News from IDWeek 2018

Another rare PrEP failure reported in San Francisco

A San Francisco man was apparently infected with partially resistant HIV despite consistent use of Truvada pre-exposure prophylaxis (PrEP), according to a poster presented at IDWeek 2018, held in San Francisco.

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Efavirenz, but not dolutegravir, linked to neurological problems in children

Children born to HIV-positive women who take efavirenz (Sustiva or Stocrin, also a component of Atripla) during pregnancy are at greater risk of developing neurological disorders, some of which may not be diagnosed until years after birth, according to a late-breaker presentation at the conference.

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Doravirine combination works well as a switch option

A combination pill containing doravirine (Delstrigo) maintains undetectable viral load in people with well-controlled HIV who switched therapy, and continues to provide sustained viral suppression at 96 weeks for newly treated people, according to research presented at the conference.

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Other aidsmap news

Wide range of views about switching to weekly, monthly or biannual ART

Two-thirds of people taking combination antiretroviral therapy (cART) would be interested in switching to a once-weekly oral regimen should it become available, according to American research published in Open Forum Infectious Diseases. Opinion was evenly split on switching to injectable therapy but treatment delivered using implants attracted relatively little interest.

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Anal HPV-16 infection significantly more common in men who have sex with men, especially those living with HIV

Anal infection with HPV-16, the type of human papillomavirus most strongly associated with anal cancer, is most common in HIV-positive gay men, similar between HIV-negative gay men and HIV-positive heterosexual men, and lowest among HIV-negative heterosexual men, according to a meta-analysis of studies of HPV-16 prevalence in men published in Clinical Infectious Diseases.

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Older people less likely to be offered an HIV test in English sexual health clinics

Despite their mandate to offer HIV testing to all attendees, sexual health clinics in England are less likely to offer a test to older patients, according to an analysis of Public Health England data recently published in the International Journal of STD & AIDS.

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Hepatitis C elimination in people living with HIV in the UK is feasible by 2021, British HIV Association says

Hepatitis C co-infection can be eliminated in people living with HIV in the United Kingdom by 2021, the British HIV Association (BHIVA) has said. “The UK can be the first country to achieve microelimination of hepatitis C in those living with HIV, well ahead of WHO [World Health Organization] targets. We should seize this opportunity,” BHIVA said.

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TB vaccine halves risk of disease in people with latent TB

A vaccine against tuberculosis (TB) reduced the risk of developing active TB in HIV-negative people with latent TB infection by 54% in a large phase 2b study published last month in The New England Journal of Medicine.

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Dual-antibody combination therapy produces three to seven months of viral suppression without pills

A group of researchers have for the first time used infusions of antibodies to produce prolonged suppression of HIV viral load without antiretroviral therapy (ART) in the majority of a group given them.

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Some gay and bisexual men see PrEP as a 'social problem'

Gay and bisexual men have differing attitudes towards men who are using pre-exposure prophylaxis (PrEP), according to US research published in Sociology of Health & Illness. A series of focus groups conducted in New York City showed that some men regarded PrEP users as immoral, irresponsible, naïve and vectors of disease.

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Adolescent girls’ male partners are not all much older, much wealthier ‘sugar daddies’

The male partners of adolescent girls and young women in eSwatini (Swaziland) and South Africa report substantial HIV risk behaviours, but the data also challenge the stereotypical image of a ‘sugar daddy’. The men were only a few years older than their partners and many described challenging life circumstances such as unemployment, homelessness and violence.

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People living with HIV underestimate the harm of smoking

People with HIV in Denmark who smoke greatly underestimate the impact of smoking on life expectancy, a study of perceptions of life expectancy published this month in the Journal of Acquired Immune Deficiency Syndromes shows.

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Most PrEP users in Berlin obtained it from informal channels

Over half of men who have sex with men (MSM) living in Berlin who were using HIV pre-exposure prophylaxis (PrEP) accessed it through informal sources, without consistent medical monitoring, according to a recent study published in PLOS ONE.

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Large proportion of people living with HIV, including gay men, would like to have children

Approximately 40% of HIV-positive adults starting antiretroviral therapy (ART) in the United States would like to have children in the future, a proportion that remained unchanged after two years of follow-up, investigators report in Open Forum Infectious Diseases. There was no significant difference in the proportion of women, men who have sex with women (MSW) and men who have sex with men (MSM) who said they would like to have children.

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One in five exposed to TB during HIV clinic visits, Malawi study finds

As many as one in five people attending an HIV clinic in Malawi had prolonged exposure to another patient with potentially infectious tuberculosis (TB) during the course of a year, according to a review of how people subsequently diagnosed with active TB overlapped in clinic attendance with other patients, published in the journal AIDS.

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Meta-analysis shows hepatitis C treatment is highly effective for drug users

Direct-acting antiviral treatment is highly effective at curing hepatitis C in people who inject drugs and in people receiving opioid substitution therapy (OST), a systematic review and meta-analysis of 38 studies published in The Lancet Gastroenterology and Hepatology shows. Experts from Australia’s leading hepatitis C research centre say that the findings of the review demonstrate that policies that deny hepatitis C treatment for people who use drugs are unacceptable.

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Study confirms STIs make no difference to undetectability and infectiousness in people taking HIV treatment

A study conducted with gay men in Thailand has found that people who are diagnosed with HIV and start antiretroviral therapy (ART) are no less likely than others to have an undetectable viral load if they are diagnosed with a sexually transmitted infection (STI).

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Lymph node biopsies in individuals with acute HIV infection are safe and well tolerated

Biopsies of lymph nodes in the groin, performed in the context of acute HIV infection, are safe and well tolerated, according to a Thai study published in the Journal of Acquired Immune Deficiency Syndromes. Many HIV cure studies depend on lymph node biopsies in people who have acute (very early) HIV infection.

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Older age and baseline kidney function, not ARV choice, are key risk factors for chronic kidney disease in people with HIV in Australian cohort

Older age and lower baseline kidney function are the only significant risk factors for the development of chronic kidney disease (CKD) in HIV-positive adults, investigators from Australia report in AIDS. No antiretroviral (ARV) drug was associated with a decline in estimated glomerular filtration rate (eGFR) – a key marker of kidney function – below the key 60 ml/min threshold.

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PEPFAR funded 15 million medical male circumcisions between 2007 and 2017

PEPFAR (the US President’s Emergency Fund for AIDS Relief) has supported the voluntary medical male circumcisions (VMMC) of 15,269,720 men and boys in 14 countries in sub-Saharan Africa, in the eleven years to 2017, according to a paper recently published in BMJ Open. The World Health Organization estimates that PEPFAR supported 84% of all VMMCs in the 14 countries. 

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Loneliness associated with poorer cognitive function, mental health and physical health in older people with HIV

Loneliness in older HIV-positive adults is associated with reduced cognitive function as well as poorer mental and physical health, according to Canadian research presented to the recent Aging and HIV Workshop in New York. Approximately two-thirds of study participants reported loneliness, which was associated with both HIV-related and lifestyle factors.

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Editors' picks from other sources

My PrEP story: Will

from Prepster

As the IMPACT Trial hits its first anniversary, PrEPster co-founder Will Nutland says that the waiting needs to stop: full implementation of pre-exposure prophylaxis (PrEP) must become a priority.

US: HPV vaccine approved for women and men up to age 45

from Cancer Health

On 5 October, the Food and Drug Administration (FDA) expanded its approval of the Gardasil 9 vaccine, which protects against nine difference strains of human papillomavirus (HPV), to cover women and men ages 27 to 45.

Brexit, health care, and life sciences: plan for the worst

from The Lancet (requires free registration)

Negotiations continue between the UK and the EU27 for Brexit plans. Deal or no deal, leaders in health care, pharmaceutical, and life sciences are covering all bases.

Britons pay hundreds for HIV drugs. Why do Americans pay thousands?

from New York Times

Britain’s National Health Service far outperforms America’s healthcare system for far less money at keeping people living with HIV healthy.