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17 APRIL 2015 VOLUME 16 ISSUE 16

Media Coverage

  • I am visiting SA this week at the invitation of the Center for the AIDS Program of Research in SA (Caprisa). Recently recognized as a center of excellence in HIV prevention, Caprisa’s research is world-class. As its new scientific adviser, my mission will be to play an active role in reviewing and guiding South African AIDS research into the future. It is an honor, as well as a huge responsibility, because the fight against AIDS is far from over; the task ahead of us is still huge. We can and we must always do better.

    April 17, 2015
    BD Live
  • Durban holds poignant memories for Nobel laureate Francoise Barré-Sinoussi, who has dedicated a 30-year career to trying to put an end to HIV/AIDS. Fifteen years ago she helped organize the 13th international AIDS conference in Durban, where then-president Thabo Mbeki gave an opening speech in which he insisted poverty was a bigger enemy than HIV, dashing hopes that he might publicly declare once and for all that HIV caused AIDS and so end the controversy he had courted with AIDS dissidents.

    April 17, 2015
    BD Live
  • AIDS Healthcare Foundation (AHF) which operates 43 AHF Healthcare Centers and 37 pharmacy outlets in the United States, has been accused of a far-reaching kickback scheme that extended to 12 states, according to a lawsuit unsealed last week at a federal court in South Florida. But it also has a history of practices that have spurred controversy or raised ire with some in the HIV/AIDS community and government officials.

    April 16, 2015
    The Body
  • While this is good news for Duke and the HIV vaccine field, it also highlights the importance of external funding for such programs, funding without which research can stall. Just a week ago, GeoVax Labs...successfully completed a Phase IIa safety trial of its vaccine candidate....The next step is a Phase IIb efficacy trial, but the $70 million clinical trial cost is prohibitive, for the company...and for the NIH and HIV Vaccine Trials Network.

    April 16, 2015
    Fierce Vaccines
  • Beijing has threatened to punish a nongovernmental organization that lobbied for the release of five now bailed female activists, saying the group must be held accountable for "breaking the law." Yirenping, an anti-discrimination NGO, has defended the rights of people with HIV, Hepatitis B, women and those with disabilities.

    April 16, 2015
    The Standard
  • "Guys talk about trying to make their own condoms [using] Saran Wrap." "They told me that the [Depo Provera] shot will make my bones weak." Those misguided quotes came from Memphis teens in a study organized by SisterReach, a grassroots nonprofit that works to empower women of color around issues of reproductive and sexual health. The study...claims that Tennessee's 2012 law that promotes abstinence-only sexual education in public schools has negatively impacted teens of color.

    April 16, 2015
    Memphis Flyer
  • Jack Whitescarver, Ph.D., who has led the Office of AIDS Research (OAR) at the National Institutes of Health since 2000, announced that he will step down from his post, effective July 1, 2015. He also serves as NIH Associate Director for AIDS Research. The NIH will appoint an acting director for the office while it seeks to recruit a new director.

    April 15, 2015
    FirstWord Pharma
  • I've been tweeting about recent news that HIV has reached a crisis in one county in Indiana, and that Texas just voted to divert HIV prevention funds to pay for abstinence-only education. One of the points I've hammered home is that the ultimate cost of refusing to teach youngsters the facts about sex translates into the spread of STDs. A few critics have questioned why I link HIV in addicts...to sex education....To sexologists, the links between any number of social problems and the lack of evidence-based sex education are glaringly obvious.

    April 15, 2015
    Huffington Post
  • HIV/AIDS research in Kwa-Zulu-Natal has been given a high-profile boost, with the announcement Tuesday that a Nobel laureate would be coming on board. The Centre for the AIDS Programme of Research in SA (Caprisa) said Professor Françoise Barré-Sinoussi would be joining its scientific advisory board. Barré-Sinoussi...discovered the retrovirus HIV in 1983. It is hoped her appointment will help fast-track HIV/AIDS prevention, particularly among young women.

    April 15, 2015
    Independent Online
  • African health officials announced Monday they will partner with the US to establish a continent-wide African CDC [that]...will initially set up shop in Addis Ababa, Ethiopia, home to the African Union...later this year. Soon after, five regional centers will open at undetermined locations across the continent....Field epidemiologists will staff each location....In the event of a health emergency,...the office in Addis Ababa will act as a central command post.

    April 14, 2015
    NPR
  • The World Health Organization called Tuesday for release of clinical trial results for all drugs, vaccines and medical devices - whatever the result - in the latest salvo against withholding of data....The WHO also wants disclosure of older unreported clinical trials, which may still have important bearing on medical practice and research....Ben Goldacre, who led a campaign urging full disclosure, said the statement was "powerful and welcome" but required practical implementation, for example routine audits.

    April 14, 2015
    Reuters
  • As HIV investigators work to control and eradicate the virus worldwide, certain myths or misconceptions about the disease have been embraced, whereas other concepts with merit have been left relatively unexplored, argues HIV/AIDS researcher Jay Levy in an April 14 commentary in Trends in Molecular Medicine. He calls on fellow researchers to continue questioning and not lose sight of alternative strategies that could ultimately lead to a sustainable, long-term solution to HIV infection.

    April 14, 2015
    Cell Press
  • Researchers have begun enrolling participants in a multicenter international clinical trial to test whether statin administration can reduce the risk for major adverse cardiovascular events, such as heart attacks, strokes, and heart disease, in people with HIV infection. The trial is supported by the NIH's National Heart, Lung, and Blood Institute and National Institute of Allergy and Infectious Diseases. Known as the Randomized Trial to Prevent Vascular Events in HIV, or REPRIEVE, the trial is the largest to date focused on HIV-related cardiovascular disease.

    April 14, 2015
    Health Canal
  • The challenges include: progress hindered by an under-equipped and understaffed health system; criminalized populations uncounted and untended; civil society efforts effective but inadequately supported; an effective system for children with HIV and TB desperately needed....Long-term, targeted investment is needed for a decade of unprecedented global health partnerships to bring lasting success.

    April 13, 2015
    Science Speaks
  • Haiti [is] frequently cited as one of the bright spots in the battle against HIV/AIDS....But Haiti faces a new challenge in its drive to stamp out HIV: young people becoming increasingly blasé about the virus even as they become more sexually active, sometimes trading sexual favors for everyday items like a moto-taxi ride, cell phone minutes or even school uniforms. The lack of concern among younger Haitians about HIV is mirrored in other parts of the world.

    April 13, 2015
    Thompson Reuters
  • The human immune system can handle large bursts of HIV activity and so it should be possible to cure HIV with a 'kick and kill' strategy, finds new research led by University College London, University of Oxford, and University of North Carolina at Chapel Hill. The strategy aims to cure HIV by stimulating the immune system with a vaccine, then re-awakening dormant HIV hiding in white blood cells with a chemical 'kick' so that the boosted immune system can identify and kill them.

    April 13, 2015
    Science Daily
  • Senator Jerry Moran (R–KS) successfully offered an amendment that would allow Congress to steer more funding to disease research....Moran’s deficit-neutral provision includes a phrase that pleased advocates, calling for “increasing funding to account for inflation,”...code for restoring the billions of dollars in buying power the NIH has lost since 2003 as a result of the rising costs of biomedical research. NIH advocates were particularly were happy to see Moran’s move draw heavily bipartisan support.

    April 13, 2015
    Science
  • Widespread vaccination of boys against human papillomavirus infection proved to be a cost-saving approach to prevent subsequent head and neck cancer, according to data based on the Canadian health system. A 70% immunization rate and 99% efficacy with the quadrivalent vaccine Gardasil might reduce costs by as much as $28 million ($22.2 million US). Reducing uptake and efficacy to 50% still might save $8 million ($6.35 million US), [the researchers]...reported online in Cancer.

    April 13, 2015
    MedPage Today
  • Post-study interviews and computer questionnaires conducted with former participants in a trial of pre-exposure prophylaxis (PrEP) that reported zero effectiveness show that participants concealed their low adherence to the study pills because, despite reassurances from researchers, they feared they would be asked to leave the study. The interviews reveal that some participants went to elaborate lengths to disguise their low adherence – underlining that, while they had doubts about the value of the intervention on offer, they greatly valued the medical care that the study offered.

    April 10, 2015
    aidsmap
  • Researchers monitored 1852 people living with HIV, who were injecting drugs and eligible for HIV treatment, for an average of 5.5 years....“The benefits in HAART medication refill adherence caused by exposure to OST lead directly to improved disease progression profiles, as well as reductions in infectivity through viral suppression,” the investigators write. “These secondary benefits of OST should be incorporated directly into...models developed to determine the long-term cost-effectiveness of competing OST modalities.”

    April 9, 2015
    aidsmap
  • House Republicans are promoting a broad new bill supported by drugmakers and medical-device manufacturers that they say would make promising medications and devices available to the public faster and significantly reduce costs associated with product development. But critics, including the recently departed commissioner of the FDA, say the 21st Century Cures Act could heighten the risk of patients being exposed to inadequately tested and potentially harmful products while increasing healthcare spending.

    April 8, 2015
    Modern Healthcare

Published Research

  • The science is now clear: oral pre-exposure prophylaxis (PrEP) with a coformulation of tenofovir disoproxil fumarate and emtricitabine (Truvada) significantly reduces the risk of HIV infection among individuals at high risk of HIV infection. The news that PrEP has shown consistent efficacy among those who take it as prescribed should be a cause for celebration, and galvanise action to ensure access to PrEP for those who could benefit the most. But almost 3 years since the US Food and Drug Administration approved tenofovir–emtricitabine for PrEP,1 little is being done on implementation.

    April 17, 2015
    Lancet
  • We previously published systematic reviews of retention in care after ART initiation among general adult populations in sub-Saharan Africa from 2007 to 2010. This report extends the review to cover 2008–2013 and expands it to all low- and middle-income countries. Conclusions: Retention at 36 months on treatment averages 65%–70%. There are several important gaps in the evidence base, which could be filled by further research, especially in terms of geographic coverage and duration of follow-up.

    April 16, 2015
    JAIDS
  • In regression analyses controlling for marital status, young women's risk of HIV acquisition increased if their partner was a truck driver, drank alcohol before sex, and used condoms inconsistently. In young men, the risk of HIV acquisition increased with partners who were not enrolled in school, in partnerships with higher coital frequency, and in partnerships where respondents were unable to assess the HIV risk of their partner. Partner characteristics predicted HIV acquisition among youth.

    April 16, 2015
    JAIDS
  • In 2007, Swaziland initiated a hub-and-spoke model for decentralizing ART access...through (1) down-referral of stable ART patients from overburdened central facilities (hubs) to primary health care clinics (spokes) and (2) ART initiation at spokes (spoke-initiation). Controlling for known confounders, down-referral and spoke-initiation within a hub-and-spoke ART decentralization model were protective against loss to follow-up and overall attrition and could facilitate future ART program expansion.

    April 16, 2015
    JAIDS
  • We enrolled 1147 HIV-negative individuals in long-term serodiscordant relationships at 3 sites in Uganda from the Partners Pre-exposure Prophylaxis Study, a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir. Conclusions: Risk of low overall adherence was higher in participants who reported sex outside primary partnerships and suboptimal condom use, as well as in those who abstained from sex. Adherence gaps were common...

    April 16, 2015
    JAIDS
  • The injectable hormonal contraceptive depot medroxyprogesterone acetate (DMPA) may increase the risk for HIV-1 acquisition. We assessed the local concentration in the female genital mucosa of cationic polypeptides with reported antiviral activity in relation to DMPA use in Nairobi, Kenya. This study suggests a potential mechanism underlying the effect of DMPA on the innate immune defenses, providing a rationale to investigate its effect on HIV-1 acquisition risk.

    April 16, 2015
    JAIDS
  • Our] observations provide evidence that the human immune response is capable of controlling coordinated global HIV-1 reactivation, remarkably with potency equivalent to combination antiretroviral therapy. These data will inform design of vaccines for use in HIV-1 curative interventions.

    April 16, 2015
    Clinical Infectious Disease
  • This study was a randomized, double-blind, placebo-controlled trial among people who inject drugs, 2005–2012. A total of 2413 people enrolled and contributed 9665 person-years of follow-up. The risk of HIV infection decreased as adherence improved, men were less adherent than women, and participants 20–29 years old and 30–39 years old were less adherent than older participants. In this HIV PrEP trial among people who inject drugs, improved adherence to daily tenofovir was associated with a lower risk of HIV infection.

    April 16, 2015
    Journal of Acquired Immune Deficiency Syndromes
  • The history of passive immunization with antibodies to prevent or treat infectious diseases is a story of different eras....The current era began in 2003 with publications demonstrating processes for rapidly producing human mAbs. This technology combined with new sequencing technology, advances in structural biology, atomic-level molecular design, and increased capacity for synthetic biology, promises new opportunities to apply passive immunization to the prevention and treatment of infectious diseases.

    April 16, 2015
    Current Opinion in HIV & AIDS
  • On April 14, 2015, the World Health Organization published a new statement on the public disclosure of clinical trial results. The statement not only re-affirms the ethical imperative of clinical trial results reporting, it also defines reporting time frames, calls for results-reporting of older but still unpublished trials, and outlines steps to improve linkages between clinical trial registry entries and their published results.

    April 14, 2015
    PLoS Med

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