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17 February 2017 VOLUME 18 ISSUE 7

Media Coverage

  • The Conference on Retroviruses and Opportunistic Infections (CROI 2017) heard about a case where someone in a PrEP demonstration study caught a strain of HIV with no drug resistance, despite documented high drug levels.

    February 17, 2017
    aidsmap
  • A six-month course of isoniazid preventive treatment (IPT) at the beginning of the Temprano trial in Ivory Coast reduced the risk of death by 37% over a mean follow-up period of 4.5 years, Anani Badje reported at CROI Wednesday....Dr Badje said that the study findings provide strong evidence of the merits of IPT to countries that are still reluctant to recommend it for people living with HIV.

    February 16, 2017
    aidsmap
  • Infants exposed to an antiretroviral regimen of tenofovir, emtricitabine and efavirenz (Atripla) from conception experienced fewer adverse birth outcomes compared to other three-drug regimens....The Tsepamo study...provides important information on the safety of various regimens in common use in sub-Saharan Africa, Asia and Eastern Europe....“Our data for the first time show that there really could be differences [in birth outcomes] between regimens,” said Rebecca Zash, Beth Israel Deaconess Medical Center, Boston.

    February 16, 2017
    aidsmap
  • Industry trade group BIO told Reuters that during high-level discussions with Trump advisors, lobbyists urged the administration not to name a new FDA commissioner who would act rashly to speed up agency approval of new medicines...That stance underscores the unique position the drug industry finds itself in....While most sectors welcome less oversight, drugmakers say a robust review process is critical in convincing physicians and insurers that a pricey new medicine has value.

    February 16, 2017
    Reuters
  • CROI offered excellent webcast coverage of the press conferences (schedule at http://www.croiwebcasts.org/), as well as taped playbacks. Electronic posters will be available a week after the conference and webcasts of sessions will be archived online. Medscape and aidsmap are covering a range of research areas and you can follow all the latest on Twitter at #CROI2017, where AVAC and others tweeted the latest data.

    February 16, 2017
    CROI Conference
  • GlaxoSmithKline thought it might spin off its HIV business, ViiV Healthcare, last year, but decided against it as the unit continued churning out sales growth. Now the company is one step closer to a new FDA approval that could hone its edge in the competition against rival HIV drugmakers. GSK and Gilead Sciences were among the headliners at the first major HIV confab of the year, the Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, and kicked off the show with data on two drug regimens that analysts predict will be dueling blockbusters.

    February 16, 2017
    Fierce Pharma
  • Continuing ART services for women in settings where postnatal services are provided to them and their infants is a “simple and highly effective strategy” for maintaining them in care during the post-partum period, according to Landon Myer, University of Cape Town....At 12 months, 77 percent of the women who received integrated services remained in care and achieved HIV viral suppression compared to 56 percent of the women referred to adult HIV clinics to continue their own care.

    February 15, 2017
    Science Speaks
  • Close monitoring of earlier-stage cervical abnormalities (CIN-2) may be preferable to treatment for many women with HIV, a US study suggests. The findings, presented at CROI, show that CIN-2 regressed in over three-quarters of women taking ART without the need for CIN treatment. A higher CD4 count was associated with a lower likelihood that lesions would progress.

    February 15, 2017
    HIV&Hepatitis
  • Use of the antibiotic doxycycline as on-demand post-exposure prophylaxis by men who have sex with men taking part in the Ipergay HIV PrEP trial produced a 70% drop in chlamydia infections and a 73% drop in syphilis, but no reduction in gonorrhea, according to a late-breaking report at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) this week in Seattle.

    February 15, 2017
    HIV&Hepatitis
  • Three candidates to become the next director of the Global Fund to Fight AIDS, Tuberculosis and Malaria are likely to draw harsh scrutiny from the fund’s largest donor, the United States....While all might have been considered excellent candidates for the job in earlier years, global health officials are worried that their backgrounds could push the Trump administration away from historical commitments to the fund.

    February 15, 2017
    NY Times
  • “Overall, cryotherapy was associated with a 52% to 64% higher risk of recurrence of cervical precancer,” study lead author, Sharon Greene, said during a news conference at CROI 2017. “So the results from this randomized trial provide compelling evidence for WHO and ministries of health to develop screening and treatment algorithms based on HIV status.” The study included 400 HIV–infected women in Nairobi, Kenya, who underwent cervical screening from June 2011 to July 2014.

    February 15, 2017
    Healio
  • A Ugandan community...experienced substantial long-term decline in HIV incidence following scale-up of ART and male circumcision....The 42% decline in HIV incidence in Rakai district over a 17-year period also coincided with a decrease in sexual activity among adolescents, according to Mary Grabowski, Hopkins Bloomberg School of Public Health, and colleagues. “Our objective was to assess the real-world impact of a PEPFAR–sponsored scale-up of combination HIV prevention,” she said at a news conference at CROI 2017.

    February 15, 2017
    Healio
  • The ARV-containing vaginal ring form of PrEP that reduced HIV risk in a major trial does not lower the effectiveness of hormonal birth control. This finding assuages concerns raised by previous research that the NNRTI class of ARVs was associated with lowered effectiveness of some hormonal contraceptives....Jennifer Balkus of the Fred Hutchinson Cancer Research Center presented results at CROI 2017 [from]...a subsequent analysis of the ASPIRE trial to examine the vaginal ring’s effects on birth control effectiveness.

    February 15, 2017
    POZ
  • Sustained viral suppression over the course of a year may be a better measure than the most recent viral load test result when it comes to understanding access to and engagement in HIV care, according to a study by US CDC researchers presented at CROI 2017. The researchers found that overall, 48% of people had viral load below 200 copies/ml on all tests they received during 2014, while 8% never fell below this level. But there were substantial disparities based on sex, race/ethnicity and age.

    February 15, 2017
    aidsmap
  • Viral load and viral DNA fall rapidly in infants who begin ART within days of birth, two South African studies have found, showing the potential for clearing the reservoir of HIV-infected cells – but infants with such a dramatic response to treatment may be a minority. The findings were presented at CROI 2017 Tuesday by Louise Kuhn of Columbia University Medical Center.

    February 15, 2017
    aidsmap
  • Last week, Melinda Gates said HIV is one of the top five priorities of the Bill & Melinda Gates Foundation, and she predicted that those five issues will continue to top the list in 10 years time....Devex caught up with Emilio Emini, director of the HIV program at the foundation, to check in on progress made in the prevention, diagnosis and treatment of the disease, as well as what more is needed to control the epidemic.

    February 15, 2017
    devex
  • As Congress moves to repeal the Affordable Care Act, a new analysis from the Kaiser Family Foundation provides the first national estimates of changes in health coverage for people with HIV since the law was implemented. It finds that rolling back the law’s Medicaid expansion could significantly impact coverage for people with HIV.

    February 15, 2017
    Kaiser Health News
  • Merck has taken a big step toward getting its lead HIV candidate doravirine to market, setting up a showdown with Johnson & Johnson's big-selling Prezista [darunavir]....Merck's R&D head Roger Perlmutter told delegates at [a]...conference last year that doravirine has properties "very much like efavirenz, but a substantially better safety profile which could lead it to be one of the dominant agents used in HIV treatment."

    February 15, 2017
    Fierce BioTech
  • The government reported more evidence of progress against HIV on Tuesday, citing an 18 percent decline in U.S. infections between 2008 and 2014 and even sharper drops among heterosexuals and people who inject drugs....Some populations did not share in the advances. Among gay and bisexual men ages 25 to 34, the number of diagnoses rose by 35 percent in 2014....Among Latino gay and bisexual males of all ages, it increased by 20 percent.

    February 15, 2017
    Washington Post
  • Dr. James Hakim delivered the N’Galy-Mann Lecture Monday night, a tradition at this conference that honors the work of Drs. Bosenge N’Galy and Jonathan Mann for the groundwork they laid together for the fight against HIV in Africa, and his story paid tribute to both the global response and the Zimbabwean contributions that followed.

    February 14, 2017
    Science Speaks
  • On one hand, Botswana stands before the world, and certainly before its nearest neighbors as a model of determined and successful policies that confront one of the largest HIV burdens in the world....On the other hand, the country exemplifies a frustrating plateau — with more than 1 percent of people there acquiring the virus yearly. A gap in the Botswana’s AIDS policy gives one clue to what might be stalling advances against the epidemic there.

    February 14, 2017
    Science Speaks
  • Although WHO recommends that all infants exposed to HIV during pregnancy or delivery should receive a nucleic acid test for HIV DNA within six weeks of birth, there are numerous logistical barriers to achieving this target. Using a point-of-care test to diagnose HIV in infants significantly improved retention in care, speeded up ART initiation and increased the proportion of infants who started treatment, a large randomised study in Mozambique has found. The results were presented at CROI 2017 Tuesday.

    February 14, 2017
    aidsmap
  • HIV incidence has started to tumble in one of the best-studied groups of people in Africa, CROI 2017 heard in Seattle today....A combination of factors, including wider availability of ART, increased male circumcision, and later age of sexual debut in young people, all appear to be contributing to this decline. Presenter Mary Grabowski confirmed that this is the first time a population-level decline in incidence in the Rakai cohort has been observed.

    February 14, 2017
    aidsmap
  • Just as the American science community is now struggling with whether to speak out and march or stay quiet and do its work, Canadian scientists wrestled with the same questions. Ultimately, Canada’s scientific community came together to save our research, galvanized support to fight back, and captured the attention and concern of the public. I hope our experience — in the spirit of science transcending borders — can be instructive.

    February 14, 2017
    NY Times
  • Last summer, politicians on both sides of the aisle of Theresa May's anti-European Union-leaning U.K. government voted to maintain the country's $16 billion foreign aid package....“If you interpret America First (the stated doctrine of President Trump) in certain ways, it would suggest not prioritizing the stability of Africa and American leadership” on African issues, Gates, 61, told USA TODAY during a visit to Silicon Valley, just weeks after arguing that very point in a private meeting with the then president-elect.

    February 14, 2017
    USA Today
  • On Tuesday, the Bill & Melinda Gates Foundation published their annual letter for 2017, outlining the work the organization is doing to improve 'global health'...In interviews carried out to promote the letter, Gates has expressed concerns about Donald Trump's policies and what they could mean for their aid work

    February 14, 2017
    Business Insider
  • Gilead Sciences has thrown down a challenge to GlaxoSmithKline with good clinical trial results for an experimental HIV drug that works the same way as the British group's successful dolutegravir. Gilead's bictegravir...delivered 97 percent virus suppression, making it just as effective as GSK's product....Importantly, there were no cases of resistance...in the 98-patient study and no patients discontinued treatment due to kidney problems.

    February 14, 2017
    Reuters
  • In a CROI session today,...Richard Kroup from NIAID provided an overview of recent advances in the field and what antibodies could mean for future vaccine and HIV treatment options. “I like to think there’s a reasonable likelihood that antibodies will work [for prevention],” said Koup. “There’s a good safety record with monoclonal antibodies for other targets, and the potential that a single shot could confer long-lasting protection for three to six months.”

    February 13, 2017
    BETA
  • A new working paper from Cameroon shows evidence that simply talking about HIV can reduce teen pregnancy....“Our results suggest that simple and short HIV prevention interventions can be effective at reducing the incidence of teen pregnancy in rural areas, where teenage pregnancy is common,” according to the report written by Pascaline Dupas, Elise Huillery and Juliette Seban.

    February 13, 2017
    Humanosphere
  • To help shed light on Congress’ role in global health, this primer provides an overview of its engagement in this area, aiming to provide a basic framework with which congressional efforts may be understood,...illustrating these by using two global health examples: the creation and evolution of PEPFAR and the 2014/2015 Ebola outbreak in West Africa....Finally, it discusses opportunities and challenges related to congressional engagement in global health going forward.

    February 13, 2017
    Kaiser Family Foundation
  • Chinese biomed ApolloBio negotiated exclusive rights to develop Inovio’s lead DNA immunotherapeutic for human papillomavirus (HPV) VGX-3100 within China, Hong Kong, Macao, and Taiwan....Inovio is exploiting its DNA plasmid technology...to develop DNA immunotherapeutics against multiple cancers and infectious diseases, including HIV and hepatitis.

    February 13, 2017
    GEN News
  • The Globally Relevant AIDS Vaccine Europe-Africa Trials Partnership (GREAT) will evaluate a new vaccine that triggers the body to produce specialised immune cells called T-cells....The project, supported by an EDCTP grant of over 7 million euro..., is a research collaboration between Oxford University, Imperial College London, International AIDS Vaccine Initiative, Kenya AIDS Vaccine Initiative and Medical Research Institute, Wellcome Trust Research Programme, Medical Research Council at Uganda Virus Research Institute, and Zambia Emory HIV Research Program.

    February 12, 2017
    EDCTP Update
  • Melinda Gates says she and her husband hope to convince the Trump administration of the value of foreign aid.... In an interview with the Seattle Times, Gates said that while U.S. funding for foreign aid accounts for less than 1 percent of the federal budget, it has a huge impact on people around the world,...for both humanitarian and peace and security reasons....Programs like...PEPFAR, created by George W. Bush, have been lifesavers for people in poor countries with high rates of HIV, Gates pointed out.

    February 11, 2017
    Seattle Times
  • Growing up in eastern Ukraine, Svitlana Moroz said she was a typically reckless teenager who believed she'd live forever....Before her [HIV] diagnosis [in 1998], the 19-year-old Moroz said she had only heard about AIDS in one biology lesson....Moroz is now a leading HIV activist in the Ukraine - a country of 45 million people with one of the world's fastest growing HIV epidemics [and] home to about 220,000 people living with HIV.

    February 10, 2017
    Reuters
  • The 2017 Conference on Retroviruses and Opportunistic Infections (CROI), starting here Feb. 13, has no specific theme, according to meeting chair Susan Buchbinder, MD, University of California San Francisco. But the state of the HIV/AIDS pandemic around the world will be an important part of the discussion....Researchers will present data...[that] should begin to help answer key questions...[and] the most recent snapshot of the U.S. epidemic.

    February 10, 2017
    MedPage Today
  • [According to Katharine Looker, University of Bristol, and colleagues writing in Lancet Global Health,] most cases of neonatal herpes occurred in Africa, due to high incidence and prevalence of HSV-2 infections and high number of births. The Americas, however, had the highest overall infection rate, with 19.9 cases per 100,000 live births, due to high HSV-1 rates.....In the Americas, Europe and the Western Pacific, most cases were caused by HSV-1.

    February 10, 2017
    Healio
  • After adjustment for sex, age and other factors, diabetes prevalence was 3.8% higher [in people] with HIV than in the general U.S. population. Among people with HIV, women, persons 20 to 44 years old and non-obese individuals all had significantly higher diabetes prevalence than comparable groups in the general population....The CDC investigators note that their analysis offers the first nationally representative estimate of diabetes prevalence in adults in care for HIV infection in the United States.

    February 9, 2017
    BodyPRO
  • Anthony S. Fauci...reflects on lessons learned... and how the administrations of Presidents Ronald Reagan, George H.W. Bush, Bill Clinton, George W. Bush, and Barack Obama responded to public health crises....Fauci writes, "If history has taught us anything, it is that the new administration is likely to experience at least one infectious disease crisis of significance [and]... that emerging infections will continue to be a perpetual challenge, requiring the attention of all Presidents to come.

    February 9, 2017
    Health Affairs Blog

Published Research

  • As Trump defines a strategy for his priority issues, it would be good business practice for him to consider existing strengths and weaknesses, opportunities and threats in the national and global environments,....rely on existing opportunities and strengths, and provide continuity to programmes that have promoted the removal of the threats at the source, through adequate financing for the Global Health Security Agenda and bilateral programmes like [PEPFAR] or the President's Malaria Initiative.

    March 1, 2017
    Lancet
  • Between June 15, 2014, and Dec 10, 2015, we equipped church leaders with knowledge and tools...in 8 intervention villages and compared the outcomes with those in 8 control villages. Results: Education of religious leaders had a substantial effect on uptake of male circumcision, and should be considered as part of male circumcision programmes in other sub-Saharan African countries.

    February 14, 2017
    Lancet
  • Bictegravir plus emtricitabine and tenofovir alafenamide and dolutegravir plus emtricitabine and tenofovir alafenamide both showed high efficacy up to 24 weeks. Both treatments were well tolerated. Administration of bictegravir, a novel, potent, once-daily INSTI designed to improve on existing INSTI options with the backbone of emtricitabine and tenofovir alafenamide, might provide an advantage to patients.

    February 14, 2017
    Lancet
  • Vertical transmission of a sexually transmitted disease comes with a host of documented emotional and psychosocial consequences. This is what neonatal herpes does: it ravages the lives of newborn babies and parents.

    January 30, 2017
    Lancet

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