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27 FEBRUARY 2015 VOLUME 16 ISSUE 9

Media Coverage

  • ARV trial just won’t gel

    In a blow for HIV prevention, a vaginal gel that showed some effect against HIV in an earlier trial has failed to protect women in a big follow-up trial....“This reinforces the fact that HIV prevention is difficult and interventions to protect women are complicated,” said Professor Glenda Gray, president, SA Medical Research Council....Two other HIV prevention products are being tested: a vaginal ring with ARVs that can stay inside a woman for a month, the other a three-monthly injection of the ARV drug cabotegravir.
    February 26, 2015
    IOL

  • Former Iowa State University HIV vaccine researcher pleads guilty to falsifying lab reports

    A former Iowa State University researcher pleaded guilty in federal court Wednesday to making false statements about a potential HIV vaccine in research reports. A judge accepted the terms of a plea agreement Dong-Pyou Han signed with federal prosecutors in January....Han faces up to 10 years in prison and a fine of up to $500,000. He also may be required to make restitution to the federal government.
    February 26, 2015
    HIV Vaccine
    The Republic

  • Could an HIV drug beat strep throat, flesh-eating bacteria?

    With antibiotic resistance on the rise, scientists are looking for innovative ways to combat bacterial infections. The pathogen that causes conditions from strep throat to flesh-eating disease is among them, but scientists have now found a tool that could help them fight it: a drug approved to treat HIV. Their work, appearing in the journal ACS Chemical Biology, could someday lead to new treatments.
     
    February 26, 2015
    Science Daily

  • Gel to prevent HIV infection fails -- again

    [T]here have now been at least three major studies of microbicide gels that have not produced positive results...."To me this study didn't fail," said Sharon Hillier, who moderated a press conference where the FACTS 001 results were presented...."This study answered the question: If you gave women tenofovir gel and told them to use it before and after sex, would it reduce HIV? And the study answered 'No'....The things in clinical trials right now that we are hopeful about are more sustained deliveries."
    February 26, 2015
    MedPage Today

  • Disappointing result for women's microbicide

    After encouraging results on PrEP presented at CROI, there was one major HIV prevention setback. FACTS 001, a study testing the efficacy of a vaginal microbicide gel containing tenofovir, produced a null result....The researchers put extra effort into community support and education programmes for trial participants, and this did improve adherence to some extent.
    February 25, 2015
    AIDSMap

  • A game-changer: 86% fewer HIV infections in two PrEP studies

    The most exciting news from CROI concerns pre-exposure prophylaxis (PrEP), the use by HIV-negative people of antiretrovirals to prevent HIV infection. Two studies of PrEP in gay men and trans women have demonstrated that the availability of PrEP reduced the rate of infection by 86%. This amounts to the highest effectiveness yet seen for PrEP and is superior to most other HIV prevention interventions.
    February 25, 2015
    PrEP
    AIDSMap

  • Overcoming demand barriers through PrePex

    It has been six years since the PrePex device for medical male circumcision came into the fore and joined the global effort of facing one of the biggest health challenges of our times: stopping the spread of HIV and AIDS....PrePex’s unique features overcome the demand barriers, which existing male circumcision methods and devices are facing, especially in low resource settings.
    February 25, 2015
    Voluntary Medical Male Circumcision
    Swazi Observer

  • CROI 2015: Trial to evaluate the use of health navigators to link HIV/TB patients to care and treatment fails to show positive results

    Patients randomized to the support of a health navigator were not more likely than those  who received standard of care to complete tuberculosis treatment or begin antiretroviral therapy within three months of HIV diagnosis, according to the results of a randomized trial presented today. Ingrid Bassett, Massachusetts General Hospital, reported on the study, which enrolled 4,903 patients at two hospital outpatient clinics and two rural primary care clinics in Durban South Africa.
    February 25, 2015
    Science Speaks

  • CROI 2015: Breastfeeding women in Africa with HIV go undiagnosed

    Findings from household surveys across three African countries presented here Tuesday showed large numbers of HIV-infected women remaining undiagnosed while breastfeeding their infants, despite some level of participation in antenatal and HIV testing services. Médecins Sans Frontières physician David Maman presented the findings, from Kenya, Malawi and South Africa. The household surveys, conducted between September 2012 and November 2013, included interviews and testing of 11,550 women.
     
    February 25, 2015
    Science Speaks

  • In 2013, measles killed more kids than car accidents or AIDS

    Measles killed 82,100 children under age 5 in 2013, ranking the disease No. 7 on the list of top causes of child death, according to recent statistics from the Lancet. Lower respiratory infections like pneumonia were the number one killer, followed by malaria, diarrhea, nutritional deficiencies, congenital defects and meningitis. More small children died from measles in 2013 than died from drowning, road injuries or AIDS....
     
    February 25, 2015
    Washington Post

  • Week-on, weekend-off treatment controls viral load in young people

    Taking an efavirenz-based antiretroviral regimen during the week and taking no medication on two days over the weekend was just as effective as daily treatment in controlling viral load in an 11-country trial conducted among adolescents and young people, Professor Karina Butler of Our Lady’s Children’s Hospital, Dublin, Ireland, reported at CROI 2015....Experts stressed that these results should be treated with caution.
     
    February 25, 2015
    AIDSMap

  • Combination PrEP and ART almost eliminates transmission in serodiscordant couples

    Giving both PrEP and ART to heterosexual couples where one partner has HIV can almost eliminate the chance of infection in the HIV-negative partner, a study presented at CROI 2015 has shown.
    February 25, 2015
    PrEP
    AIDSMap

  • Ryan White patients with HIV more likely to undergo ART

    Among uninsured and underinsured HIV patients, recipients of Ryan White HIV/AID Program [RWHAP] assistance have a greater likelihood of ART prescription and viral suppression vs. patients with other types of insurance, according to findings presented at CROI 2015....Further analysis indicated that patients with RWHAP assistance were more likely to be prescribed ART than those with private insurance, Medicaid and Medicare. 
    February 25, 2015
    Healio

  • Daily pill Truvada cuts spread of HIV by 86%, study shows

    A daily pill can effectively protect gay men against infection with HIV, a UK trial has shown, which experts say now offers hope of reversing the virus’s spread....The study, carried out in 12 NHS trusts, showed that Truvada, which is already used to treat people with HIV, cut infections among men who have sex with men by 86%....The study, Proud (Pre-exposure Option for reducing HIV in the UK: immediate or Deferred), follows a number of trials in other countries and has achieved a success rate higher than all of them.
    February 24, 2015
    Guardian

  • Pharma narrowly defines when compulsory licenses should be used

    As the US Trade Representative holds a hearing today to discuss how countries protect intellectual property, the pharmaceutical industry hopes to persuade the agency that countries should only be allowed to grant licenses to companies to make low-cost generic drugs when there is a health emergency. That posture, however, contradicts the position taken by the World Health Organization.
    February 24, 2015
    Pharmalot

  • Study that paid patients to take HIV drugs fails

    A major study testing whether Americans would take their H.I.V. drugs every day if paid to do so has essentially failed....“We did not see a significant effect of financial incentives,” said Wafaa M. El-Sadr, AIDS expert at Columbia University and lead investigator. But, she said, there is “promise for using such incentives in a targeted manner”.... Mathematical modeling suggested that paying people up to $5,000 a year could be cost effective, but $280 was settled on after a long, difficult debate....
    February 24, 2015
    New York Times

  • CROI 2015: Financial incentives can increase patient engagement in HIV care and improve viral suppression in some care settings

    Wafaa El Sadr, Columbia University, presented findings from HPTN 065, conducted in Washington DC and Bronx, New York....Financial incentives to encourage people newly identified with HIV to access and stay in care did not significantly increase linkage to care [or] viral suppression overall....The study did find, however, that financial incentives did increase continuity in care by 8 percent overall [and] substantial increases in viral suppression were noted in hospital clinics, smaller sites, and sites with lower levels of viral suppression prior to the study.

    February 24, 2015
    Science Speaks

  • Why it took so long for the world to start using ‘smart,’ self-destructing syringes

    The World Health Organization called Monday for the worldwide use of needle syringes that self-destruct after a single injection....The WHO has been hunting for solutions for nearly 25 years. Only recently has the technology become feasible – cheap, easy to use, hard to break....The WHO’s quest began in 1987 – just as the spread of a disease called HIV was beginning to cause alarm. 
     
    February 24, 2015
    Washington Post

  • CROI 2015: PrEP, microbicide findings show divergent paths of prevention responses

    Presentations on [the PROUD and Ipergay] studies this morning highlighted the promise of antiretroviral drugs as pre-exposure prophylaxis, giving numbers to findings already known to be good news....In the same morning session, findings from a much anticipated trial served up a fresh helping of bad news in ongoing efforts to find an HIV prevention measure that women can control....The results from the FACTS 001 trial...are, it appeared, the last nail in the coffin for one approach to a strategy that once seemed a simple answer to putting protection into the hands of those who need it most.

    February 24, 2015
    PrEP
    Science Speaks

  • CROI 2015: Financial incentives can increase patient engagement in HIV care and improve viral suppression in some care settings

    Wafaa El Sadr, Columbia University, presented findings from HPTN 065, conducted in Washington DC and Bronx, New York....Financial incentives to encourage people newly identified with HIV to access and stay in care did not significantly increase linkage to care [or] viral suppression overall....The study did find, however, that financial incentives did increase continuity in care by 8 percent overall [and] substantial increases in viral suppression were noted in hospital clinics, smaller sites, and sites with lower levels o
    February 24, 2015
    Science Speaks

  • CROI 2015: Medical circumcision strategies and results include implications for partners, herpes findings, effect of ARVs

    Presentations on Tuesday in Seattle on circumcision highlighted the benefit of the procedure as an HIV intervention, providing more evidence for benefits and risks for men and their sexual partners. Findings also pointed to strategies with some success reaching men most at risk....[P]lacing men on antiretroviral therapy and co-locating treatment and circumcision services may be warranted to reduce potential for HIV transmission to sexual partners during the healing period. 
     
    February 24, 2015
    Voluntary Medical Male Circumcision
    Science Speaks

  • CROI 2015: With strides in treatment, prevention, and cures, science meets realities

    [A]s conference chairs and opening speakers discussed the scientific research that brought them here, they also discussed the realities that challenge those advances....This is a big week for prevention, with findings on PrEP PROUD and Ipergay trials, as well as microbicidal vaginal gels to prevent HIV acquisition among women with the FACTS 001 trial.
    February 24, 2015
    PrEP
    Science Speaks

  • New deal allows generics makers license to sell HIV drug

    Children living with HIV...ay soon have access to a lower-cost antiretroviral treatment. The  Medicines Patent Pool has struck a licensing agreement with Merck, allowing development of generic formulations of the oral ART drug raltegravir targeting babies and children from 4 weeks to 12 years old....The lower-cost version of the drug can be sold in 92 low- and middle-income countries which together account for 98 percent of the disease burden among children.
     
    February 24, 2015
    Devex Newswire

  • New study shows the substantial value of preventing HIV infection in the United States

    How much money would be saved if one high-risk person was prevented from contracting HIV in the United States? A new study led by Weill Cornell Medical College and published online Feb. 24 in Medical Care, answers this question: from $229,800 to $338,400, depending on continuity of treatment....The study results, presented at CROI, will be used by fiscal planners and public health advocates as they evaluate current prevention programs and make decisions about resource allocation.
     
    February 24, 2015
    Health Canal

  • HIV care slammed by Ebola

    The Centre Medicale de Macenta, a 100-bed medical facility in remote Guinea, managed to provide continuous care during the worst of the epidemic, according to David Leuenberger, MD, of Mission Philafricaine, a Swiss nongovernmental organization. But patients stayed away in droves, he told reporters at CROI 2015. The result was about a 50% drop in HIV testing, new HIV diagnoses, and entry into care, Leuenberger said, although relatively few patients already in care were lost to follow-up.

     

     
    February 24, 2015
    MedPage Today

  • Pill taken before, after sex may prevent HIV

    An HIV prevention pill taken by gay men before and after sex reduced the risk of virus transmission by 86 percent, according to results of a clinical trial released Tuesday. The study, led by the French National HIV research agency ANRS..."provides the first evidence that an event-driven regimen is effective among high-risk MSM with frequent sex," said Jonathan Mermin, US Centers for Disease Control and Prevention.
     
    February 24, 2015
    AFP

  • HIV transmission at each step of care continuum in the United States

    Individuals infected but undiagnosed with the human immunodeficiency virus (HIV) and those individuals diagnosed with HIV but not yet in medical care accounted for more than 90 percent of the estimated 45,000 HIV transmissions in 2009, according to an article in JAMA Internal Medicine....In a related commentary, Thomas Giordano writes: "[T]he study demonstrates that the steps of the cascade that propel HIV transmission in the United States are delayed diagnosis and inadequate retention in care.

    February 23, 2015
    Science Daily

  • WHO calls for ‘smart’ syringes to stem deadly diseases

    The World Health Organization has called on healthcare providers around the globe to switch to syringes that can only be used once. “Adoption of safety-engineered syringes is absolutely critical to protecting people worldwide from becoming infected with HIV, hepatitis and other diseases,” said Gottfried Hirnschall, head of WHO’s HIV/AIDS Department....However, these types of needles cost at least twice the three to four US cents the regular ones cost when ordered through a UN agency. 
    February 23, 2015
    New Straits Times

  • Scientists hope an AIDS vaccine lies in llamas

    Llamas appear to be immune to AIDS and HIV. The discovery, experts say, just might lead to a vaccine against the deadly virus or a treatment for those already infected. That’s according to new research by experts from University College London, Harvard Medical School and Argentina’s Center of Animal Virology. Their study, published in PLOS Pathogens, says that one llama antibody, which develops in response to the virus, “potently neutralizes more than 95 percent of HIV strains.”
    February 23, 2015
    Global Post

  • Kenya: New pregnancy HIV prevention tools on the way

    Janet is in primary school and already has two children. Janet's mother worries that she has not stopped seeing men despite many talks and counselling sessions. She feels that HIV prevention takes a backseat to pregnancy prevention. A third baby would bring further shame to the family....Aside from the embarrassment, Janet's mother cannot afford an additional mouth to feed....This is the situation of many women in developing countries such as Kenya.
     
    February 23, 2015
    The Star

  • Canadian paper backpedals from Gardasil side effects story

    Merck has already had its fair share of struggles with uptake rates for its HPV vaccine, Gardasil. A Toronto Star story earlier this month, which focused on young women who'd suffered serious problems following vaccination, didn't help matters. The paper has since backed away from its story, but some damage may already be done. The Star article was an example of how mainstream media can misreport health-related stories by favoring personal stories over scientific data. 
     
    February 23, 2015
    FiercePharma

  • 91% of HIV passes from those unaware they’re infected or not in care

    Publishing their findings in JAMA Internal Medicine, researchers analyzed national databases to estimate the rates of infection deriving from HIV-positive Americans at each stage of the “treatment cascade” in 2009....Of the [approximately 45,000 new cases of HIV in 2009], an estimated 30.2 percent transmitted from people unaware of their infection, and an estimated 61.3 percent came from those diagnosed with the virus but not in medical care.
    February 23, 2015
    POZ

  • HIV prevention on the line

    HIV Prevention on the Line, looks at the current state of global targets for the AIDS response, looking beyond pithy slogans to explore what’s in place and what’s not in terms of targets, resources and action to begin to end the AIDS epidemic. We also provide concise updates and calls to action on key prevention interventions including AIDS vaccines, voluntary medical male circumcision, microbicides, PrEP, and hormonal contraception use and HIV risk.
     
    February 23, 2015
    POZ

  • Women and PrEP: The bridging role of local health departments

    On the day before the opening of CROI 2015, the US Women and PrEP Working Group gathered to reflect on two years of successes and challenges with respect to research, programs and policies that encourage or impair access to pre-exposure prophylaxis (PrEP) for transgender and non-transgender women.
    February 23, 2015
    PrEP
    The Body PRO

  • Gay men better at predicting when they won't have sex than when they will

    A study in which a group of HIV negative gay and bisexual men from New York City were asked to predict each day whether they would have sex the following day, and then compared their prediction with what actually happened, found that men generally overestimated the likelihood they would have sex. This study, published in the April 1 Journal of Acquired Immune Deficiency Syndromes, suggests possible pre-exposure prophylaxis (PrEP) dosing strategies.
    February 23, 2015
    PrEP
    HIV and Hepatitis

  • AIDS experts explain why we still don’t have an HIV vaccine

    In 1981, James Curran and his team of scientists from the Centers for Disease Control [sic] investigated a particular type of pneumonia which seemingly circulated among homosexual men in New York City and Los Angeles.....[He] recently visited Reddit’s /r/science to answer some of the most pressing questions about AIDS, and current progress of the research. He is joined by another AIDS expert, Dr. Carlos del Rio. Here are some of the most intriguing questions answered.
     
    February 22, 2015
    HIV Vaccine
    Inquisitr

  • Food aid shortage threatens HIV patients

    Thousands of people living with HIV/AIDS in Burkina Faso could soon face cuts in food assistance because of a funding shortage, the World Food Program has warned. The shortage threatens more than 12,000 patients and other people affected by HIV/AIDS, local WFP representative Jean-Charles Dei said this week....So far this year, the program has received only 27 percent of its funding needs....The projected cost of the program this year is $1.8 million.
    February 21, 2015
    Associated Press

  • Ebola on stage at Retrovirus Conference

    When virologists gather, can the subject of Ebola be far away? Certainly not at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI), starting here next week....The Ebola epidemic in West Africa has intrinsic interest to virologists, Conference chair Scott Hammer, MD, of Columbia University Medical Center in New York City....told MedPage Today, but it also has parallels to and impacts on CROI's main focus -- HIV.
    February 20, 2015
    MedPage Today

  • Fast-replicating HIV strains drive inflammation and disease progression

    The strain of HIV someone is first infected with, and its capacity to replicate in the body, can have lasting influence on how it disrupts the immune system, according to a study in the Proceedings of the National Academy of Sciences. "These results reinforce our previous findings suggesting that interventions that affect replicative capacity can not only impact disease progression, but also the efficiency of transmission to other people," says Eric Hunter, Emory University.
    February 18, 2015
    Science Daily

Published Research

  • Combination HIV prevention and the battle of the sexes

    We recommend that any cost-effectiveness analysis of the combination HIV prevention (CHP) approach should be extended to allow sex-equity and ethics, as well as other criteria, to be factored into the analysis; likewise, the effect of interventions on the reduction of mother-to-child transmission needs to be considered. To provide direct protection to men, but only indirect protection to women, would be unethical. Furthermore, to preferentially allocate treatment and its survival benefit to men would also be unethical.
    February 26, 2015
    Lancet

  • Prevalence of sexually transmitted infections including HIV in street-connected adolescents in western Kenya

    Street-connected adolescents ages 12-21 years [N=200] in Eldoret, Kenya are engaged in high-risk sexual behaviours and females in particular have a substantial burden of STIs and HIV. There is a need for STI interventions targeted to street-connected youth.
     
    February 26, 2015
    Sex Transm Infect

  • Knowledge, attitudes, and likelihood of pre-exposure prophylaxis (PrEP) use among US women at risk of acquiring HIV

    We conducted a qualitative focus group study with 144 at-risk women in six US cities in 2013. Women expressed anger at the fact that they had not heard of PrEP, but once informed most found it attractive as additional, not substitute, protection to condoms....Findings suggest that US women view PrEP as an important prevention option, assuming side effects and cost to consumer are minimal, efficacy is reasonable, and [it] is delivered by trusted providers in trusted venues.
    February 25, 2015
    PrEP
    AIDS Patient Care and STDs

  • ACTS 001 Phase III ttrial of pericoital tenofovir 1% gel for HIV prevention in women

    FACTS 001 is a phase III, double-blind, randomised, placebo-controlled trial undertaken in 9 sites in South Africa which evaluated the safety and effectiveness of pericoital tenofovir (TFV) 1% gel. 3844 participants were screened [and] 2059 enrolled. Overall 123 HIV infections occurred: 61 in the TFV arm and 62 in the placebo group. In this trial, pericoital vaginal TFV 1% gel was not effective in preventing HIV acquisition.
    February 25, 2015
    CROI

  • Models for predicting effective chemoprevention in women

    Model systems that rapidly identify tissue drug concentrations protective of HIV infection could streamline the development of chemoprevention strategies. Comparative effective concentration data were generated for tenofovir and maraviroc in 3 HIV chemoprophylaxis models. The results provide a framework for future early investigations of antiretroviral efficacy in HIV prevention to optimize dosing strategies in clinical investigations.
    February 25, 2015
    JAIDS

  • The impact of adherence to preexposure prophylaxis on the risk of HIV infection in the Bangkok tenofovir study, 2005-2012

    The Bangkok Tenofovir Study was a randomized, double-blind, placebo-controlled trial among people who inject drugs, 2005-2012. A total of 2413 people enrolled. The risk of HIV infection decreased as adherence improved, from 48.9% overall to 83.5% for those with at least 97.5% adherence. Men were less adherent than women and participants 20-29 years old and 30-39 years old were less adherent than older participants.
    February 25, 2015
    AIDS

  • Estimating the range of potential epidemiological impact of pre-exposure prophylaxis: run-away success or run-away failure?

    The cumulative impact of a PrEP intervention could be increased approximately two-fold if positive interactions (between coverage and cost, coverage and adherence, prioritization and time) are assumed, whereas negative interactions between these factors could almost entirely negate the preventive benefit of the PrEP intervention. Model forecasts should reflect that uncertainty and programmes should focus on these factors and measure them.
     
    February 25, 2015
    PrEP
    AIDS

  • Time for Option B+? Prevalence and characteristics of HIV infection among attendees of 2 antenatal clinics in Buea, Cameroon

    As countries consider a wider use of triple antiretroviral therapy (ART) in pregnancy, which in recent World Health Organization guidelines is called Option B+, this study sought to explore the potential implications of adopting Option B+ by characterizing HIV infection in pregnant women attending 2 semiurban antenatal clinics in Cameroon....Adopting Option B+ in this setting would result in a 5-fold increase in the number of HIV-infected pregnant women being placed on lifelong triple ART.
     
    February 25, 2015
    J Intl Assn Providers of AIDS Care

  • Human immunodeficiency virus transmission at each step of the care continuum in the United States

    Persons who are HIV infected but undiagnosed and persons HIV diagnosed but not retained in medical care were responsible for 91.5% of the estimated 45 000 HIV transmissions in 2009. Improvements in HIV diagnosis and retention in care, as well as reductions in sexual and drug use risk behavior, primarily for persons undiagnosed and not receiving antiretroviral therapy, would have a substantial effect on HIV transmission in the United States.
     
    February 25, 2015
    JAMA Intern Med.

  • Vaccine hesitancy: Journal collection investigates vaccination decision-making

    Researchers explore individuals' confidence or reluctance to vaccinate their families and the associated effects on global health, in a collection published on February 25, 2015 by the open-access journal, PLOS Currents: Outbreaks. The freely available collection is available at: http://currents.plos.org/outbreaks/perspectives-on-vaccine-hesitancy-and-vaccination-coverage/
    February 25, 2015
    Science Daily

  • Pragmatic open-label randomised trial of preexposure prophylaxis: the PROUD study

    In this high incidence cohort, daily TDF/FTC conferred impressive protection against HIV, and higher than the levels previously observed in the placebo-controlled trials. Concerns that effectiveness would be undermined in a real-world setting were unfounded. There was no evidence of an increase in STIs in this population, although they were frequently reported in the year before enrolment. This result strongly supports the use of PrEP among MSM who are at risk of HIV infection.
    February 24, 2015
    PrEP
    CROI Conference

  • PROMISE: Efficacy and safety of 2 strategies to prevent perinatal HIV transmission

    PROMISE is an ongoing, prospective, open-label randomized trial being conducted in 14 sites in Africa and India among HIV+ pregnant and postpartum women with high CD4 counts. On 11/4/14, the Data Safety Monitoring Board recommended release of interim antepartum data through 14 days post delivery....These results provide the first clinical trial evidence to support the current WHO PMTCT recommendations for use of triple ARVs during pregnancy. The safety findings require further study.
    February 24, 2015
    CROI Conference

  • Hormonal contraception does not increase women's HIV acquisition risk in Zambian discordant couples

    From 1994-2012, HIV discordant couples recruited from a couples' voluntary HIV counseling and testing center in Lusaka, Zambia were followed longitudinally. This analysis is restricted to couples in which the man was HIV-positive, the woman was HIV-negative at enrollment, and the man was not on antiretroviral treatment. Among 1393 couples, 252 incident infections occurred in women over 2842 couple-years.
    February 20, 2015
    Journal of Contraception

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