Life insurance for people with HIV
Thanks to improvements in treatment and care, many people living with HIV now have an excellent prognosis and are expected to have a normal life expectancy.
Some affordable life insurance products are already available for people with HIV, but many insurers are still wary of providing life cover or charge inflated premiums.
Researchers therefore compared the mortality risk of people living with HIV and individuals in the general population in some European countries.
Their study looked at data from 35,000 people who started HIV therapy between 1996 and 2008.
The results showed that people doing well on HIV treatment – a CD4 cell count above 350 and an undetectable viral load – had a mortality risk that qualified them for life insurance, and that their mortality risk was sufficiently low to obtain cover for a mortgage.
There have been significant improvements in HIV treatment in recent years, and the researchers emphasise that their results therefore over-estimate the mortality risk for people taking modern antiretroviral therapy.
They intend to communicate their findings directly to insurers in the hope that they change their policy terms “with consequent improvements in the quality of life for HIV positive people”.
For more on life insurance, you may find the article ‘Rest assured’ in an edition of HIV treatment update from 2012 helpful.
HIV and sexual health
Good sexual health is especially important for people with HIV. Untreated infections can increase the risk of HIV transmission, even if you are taking treatment and have an undetectable viral load. In addition, some STIs can be harder to treat, especially if you have a low CD4 cell count, making prompt diagnosis and treatment especially important.
UK guidelines recommend that all sexually active people living with HIV should have a sexual health check-up at least once a year, as part of their routine care. But this doesn’t always happen, meaning that infections may be missed.
Healthcare workers in north London were prompted by a new electronic patient records system to offer annual sexual health screening.
They found that this increased diagnoses of several infections, including chlamydia, gonorrhoea and early syphilis.
Sexual health screening is available free of charge from NHS sexual health clinics. You can find out more about check-ups and STIs in the NAM booklet, HIV & sex.
HIV and TB treatment
Globally, there are approximately 9 million cases of TB each year and almost 1.5 million TB-related deaths. TB is the single biggest cause of serious illness and death in people living with HIV.
Almost all cases of TB can be successfully treated with a combination of antibiotics.
There’s good evidence that taking steroids at the same time reduces the risk of death for people with TB meningitis (TB infection in the central nervous system). But the impact of steroids on mortality risk for people with other forms of TB is less certain.
Doctors therefore looked at the results of all studies that examined mortality rates in people taking treatment for TB, and looked at the use of steroids.
A total of 41 studies conducted between 1955 and 2011 were identified.
Overall, treatment with steroids was associated with a statistically significant 17% reduction in mortality risk, and reduced the risk of death by 28% for people taking treatment for pulmonary TB.
Steroid treatment had a similar impact on mortality when the researchers restricted their analysis to studies conducted in the era of modern TB therapy and the use of combinations based on rifampicin.
Three studies looked at the use of steroids in people with HIV. There was little evidence that they were of any benefit. However, the researchers emphasise that the number of people in these studies was small, meaning that the results were difficult to interpret.
The beneficial impact of steroids is likely to be because they reduce inflammation.
However, the researchers don’t think their results should lead to changes in TB treatment strategies. Instead they are calling for big clinical trials to properly investigate the benefits of steroids as an addition to TB therapy.
For more information, start with our HIV & TB booklet, online at www.aidsmap.com/booklets.
Editors' picks from other sources
EU new drug approval studies "have too few patients to evaluate safety"
from Pharma Times
For medicines intended for chronic use, the number of patients studied before regulatory approval in the European Union is insufficient to properly evaluate safety and long-term efficacy, and this points to a need for new EU legislation, say researchers writing in this week's PLOS Medicine.
Fury erupts over government review of sex education
from Children & Young People Now
The government rejected calls for national guidelines on sex education lessons, sparking a furious reaction from campaigners. Individual schools will continue to be able to decide on the content of personal, social, health and economic (PSHE) classes, which will not necessarily address the needs of young gay and bisexual people.
Kenya condom advert pulled after religious complaints
from BBC
A TV advertisement promoting condom use in Kenya has been withdrawn after an outcry by religious leaders. Christian and Muslim clerics said the advert encouraged infidelity, rather than safe sex to curb HIV.