17 February 2017 VOLUME 18 ISSUE 7

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.

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.

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.

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.

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.

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.

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.

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.

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."

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.

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.

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.

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

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.”

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.

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.

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.

[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.

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.

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.

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.