hiv & other infectious diseases

~latest info at the top~

• Contagion Online Dual Therapy MK-8591 Plus Doravirine Efficacious in Treatment-Naive PLWH
• Journal of Clinical Investigation Persistent HIV-infected cells in cerebrospinal fluid are associated with poorer neurocognitive performance
• AIDSMAP Starting ART at a high CD4 cell count has clear benefits for people with a low viral load
• AIDSMAP PrEP reduces HIV infections by over 95% in US ‘real world’ study
• ContagionLive Study Finds Lower Than Expected Bone Density Loss in Regular PrEP Users
• POZ Heavy Drinking, Hep C Boost Inflammation, Immune Activation in Those With HIV
• POZ Rectal Douching Linked to Higher Risk of HIV, STIs, Hep B and C in Gay Men
• AIDSMAP ART for treatment-experienced people with virological failure can omit NRTIs if three active drugs available
• AIDSMAP Just 18% of people with hepatitis/HIV co-infection and cirrhosis are screened for liver cancer as often as recommended
  NPR Expert Panel Recommends Wider Use Of Daily Pill To Prevent HIV Infections
• POZ Very Early HIV Treatment May Preserve Key Immune Responses to Virus – Researchers compared the immune systems of South African women who started treatment at different points postinfection.
• TheBodyPro FDA Approves First Throat and Rectal Tests for Detecting Chlamydia and Gonorrhea
• POZ High STI Rate Among Some PrEP Users Suggests Need for Frequent Testing – A quarter of study participants accounted for three-quarters of newly diagnosed cases of chlamydia, gonorrhea and syphilis
• POZ Early Studies of HIV Maturation Inhibitor Shows It’s Safe and Tolerable – ViiV Healthcare and GlaxoSmithKline are jointly developing GSK3640254.
• AIDSMAP The throat is a major source of gonorrhoea infections in MSM
• IAS May Topics In Antiviral Medicine
• CDC Increase in Hepatitis A Virus Infections — United States, 2013–2018
• ScienceDaily In rare cases, immune system fails despite HIV suppression – Scientists identify paradoxical response to HIV medication in five individuals
• NBCNews Generic HIV prevention drug coming in 2020, Gilead says
• TheBodyPro New Website Helps People Trying to Navigate Their PrEP Options
• AIDSMAP No reduction in HIV stigma in San Francisco, 2011 to 2017
• POZ New Combo (genamicin + azithromycin) Could Work as Backup Treatment for Drug-Resistant Gonorrhea (however, it does not work as well as current therapy for rectal or throat infections)
• POZ More U=U confirmation
• POZ ViiV Applies for Approval of First Long-Acting Injectable HIV Regimen: cabotegravir + rilpivirine
• IAS-USA/CROI 2019
  • A summary of advances in antiretroviral therapy from CROI.
  • Advances in HIV Prevention and Plans to End the Epidemic
  • Neurologic Complications of HIV Disease
  • Complications and Coinfections in HIV Infection
  • Highlights of Viral Hepatitis
  • Advances in Basic Science Understanding of HIV
• MedPageToday Syphilis invades rural America – and puts the U.S.’s fraying support system to the test
• AIDSMAP PrEP should be offered urgently to gay men with a recent STI or multiple condomless partners
• CROI 2019 HCV Re-Infections Common Among Men With HIV
• POZ New Antibody Shows Promise as Long-Acting HIV Treatment: A series of antibody infusions suppressed HIV for up to four months without prompting the virus to develop resistance.
• POZ A Growing Number of People With HIV Have Fatty Liver Disease: The number of HIV-positive Medicare recipients with liver disease is rising, almost entirely as a result of NAFLD
• Rapid Initiation of Symtuza for HIV Treatment Shows Promise (editorial note: however, protease inhibitors have higher rates of ASCVD and thousands of drug-drug interactions) – more from MDAlert
• Open Forum Infectious Diseases: HCV therapy works in real-life HIV co-infected patients
• Gilead requests approval for Descovy as PrEP
• CROI 2019 Dr. Paul Sax’s take including Using EMR Data To Identify PrEP Candidates
• JID The Costs of Drugs in Infectious Diseases: Branded, Generics, and Why We Should Care
• Updated DHHS Guidelines late 2018 agree with previous IAS recommendations: 1. A combined analysis of European cohorts,^16,66 a small randomized trial,⁶⁷ and a case series⁶⁸ found a low incidence of PCP in patients with CD4 counts between 100 cells/mm³ and 200 cells/mm³, who were receiving ART and had HIV plasma viral loads <50 to 400 copies/mL, and who had stopped or never received PCP prophylaxis, suggesting that primary and secondary PCP prophylaxis can be safely discontinued in patients with CD4 counts between 100 cells/mm³ to 200 cells/mm³ and HIV plasma RNA levels below limits of detection of commercial assays. Data on which to base specific recommendations are inadequate, but one approach would be to stop primary prophylaxis in patients with CD4 counts of 100 cells/mm³ to 200 cells/mm³ if HIV plasma RNA levels remain below limits of detection for ≥3 months to 6 months (BII). Similar observations have been made with regard to stopping primary prophylaxis for Toxoplasma encephalitis.⁶⁹ 2. Primary prophylaxis against disseminated MAC disease is not recommended for adults and adolescents with HIV who immediately initiate ART (AII). People with HIV who are not receiving ART or who remain viremic on ART but have no current options for a fully suppressive ART regimen should receive chemoprophylaxis against disseminated MAC disease if they have CD4 counts <50 cells/mm³(AI). Primary MAC prophylaxis, if previously initiated, should be discontinued in adults and adolescents who are continuing on a fully suppressive ART regimen (AI). Two randomized, placebo-controlled trials and observational data have demonstrated that people with HIV taking ART can discontinue primary prophylaxis with minimal risk of developing MAC disease.^36-4

• TheBodyPro The next frontiers of U=U science
• JAMA Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection
• Dovato, a co-formulation of dolutegravir and lamivudine, approved by FDA 4/8/2019. More info at Medpagetoday.
• Opioid epidemic is increasing rates of some infectious diseases
• Raltegravir plus lamivudine is likely to work as PrEP
• Systematic analysis suggests that circumcision helps protect MSM from infection with HIV
• Clusters of co-morbidities in people living with HIV show major non-HIV medical needs
• Viral suppression maintained with alternate-day dosing of efavirenz/tenofovir/emtricitabine
• Diet and exercise advice lowers diabetes risk in people with HIV
• Case of On-Demand PrEP Failure Reported in Australia
• 3-Month Naltrexone Implant Improves HIV, Addiction Treatment Outcomes
• CROI 2019: Opioid overdose deaths are rising among people with HIV in the United States
• CROI 2019: Non-adherence to HIV treatment for cost-saving reasons reported by 8% in American study
• HIV Exposure in Womb Tied to Metabolic Disease in Later Life: Upped risk for immune dysfunction as well, possibly due to inflammation
• Healthcare providers should discuss U=U with all their HIV-positive patients
• CROI 2019: High rate of viral suppression among people new to HIV care
• Many recovering from addiction have chronic health problems, diminished quality of life
• CROI 2019 – Video: Paul Volberding on HIV stigma
• The impact of older antiretrovirals on fat redistribution and cardiovascular risk factors may be irreversible
• CROI 2019: Trogarzo’s Effects on Hard-to-Treat HIV Are Stable Over Two Years
• Women, Young People and Medicaid Recipients Are More Likely to Stop PrEP
• Dolutegravir-based second-line ART achieves excellent virological outcomes even in the presence of resistance to recycled NRTIs
• Chronic Pain Is a Huge, Underrecognized Problem for People With HIV [POZ]
• A 3rd Man Received HIV-Resistant Stem Cell Transplant, Is in Viral Remission (it’s too early to say he is “cured”)
• Latest anti-retroviral drug regimens provide ‘Lazarus Effect’ for HIV patients
• CROI 2019 How many people who have used PrEP get HIV the same year? New York study finds out
• CROI 2019 Gay & Bi Men With HIV Cured of Hep C Are Reinfected at High Rate
• CROI 2019 Early Trial of Gilead’s HIV Capsid Inhibitor Supports 3-Month Dosing
• CROI 2019 The Viral Reservoir (or cellular clonal expansion) Can Explain Persistent Low Level Viremia With Good Adherence on ART. POZ has another post on this issue.
• CROI 2019 Neural tube defects and integrase inhibitors: still waiting for stronger evidence
• CROI 2019 Study Highlights Link Between ART and Weight Gain in Virally Suppressed Participants
• CROI 2019 Researchers report high rate of viral suppression among people new to HIV care
• CROI 2019 Individuals With HIV May Be at Higher Risk of Opioid Overdose Death
• CROI 2019 Depo injection cabotegravir + rilpivirine found to be noninferior at 48 weeks to 3-drug oral ART as well as to dolutegravir/abacavir/lamivudine
• CROI 2019 TAF/emtricitabine appears to be noninferior to TDF/emtricitabine in MSM, transgender women for PrEP
• CROI 2019 HIV is a risk for cardiac death if the HIV viral load is not suppressed
• CROI 2019 A second patient who has received an HIV-resistant bone marrow transplant may be cured of HIV (the famous “Berlin” patient is the first one). More detailed info from theBody.com
• Ryan White Conference 2018: presentations, handouts, slides, etc.
• 3/3/2019 Dolutegravir may work as monotherapy in early infection
• 1/10/2019 Information from the NIH clearly supports U=U which is one of the most destigmatizing concepts for people with HIV.
• 1/15/2019 PrEP with Truvada may have a negative effect on condom use and STI rates, but if so, PrEP is still worth it in my opinion.
• 1/21/2019 Even with good treatment, HIV seems to accelerate the aging process.
• 1/29/2019 Nonalcoholic fatty liver disease may be increasingly common in people with HIV.
• 2/1/2019  HIV RNA suppression rates are equivalent between Ryan White clinics and the private sector.
• 2/2/2019 Introducing the single-use genderless internal condom
• 2/3/2019 STIs drive HIV transmission approximately 10% of the time in gay/bi men.
• 2/4/2019 The search for the cure is ongoing. Two new types of cell therapy attempt to target the elusive HIV reservoir.
• 2/5/2019 The intention of the manufacturer to make Oxycontin resistant to abuse by crushing it up, led to an increase in hepatitis C cases
• 2/8/2019 Researchers identify a new T-cell marker that could help to find better treatment and a cure for HIV
• 2/9/2019 NIH “U=U” is scientifically valid.
• 2/10/2019 An immune system receptor may be the key to HIV complications
• 2/12/2019 Switching from protease inhibitors to integrase inhibitors improved risk factors for diabetes
• 2/13/2019 Smoking, blood pressure, lipids are important determinants of health in people with HIV
• 2/15/2019 Smoking pot is linked to higher risk of lung disease in HIV infected men (read the study)
• 2/23/2019 Only 2 in 5 male PrEP users continue it over 2 years
• 2/25/2019 Men with hepatitis C may have low testosterone levels