New study: AIDS drug cuts risk of infection by 86 percent

prep-400x210(Reuters) – Gay men at high risk of HIV who took a daily dose of a Gilead AIDS drug as a preventative measure cut their risk of infection by 86 percent, according to results of a British trial released on Tuesday. Researchers who conducted the trial of so-called pre-exposure prophylaxis (PrEP) said the results offer real hope of reversing the HIV epidemic among men who have sex with men, one of the highest risk groups.

“These results … show PrEP is highly effective at preventing HIV infection in the real world,” said Sheena McCormack, a professor of clinical epidemiology at University College London and the study’s lead investigator.

PrEP involves people who do not have HIV but who are at high risk of becoming infected and seek to protect themselves by taking a single pill, usually a combination of two antiretrovirals, every day.

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Diagnoses of HIV Infection in the United States 2013 is now available online

map2From the CDC

The Centers for Disease Control and Prevention’s (CDC) annual HIV Surveillance Report titledDiagnoses of HIV Infection in the United States and Dependent Areas, 2013, is now available online [PDF 2.9MB]. The report summarizes information about diagnosed HIV infection from 2009 to 2013 representative of all 50 states, the District of Columbia, and six U.S. dependent areas. Overall, HIV diagnosis rates remain stable yet disparities persist among some groups.

The report shows that the annual rate of diagnosis in the United States remained stable with 15.0 per 100,000 in 2013 compared to 15.3 per 100,000 in 2009.

Despite this, disparities persist—and in some cases—rates have increased among certain groups. As evidenced by this report and other previously released data, gay, bisexual, and other men who have sex with men (MSM); young adults; and racial and ethnic minorities continue to bear the disproportionate burden of HIV…

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Early HIV treatment advantage is lost if treatment is interrupted

From AIDSMEDS.comAnti-Retroviral-AIDS-Drug-006

The immune recovery benefits conferred by starting antiretrovirals (ARVs) for HIV shortly after infection are lost if treatment is later interrupted, aidsmap reports. In a recent study, there was no difference in terms of immune reconstitution between those who started treatment immediately and later interrupted it for a time and those who waited to start treatment. Publishing their findings in the journal AIDS, French researchers measured the CD4 to CD8 cell counts, and determined the ratio between them, among 727 HIV-positive people in the PRIMO cohort study.

CD4 cells are also known as “T-helper” cells, and are key to instigating the body’s immune response to an infection. CD8, or “T-suppressor,” immune cells are involved in killing off infected cells. Healthy HIV-negative people HIV typically have more CD4s than CD8s, meaning their CD4 to CD8 ratio is greater than 1.0—usually between 1.0 and 2.0. The ratio for an HIV-positive person is typically below 1.0.

continue reading on AIDSMEDS.

Read the study abstract here.

Study shows “it get better,” but…

A new study released in the Journal of Adolescent Health looked at the lives of 231 LGBTQ adolescents to see if it really does get better–referencing the It Gets Better campaign launched by activist Dan Savage. After following the youth for 3.5 years, researchers at Northwest University in Chicago found that, technically, yes, “it gets better.” But the findings also suggested a more complex set of mental health issues at play for LGBTQ youth. In short, things don’t automatically get better. Early experiences of victimization were shown to have a lasting impact on later psychological functioning. As a result, researchers went on to suggest the need for interventions which decrease stigma and victimization at an early age.

You can read more about the study on  Reuters Health.

Mental health issues put gay and bi men at increased risk for HIV

(Reuters Health) – Gay and bisexual men are at increased risk of acquiring the virus that leads to AIDS if they have mental health problems, according to a new study. What’s more, their risk of acquiring HIV increases with the number of mental health factors they report, researchers found. Past studies have found that mental disorders, ranging from depression to substance abuse, are often seen among men with HIV, but “nothing about whether these factors predict HIV risk behaviors or becoming infected with HIV,” said study leader Matthew Mimiaga, from Harvard Medical School and Massachusetts General Hospital in Boston.

The Centers for Disease Control and Prevention (CDC) estimates that some 1.1 million people in the U.S. are living with HIV. About one case in six is undiagnosed. While the CDC says only about 4 percent of U.S. males have sex with other men, they represent about two-thirds of the country’s new infections. Additionally, it’s known that the lesbian, gay, bisexual and transgender (LGBT) community also suffers from an increased burden of mental health problems.

When two health conditions tend to occur together in one population, researchers call them “syndemic.” For the new study in the Journal of Acquired Immune Deficiency Syndromes, the researchers looked at how five conditions – depression, alcohol abuse, stimulant use, multi-drug abuse and exposure to childhood sexual violence – affect men’s risk of acquiring HIV. They analyzed data on 4,295 men who reported having sex with men within the previous year. The participants were asked about depressive symptoms, heavy alcohol and drug use and childhood sexual abuse.

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Smoking doubles risk of death for patients taking HIV therapy

From aidsmap.com

Smoking doubles the mortality risk for people with HIV taking antiretroviral therapy, a study published in AIDS shows. Smokers had an increased risk of death from cardiovascular disease (CVD) and non-AIDS-related cancers, and the life expectancy of a 35-year-old man with HIV was reduced by almost eight years due to smoking. “Smoking was associated with a two-fold increase in mortality,” comment the authors. “More than a third of all non-AIDS related malignant deaths were from lung cancer and all deaths from lung cancer were in smokers.”

The benefits of not smoking were clear. HIV-positive non-smokers who were doing well on antiretroviral therapy had a similar life expectancy to non-smokers in the general population.

With the right treatment and care, people living with HIV can have a normal life expectancy. However, mortality rates remain higher among people with HIV compared to the background population. The reasons for this are unclear, but important causes of death among people with HIV now include smoking-related diseases such as heart and lung complaints and non-AIDS-related malignancies.

Investigators therefore wanted to determine the association between smoking and mortality risk among people taking HIV therapy.

Continue reading on aidsmap.com.

U.S. HIV ‘Treatment Cascade’ stats dismal among western nations

From AIDSmeds.com

Compared with other high-income Western nations, the United States fares remarkably poorly in getting people with HIV diagnosed, into stable care, on treatment and to an undetectable viral load, aidsmap reports. Researchers conducted an analysis of the “treatment cascade” figures for Australia, British Columbia (statistics for all of Canada were not available), Denmark, France, the Netherlands, the United Kingdom and the United States. Results were presented at the HIV Drug Therapy Glasgow conference in Scotland.

The estimated rates of HIV diagnosis among the countries ranged from a low of 71 percent in British Columbia to a high of 86 percent in Australia, with the United States at 82 percent. The United States had the lowest rate of linkage to care, at 66 percent, and Denmark had the highest at 81 percent. The United States had by far the lowest rate of HIV-positive people retained in care at 37 percent, with British Columbia the next lowest at 57 percent. Australia’s 76 percent care-retention rate was the highest. 

Because of the United States’ low retention figures, the remainder of the nation’s figures were also markedly lower than the other countries’. The U.S. rate of people with HIV taking antiretrovirals was 33 percent. The high for that figure was the United Kingdom’s 67 percent. The rates of viral suppression were as follows: the United States, 25 percent; British Columbia, 35 percent; France, 52 percent, the Netherlands, 53 percent, the United Kingdom, 58 percent; Denmark, 59 percent; and Australia, 62 percent.

To read the aidsmap story, click here.

To read the conference abstract, click here.