aidsmap news: People living with HIV, regardless of CD4 count or viral load, more likely to experience COVID-19 breakthrough infections, 14 December 2021

News from aidsmap

People living with HIV, regardless of CD4 count or viral load, more likely to experience COVID-19 breakthrough infections

A large US study from Johns Hopkins University confirms that COVID-19 infection is uncommon for fully vaccinated people, regardless of HIV status. Nonetheless, their analysis also shows that fully vaccinated people with HIV are about 40% more likely to experience breakthrough cases than HIV-negative people, regardless of CD4 counts or viral suppression.

Uncontrolled HIV causes the majority of deaths in children with HIV in western Kenya

The vast majority of deaths amongst children with HIV in western Kenya are a result of uncontrolled HIV infection, according to a mortality study published in the January issue of AIDS. The study also found that one in six deaths in children under five in western Kenya are caused by HIV, with around 1% of all children born in the region dying as a result of HIV infection.

Many effective interventions that improve HIV outcomes for Black men who have sex with men exist – now they need to be scaled up

A range of approaches can be used to address barriers to support Black men who have sex with men along the HIV continuum of care, according to a review of US interventions. All 14 interventions reviewed were associated with at least one statistically significant outcome on linkage to care, retention in care, medication adherence, and/or viral suppression.

Practitioners and policies create barriers to PrEP and HIV testing for young people in sub-Saharan Africa

Healthcare workers providing PrEP in Kenya, South Africa, and Zimbabwe are largely supportive of PrEP as an HIV prevention option for adolescent girls and young women, but many have negative attitudes about adolescent girls being sexually active and concerns about their ability to adhere to PrEP, according to a recent study published in BMC Health Services Research.

HIV genes can successfully be removed from cells, scientists find

Scientists have demonstrated the potential of CRISPR-Cas9 technology to remove the HIV genome from the DNA of infected cells. They have also identified some of the consequences of doing so and begun to investigate how these side effects may be mitigated.

Australia on track to eliminate hepatitis C among gay and bisexual men before 2030

Access to direct-acting antivirals to cure hepatitis C has slashed incidence rates for groups most affected in Australia. Among gay and bisexual men living with HIV, incidence fell by 78% in 2019 when compared to 2015, the year before direct-acting antiviral treatment became widely available. A similar trend in hepatitis C infections was seen for HIV-negative men taking PrEP, with an 80% decline in 2019 compared to 2016.

Women living with HIV are under-represented in research, limiting our understanding of co-morbid diseases

A systematic review of studies of medical conditions in women living with HIV has found large gaps in the data, particularly for women over 50. The studies that do explore this topic showed that women living with HIV are at increased risk of acute cardiac disease, reduced bone mineral density and poorer cognitive function than women in the general population, while their gender increases the risk of kidney disease.

HIV in the UK 2020: some good news, some less good, but many unknowns

At the recent European AIDS Conference, Teymur Noori of the European Centre for Disease Prevention and Control remarked that one of the most severe impacts of the COVID pandemic on HIV was that it had reduced the capability of the vast majority of European countries to document their own HIV epidemic, as human resources were diverted from the monitoring and surveillance of HIV to that of COVID. The report on HIV compiled by the UK Health Security Agency bears witness to this situation.

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Editors' picks from other sources

Merck announces clinical holds on studies evaluating islatravir for the treatment and prevention of HIV-1 infection | Merck press release

The US Food and Drug Administration (FDA) has placed clinical holds on the investigational new drug applications for the oral and implant formulations of islatravir (MK-8591) for HIV-1 PrEP; the injectable formulation for HIV-1 treatment and prophylaxis; and the oral doravirine/islatravir HIV-1 once-daily treatment. The FDA’s clinical hold is based on previously announced observations of decreases in total lymphocyte and CD4+ T-cell counts in some participants receiving islatravir in clinical studies.

IPM statement on US Food and Drug Administration review of dapivirine vaginal ring | International Partnership for Microbicides

The nonprofit International Partnership for Microbicides (IPM) has announced that it has voluntarily withdrawn from the US FDA its New Drug Application for the dapivirine vaginal ring, a woman-controlled method for HIV prevention. This decision was made following feedback during the agency’s review that current data are unlikely to support US approval at this time given the context of the current HIV prevention landscape for women in the United States. 

A failure to disseminate transformative science  – HIV treatment as prevention, 10 years on | The New England Journal of Medicine (free registration required)

Sharing information on treatment as prevention (TasP) and U=U is important not only from an ethical standpoint; there is growing evidence that it’s good clinical and public health practice. In the second decade of TasP, we believe it’s essential to ensure that the science is disseminated to all who stand to benefit.

CDC: tell everyone about HIV PrEP and don't 'grill' patients | Medscape (requires free registration)

Since the US FDA approved the first pill to prevent HIV in 2012, the medication has been slow to move out of sexual health and infectious disease practices. The new guidelines ask clinicians to step up.

Community position statement: darunavir/ritonavir must urgently become the preferred protease inhibitor used in adult second-line ART | AfroCAB

Darunavir/ritonavir (DRV/r) has not been widely used in low- and middle-income countries despite DRV/r’s significant benefits. The recent development of a quality-assured fixed dose combination of DRV/r that is now available at a price below that of lopinavir/r paves the way for the uptake of DRV/r to replace poorly tolerated medicines.

Nation’s first supervised drug-injection sites open in New York | The New York Times

During the first official day in operation at the two Manhattan facilities, trained staff reversed two overdoses, officials said.

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