As well as our news reporting, the news pages on our website now also include selected stories from other sources. Here we highlight stories from the last quarter – visit www.aidsmap.com/news for the full news reports and references to the original sources.
Since the last issue, aidsmap has also covered the IAS Conference in Rome (see www.aidsmap.com/ias2011) and the AIDS Impact behavioural conference in Santa Fe.
Cure “getting nearer”
Gene researcher Sangamo Biosciences has said it is making "significant progress" toward a functional cure for HIV with its SB-728-T process. This involves taking CD4 cells out of patients' bodies, using gene splicing to turn them into cells HIV can't infect, and then injecting them back in. Fifteen patients given the therapy experienced increased CD4 counts and six who took a break from their HIV treatment had significantly reduced viral loads. One patient remained undetectable, despite coming off therapy, after a course of SB-728-T. If this state could be maintained without the need for more treatment, researchers would describe it as a functional cure, even though HIV hasn’t been eradicated from the body. The company is now looking for longer-lasting and more potent versions of the treatment, and trying to understand whether genetic make-up influences the likelihood of a strong response to the treatment.
For the full news report see: www.aidsmap.com/page/2081571
A previous edition of HIV treatment update included a personal perspective on this process from a trial participant.
Beware hepatitis D and E
Two studies recently focused on hepatitis D and E, viruses which may kill and cause liver inflammation; much less is known about them than hepatitis A, B or C, and they are less easily treated. A European survey of hepatitis D virus (often called hepatitis delta), a virus which 'piggybacks' alongside hepatitis B infection, found an increased risk of death in people with hepatitis B if they also had D. Hepatitis D was largely being transmitted through shared needles but could also be sexually transmitted, it was found. Meanwhile, a Swiss study found that one in 40 people with HIV had evidence of infection with hepatitis E, a virus spread through contaminated meat and water (like hepatitis A), including one in 30 with unexplained but persistently elevated liver enzyme levels. Hepatitis E may be difficult to detect in patients with low CD4 counts.
For the full news reports see: www.aidsmap.com/page/2063338 and www.aidsmap.com/page/2066086
Prevention trials disappoint
Two programmes in southern Africa that aimed to reduce people's HIV risk behaviour by training peer educators have published disappointing results. A study in South African schools found that a programme training schoolchildren to talk to friends about safer sex produced no increases in condom use and no reduction in the age at while people started having sex. And a programme training men who went to beer halls in Zimbabwe to educate their buddies also produced no differences in extramarital sex, condom use or HIV testing. In more bad news for behavioural interventions, a meta-analysis of trials of a widely-used counselling technique called motivational interviewing, which has been used successfully to help people stop drinking, using drugs and eating junk food, found that it made no difference to sexual risk behaviour.
For the full news reports see: www.aidsmap.com/page/2077261 and www.aidsmap.com/page/2075726
No one way to stay safe
Using condoms 100% of the time, although still the single most popular HIV prevention method adopted by gay men, is now a minority strategy, an Australian study found. The national survey found that only a third of HIV-negative and a quarter of HIV-positive men attempted to use condoms for anal sex every time. In contrast, 38% of HIV-negative and 47% of HIV-positive men used a variety of strategies involving not using condoms when they knew, or thought they knew, that their partner had the same HIV status as themselves (serosorting). HIV-negative men, in the main, only serosorted with committed partners but HIV-positive men were more likely to do it with casual partners too. Only 5% of gay men, whether HIV positive or negative, had no strategy for trying to avoid sexual risk while at the other extreme 5% had no sex at all and about 10% had no anal sex.
For the full news report see: www.aidsmap.com/page/2079364
Coffee helps hep C treatment side-effects
Drinking coffee reduces the amount of liver scarring (fibrosis) in people with hepatitis C and also considerably reduces the side-effects of treatment, two studies have found. A study published in June found that people who drank three or more cups of coffee a day had an 80% reduced chance of liver fibrosis than people who drank none. Now a French study has found that people drinking three or more cups of coffee are also 81% less likely to report adverse side-effects of hepatitis C therapy, such as depression and aches and pains.
For the full news report see: www.aidsmap.com/page/2074096
PrEP works for women too
Two trials of Truvada (tenofovir/FTC) pills used as pre-exposure prophylaxis (PrEP) to prevent HIV infection in HIV-negative people have produced the best results so far seen for the technique. In the Partners PrEP study, which gave PrEP to the HIV-negative partner in so-called 'magnet' or serodiscordant couples (where one partner is HIV positive and the other HIV negative), the efficacy of Truvada in reducing HIV infection was 83% in men and 63% in women - and in women, tenofovir alone was just as effective (68%). In the TDF2 study, PrEP was 80% effective in men but only 50% in women; but this still means half of the women who would probably have been infected with HIV were not, and efficacy was 73% in women with good adherence. The reason these figures are important is because a study called FEM-PrEP closed in April because PrEP had not been effective in the women participating in it.
For the full news report see: www.aidsmap.com/page/1879841
However, another study, VOICE, which is comparing a microbicide or PrEP in women, recently dropped tenofovir PrEP because it is unlikely to work, but is continuing to study tenofovir microbicide gel and Truvada PREP. Results are expected in early 2013.
For the full news report see: www.aidsmap.com/page/2090698
Canada's climate of fear
A vague law – and over-stringent interpretations of it – have made people with HIV in Canada “angry, confused and frightened” and have led counsellors to adopt a 'don't ask, don't tell' approach towards the sex lives of patients, a report says . Canadian law requires people with HIV to disclose before having sex that poses 'significant risk' of HIV infection. The report calls for better guidance for prosecutors. Meanwhile, a Canadian internet campaign that asked “If you were rejected every time you disclosed [HIV], would you?” seems to have changed attitudes. Men who saw the campaign were 82% more likely to acknowledge that gay men with HIV face stigma and 48% more likely to agree that this made them resultant to disclose. It produced a 36% reduction in the use of terms like 'clean' or 'disease-free' in ads on the sex contact website on which it featured.
For the full news report see: www.aidsmap.com/page/2052837 and www.aidsmap.com/page/2080609
Middle East faces HIV rise
The predominantly Islamic states stretching from Pakistan to Morocco are currently amongst the world's lowest-prevalence regions for HIV. However, an international team of investigators has found that what little evidence there is suggests that HIV is rapidly on the rise amongst men who have sex with men (MSM) there. More than one in four MSM in some parts of Pakistan has HIV and more that half of all new HIV diagnoses in Lebanon are in MSM, even though only 13% of the positive population is currently in this group, suggesting a large new increase.
For the full news report see: www.aidsmap.com/page/2023180
'Viral sorting' gains ground
Two studies in the Netherlands and the US have found that gay men are increasingly taking their or their partner's HIV viral load into account when deciding whether or not to have unprotected sex. The Dutch study found that 57% of gay men with HIV had taken their viral load into account when deciding whether to have unprotected sex with a casual partner and 64% with a steady partner. The US study found that almost all HIV-positive gay men had disclosed to steady partners and regular 'sex buddies' and that viral load had been discussed with most of them. Viral load discussions led, if anything, to a slight increase in condom use. The study also found, however, that very few HIV-negative men were aware of or asked about their partners' HIV status or viral load.
For the full news report see: www.aidsmap.com/page/2076682
Love and condoms don't gel
Young gay men aged 16 to 20 are very much less likely to use condoms with a 'serious' partner than in casual sex situations, a US study has found. The 122 gay teens almost universally used condoms in casual sex situations, but were eight times less likely to do so when having sex with someone described as 'someone you feel committed to above all others', and ten times less likely when that someone was a man (at least a quarter of the group were bisexual). Being in a 'serious' relationship was more significantly associated with unprotected sex than any other risk factor. The problem was that 'serious', in this group, didn't mean 'long-lasting'; only 8% of 'serious' relationships lasted longer than six months.
For the full news report see: www.aidsmap.com/page/2056755
News picks from other sources
As well as writing our news reports, our team of editors regularly select news from other sources for the news pages of our website. Here is a small selection of recent examples. For more of these, visit www.aidsmap.com/news
Prevention combo for Africa
A team of UK and US researchers led by the London School of Hygiene and Tropical Medicine (LSHTM) has been awarded $37 million to conduct the largest HIV prevention trial ever mounted. The PopART, or HPTN071, trial will recruit 60,000 adults living in 16 villages in Zambia and South Africa, divided into two groups of eight villages each. Half of the villages will be offered an enhanced package of HIV prevention care, including at-home HIV testing, the offer of circumcision to all uncircumcised men, and immediate antiretroviral treatment for everyone found to have HIV, while the other eight will receive the current standard of care. PopART will start in 2012 and, if all goes well, should finish two years later.
For the full news report, see the LSHTM website: http://bit.ly/n32FzK
Edurant (rilpivirine) receives positive opinion from the Committee for Medicinal Products for Human Use (CHMP) for use in treatment-naïve adults with HIV-1
Rilpivirine is closer to being licensed in Europe.
For the full news report, see the PR Newswire website: http://tinyurl.com/6ggn9oa
Online gamers crack AIDS enzyme puzzle
Online gamers have achieved a feat beyond the realm of Second Life or Dungeons and Dragons: they have deciphered the structure of an enzyme of an AIDS-like virus that had thwarted scientists for a decade.
For the full news report, see the France 24 website: http://f24.my/nmxmzm
UK: Gay blood donations ban likely to be lifted
The lifetime ban on blood donations by men who have sex with men is expected to be lifted in the UK.
For the full news report, see the BBC website: http://bbc.in/oujRqz