This week, we read a study that identifies HIV as the leading risk factor for stroke in young adults in Africa. We also look at data on drivers of new HIV infections from the Swiss HIV Cohort Study. And a study examines rates of treatment and viral suppression for those receiving health coverage through the Ryan White HIV/AIDS Program compared with other types of insurance.
This Week in HIV Research will return on Jan. 8, 2016. Happy holidays and have a healthy new year! As always, to beat HIV, you have to follow the science!
Having HIV is the leading risk factor for stroke among young African adults, according to a new study in the journal Neurology.
The study followed 222 adults who experienced acute stroke and 503 control patients. Among stroke patients under 45, up to 42% of cases were attributed to HIV. There was an increased risk for stroke in HIV-positive patients who were not on treatment, but the highest risk was among those who had started antiretroviral therapy within the previous six months. No interaction was found between HIV and hypertension on the risk of stroke.
"The link between HIV infection and stroke is now more convincing than ever. While in the longer term treatment reduces stroke risk, we were surprised to find that the risk actually increases in the first few months of therapy," said lead author Laura Benjamin, Ph.D., according to the study press release.
Treatment as Prevention
A large portion of HIV transmissions stem from patients newly infected with HIV (during their first year), as well as from patients on antiretroviral therapy during treatment interruption, according to a study published in Clinical Infectious Diseases.
After constructing a phylogenetic tree and estimating seroconversion dates for 4,079 patients, researchers from the Swiss HIV Cohort Study found that 43.7% of transmissions occurred within the first year of infection. Furthermore, at least 14% of chronic-phase transmissions occurred during treatment interruptions.
"We demonstrate a high fraction of transmission during recent HIV infection but also chronic transmissions after interruption of [antiretroviral therapy] in Switzerland. Both represent key issues for treatment as prevention and underline the importance of early diagnosis and of early and continuous treatment," the authors conclude.
In the Clinic
Individuals living with HIV who had little or no health insurance but who were receiving assistance from the Ryan White HIV/AIDS Program were more likely to be on antiretroviral therapy and have an undetectable viral load, according to a study published in Clinical Infectious Diseases.
The study analyzed data on 18,095 patients between 2009 and 2013 from the Medical Monitoring Project, a surveillance system that assesses data on HIV-positive adults receiving care in the United States.
About 41% received assistance from the Ryan White Program, with 15% relying solely on the Ryan White Program for HIV care. Patients without insurance who received assistance through Ryan White were more likely to be on treatment (94% vs. 52%) and achieve an undetectable viral load (77% vs. 39%) than uninsured patients who did not receive Ryan White assistance.
Furthermore, patients who had private insurance were 6% less likely to be on treatment and 5% less likely to have an undetectable viral load than those who received Ryan White assistance only. Patients who had Medicaid were 7% less likely to be on treatment and 12% less likely to have an undetectable viral load than those who received Ryan White assistance only.
Is there a development this week in HIV research that you think we missed? Send us a tip!