News from aidsmap

Gene therapy snips HIV out of infected cells and makes uninfected cells resistant

For the first time, researchers have used a gene-editing technique already used to produce cells resistant to HIV infection to target HIV-infected cells. They have managed to remove HIV genes completely from infected cells, as shown by reductions in the cells' overall rate of HIV production. In cells not already infected, the therapy has itself become part of their genome, producing cells that are resistant to infection for a prolonged period.

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HCV epidemic in North America peaked between 1940 and 1965 with medical procedures likely source of most infections

The spread of hepatitis C virus (HCV) in North America peaked between 1940 and 1965, according to research published in Lancet Infectious Diseases. The investigators attribute the rapid spread of the infection to hospital transmissions and reuse of medical injecting equipment rather than risky behaviours such as injecting drugs, unsafe tattooing and unprotected sex.

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African women in London with poor adherence feel that HIV treatment is difficult and unrelenting

A qualitative study with West African women living in London who have difficulties adhering to their HIV treatment has found that many think of HIV treatment as a ‘life sentence’ that they long to escape from. Internalised stigma about HIV is an undercurrent in many of these women’s accounts, according to an article published online ahead of print by AIDS and Behavior. But some women described an improvement in their feelings about the medication over time, talking about the factors that helped them with adherence.

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Long-acting oral antiretroviral MK-8591 could represent 'paradigm shift' in HIV treatment and prophylaxis

An investigational antiretroviral agent that maintains drug levels that are able to inhibit HIV up to six months after dosing could represent a “paradigm shift” in HIV therapy and prophylaxis, according to research presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2016) in Boston, USA, in February.

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Antidepressant modestly improves HIV-related cognitive impairment

The SSRI antidepressant paroxetine (Paxil) was associated with modest improvement in cognitive function and reduced central nervous system inflammation in people with HIV-related neurocognitive disorder, but the antifungal drug fluconazole showed no apparent benefit even though it reduced oxidative stress, according to a study presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2016) in Boston in February.

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High-risk anal HPV infections persist in a significant proportion of HIV-negative MSM

Anal infection with human papillomavirus (HPV) types associated with a high risk of pre-cancerous and cancerous cell changes persisted for two years in 37% of men who have sex with men (MSM) enrolled in an international study published in Clinical Infectious Diseases. The prospective, observational study involved 406 HIV-negative MSM recruited in Brazil, Mexico and the United States. Among men with prevalent high-risk HPV infection, 37% retained the infection for at least 24 months and HPV-16 infection persisted for at least 24 months in 30% of those with this infection at baseline.

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Isoniazid alone prevents tuberculosis in people with advanced HIV, urine test may lower mortality

Using isoniazid alone to prevent the development of active tuberculosis (TB) in people with advanced HIV disease was equally effective and better tolerated than a common four-drug empirical TB regimen, according to a study published in the March 19 edition of The Lancet in advance of World TB Day. Another study in the same issue found that a new inexpensive urine test has the potential to help reduce TB-related mortality by enabling faster treatment.

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Tailored programmes encourage black gay men to start and stay on PrEP in US study

Providing culturally tailored support programmes for black men who have sex with men can increase their likelihood of maintaining adherence to pre-exposure prophylaxis (PrEP) for HIV prevention, helping to address a key public health gap, according to findings from the HPTN 073 study presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2016) in Boston in February.

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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.

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Opt-out HIV/HBV/HCV testing for patients attending emergency departments identifies significant number of new infections

A week-long pilot study involving nine UK emergency departments has shown that routine, opt-out testing for HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) can identify a significant number of previously undiagnosed infections. The results are published in HIV Medicine. Adult patients having blood tests as part of their care were offered opt-out screening for HIV/HBV/HCV. Over a quarter of patients consented to be tested and 3% of these individuals were identified as being infected with a blood-borne virus (BBV), and 45% of these infections were new diagnoses.

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Editors' picks from other sources

PrEP – What went wrong? What should happen?

from National AIDS Trust

Rarely has a U-turn, rarely has a breach of trust, been so misleadingly announced. Reading NHS England’s press release, ‘Update on commissioning and provision of PrEP for HIV prevention’ (21 March 2016), you would think the NHS were simply clarifying progress to date and the well understood responsibilities for the commissioning of PrEP. In fact this press release was the announcement of a shocking U-turn as NHS England suddenly abandoned its own process for the approval of PrEP, just before its conclusion, with nothing to replace it bar some loose change found down the back of the sofa.

In a first, liver and kidney from HIV-infected donor are transplanted into HIV-positive patients

from Los Angeles Times

In a first that gives HIV-positive patients yet another chance for long lives, surgeons at Johns Hopkins University Medical Center have transplanted a kidney and a liver from a deceased donor who was positive for HIV into two HIV-positive recipients.

Barack Obama: 'Drug addiction is a health problem, not a criminal problem'

from The Guardian

“For too long we’ve viewed drug addiction through the lens of criminal justice,” Obama said at a conference in Atlanta. “The most important thing to do is reduce demand. And the only way to do that is to provide treatment – to see it as a public health problem and not a criminal problem.”

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.”