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Undetectable viral load at time of immunisation enhances yellow fever vaccine protection for people with HIV

National Aids Manual (UK) - 24/11/2017
Viral suppression at the time of immunisation is the most important determinant of long-term response to yellow fever vaccination among people with HIV, Swiss investigators report in Clinical Infectious Diseases. Every person with an undetectable viral load at the time of first yellow fever vaccination continued to have a protective response ten years after vaccination, they

To better target HIV prevention, identify people whose social contacts have high viral loads

National Aids Manual (UK) - 23/11/2017
Rather than relying on assessment of an individual’s sexual behaviour or of ‘community viral load’, targeting of pre-exposure prophylaxis (PrEP) and other prevention interventions could in part be based on the proportion of a person’s social contacts who have unsuppressed HIV. There is a correlation between young gay men having HIV and their ‘network

Despite reassuring data, we can’t yet say U=U for breastfeeding

National Aids Manual (UK) - 22/11/2017
While effective HIV treatment greatly reduces the risk of onward transmission during breastfeeding, it does not appear that the risk is zero, a leading paediatrician told the British HIV Association (BHIVA) conference in London last week. Although formula feeding is the safest option in high-income countries, some women will choose to breastfeed and healthcare

Risk of chronic kidney disease and cardiovascular disease in people with HIV should be assessed together

National Aids Manual (UK) - 21/11/2017
People with HIV should have their risk of cardiovascular disease (CVD) and chronic kidney disease (CKD) assessed together, results from the D:A:D study published in PLOS Medicine show. Investigators found that individuals with a high predicted risk for both CVD and CKD had a much greater risk of developing both CVD and CKD events,

Schistosomiasis increases risk of infection with HIV, especially for women and is also associated with a higher HIV viral load

National Aids Manual (UK) - 20/11/2017
Infection with schistosome parasitic worms has an important role in HIV transmission, especially for women, and may accelerate HIV disease progression, according to research published in PLOS Neglected Tropical Diseases. Women with schistosomiasis had a three-fold increased risk in becoming infected with HIV, compared to women who did not carry the worms. Moreover, HIV viral load

Gay men’s stories of monogamy and non-monogamy: change, flexibility and tensions

National Aids Manual (UK) - 17/11/2017
Although some gay men idealise monogamy, particularly in the early stages of a relationship, couples often become non-monogamous over time, Australian researchers report in an article published online ahead of print in Culture, Health and Sexuality.Men often saw non-monogamy as realistic in gay relationships, due to social and cultural norms in gay communities. But

European Cure Review concentrates on HIV therapeutic vaccines

National Aids Manual (UK) - 16/11/2017
A cure for HIV would almost inevitably have to involve a vaccine to improve the body’s natural ability to control HIV, a seminar on European HIV cure research heard recently. The STEPS seminar, held by the European AIDS Treatment Group (EATG) ahead of the 16th European AIDS Conference (EACS) in Milan last month, also

Who is taking an HIV test in England and where?

National Aids Manual (UK) - 15/11/2017
The range of settings in which people test for HIV has expanded significantly in recent years in England, according to a new Public Health England report on HIV testing services. It includes new estimates of the numbers of people who test and re-test for HIV, suggesting that relatively few people

HIV incidence is falling in English gay men, say Public Health England

National Aids Manual (UK) - 15/11/2017
While several recent reports have shown that new HIV diagnoses have been falling in UK gay men, what really matters is the actual number of new HIV infections, regardless of whether people are diagnosed or not. This is HIV incidence and Public Health England (PHE) said today that, according to their current estimates, incidence

Screen all HIV-positive MSM for pre-cancerous anal cell changes, say Dutch investigators

National Aids Manual (UK) - 15/11/2017
Younger age and shorter duration of viral suppression are risk factors for the development of high-grade pre-cancerous anal lesions in HIV-positive men who have sex with men (MSM), investigators from the Netherlands report in AIDS.They designed the study to identify demographic and HIV-related risk factors associated with the development of

Nivolumab improves outcomes in liver cancer study

National Aids Manual (UK) - 14/11/2017
Nivolumab (Opdivo), a PD-1 checkpoint inhibitor that helps the immune system fight cancer, was associated with a decrease in tumour size or disease stabilisation in people with hepatocellular carcinoma (HCC) in the CheckMate 040 study, according to a report at the 2017 AASLD Liver Meeting last month in Washington, DC.Over years or decades, chronic hepatitis B or C virus

No change in cognitive function or brain structure in people taking effective HIV treatment for 2 years

National Aids Manual (UK) - 13/11/2017
People with HIV taking antiretroviral treatment who had undetectable viral load did not suffer any loss of cognitive function or brain volume during a two-year period when compared with their HIV-negative peers, but did have lower cognitive function and brain volume at the start of the study, suggesting that changes

Up to a quarter of HIV-negative gay men attending three English clinics used PrEP in the last year

National Aids Manual (UK) - 13/11/2017
A prospective cohort study of gay men attending three clinics in southern England – 56 Dean Street and Mortimer Market Centre in London and the Brighton & Hove SHAC (Sexual Health & Contraception) service – have found that 23% of HIV-negative service users who responded to a follow-up questionnaire had used PrEP (pre-exposure prophylaxis)

Healthcare workers living with HIV have different motivations for disclosing or concealing their HIV status

National Aids Manual (UK) - 10/11/2017
Nurses and other healthcare workers who are living with HIV have mixed reactions when they mention their HIV status to colleagues, according to a small Dutch study reported in the November/December issue of the Journal of the Association of Nurses in AIDS Care. Some healthcare workers disclosed because they expected a positive reaction or they

HIV diagnoses in English gay men have been falling since 2014

National Aids Manual (UK) - 08/11/2017
A new analysis by Public Health England of testing rates and HIV diagnoses from all of England’s sexual health clinics shows that the decline in diagnoses is England-wide, started at least a year before the decline was first noticed at London's 56 Dean Street clinic, and is not restricted to

High HIV incidence from non-primary partners and low PEP and PrEP use seen in PARTNER study

National Aids Manual (UK) - 08/11/2017
HIV incidence among the HIV-negative gay men in the PARTNER 1 and 2 studies, due to sex with partners outside the main relationship, was high, and very high in partners who admitted having condomless anal sex with non-primary partners, the 16th European AIDS Conference (EACS 2017) heard recently. The conference heard

European AIDS Clinical Society strengthens HPV vaccination advice

National Aids Manual (UK) - 08/11/2017
The European AIDS Clinical Society (EACS) has recommended HPV (human papillomavirus) vaccination for everyone living with HIV aged under 26 and all men who have sex with men up to the age of 40. HPV is a sexually transmitted virus that causes genital warts, and in some forms, leads to the

People with HIV more likely to adhere to their antiretroviral therapy than treatment for other chronic health problems

National Aids Manual (UK) - 07/11/2017
Ageing HIV-positive people have significantly higher levels of adherence to their antiretroviral therapy than to medication taken for other chronic health problems, Swiss investigators report in HIV Medicine. The research also revealed that people living with HIV rated the necessity of their HIV treatment more highly than therapy for other illness and also had lower

Starting ART immediately after HIV diagnosis cuts mortality risk by two-thirds for people with high CD4 cell counts

National Aids Manual (UK) - 06/11/2017
People with a high CD4 cell count who start antiretroviral therapy (ART) immediately after diagnosis with HIV cut their 12-month mortality risk by two-thirds, according to research conducted in China and published in Clinical Infectious Diseases. The retrospective study involved over 35,000 people who were newly diagnosed with HIV between

Swiss study examines which years gay men decided to stop consistent condom use

National Aids Manual (UK) - 04/11/2017
An innovative study presented at the 16th European AIDS Conference (EACS 2017) in Milan two weeks ago used a machine-learning algorithm (originally developed to help astronomers classify galaxies) to tease out whether there were specific groups of gay men within a large national cohort whose sexual risk behaviours followed similar trajectories over