Sexual health
Antibiotic-resistant gonorrhoea is widespread in the UK, recently released figures show. The Health Protection Agency (HPA) also announced that there were almost 500,000 diagnoses of sexually transmitted infections in the UK in 2009.
The drugs currently recommended for the treatment of gonorrhoea come from a class of antibiotics called cephalosporins. Two of these drugs are cefixime and ceftriaxone.
Cefixime is the most commonly used of these drugs. Researchers found that about 1% of gonorrhoea cases are resistant to the drug. But when they used a stricter definition of resistance, this figure leapt to 10%.
Resistant strains were especially likely to be detected in gay men, a third of whom had HIV.
Few gonorrhoea cases were resistant to ceftriaxone. But the researchers found that if an infection was resistant to one drug in the cephalosporin class it was often resistant to another drug as well.
Professor Cathy Ison of the HPA commented: “At the moment the drugs we use in the UK are still effective for treating gonorrhoea. But our lab tests show that the bacteria are becoming less sensitive to these drugs and the worry is that we could see gonorrhoea become a very difficult infection to treat within the next five years, as [it is] elsewhere in the world.”
The HPA also announced that there were 482,696 new diagnoses of sexually transmitted infections in 2009. Many of these were in young adults. New diagnoses of chlamydia, gonorrhoea and genital herpes increased between 2008 and 2009.
HIV and flu
The annual flu season is fast approaching, and separate studies have looked at the effectiveness of flu vaccines in people with HIV.
Treatment as prevention
One of the most exciting and controversial areas of HIV medicine is the use of HIV treatment as prevention.
HIV treatment reduces the amount of virus (viral load) in blood and other body fluids. The Swiss doctors pointed to research that showed that few new HIV infections originated in people with a viral load below a certain level.
Few have gone as far as the Swiss and said that people with an undetectable viral load are completely uninfectious. However, there is a growing consensus that people who take HIV treatment have their infectiousness reduced. And there are real hopes that that might have an impact on the spread of HIV.
Doctors in the Canadian province of British Columbia want to increase the number of people with HIV who take treatment as a way of controlling the epidemic. They have even estimated that in certain circumstances it could eventually eliminate new HIV infections.
Now new figures show that there were marked falls in the number of new HIV diagnoses in the province between 1996-99 and 2004-2009. These were periods when the number of patients starting treatment increased substantially.
The number of new HIV diagnoses fell during these periods, despite more HIV tests being conducted.