News from aidsmap

European HIV response "falling behind" as Eastern European epidemic grows

HIV diagnoses have increased by 80% in the European region since 2004, and three quarters of new HIV diagnoses in the European region are occurring in Eastern Europe, yet the scale and targeting of HIV prevention, testing and treatment in Eastern Europe are inadequate, a European meeting on standards of care for HIV and co-infections in Europe heard last week in Rome, Italy.

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No new HIV infections seen among Kaiser PrEP users

No new HIV infections have occurred among more than 500 users of the Kaiser Permanente healthcare provider system in the US in members using pre-exposure prophylaxis – better known as PrEP.

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HIV most often passed on by younger gay men who have undiagnosed HIV, are not on treatment, and have an ongoing partnership

A modelling study based on the UK’s HIV epidemic among gay men estimates that two-thirds of infections originate in men with undiagnosed HIV, 85% in men who are not taking treatment and 90% within the context of an ongoing sexual partnership. Moreover, HIV transmissions most frequently involve men under the age of 35 who report relatively high levels of sexual activity, according to the study published online ahead of print in AIDS.

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HIV has become more virulent over time, not less, European study finds

The largest cohort study ever to look at CD4 count and viral loads in HIV-positive people around the time of diagnosis has found evidence that HIV, at least in Europe, has become more virulent over time. The average time taken to reach a CD4 count below 350 has halved over the last 25 years, researchers calculate.

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Sofosbuvir/ledipasvir cures most previously treated hepatitis C patients with cirrhosis

Difficult-to-treat hepatitis C patients with liver cirrhosis who were not cured with a prior course of first-generation HCV protease inhibitors had a sustained response rate of 96-97% when re-treated with sofosbuvir/ledipasvir with ribavirin for 12 weeks or without ribavirin for 24 weeks, researchers reported at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting last month in Boston, United States. Sofosbuvir/ledipasvir also worked well for people previously treated with other sofosbuvir-containing regimens. 

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Poor weight gain during first year of ART associated with increased mortality risk for children with HIV in resource-limited settings

Poor weight gain after starting antiretroviral therapy (ART) is associated with increased mortality risk for children with HIV, investigators report in the online edition of AIDS. An international team of researchers developed a model to examine the association between weight gain and mortality risk for children starting ART. Poor weight gain was associated with increased mortality risk, independent of other factors.

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Reduced physical function significantly increases mortality risk of middle-aged people living with HIV

HIV infection is associated with reduced physical performance, investigators report in the online edition of AIDS. They also found that people living with HIV who had reduced physical function had a significant increase in their mortality risk.

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Safer injecting practices would be better promoted by focusing on pleasure and practical concerns – not the risk of infection

Harm reduction interventions often fail to engage people who inject drugs because they over-emphasise infection and risk, Magdalena Harris of the London School of Hygiene and Tropical Medicine told the recent HIT Hot Topics conference in Liverpool. Her interviewees frequently adopted safer injecting practices, but were more motivated by a desire to have a quick, pleasurable hit than by concerns about blood-borne viruses.

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Sofosbuvir/ledipasvir with ribavirin cures most people with hepatitis C recurrence after liver transplantation

An interferon-free regimen of sofosbuvir plus ledipasvir (Harvoni) taken with ribavirin for 12 or 24 weeks led to sustained virological response in nearly all HCV genotype 1 patients with fibrosis or less-advanced liver cirrhosis, researchers reported at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting last month in Boston, United States. Response rates fell for people with more severe cirrhosis and signs of liver decompensation, but still a majority were cured.

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Sofosbuvir + simeprevir shows good results for hepatitis C in real-world use

Regimens containing sofosbuvir (Sovaldi) – including sofosbuvir plus simeprevir (Olysio) – work well for people with hepatitis C genotype 1 in real-world use, which to date has included some of the patients most urgently in need of treatment at the dawn of the interferon-free era, according to a pair of presentations at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting last month in Boston, United States. Sofosbuvir plus ribavirin alone is highly effective for people with genotype 2.

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Editors' picks from other sources

British public still in the dark about HIV 30 years on

from NAT press release

Less than half (45%) of the British public understand how HIV is and isn’t transmitted, new research reveals. NAT (National AIDS Trust) research commissioned from Ipsos MORI also reveals an increase in myths and misunderstanding about HIV.

Issue Brief: Achieving undetectable: what questions remain in scaling-up HIV virologic treatment monitoring?

from MSF

Although the majority of developing countries do not yet offer viral load testing on a routine basis, the use of HIV viral load monitoring is rapidly gathering pace in most developing countries. Which questions remain in further scaling up this gold standard for HIV treatment monitoring in these countries? Médecins Sans Frontières (MSF) is releasing Achieving Undetectable, the latest in a series of issue briefs and reports on access to viral load monitoring in resource-limited settings.

National HIV Prevention Funding – An essential investment

 from NAT

The Government is reducing funding for HIV prevention in England by 50% from 2015. There is no indication that HIV transmission rates in England are reducing and there continue to be major gaps in public understanding of how to prevent HIV. HIV prevention funding must remain at least at current levels.

HIV dollars drop with waning philanthropic funds

from Science Speaks

Last year saw the lowest level of funding from charitable donors since 2007, the year when government spending on HIV began to drop, according to a new report. While the report notes that philanthropic support accounted for just 3% of all international funding for HIV-related efforts in low and middle-income countries, it has increasingly been cited in recent years as a source of support to fill gaps left by constricting national budgets.

The best way to beat AIDS isn't drug treatment. It's a living wage

from New Republic

Being poor is a more accurate predictor of HIV than being male, female, Black or Hispanic is. A 2010 study of poor urban areas found that race and gender were not significant predictors of HIV prevalence. Why then are our proposed solutions for a problem with economic roots overwhelmingly clinical?

Twenty-one attempts at swallowing Truvada

from Slate

Why are some gay men hesitant about preventing HIV with a pill? A few thoughts.

Appeal to global donors to save the Treatment Action Campaign

from The Lancet

Fulfilling the right to health depends on common purpose between researchers, clinicians, and activists. On the eve of World AIDS Day 2014 (Dec 1), we write this letter as scientists and academics who are concerned about the possible closure of the Treatment Action Campaign (TAC) in South Africa as a consequence of serious funding difficulties.