News from aidsmap
Seventy per cent fewer HIV infections seen with PrEP injections, compared with pills, in gay/bi men and trans women
The news that a trial of an injectable formulation of PrEP was stopped early due to high efficacy has been greeted by Science magazine as “Not an AIDS vaccine, but it may be the closest thing to one so far.” The early termination of the HPTN 083 study is good news – and may fundamentally change the nature of HIV pre-exposure prophylaxis, and indeed of all HIV prevention.
No increased risk of severe COVID-19 in people living with HIV, but vigilance over bacterial pneumonia required
Two studies of COVID-19 cases published in recent days lead investigators to the cautious conclusion that people living with HIV are not at higher risk of death or severe illness, but one study shows a higher frequency of bacterial pneumonia leading to death in people living with HIV hospitalised with COVID-19.
Very low CD4 count in the past raises anal cancer risk
The development of anal cancer in people living with HIV is associated with a history of prolonged or severe immune suppression, a large North American study of anal cancer risk has reported. Having a CD4 count below 50 at some point in the previous eight and a half years or a longer period with a CD4 count below 200 each carried a higher risk of developing anal cancer, the study found.
Short-course treatment for recent hepatitis C: some courses may be too short
An eight-week course of grazoprevir/pibrentasvir (Zepatier) achieved a high cure rate in people recently infected with hepatitis C, but a six-week course of sofosbuvir/velpatasvir (Epclusa) in recently infected people resulted in an inferior cure rate compared to standard treatment, two recent studies show.
Disruption to HIV treatment in Africa during COVID-19 pandemic could double HIV deaths, modelling studies warn
A synthesis of five different studies that model the effect of a three- or six-month interruption of HIV services across sub-Saharan Africa finds that excess deaths due to HIV – in other words those in addition to the usual number of HIV deaths – may be in the order of 550,000. As the current annual HIV-related death toll is around 470,000 (in 25 million people living with HIV in the region), there may therefore be around a million deaths, equating to a 2.2-fold rise in HIV mortality, during the COVID-19 pandemic.
Non-alcoholic fatty liver disease affects a quarter of lean people living with HIV
A quarter of people living with HIV with normal body weight have non-alcoholic fatty liver disease (NAFLD), Italian and Canadian investigators report in Clinical Infectious Diseases. Risk factors were older age, high blood lipids and disturbed liver function. Significant liver fibrosis was observed in 16% with NAFLD, and this progressed in a significant proportion of individuals at a rate comparable to that seen in overweight or obese study participants.
Multi-month supplies of HIV medications – recommended during lockdowns – are not authorised in many countries
During the coronavirus pandemic, allowing people who are stable on their HIV treatment to collect enough medication to cover three or six months – therefore minimising unnecessary visits to healthcare facilities – is recommended by the World Health Organization (WHO), UNAIDS, the International AIDS Society, the Global Fund and PEPFAR. However, a third of countries do not permit prescriptions of three months or longer, according to a rapid analysis published by the O’Neill Institute for National and Global Health Law at Georgetown University.
A quarter of people with HIV may have post-traumatic stress disorder
There is a high prevalence of post-traumatic stress disorder in people living with HIV, according to the first comprehensive systematic review and meta-analysis on the topic, published in BMJ Open. Post-traumatic stress disorder (PTSD) occurs when a person has experienced a traumatic event and is unable to process the shock properly.
People switching from TDF to TAF experience rising cholesterol levels
A study by Dr Aoife Lacey and colleagues of 164 patients at HIV clinics in Dublin, Ireland who switched from antiretroviral therapy (ART) regimens containing tenofovir disoproxil fumarate (TDF) to ones containing tenofovir alafenamide (TAF) has found that the proportion of people with total cholesterol levels indicating “very high grade abnormal dyslipidemia” rose threefold from 5.2% to 15.5%. The proportion with abnormally high levels of low-density lipoprotein (LDL or 'bad' cholesterol) rose 1.5-fold from 23.7% to 36.6%.
Migrants left behind in HIV treatment cascade in Australia
There are important gaps in the HIV treatment cascade for migrant populations in Australia, especially at the stage of diagnosis, according to a study recently published in PLOS Medicine. People born in other countries did not do as well as the general population in terms of HIV testing, staying in care, receiving treatment, and reducing their viral load to undetectable levels, with variation between different groups of migrants.
aidsmapCHAT
The final episode in this series of aidsmapCHAT is taking place on Thursday. Our guests are: Shannon Hader, Deputy Executive Director of Programme at UNAIDS; Winifred lkilai, who works with the AIDS Vaccine Advocacy Coalition (AVAC); and Julia Marcus, infectious disease epidemiologist and Assistant Professor at Harvard Medical School.
Join us at 6pm on Thursday 21 May, on aidsmap’s Twitter and Facebook pages.
Editor's picks from other sources
Will COVID-19 make modernising HIV criminal laws harder? | TheBody
TheBody asked several HIV criminal law modernisation advocates about what the novel coronavirus pandemic could mean for HIV laws, and vice versa. Most were cautiously optimistic that their years of educating lawmakers and law enforcement could make it easier to prevent new, draconian laws around criminal transmission of the COVID-19 virus.
What to do if you're HIV positive and are admitted to hospital with COVID-19 – advice from the British HIV Association (BHIVA) | BHIVA
In response to questions from the HIV community on what to expect, and what to do, if you are an HIV-positive person who is admitted to hospital with COVID-19, the British HIV Association (BHIVA) has given the following advice to answer the main points that have been raised.
COVID-19 crisis raises hopes of end to UK transmission of HIV | The Guardian
Sexual health experts see in lockdown restrictions a ‘once-in-a-lifetime’ chance. “If we can now find the remaining people with HIV through testing and put them on treatment,” says Dr Alan McOwan, “we could remove anyone who is infectious from the population with long-lasting effects. We won’t get this two-month window of no sex again.”
Money for worldwide AIDS fight at issue in Supreme Court | New York Times
The Supreme Court’s second day of arguments by phone is devoted to a new version of a case it decided seven years ago involving federal money to fight AIDS around the world. The justices are taking up the Trump administration’s appeal to force the foreign affiliates of US-based health organisations to denounce prostitution as a condition of receiving taxpayer money.
New page: Should HIV controllers take HIV treatment?
Elite controllers and HIV controllers are rare individuals who have a very low viral load without taking HIV treatment. This page looks into the pros and cons of HIV controllers taking antiretroviral therapy.