the Advisory Council for the Misuse of Drugs has found that akyl nitrates are 'not psychoactive' under the terms of the new Psychoactive Substances Act.