May 1, 2015
This week we look at a couple of promising innovations in antiretroviral therapy. We also get an update on the Indiana outbreak that identifies the main cause. Additionally, despite the risks of participating in cure research, many people living with HIV are willing to do it. To beat HIV, you have to follow the science!
A new subdermal implant shows a lot of promise in delivering antiretroviral therapy for up to 40 days, according to research from the Oak Crest Institute of Science. The matchstick-sized implant acts similarly to a contraceptive implant, which is inserted under the skin (usually in the upper arm) by a health care provider and prevents pregnancy by steadily releasing hormones. The HIV subdermal implant was tested in dogs and was able to deliver controlled, sustained doses of tenofovir alafenamide (TAF) for up to 40 days, with no adverse side effects. If effective in humans, the implant could be a new tool for preventing and treating HIV, especially in those with adherence challenges.
In a rural county consisting of 4,200 people that historically sees fewer than five HIV cases a year, the Indiana State Department of Health diagnosed 135 new cases of HIV as of April 21. The majority of cases are linked to syringe-sharing partners injecting the prescription opioid oxymorphone (a powerful oral semi-synthetic opioid analgesic).
A survey of nearly 1,000 people with HIV found that nearly all were interested in being a part of HIV cure research. While nine in 10 found it very or extremely desirable to "no longer have HIV in your body," an equal or even higher percentage expressed eagerness for the benefits of a functional cure that would eliminate risk of HIV-related health problems or passing HIV to sexual partners and nix the need for HIV medication. Over half said they'd risk detectable viral load, a low CD4+ count or severe side effects as part of a study; almost two-thirds said they might be willing to interrupt their antiretroviral treatment.
The treatment management elements of Rwanda's 2013 National guidelines for prevention and management of HIV, STIs and other blood borne infections have been packed into a computer application -- called HIV SMART Project -- to help providers identify and address HIV treatment failure. By allowing a clinician to methodically enter patient data step-by-step, it may reveal adherence issues and inform the decision of whether or when to switch regimens.
People with alcohol use disorders (AUD) are at a much higher risk of death, in both the general population and those living with hepatitis C (HCV), according to a study presented at the 2015 International Liver Congress. Moreover, having chronic HCV alone does not increase the risk of death, unless individuals have other severe comorbidities, such as HIV, cancer or kidney disease.
While healing from circumcision surgery, men with HIV are at increased risk of transmitting HIV to female partners. In the first few weeks of healing, viral shedding increases, according to evidence in a study in Uganda. While it's unknown if the increased shedding leads to more transmission, it's clear that men who engage in sex before wounds heal have higher transmission rates, as do those with higher HIV viral load.
Gay men living with HIV who were on antiretroviral therapy had an undetectable viral load in the rectum, according to a small study presented at the British HIV Association conference (BHIVA 2015). Moreover, for men on treatment who also had rectal gonhorrea or chlamydia, rectal viral loads remained undetectable. For men not on treatment who also had rectal gonhorrea or chlamydia, rectal viral loads were lower than plasma viral loads. These findings suggest that having gonorrhea and chlamydia does not increase the risk of HIV transmission.
At the start of each work week, there's an "uptick" in Web searches for HIV/AIDS topics, calls to information hotlines and queries to "ask the expert" websites, mirroring Google search data showing peaks to searches for general health topics, according to Johns Hopkins researchers. They attribute the weekly pattern to the perception of Mondays as a "fresh start" day.
Is there a development this week in HIV research that you think we missed? Send us a tip!
Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com.
Follow Warren on Twitter: @WarrenAtTheBody.
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