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Smokers with HIV doing well on treatment now at greater risk of lung cancer than AIDS

National Aids Manual (UK) - 19/09/2017
People living with HIV on antiretroviral treatment with fully suppressed viral load who smoke are much more likely to die of lung cancer than HIV-related causes, according to the findings of a modelling study published today in JAMA Internal Medicine. The study suggests that people on successful antiretroviral treatment are between

San Francisco annual report shows continued drop in new HIV infections

National Aids Manual (UK) - 18/09/2017
The San Francisco Department of Public Health (DPH) has released its HIV Epidemiology Annual Report for 2016, showing that the number of new infections continues to decline, with decreases seen across demographic groups. Homeless people, however, have higher rates of infection and poorer treatment outcomes. "Highlights of this year's HIV annual report include a 16% decline in

High prices of DAAs mean there's been little progress towards achieving WHO target of eliminating HCV by 2030

National Aids Manual (UK) - 15/09/2017
Only a handful of countries are on course to achieve the World Health Organization (WHO) target of eliminating hepatitis C virus (HCV) as a major public health concern by 2030, according to a study published in the Journal of Virus Eradication. Investigators estimated progress towards elimination by examining 2016 data

Study documents changing opinion among Italian doctors about PrEP

National Aids Manual (UK) - 14/09/2017
A survey of Italian infectious disease physicians working with HIV, conducted in 2015 but only published this July, reveals that at that time there was still considerable scepticism about HIV pre-exposure prophylaxis (PrEP). The study data were collected in April and May 2015, two months after the results of the PROUD and IPERGAY studies were announced, but a

New guidelines recommend that women avoid tenofovir & emtricitabine during pregnancy

National Aids Manual (UK) - 13/09/2017
Women should be offered the choice to avoid treatment with tenofovir and emtricitabine during pregnancy owing to a higher risk of stillbirth and early infant death associated with these drugs, according to new recommendations published this week in the British Medical Journal (BMJ). The authors – a panel of experts in

New US PrEP cost-effectiveness model finds drug prices will need to drop substantially if HIV risk rises, or if adherence is only moderate

National Aids Manual (UK) - 12/09/2017
A new US model of the cost-effectiveness of pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM), prepared by researchers at Emory University in Atlanta, finds that taking even one year of PrEP is more cost-effective than measures like kidney dialysis, if it is used by people belonging to populations where

Maraviroc matches boosted protease inhibitor treatment over 96 weeks

National Aids Manual (UK) - 11/09/2017
Treatment with maraviroc (Celsentri/Selzentry) is associated with durable HIV suppression and a favourable lipid profile, investigators report in HIV Medicine. The 96-week randomised study compared the safety and efficacy of antiretroviral regimens based on maraviroc to those containing a ritonavir-boosted protease inhibitor. Two years after randomisation, 90% of people in

What is going on in gay men’s lives when they acquire HIV?

National Aids Manual (UK) - 08/09/2017
Gay men in England who have recently become HIV positive describe a complex web of factors which may have contributed to their infection, according to a qualitative study recently published in BMJ Open. “Individuals who experienced multiple stressors, gradually over the life course or more suddenly, were especially vulnerable to HIV and being drawn into

No new HIV infections among Kaiser PrEP users, but data shows missed opportunities

National Aids Manual (UK) - 07/09/2017
No new HIV infections have occurred among nearly 5000 people who started Truvada for pre-exposure prophylaxis (PrEP) in the Kaiser Permanente Northern California health system, according to a letter in the 29 July edition of Clinical Infectious Diseases. However, there were some infections in people who sought PrEP but decided not to take it

Lipids improved by switching from ritonavir to cobicistat as a booster for darunavir

National Aids Manual (UK) - 06/09/2017
Switching from ritonavir to cobicistat is associated with significant improvements in cholesterol and triglyceride levels for people with dyslipidaemia, investigators from Spain report in HIV Medicine. Ritonavir was replaced with cobicistat to boost the protease inhibitor darunavir. Six months after the switch, cholesterol and triglycerides had significantly improved among people with lipid abnormalities at baseline. “More than

Case reports of severe dolutegravir-related depression

National Aids Manual (UK) - 05/09/2017
Severe depression can be a side-effect of treatment with the anti-HIV drug dolutegravir. In HIV Medicine, clinicians from the Netherlands report two cases of rapid onset of serious depression after initiation of therapy with the drug. The authors are persuaded that dolutegravir was the cause. In neither case did the patient have factors predisposing

Experts concur that event-related oral PrEP probably won’t work for women

National Aids Manual (UK) - 01/09/2017
Two presentations at the recent International AIDS Society Conference on HIV Science (IAS 2017) in Paris told delegates that both trial results and analysis of drug levels supported the idea that event-related, “on demand” pre-exposure prophylaxis (PrEP) might not be sufficiently powerful to prevent HIV infection in women and trans men via vaginal

Taking dolutegravir in the morning may avert insomnia

National Aids Manual (UK) - 31/08/2017
Italian doctors say that sleeplessness after taking the integrase inhibitor dolutegravir occurred much less often when their patients took their dose of the drug in the morning.Insomnia has been reported as a common side-effect of dolutegravir, affecting at least one in a hundred people who take the drug as part

The availability of direct-acting antivirals is reducing disparities in the uptake of hepatitis C treatment

National Aids Manual (UK) - 30/08/2017
An analysis from British Columbia, Canada shows that older people, individuals with HIV co-infection, people with cirrhosis and – to some extent – people who inject drugs have been significantly more likely to receive direct-acting antiviral (DAA) treatments, compared to the older interferon-based treatments. The findings show that in the

The availability of directly acting antivirals is reducing disparities in the uptake of hepatitis C treatment

National Aids Manual (UK) - 30/08/2017
An analysis from British Columbia, Canada shows that older people, individuals with HIV co-infection, people with cirrhosis and – to some extent – injecting drugs users have been significantly more likely to receive directly acting antiviral treatments, compared to the older interferon-based treatments. The findings show that in the current

Who are trans women acquiring HIV from?

National Aids Manual (UK) - 29/08/2017
There is a lot we don’t know about trans women’s HIV risk, why they are so vulnerable to HIV and who trans women are acquiring HIV from. A study presented at last month’s 9th International AIDS Society Conference on HIV Science (IAS 2017) attempted to answer these questions, but in the process uncovered

One in seven people offered PrEP in African study start it immediately

National Aids Manual (UK) - 28/08/2017
One in seven people (14%) offered pre-exposure prophylaxis (PrEP) in a large community study of enhanced HIV testing and treatment in Kenya and Uganda started PrEP the day they were offered it, and 18% within a month, the 9th International AIDS Society Conference on HIV Science (IAS 2017) in Paris heard

What is “successful ageing” for people living with HIV?

National Aids Manual (UK) - 26/08/2017
When Canadian researchers asked HIV-positive people over the age of 50 how they would define “successful ageing”, six key themes emerged – accepting limitations, staying positive, maintaining social support, taking responsibility, living a healthy lifestyle, and engaging in meaningful activities. Writing in the International Journal of STD & AIDS, Patricia Solomon and colleagues note the

New South Wales reports record drop in HIV diagnoses: fewest this year since records began

National Aids Manual (UK) - 25/08/2017
Australia’s most populous state, New South Wales (NSW), has reported a steep drop in HIV diagnoses in gay and other men who have sex with men (MSM) in the last year, and particularly since the beginning of 2017. This is despite an equally notable increase in HIV testing, which took a sharp upward turn

No evidence of reduced efficacy or increased side-effects when patients switch to generic drugs, comparison study finds

National Aids Manual (UK) - 24/08/2017
An analysis of 440 people switched to generic antiretroviral drugs at an Italian clinic and a matched cohort of patients who remained on their branded medication has found no evidence of generic drugs being less effective or causing more side-effects, Nicola Gianotti and colleagues report in an article recently published in PLOS ONE.In many high-income