News from aidsmap
COVID-19 rapidly reshaping HIV services around the world
Healthcare workers caring for people living with HIV are expressing concern over those who are not virally suppressed, late presenters and how to manage new HIV diagnoses during the global COVID-19 pandemic. There are also concerns about access to medication and increased vulnerabilities of key populations.
Low level detectable viral load while taking HIV treatment is associated with poorer medical outcomes
New research has underlined the importance of having an undetectable viral load while taking antiretroviral therapy (ART). Published in Clinical Infectious Diseases, the study showed that individuals with a persistent low-level viral load (50-999) had a higher risk of all-cause mortality compared to people with viral suppression (a viral load below 50). They also had more serious illnesses such as heart disease and some cancers.
BHIVA issues guidelines on maintaining HIV treatment during the coronavirus pandemic
The British HIV Association (BHIVA), the professional body of HIV clinicians in the UK, issued additional treatment guidelines on 1 May for use during the coronavirus lockdown. The guidelines suggest that most stable patients can skip their next clinic appointment but that prescriptions should continue to be issued for their usual duration, which is typically six months. For newly diagnosed people, Biktarvy is recommended as a first-line combination requiring minimal testing and patient follow-up.
Kaposi sarcoma trial in Africa finds that higher cost chemotherapy option is superior
Intravenous paclitaxel plus antiretroviral therapy (ART) has clear advantages over alternative chemotherapy regimens for the treatment of advanced HIV-related Kaposi sarcoma in low- and middle-income settings, according to the results of a landmark study published in The Lancet. Paclitaxel plus ART was compared to cheaper and easier-to-administer therapies and was found to be superior in terms of progression, overall response and response duration.
Stigma and negativity from within the community increases HIV risk-taking by gay men
Stress levels and sexual risk-taking in gay men are at least as much influenced by stigma and rejection by other gay men as they are by stigma and discrimination by the non-gay community, according to a series of studies conducted by Dr John Pachankis and colleagues from the LGBT mental health unit at Yale University.
Directly observed treatment for hepatitis C highly effective in people who inject drugs
Directly observed treatment for hepatitis C achieved a very high cure rate in people who inject drugs, an Austrian study carried out in pharmacies and drugs projects offering opioid substitution therapy has reported.
Delaying treatment changes when first-line ART fails costs lives, says South African study
Promptly switching antiretroviral therapy (ART) when individuals have viral rebound saves lives, according to an important study published in the American Journal of Epidemiology. Delayed switching more than doubled the risk of death over five years and was especially dangerous when a person had a CD4 cell count below 100.
UK sexual health services are being decimated by COVID-19
A rapid survey conducted by the British Association for Sexual Health and HIV (BASHH) has found that in-person services for patients needing STI tests and treatments, contraception, and HIV testing, medications and PrEP have shrunk drastically since the COVID-19 pandemic hit the UK in mid-March.
HIV is low on the list of co-morbidities among coronavirus patients in New York
In a large case series of patients hospitalised with COVID-19 in New York, relatively few had HIV (0.8%). As the background prevalence of HIV in New York City is around 1.3%, the data appear to confirm that HIV is not in itself a risk factor for greater vulnerability to the new coronavirus.
HIV prevention trials paused during coronavirus crisis
During the COVID-19 crisis, a number of the ongoing worldwide HIV vaccine and immunotherapy efficacy trials are being paused or curtailed. The HIV Vaccines Trial Network (HVTN) originally announced on Monday 24 March that several of the large prevention efficacy trials it oversees would be curtailed or paused. Since then, a number of other study investigators have announced that their studies will be shortened, paused or postponed.
Changes in fat cells on HIV treatment may have long-term metabolic consequences
Changes in the structure of body fat after starting antiretroviral treatment are associated with increased inflammation, lipid disturbances and insulin resistance that might eventually have adverse health consequences for people living with HIV, irrespective of the amount of weight gained, an analysis of a large clinical trial published in Clinical Infectious Diseases reports.
Integrase inhibitors may be associated with a lower risk of cardiovascular disease than NNRTIs and protease inhibitors
The risk of a serious cardiovascular event is reduced by a fifth in people taking an integrase inhibitor-based antiretroviral regimen compared to alternative drugs, according to an observational US study published in the Journal of Acquired Immune Deficiency Syndromes. The study involved over 20,000 people living with HIV who started antiretroviral therapy (ART) for the first time between 2008 and 2015, a quarter of whom took treatment based on an integrase inhibitor.
aidsmapCHAT
On this week’s aidsmapCHAT, our broadcasts of news from around the world on HIV and COVID-19, we are joined by: Dr Rageshri Dhairyawan, Consultant Physician in Sexual Health and HIV at the Royal London Hospital; Bruce Richman, Founding Executive Director of the Prevention Access Campaign and U=U campaign; and Ian Green, Chief Executive of the Terrence Higgins Trust.
Join us at 6pm on Thursday 7 May on aidsmap’s Twitter and Facebook pages for episode 5.
aidsmapCHAT episodes are also available as podcasts and on Spotify.
Editors' picks from other sources
Deportation of man with HIV to Zimbabwe blocked by UK Supreme Court | BBC News
The deportation of a criminal to Zimbabwe has been stopped by the Supreme Court amid concerns his life would be shortened by HIV. The ruling changes UK law which previously allowed such deportations.
People are going off PrEP in the COVID-19 era because they’re not having sex | TheBody
Damon Jacobs has gone off his PrEP for the first time since he started it nearly a decade ago. COVID-19 – and the social distancing that has sprung up to minimise its spread, which also involves, well, sexual distancing – made him do it, he says.
Gilead ratchets up its Truvada patent fight with US in new breach-of-contract lawsuit | FiercePharma
Gilead sued the federal government in the Court of Federal Claims, claiming the Centers for Disease Control and Prevention (CDC) violated four material transfer agreements and one clinical trial agreement.
Gates Foundation will commit 'total attention' to coronavirus pandemic | The Hill
This latest commitment means that all of its workforce and expertise will be directed to the current pandemic. Gates said that clinical trials for new AIDS drugs would take a backseat to the work being done to develop treatments for COVID-19, the disease caused by the coronavirus.
COVID-19: HIV clinical services and treatment in London
HIV clinical services across London continue during the current global pandemic, but most are working differently. We've created a list of all HIV clinical services and their websites in London so patients can get in touch with their clinics to check what services are currently being offered.
We've also updated our UK services finder. Use this tool to find HIV services including clinics for HIV treatment, STIs and PrEP; support groups and services; charities and community organisations. Again, please do contact the organisation to get the latest information on their services during the lockdown.