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MEDICALBRIEF Issue No 0160 – HIV News 22 June 2017

Failure to prevent new HIV infections threatens to reverse progress

South Africa can be proud of the progress it has made in treating HIV and reducing Aids-related deaths. But its continued failure to prevent new HIV infections among young people is threatening to reverse strides achieved in the past few years, warns a report by the Joint UN Programme on HIV and Aids.
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HIV drug resistance testing not a priority for low-income settings

Resistance testing is unlikely to improve the effectiveness of second-line HIV treatment in resource-limited settings and the introduction of routine HIV drug resistance testing is not a high priority, investigators in a large international study have concluded.
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Immediate point-of-care CD4 count doubles rate of linkage to HIV care

Carrying out a point-of-care CD4 count immediately after a person was diagnosed with HIV by home-based testing doubled the rate of linkage to HIV care in a resource-limited setting, a randomised study in Kenya has shown.
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Fear prompts women to drop out of HIV treatment programmes

A US study investigated why HIV-positive pregnant women in Malawi and Uganda might drop out of a treatment programme that would protect their infants and possibly save their lives. For many, the answer was fear.
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SA National AIDS Council LGBTI HIV plan hailed as world first

In what has been hailed as a world first, the South African National Aids Council (SANAC) launched a national lesbian, gay, bisexual, trans and/or intersex (LGBTI) HIV plan on the penultimate day of the 8th South African AIDS Conference, says an IoL report.
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58,000 HIV-positive teachers – Most in KZN, Mpumalanga, Eastern Cape

Fifty-eight thousand teachers across South Africa are living with HIV – and there are eight new infections a day – according to research released at the 8th South African AIDS Conference, reports the Daily News.
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“Missed opportunities” in the National Strategic Plan for HIV

There are many “missed opportunities” in the National Strategic Plan (NSP) for HIV and tuberculosis, said Fareed Abdullah, head of Aids and TB research at the Medical Research Council, at the closing of the South African Aids Conference, reports Groundup.
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MEDICALBRIEF Issue No 0159 – HIV News 15 June 2017

Chance of viral rebound low for those on ARV treatment

People who start antiretroviral (ARV) treatment for HIV and reach an undetectable viral load within nine months have a low chance of experiencing a viral load greater than 200, considered a viral rebound.
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Incidence of fractures rises earlier in HIV-positive men

The incidence of fractures begins to rise a full decade earlier in HIV-positive men compared to their HIV-negative peers.

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At least 30% of HIV + people delay starting ARVs – CDC study

A large study found that at least 30% of HIV positive individuals in nearly a dozen countries - including Nigeria, Namibia, Swaziland, Zimbabwe, Mozambique, Tanzania, Uganda and Zambia - delay starting life-saving drugs, mainly because they are unaware that quick action increases their chances of survival.
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MEDICALBRIEF Issue No 0158 – HIV News 08 June 2017

Tracking the ‘right’ patients raises numbers returning to ART

When community health workers went looking for patients who had started antiretroviral treatment but had stopped showing up for care at 14 clinics across Uganda, Kenya and Tanzania, 13% of those sought returned to treatment.
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Patients with previously treated HGAIN have a high risk of recurrence

A high proportion of HIV-positive men who have sex with men successfully treated for high-grade anal intraepithelial neoplasia (HGAIN) experience a recurrence of disease within 18 months, a Spanish study found.
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New integrase inhibitor, bictegravir is as effective as dolutegravir

Gilead Sciences and GlaxoSmithKline will go head-to-head with rival versions of their integrase inhibitors, after clinical studies showed that Gilead's new drug bictegravir was as effective as GSK's dolutegravir, reports Reuters Health.
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SA to host another HIV vaccine trial

South Africa has been selected to host another HIV vaccine trial, which will target various strains of the HI virus, City Press reports.
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MEDICALBRIEF Issue No 0156 - HIV News 25 May 2017

Low rates of infection for workers exposed to HCV and HIV

Occupational exposure to hepatitis C virus (HCV) and HIV on the part of health care workers rarely leads to infection.
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Tenofovir reduces mother-to-child transmission of HBV

Administering tenofovir to pregnant women with a hepatitis B virus (HBV) high viral load during the 2nd or 3rd trimester reduced rates of mother-to-child transmission.
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Routine male pot smokers with HIV have higher CVD risk

Middle-aged men living with HIV who smoke pot routinely have an increased risk of cardiovascular disease compared with their peers.
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Positive outcomes from drug addiction Tx and perinatal HIV prevention

A Kenyan programme offering medication-assisted drug addiction treatment and services aimed at preventing mother-to-child HIV transmission led to improved outcomes for opioid-dependent HIV-positive mothers and their babies.
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MEDICALBRIEF Issue No 0155 - HIV News 18 May 2017

Life expectancy normalises within a year

A large study of people with HIV on antiretroviral therapy found substantial improvements in life expectancy in people with HIV who started ART after 2008, even in their first year of therapy, reports AIDSMAP.
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HIV+ mothers with high CD4+ counts may benefit from ART postpartum

Mothers in the early phases of HIV infection who continued ART postpartum experienced a significantly slower rate of disease progression than those who stopped ART after delivery.
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Protease inhibitor drug suppression of HIV in semen

Protease inhibitors may not be the best class of drug for people newly diagnosed with HIV to start treatment with, if they wish to quickly reduce their risk of passing HIV on to others, a Spanish study found.
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More HIV-positive with traditional circumcision in Lesotho

Traditionally circumcised men are more likely to be HIV positive compared to men who underwent voluntary medical male circumcision, found a Duke study conducted in Lesotho.
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MEDICALBRIEF Issue No 0154 - HIV News 11 May 2017

Gene-editing to eliminate HIV DNA a significant step towards human clinical trials

For the first time, researchers have used gene-editing to eliminate HIV DNA from the genomes of three different animal models to ensure that replication of the virus was completely shut down.
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False positive results a concern in rapid HIV diagnostic tests

An evaluation of eight rapid diagnostic tests widely used in a variety of African countries by Médecins Sans Frontières shows that the tests vary in their performance, with false positive results being a concern.
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Researchers report on 1-year findings of PopART study

The London School of Hygiene &Tropical Medicine reports early findings from PopART – a clinical trial evaluating an intervention to achieve universal HIV testing and treatment – in Zambia.
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Gilead’s Genvoya gives significantly higher rate virologic suppression

Patients with HIV experienced a significantly higher rate of virologic suppression after taking Gilead’s Genvoya (elivitegravir-cobicistat-emtricitabine-tenofovir alafenamide) than the company’s Stribild (elvitegravir-cobicistat-emtricitabine-tenofovir disoproxil fumarate).
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MEDICALBRIEF Issue No 0153 – HIV News 04 May 2017

Early ART acceptable to a majority of young women in SA

Early antiretroviral therapy (ART) is highly acceptable to the majority of young women with HIV in SA.
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Pitavastatin better lowers LDL cholesterol in HIV patients with dyslipidemia

Pitavastatin had greater low-density lipoprotein (LDL)-lowering effects than pravastatin without unfavourable effects on glucose metabolism or rates of virological failure in patients with HIV and dyslipidemia.
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Vending machines to sell HIV testing kits on campus

China is piloting the use of vending machines that sell HIV testing kits on university campuses.

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MEDICALBRIEF Issue No 0149 - HIV News 6 April 2017

New WHO-UNAIDS HIV strategy not feasible for Sub-Saharan Africa?

The World Health Organisation and UNAIDS have proposed using 'treatment as prevention' to eliminate HIV in Sub-Saharan Africa. But a University of California – Los Angeles study has concluded that the strategy might not be feasible.
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Positive results from nurse-led ART adherence support programme

A randomised controlled trial conducted in the Netherlands showed that a nurse-led antiretroviral therapy adherence support programme had a significant effect on viral load and was cost-effective.
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HIV prevention pill available in Tshwane for men who have sex with men

Men who have sex with men will soon be able to get the HIV prevention pill in Tshwane, says a Bhekisisa report.
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MEDICALBRIEF Issue No 0146 – HIV News 16 March 2017

Dolutegravir + single other drug can work as maintenance therapy

Dolutegravir used alone without other antiretrovirals was unable to keep viral load suppressed in some people who switched from a standard three-drug combination regimen.
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MRI to identify HIV persistence in brain despite effective drug Tx

University College London scientists have developed a way to use MRI scans to help identify when HIV persists in the brain despite effective drug treatment.
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‘Test and treat’ strategy successfully getting more people onto ARVs

After a second wave of intensive household testing, a large study of the 'test and treat' strategy in Zambia is diagnosing more people with HIV, getting more people onto treatment and reducing the time between diagnosis and starting treatment.
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Study looks at hypertension in sub-Saharan patients with HIV

Traditional cardiovascular risk factors predicted incident hypertension in a sub-Saharan Africa study, but no association was observed with immunological or antiretroviral treatment status.
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MEDICALBRIEF Issue No 0145 - HIV News 9 March 2017

New WHO guidance on hormonal contraception for women at high HIV risk

WHO states “there continues to be evidence of a possible increased risk of HIV among progestogen-only injectable users.” Based on this possibility and women’s right to informed choice, the WHO has changed the grade from “use without restriction” to “benefits outweigh theoretical or proven risks”.
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Dutch adherence programme boosts HIV Tx success

Dutch researchers have developed an HIV medication adherence programme that has been successful in increasing treatment success rates by almost 18%, claiming it as the first adherence intervention in HIV care that demonstrates clinical and cost effectiveness.
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HIV integrase inhibitors may increase risk of IRIS

HIV integrase inhibitors such as dolutegravir and raltegravir may increase the risk of immune reconstitution inflammatory syndrome (IRIS), studies from the Netherlands and France found.
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Transmitted drug resistance mutations increase in HIV

Transmitted drug-resistance mutations in HIV increased among ART – naive patients from 2000 to 2013, according to Gilead Sciences study findings.
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Robust pipeline of ART drugs in development

The Conference on Retroviruses and Opportunistic Infections (CROI 2017) included presentations on several new investigational antiretroviral drugs in development, reflecting a more robust pipeline
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Implications stemming from evolving definitions of ‘safe sex’

Evolving definitions of what is ‘safe s ex’ has implications for treatment as prevention and pre-exposure prophylaxis (PrEP), says Martin Holt of the University of New South Wales in a public lecture, reports Aidsmap.
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MEDICALBRIEF Issue No 0144 – HIV News 02 March 2017

Better mental health management improves Tx outcomes

Improved management of depression and other mental health disorders has the potential to improve the outcomes of HIV treatment programmes.
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Cautious use of TDF among those at fracture risk recommended

Viread, in contrast with other antiretroviral medications, was associated with an increased risk for bone fractures in people with HIV in a recent study.
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WHO guidelines on a woman-centred approach to healthcare

World Health Organisation has launched the Consolidated guideline on sexual and reproductive health and rights of women living with HIV.
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Advances in Tx of HIV/TB patients discussed at CROI 2017

The diagnostic Xpert Ultra test, set to be launched at the same price as the original Xpert, offers greater sensitivity, but comes at a price.
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MEDICALBRIEF Issue No 0143 - HIV News 23 February 2017

Isoniazid preventive treatment reduces the risk of death

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 from INSERM, Bordeaux, France, reported at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.
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One in five ‘heterosexual’ men in the UK got HIV from another man

A genetic analysis of a large database of UK people with HIV in care shows that 18% of men with HIV who claim to be exclusively heterosexual in fact belong to clusters of linked infections that consist only of men.
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Three-drug regimen beats XDR-TB in first trial

A regimen of three oral drugs given for six months was enough to clear extensively drug-resistant tuberculosis (XDR-TB) in 29 of the first 31 people to have completed the treatment course, Dr Francesca Conradie of Sizwe Tropical Disease Hospital, Johannesburg, told the 2017 Conference on Retroviruses and Opportunistic Infections.
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Hep C infections drop by half after direct-acting antiviral roll-out

A little more than a year after the Netherlands instituted a policy allowing unrestricted access to direct-acting antivirals (DAAs) for the treatment of hepatitis C, researchers have already seen a dramatic decline in acute hepatitis C virus (HCV) infections among one at-risk population, HIV-positive men who have sex with men.
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Tenofovir/emtricitabine/efavirenz less likely to cause adverse birth outcomes

Infants exposed to an antiretroviral regimen of tenofovir, emtricitabine and efavirenz (Atripla) from conception experienced fewer adverse birth outcomes compared to other three-drug regimens, according to a study of births in Botswana between 2014 and 2016.
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Treatment or watchful waiting for cervical abnormalities in HIV women?

Close monitoring of earlier-stage cervical abnormalities (CIN-2) may be preferable to treatment for many women with HIV, a US study suggests.
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Prednisone reduces TB-IRIS risk in HIV patients

Patients with HIV had significantly less risk for clinical deterioration due to tuberculosis–related inflammation when given prednisone early in their treatment regimen.
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Improving HIV service linkage and retention in Mozambique and South Africa

Linkage to care was improved by a combination intervention strategy including: (1) point-of-care CD4+ counts at HIV testing sites; (2) accelerated ART initiation for eligible patients; and (3) SMS appointment reminders.
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Significant role of sexual violence in HIV infection and depression

Sexual violence plays a significant role in HIV infection and depression, according to ground-breaking research with women living in Rustenburg. Conducted by Médecins Sans Frontières, the study involved a sample of 800 women, of which one in four had been raped, as had been a third of the women seeking abortions.
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MEDICALBRIEF Issue No 0142 - HIV News 16 Feb 2017

Trial identifies substantial primary drug resistance but with no impact on treatment outcomes

A study of the prevalence of transmitted drug resistance in participants in the ANRS 12249 trial of treatment as prevention has found that 8.4% of participants in the trial had HIV with primary resistance mutations against the virus. There was, surprisingly, no association between having drug resistance mutations and virologic failure.
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New integrase inhibitor bictegravir matches dolutegravir for first-line treatment

Bictegravir, an investigational integrase inhibitor from Gilead Sciences, was highly potent, well tolerated and worked as well as dolutegravir in a phase 2 clinical trial, according to study results presented at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.
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Dual antiretroviral regimen maintains durable HIV suppression after switch

People who switched from standard antiretroviral therapy to a two-drug regimen of dolutegravir plus rilpivirine were able to maintain an undetectable viral load for 48 weeks in a pair of late-stage clinical trials.
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Living longer with HIV associated with depression

Longer time living with diagnosed HIV infection is strongly associated with depression, anxiety and poor quality of life, according to UK research.
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Linkage to care following HIV diagnosis the biggest weakness

A study carried out through the Africa Health Research Institute in KwaZulu-Natal, found that less than half of the population with HIV in the district had linked to care within eight years, despite the fact that 82% were aware of their HIV infection.
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MEDICALBRIEF Issue No 0141 - HIV News 9 February 2017

Legalisation of sex work helps reduce HIV incidence

Countries that have legalised some aspects of sex work have fewer sex workers with HIV than countries that criminalise all aspects of sex work, according to an analysis of 27 European nations.
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SA’s radical plan to tackle HIV in sex workers

A three-year SA initiative promises to reach 70,000 sex workers through 1,000 peer educators, reports Al Jazeera.
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HIV risk-taking behaviour by older adults in SA

Older adults are sexually active and report risk behaviour consistent with HIV transmission, found a Mpumalanga, South Africa, study.
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SA students prefer to self-test for HIV

SA students would rather self-test at home for HIV than go to a health facility, reports The Times.
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Need for more pragmatism over drug use – SA expert

There is a strong need for greater awareness of pragmatic, inclusive approaches to drug use, says Shaun Shelly, People Who Use Drugs advocacy manager for the TB HIV Care Association.

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MEDICALBRIEF Issue No 0140 - HIV News 02 February 2017

Food support associated with improved HIV and diabetes health

HIV-positive people who received healthy food and snacks for six months were more likely to adhere to their medication regimens, and they, as well as people with type 2 diabetes, were less depressed and less likely to make trade-offs between food and healthcare.
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HIV co-infection increases mortality risk in younger children with TB

Without adequate treatment, children with tuberculosis, especially those younger than five years, are at high risk of death, while children with HIV have an increased mortality risk, even when receiving TB treatment.
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Starting ART immediately after diagnosis not harmful for adolescents

A lack of lengthy preparation before starting HIV treatment does not result in an increased risk of death or loss to follow-up in adolescents, a Zimbabwe study shows.
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MEDICALBRIEF Issue No 0139 – HIV News 26 January 2017

Drug-resistant TB mostly being spread person-to-person in SA

Researchers in South Africa tracked TB that is resistant to at least four key drugs and found that 69 percent of the patients had never received treatment.
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Regular economic incentives improve ART adherence

The provision of regular low-value economic incentives can improve adherence to ART, according to a Uganda study.
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Male hypogonadism frequent in young/middle-aged men on ART

Around one in six young and middle-aged HIV-positive men doing well on ART had low testosterone levels, French researchers found.
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Initiating ART reduces risk of bacterial infection in HIV+ patients with high CD4 counts

Newly published findings from the START trial show that ART has a protective effect in reducing the risk of severe bacterial infections, including infections that are not Aids-defining, and even in people with high CD4 cell counts.
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Intervention to help tell children that they have HIV

An intervention to help parents and caregivers to find developmentally appropriate ways to tell a child that it has HIV, has been developed in Uganda.
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Cognitive impairment risk very high for patients with HIV

More than half of patients with HIV who participated in a cross-sectional study screened positive for cognitive impairment, researchers in Ireland reported.
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MEDICALBRIEF Issue No 0138 - HIV News 19 January 2017

HIV testing kit now available in SA pharmacies

For R59.95 South Africans can now for the first time purchase an HIV testing kit from a local pharmacy and screen themselves for infection in the privacy of their home.
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Certain genital bacterial communities increase HIV infection risk fourfold

The most common bacterial community in the genital tract of healthy South African women is associated with a more than four-fold increase in the risk of acquiring HIV, found researchers.
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Modification of US health guidelines on PrEP recommended

US federal health guidelines on pre-exposure prophylaxis (PrEP) to prevent HIV transmission should be modified because current standards could miss some who should be on it, suggests a study.
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Miscarriage and stillbirth risk increases in smokers with HIV

Smoking 'dramatically' increases the risk of pregnancy loss in HIV-positive women, US investigators report.
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MEDICALBRIEF Issue No 0137 - HIV News 12 January 2017

High rate of viral load rebound in women who start Tx during pregnancy or postpartum

Approximately one-third of HIV-positive women who attain viral suppression after starting ART during pregnancy experience a significant rebound in viral load in the year after giving birth, according to results of a South African study.
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PrEP dramatically reducing new HIV infections, says London clinic

Increasing access to Truvada as pre-exposure prophylaxis (PrEP) through online marketplaces appears to have at least partly contributed to a dramatic recent drop in HIV diagnoses at London’s largest sexual health clinic.
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Viral suppression maintained after switch to dual therapy

Switching to a 2-drug regimen of dolutegravir plus rilpivirine maintained viral suppression among people on successful 3- or 4-drug ART in a pair of Phase 3 clinical trials.
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MEDICALBRIEF Issue No 0136 – HIV News 08 December 2016

Real time electronic monitoring improves ART adherence

Electronic monitoring of antiretroviral adherence in 'real time' significantly increases the proportion of treatment doses taken on time and reduces the frequency of treatment interruptions, according to Harvard University research.
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Africa trials dolutegravir for use against vertical transmission

A trial, conducted in Uganda and South Africa, will test new drug Tivicay (dolutegravir), which has been shown to work faster than currently recommended treatment for women with HIV who become pregnant.
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Sub-Saharan Africa’s ‘exceptional’ progress against HIV – surveys

National surveys in Zimbabwe, Malawi, and Zambia reveal exceptional progress against HIV, with decreasing rates of new infection, stable numbers of people living with HIV, and more than half of all those living with HIV showing viral suppression through use of antiretroviral medication.
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MEDICALBRIEF Issue No 0135 - HIV News 1 December 2016

Hyaluronic acid filler improves facial volume in facial lipoatrophy

Patients with HIV-associated facial lipoatrophy who received treatment with hyaluronic acid filler achieved significant improvement in facial volume up to 1 year, with no permanent adverse events.
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HIV-associated cancers less frequent in patients on ART

Kaposi sarcoma and non-Hodgkin lymphoma – two HIV-associated cancers – are less frequent, but still occur in patients undergoing antiretroviral therapy, according to a Northwestern University study
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Little emphasis on retention in care in HIV sphere

Surprisingly little emphasis is placed on retention in care compared to other issues in the HIV sphere, argue experts on the Science Speaks blog.
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MEDICALBRIEF Issue No 0134 – HIV News 24 November 2016

HIV patients with optimal care living as long as non-HIV peers

Patients with HIV who receive optimal care are now expected to live as long as their peers without HIV, according to a Danish study.
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Data system set to accelerate HIV/AIDS elimination in SA

A new web-based system has been introduced that makes pertinent data accessible to healthcare practitioners involved in managing SA's HIV epidemic in near-real time.
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Limited health literacy link to poor health outcomes

Limited health literacy has been linked to poor health and poor outcomes among patients with HIV, according to research presented at IDWeek 2016.
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MEDICALBRIEF Issue No 0133 - HIV News 17 November 2016

Giving women HIV self-tests promotes male partner testing

Providing pregnant and postpartum women in sub-Saharan Africa with HIV self-tests substantially increases the likelihood of their male partners testing for HIV.
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Non-Hodgkin’s lymphoma risk higher for Hep B & C co-infected patients

Patients with HIV who receive antiretroviral therapy have higher risk for non-Hodgkin's lymphoma if they are co-infected with hepatitis B and C viruses.
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Efficacy of school-based interventions in HIV, STDs and pregnancy

Whether school-based interventions prevent HIV, sexually transmitted diseases and pregnancy was the focus of researchers from the University of York, the SA Medical Research Council and Stellenbosch University in a Cochrane Review.
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MEDICALBRIEF Issue No 0132 - 10 November 2016

Smoking may shorten life of HIV+ more than the disease itself

Cigarette smoking substantially reduces the lifespan of people living with HIV in the US, potentially even more than HIV itself.
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Toxoplasma gondii infection link with neuro-cognitive impairment

Toxoplasma gondii infection was associated with neuro-cognitive impairment among patients with HIV, according to a University of California study.
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Undetectable viral loads maintained with experimental therapy

An experimental four days on, three days off antiretroviral regimen kept viral load fully suppressed in 96% of people for 48 weeks in French study.
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MEDICALBRIEF Issue No 0131 - HIV News 3 November 2016

SA’s ‘phenomenal breakthrough’ in treatment of XDR TB

A three-drug regimen trialled on South African tuberculosis patients, half of whom were also HIV positive, has delivered results described as as a 'phenomenal breakthrough’ in treating extensively drug-resistant tuberculosis (XDR-TB).
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Humanised monoclonal antibody therapy effective in highly treatment experienced HIV patients

TaiMed Biologics’ investigational monoclonal antibody ibalizumab led to significant reductions in viral load in patients with multidrug-resistant HIV.
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Better treatment outcomes for HIV patients with lipodystrophy

Over a 20-year period, people who suffered fat redistribution and especially fat loss when they started antiretroviral therapy (ART) actually had better health outcomes than people who did not suffer from it.
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Dual ART regimen highly effective when switching

Simplification of an ART to a boosted protease inhibitor and the nucleoside analogue lamivudine (a dual regimen) is highly effective in people switching from a stable three-drug regimen, an Italian study found.
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MEDICALBRIEF Issue No 0130 - HIV News 27 October 2016

Model paints ‘remarkable’ picture of SA’s HIV/AIDS history

The recently published outputs of the Thembisa mathematical model of HIV in SA paint a remarkable picture of the history of HIV in this country, writes Marcus Louw in Spotlight.
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Large increases in HIV suppression needed to reduce new infections

Achieving a moderate reduction of new HIV infections among men who have sex with men (MSM) will depend on significantly increasing the percentage of HIV-infected MSM whose viral load is suppressed to undetectable levels, according to a new mathematical model.
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Medicalbrief Issue No 0129 - HIV News 20 October 2016

Crohn’s disease drug produces long lasting viral suppression in primate study

In a promising experiment in rhesus macaque monkeys, scientists have used a monkey-adapted version of vedolizumab (Entyvio), a drug used to treat gut inflammation, to produce persistent viral load control and T-cell restoration in monkeys taken off ART.
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Less educated have poorer outcomes after starting ART

People with HIV who have lower educational attainment have poorer outcomes after starting combination antiretroviral therapy (cART), according to data from a large European cohort collaboration.
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MEDICALBRIEF Issue No 0127 - 6 October 2016

Risk of cervical cancer death higher for those with HIV

Women with HIV infection have a higher risk of developing cervical cancer, but the presence of HIV also significantly increases the risk of dying of the cancer, according to findings from a study of African patients.
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ARV access helps reduce TB in Zimbabwe

As the numbers of people accessing HIV treatment in Zimbabwe went up, the numbers of reported tuberculosis cases were cut nearly in half, found a Zimbabwe Ministry of Health analysis.
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One in 10 children appear to have a ‘primate like’ defence against AIDS

A study has revealed for the first time that a small group of HIV-infected South African children have evolved a unique, 'primate like' immune system that protects them from developing Aids, says a Science Alert report.
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ART effective in treating HIV-related motor neuron disease

Antiretroviral therapy is effective for treatment of HIV-related motor neuron disease (MND), according to a small US study.
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Factors responsible for formation of neutralising HIV antibodies

Researchers from the University of Zurich and University Hospital Zurich have established which factors are responsible for the human body forming broadly neutralising HIV antibodies, thereby opening new avenues for the development of an HIV vaccine.
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MEDICALBRIEF Issue No 0126 - 29 September 2016

Meta-analysis: Dolutegravir and raltegravir produce better viral suppression

The integrase inhibitor, dolutegravir or low-dose efavirenz, were associated with higher rates of long-term viral suppression than standard-dose efavirenz in patients with HIV, a meta-analysis indicated.
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Study reiterates the cost-effectiveness of PrEP

The anti-HIV drug Truvada has been shown to be very effective at preventing new infections when taken by people at high risk who strictly adhere to the drug therapy regime.
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Early HIV diagnosis in infants will save lives

Early infant HIV diagnosis in SA will save lives, extend life expectancy and be cost-effective, according to a modelling study.

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Lessons from scaling-up HIV treatment in Mozambique

A study examining the first decade of HIV antiretroviral therapy (ART) scale-up in Mozambique revealed fewer people are dying from HIV in recent years, likely due to more patients starting treatment at earlier disease stages.
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MEDICALBRIEF Issue No 0125 - HIV News 22 September 2016

Immediate ART combo to reduce infection-related cancer risk

Immediate initiation of combination ART can reduce the risk of infection-related cancers in newly diagnosed HIV patients,s a University of Copenhagen analysis indicated.

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More international support for statement on HIV transmission risks

Leading international researchers and organisations have endorsed a consensus statement that people living with HIV who have been on ART for at least six months with an undetectable viral load have a negligible risk of sexual transmission of HIV.

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MEDICALBRIEF Issue No 0124 - 15 September 2016

Significant regional disparities in cART life expectancy

There are significant disparities in the life expectancy of HIV-positive people starting combination antiretroviral therapy (cART) between world regions, according to a meta-analysis.
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Time lag in adopting new WHO guidelines must be shortened

There is an urgent need to shorten the time lag in adopting and implementing the new WHO guidelines recommending ‘treatment for all’ to achieve the 90-90-90 targets.
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HIV-positive gay and bisexual men more likely to be admitted with AMDs

HIV-positive gay and bisexual men are almost 10 times more likely to be hospitalised because of anxiety and mood disorders (AMD) than men in the general population, according to Australian research.
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Medicalbrief Issue No 0123 - HIV News 8 September 2016

PrEP chosen during pre-conception, pregnancy and breastfeeding

Women in two US cities frequently chose to use Truvada for pre-exposure prophylaxis (PrEP) when it was offered as an additional tool for preventing HIV infection during the pre-conception period, pregnancy and breastfeeding.
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New WHO guidelines for treatment of three STIs

New guidelines for the treatment of three common STIs have been issued by the World Health Organisation in response to the growing threat of antibiotic resistance.

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MEDICALBRIEF Issue No 0122 - HIV News 01 Sep 2016

Modelling SA’s HIV/AIDS epidemic

Projections for overall declines in HIV epidemics might have been optimistic, while future treatment and HIV prevention needs might be greater than previously forecasted, found a comparison of mathematical models used to analyse the SA HIV epidemic.
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Low transmission if couples both receiving ART and PrEP

Providing HIV medication to both members of a couple may substantially reduce the risk of transmission within that couple, according to a University of Washington study.
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Risk factors for cognitive decline in HIV patients

Elevated cholesterol and a gene associated with Alzheimer’s risk in the general population are both risk factors for cognitive decline in middle-aged HIV-positive patients with a suppressed viral load.
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GSK focuses on two-drug HIV treatment

GlaxoSmithKline is pinning the future of its HIV business on an audacious bet: that their latest HIV pill is powerful enough to suppress the virus with the help of just one other drug, reports The Wall Street Journal.
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MedicalBrief Issue No 0121 - HIV News 25 Aug 2016

Evidence continues to suggest Depo-Provera is associated with increased HIV risk

Birth control pills and some types of injectable and implanted contraceptives were not associated with an increased risk of HIV acquisition found a German meta-analysis. However, evidence continues to suggest that Depo-Provera raises the likelihood of HIV infection.
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Diagnostic algorithm to reduce TB deaths in HIV patients

The World Health Organisation released a new diagnostic algorithm to reduce the likelihood of ‘seriously ill’ people with HIV dying of undiagnosed and untreated tuberculosis.
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Lack of research of HIV-positive pregnant women must be addressed

The lack of research of HIV-positive pregnant women and pregnant women who are at risk of contracting HIV has 'led to a dearth of evidence to guide safe and effective treatment and prevention'.
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HIV pandemic not driving transmission of MDR-TB

Although the HIV pandemic fuels tuberculosis (TB) outbreaks, it does not drive the development and transmission of multidrug resistance in TB patients as previously suspected, found a large international collaboration
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MEDICALBRIEF Issue No 0118 - HIV News 4 August 2016

Interventions successful in supporting Tx adherence

Interventions which reduce the need for people to attend clinics are proving highly successful in retaining people in care and supporting adherence to HIV medication in southern Africa.
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Some have greater risk reduction than others – study

Starting antiretroviral therapy soon after HIV diagnosis led to greatest risk reductions for patients over age 50, those with a lower CD4:CD8 ratio and higher viral loads, and those with cardiovascular risk factors.
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Suppression of HIV prevents transmission

Complete suppression of HIV replication appears 100% effective in preventing transmission of the virus, concludes a landmark trial on serodiscordant heterosexual couples, reports The New England Journal of Medicine.
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MEDICALBRIEF Issue No 0117 - 28 July 2016

‘Test and treat’ strategy fails to reduce new infections

The first major research study of ‘test and treat’ as a public health intervention to report its final results has found that the strategy failed to reduce new HIV infections in the SA communities where it was provided.
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Two-drug regimen successful as initial ART

In a small pilot study, dual therapy with dolutegravir plus lamivudine induced rapid virologic suppression with a favourable safety/tolerability profile in HIV-1 infected, treatment-naive individuals.
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Social activism: Lighting a fire without sparking a conflagration

The past week’s AIDS 2016 was the second conference of the International Aids Society to be held in Durban. The first took place in 2000, writes MedicalBrief's William Saunderson-Meyer. The first was a grim affair, overshadowed by denialism. This one was a triumph.
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MEDICALBRIEF Issue No 0116 - HIV News 21 July 2016

Durban 2016: Oh, how things have changed!

The contrast could not be more stark, writes Nicola Jenvey for MedicalBrief, who in 2000 covered the 13th International Aids Conference in Durban. The failure then of former President Thabo Mbeki to abandon his government's Aids denialism cast a grim shadow over the entire proceedings. In contrast, Aids 2016 at the same venue has been a week of hope...
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ATM-type machines to dispense ARVs

A SA-developed hole-in-the-wall machine that dispenses antiretroviral drugs was unveiled ahead of a pilot scheme that will see units installed in rural areas.
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Africa’s homophobia hinders access to prevention and Tx

Africa was a place of phobia for men who have s ex with men thanks to the homophobia imported from the Commonwealth, said Constitutional Court Judge Edwin Cameron.
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CAPRISA explains high HIV infection rates in young women

Work from the Centre for the AIDS Programme of Research in SA consortium of researchers shed new light on why young women in have high rates of HIV infection.
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Rare success story in treating rural XDR TB

Over the past decade, drug-resistant TB has been brought under control in Tugela Ferry, SA - not through any magic bullet, a combination of interventions implemented by motivated health workers and scientists, reports Groundup.
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Prisoners key to controlling HIV and TB epidemics

The worldwide mass incarceration of drug users, and failure to provide harm reduction and treatment strategies has led to high levels of HIV, TB, and hepatitis B and C infection among prisoners.
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Decline in new infections among adults stalled – UNAIDS

A UNAIDS report reveals concerning trends, with the decline in new HIV infections among adults stalled.
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New infections threaten 2030 goals – GBD study

While HIV-related deaths are falling in most countries, the rate of new infections has increased in several others over the past decade, effectively threatening to undermine the efforts to end the pandemic by 2030, reports MedicalBrief.
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MEDICALBRIEF Issue No 0114 - HIV News 7 July 2016

Prenatal testing and the risk of vertical transmission

For pregnant women with HIV infection, invasive prenatal testing does not increase the risk of vertical transmission, found an Italian study.
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Blood tests to predict neuro-cognitive decline in HIV patients

A combination of simple, routine blood tests may be able to predict which people living with HIV are especially vulnerable to neuro-cognitive decline, according to US research.
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MEDICALBRIEF Issue No 0113 - HIV News 30 June 2016

New global models on HIV drug recommendations outperform genotyping and African models

New global computer models published this week predict how patients whose HIV therapy is failing will respond to any new combination of drugs, with the highest accuracy to date.
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ART averts 161,000 opportunistic infections a year among children

Antiretroviral therapy is averting more than 161,000 opportunistic infections a year among HIV-positive children in low- and middle-income countries and is saving $17 million annually, a meta-analysis shows, reports aidsmap.
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FDA updates for Darunavir in pregnant HIV-positive women

The US Food and Drug Administration recently updated its testing and dosage recommendations for Prezista in pregnant women with HIV, reports Healio.
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MEDICALBRIEF Issue No 0112 - HIV News 22 June 2016

Humanised monoclonal antibody as standalone treatment

Findings from a phase 2b trial of PRO 140, a humanised monoclonal antibody, suggest the treatment could be used as a standalone therapy in place of ART for some patients.

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WHO releases second edition of consolidated ARV guidelines

The 2016 edition updates the 2013 consolidated guidelines on the use of antiretroviral drugs following an extensive review of evidence and consultations.
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Injectable ARVs to combat adherence problems

Both injectable regimens of cabotegravir and rilpivirine appear to be effective and safe for maintenance therapy as compared with the oral regimen of cabotegravir and abacavir/lamivudine, found a recent study.
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New integrase inhibitor well tolerated and effective

A new integrase inhibitor known as bictegravir was found to be well tolerated and effective as HIV treatment in a 10-day monotherapy study.
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Quarter of people with HIV in KZN are unaware of their status

A quarter of people living with HIV in KwaZulu-Natal are unaware of their infection status, according to Médecins sans Frontières research.
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MEDICALBRIEF Issue No 0111 - 16 June 2016

UNAIDS 90-90-90 would prevent deaths in South Africa

Achieving the UNAIDS 90-90-90 targets for getting more people with HIV tested and on effective treatment in SA would cost nearly $16bn over 10 years, but could avert more than 2m new HIV infections and prevent 2.5m
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HIV patients with aggressive lymphoma ARE candidates for Tx

People with HIV-associated lymphoma who receive autologous stem cell transplant have similar survival rates and are no more at risk of serious complications compared to those without HIV receiving this therapy.
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Neurologic issues pervasive in newly infected patients with HIV

Researchers found that half of people newly infected with HIV experience neurologic issues.
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FDA approves supplemental application for dolutegravir in children

The US Food and Drug Administration has approved a supplemental new drug application for dolutegravir oral tablets.
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MEDICALBRIEF Issue No 0110 - HIV News 9 June 2016

Depression risk and HIV – A major problem largely ignored

Depression is a major issue in South Africa among people living with HIV, but has received little attention. New studies have highlighted strong links between HIV-AIDS and mental illness including depression, heightened risks of violence faced by children affected by the virus, and suggest some ways to tackle the problem, writes Karen MacGregor for MedicalBrief.
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Significant attrition at each stage of HIV care

There is significant attrition at each stage of the HIV care continuum in SA, according to research conducted in North West Province.
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Botswana rolls out Dolutegravir as first-line drug for all HIV patients

An HIV drug first approved less than three years ago is being rolled out in Botswana as a core medicine to be administered to everyone diagnosed with HIV, whereas previously antiretroviral treatment was reserved for sicker patients.
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HIV once weekly injectable ART study meets primary objective

Frontier Biotechnologies has reported that a phase-3 clinical trial of its lead product albuvirtide meets primary objective based on an interim analysis.
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Collaborative approach HIV and mental illness comorbidity

Evidence suggests that a collaborative approach to the care of HIV patients with serious mental illness may be a viable, effective strategy for managing this comorbidity.
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MEDICALBRIEF Issue No 0109 - HIV News 2 June 2016

Efavirenz associated with liver injury risk

Treatment with efavirenz has been associated with rare but severe liver complications among patients receiving antiretroviral (ART) therapy in SA.
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The real-world impact of ARV treatment

ART initiation linked to a very large reduction in HIV acquisition in serodiscordant couples in rural KwaZulu-Natal, but real-life effectiveness was substantially lower than in the trial.
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Metabolic syndrome link with highly active ART

Among people with HIV, metabolic syndrome is more prevalent among those exposed to highly active ART.
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Higher risk of AIDS patients dying of cancer

People diagnosed with AIDS have a high risk of dying of a non-AIDS-defining cancer, Italian investigators report.
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HIV organisations slate NHS

In a rare move, the entire HIV sector in the UK has called on the National Health Service to provide the drug Truvada as part of a pre-exposure prophylaxis (PrEP) treatment programme.
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MEDICALBRIEF Issue No 0108 - HIV News 26 May 2016

Barriers to retention in Option B+ programmes

A Malawi study on women who chose not to take HIV treatment, or who interrupted treatment, identified a range of reasons for their actions.
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Early findings set stage for large HIV vaccine trial

An early-stage HIV vaccine clinical trial in SA has determined that an investigational vaccine regimen is safe and generates comparable immune responses to those reported in a landmark 2009 study.
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Acute HIV infection contribution to HIV transmission

Acute HIV infection (AHI) contributes significantly to HIV transmission and may be important for intervention strategies seeking to reduce incidence and achieve a functional cure, found a study by the US Military HIV Research Programme.
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ART with tenofovir reduces mortality in Hep B co-infected patients

The use of antiretroviral (ART) regimens containing tenofovir significantly reduced mortality in HIV-positive people with hepatitis B virus co-infection.
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Accuracy of TB diagnostic urine test in HIV patients reviewed

An international review team has prepared a Cochrane Library systematic review to assess the accuracy of a point-of-care urine test for diagnosing and screening tuberculosis (TB) in people living with HIV.
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MEDICALBRIEF Issue No 0107 - HIV News 19 May 2016

Same day ART initiation improves health outcomes

A clinical trial of same-day initiation of antiretroviral therapy (ART) for HIV patients in SA led to a higher proportion of people starting treatment and to better health outcomes.
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Neonates of HIV-infected mothers have reduced sepsis risk

A study at the University Teaching Hospital Zambia, found that, counter-intuitively, neonates born to mothers infected with HIV had a reduced risk for sepsis.
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HIV transmission risk remains during first 6 months of ART

A risk of HIV transmission persists for six months after the initiation of antiretroviral therapy, investigators from the PARTNERS PrEP study confirm.
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Syphilis and HIV prevalences linked in sub-Saharan Africa

A study from the Institute of Tropical Medicine, Belgium has collated a history of syphilis and found that while rates dropped world-wide in the post-penicillin era after 1945, they remained, up until recently, much higher in sub-Saharan Africa. The researchers found strong correlations between syphilis prevalence and those of Herpes Simplex Virus-2 prevalence and HIV prevalence.
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WHO’s recommends a 9 months MDR-TB treatment

The World Health Organisation announced new recommendations for a nine-month shortened treatment regimen for multi-drug resistant tuberculosis (MDR-TB) patients.
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MEDICALBRIEF Issue No 0106 - HIV News 11 April 2016

Updated US Nonoccupational Postexposure Prophylaxis Guidelines recommend Truvada and an Integrase inhibitor

New evidence-based guidelines, Updated Guidelines for Antiretroviral Postexposure Prophylaxis after Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV — United States, 2016, are now available.
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Age-related problems dog older HIV-positive patients

Older HIV-positive patients have a high prevalence of multiple age-related problems, investigators from the US report.
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‘Treatment as prevention’ could eliminate HIV/AIDS

Treatment as prevention has slowly brought the HIV epidemic in Denmark close to an end, found a statistical analysis.
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SA adopts WHO’s ‘test and treat’ HIV guidelines

SA will adopt the World Health Organisation's new 'test and treat' guidelines for HIV patients in September, enabling people to start treatment as soon as they are diagnosed.
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MEDICALBRIEF Issue No 0105 - HIV News 5 May 2016

HIV/AIDS to be added to prohibited grounds for discrimination

The SA government is adding HIV/AIDS to the list of prohibited grounds for discrimination as current legislation is often not able to provide viable recourse before the country's Equality Courts.
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Hypertension rates rising in HIV patients

An analysis of US hypertension rates suggested that incidence among HIV patients has more than tripled from 1996 through 2013 and are accompanied by an increase in several hypertension risk determinants such as obesity or diabetes.
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Intimate partner violence and risky behaviour correlate

An Eastern Cape-based study found that intimate partner violence correlates with sexual risk behaviour.
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Costly US HIV prevention programmes ineffective

The US government invested $1.4bn in HIV prevention programmes that promote abstinence and fidelity, but there is no evidence that these have been effective at changing behaviour and reducing HIV risk, according to a Stanford University study.
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MEDICALBRIEF Issue No 0104 - HIV News 28 April 2016

HIV scientist a finalist for prestigious inventor award

A rapid, point-of-care diagnostic test invented by University of Cambridge blood scientist and researcher Helen Lee, 75, is tilting the scales in the battle against the global HIV epidemic.
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Poor HIV care attendance linked to money problems

People who miss appointments for HIV care are more likely to have money problems, childcare responsibilities and a history of depression according to a University College London.
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HIV prematurely ages patients by about 5 years

A University of Nebraska study has applied a highly accurate biomarker to establish that HIV infection ages people at the biological level by an average of almost five years.

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Improved reporting explains HIV mortality figures hike

HIV/AIDS deaths among the young have more than doubled in five years, but SA Health says this simply reflects more accurate reporting.
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MEDICALBRIEF Issue No 0103 - HIV News 21 April 2016

Dolutegravir registered in South Africa

ViiV Healthcare is expected to debut one of the world's newest antiretrovirals (ARV), dolutegravir, in South Africa's private sector.
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Encouraging results from mono-therapy trial

An ongoing extension study of PRO-140 mono-therapy in a cohort of HIV-infected patients has shown complete viral-load suppression for well over a year with some patients approaching 17 months.
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Project finds 25% ARV and TB drug stock outs

The civil society coalition Stop Stock Outs Project annual survey reports that about one in four of SA's public health facilities reported an antiretroviral (ARV) or TB medication stock out in 2015.
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New programme to cure HCV in co-infected patients

A first-of-its-kind programme has been launched in Africa and Asia aimed at curing hepatitis C (HCV) among patients co-infected with HIV.
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Gene-editing platform ‘needs more tweaking’

The CRISPR/Cas9 gene-editing platform may need a little bit more tweaking before it can be used as an effective antiviral, an international collaborative study found.
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MEDICALBRIEF Issue No 0101 - HIV News 7 April 2016

Bodyweight influences risk for inflammation mortality

High or low bodyweight appears to be a risk factor for heightened systemic inflammation among HIV patients initiating anti-retroviral therapy (ART).
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Discrimination impacts on health services for gay men

Because of stigmatisation, as many as six out of 10 men who visited Mozambique health centres in the past year left without getting an HIV test, despite the government’s prioritisation of HIV services in healthcare settings.
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Gene editing snips out HIV-infected cells

For the first time, researchers have used a gene-editing technique already used to produce cells resistant to HIV infection to target HIV-infected cells, producing significant reductions in the ability of CD4 cells to be infected with HIV.
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SADC guidelines to harmonise HIV prevention and Tx

The Southern African Development Community (SADC) has produced a guideline of a basic package of services for high HIV risk populations along the region’s transport corridors.
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Hepatitis C antiviral Tx by non specialists is safe and effective

Direct-acting antiviral therapy for hepatitis C (HCV) delivered by non-specialists such as primary care physicians and nurse practitioners is safe and effective – even for the most difficult-to-treat patients, found the ASCEND study.
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MEDICALBRIEF Issue No 0100 - HIV News 31 March 2016

Non-judgemental space needed for discussion

Health care providers need to provide a safe, non-judgemental space for patients to discuss their sexual orientation and identity, which will better allow physicians to make recommendations for HIV testing and hepatitis vaccines based on potential risk factors, found a US study.
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Non-nuke HIV strains resistant to ARVs

People contracting HIV increasingly acquire strains resistant to ARVs, in particular non-nucleoside reverse transcriptase inhibitors (NNRTIs or non-nukes), according to data from the San Diego Primary Infection Cohort.
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Potent drugs see decline in drug resistant HIV

An analysis of the ongoing Swiss HIV Cohort Study suggests the emergence of newly acquired drug resistant HIV has greatly declined from 1999 to 2013.
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Botswana has 96% rate of viral suppression for ART patients

Botswana has achieved very high rates of HIV diagnosis, treatment, and viral suppression – much better than most Western nations, including the US, according to a Botswana Harvard AIDS Institute Partnership study.
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Renal impairment plus TMP-SMX boosts hyperkalemia risk in Japanese patients

Renal insufficiency is a risk factor for hyperkalemia associated with low-dose trimethoprim-sulfamethoxazole (TMP-SMX), a drug prescribed to prevent pneumocystis pneumonia.
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MEDICALBRIEF Issue No 0099 - HIV News 24 March 2016

ARVs improve liver function in HIV positive men

Starting antiretroviral therapy (ART) is associated with improvements in liver function in HIV-positive men with and without viral hepatitis co-infection, investigators from the US report.
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High HIV burden among female sex workers in SA’s metro areas

Behavioural indicators reveal high levels of unrecognised HIV infections and rates of recent HIV seroconversions, according to the recent South Africa National Health Monitoring Study (SAHMS.)
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ART rollout saves lives and money

Incidence of opportunistic infections (OIs) declined by between 57%-91% in the first year after starting ART, with the greatest reductions in cases of oral thrush, toxoplasmosis and PCP pneumonia.
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New US Guidelines for the use of Antiretroviral Agents in Paediatric HIV Infection

Key changes made by the Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children to update the 5 March, 2015, Guidelines for the Use of Antiretroviral Agents in Paediatric HIV Infection are summarised at https://aidsinfo.nih.gov/guidelines/html/2/pediatric-arv-guidelines/0
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Effectiveness of standalone anti-TB drug affirmed

A study strongly affirms the effectiveness ofanti-tuberculosis drug isoniazid alone – in place of the standard four-drug regimen – to prevent TB and reduce death in people with advanced HIV/AIDS.
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MEDICALBRIEF Issue No 0098 - HIV News 17 March 2016

SA HIV Clinicians Society releases PrEP guidelines

The Southern African HIV Clinicians Society released guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection. The aim of the this PrEP guideline is to explain what PrEP is, outline current indications for its use, outline steps for appropriate user selection and provide guidance to monitor and maintain PrEP users.
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SA leads the way with PrEP roll-out

SA has become one of the world's first countries to begin rolling out pre-exposure prophylaxis (PrEP) to sex workers.
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Bone mass and HIV

Accumulating evidence suggests that rates of bone mass loss are greater in HIV-infected males than females.
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Deferring Hepatitis C Treatment increases morbidity and mortality risk

Deferring hepatitis C virus (HCV) therapy until advanced liver fibrosis is established could increase liver-related morbidity and mortality in HIV/HCV co-infected individuals.
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MEDICALBRIEF Issue No 0097 - HIV News 10 March 2016

South Africa’s XDR-TB epidemic is ‘driven by transmission’

A study in KwaZulu-Natal found that transmission – in both hospitals and households – has been the primary driver of the drug resistant tuberculosis (XDR-TB) epidemic.
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Women need more Truvada as PrEP than men do

Women need daily doses of Truvada for pre-exposure prophylaxis while men only need two doses per week due to the way the drug accumulates in body tissues.
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ART improves quality of life modestly

Rather than treatment side-effects having a negative impact on people’s quality of life when they start HIV treatment, data from the large randomised START study show a modest but statistically significant improvement in quality of life, the recent Conference on Retroviruses and Opportunistic Infections (CROI 2016) in Boston heard.
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Kidney function decline with Truvada

Participants taking Truvada for pre-exposure prophylaxis (PrEP) in two major studies experienced modest declines in kidney function.
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HIV/AIDS costs too much for many African countries

There will be a significant shortfall in the funding needed for HIV control in sub-Saharan Africa in the coming years and those countries with the highest HIV burden will be unable to meet their obligations on their own to sustain control efforts,
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MEDICALBRIEF Issue No 0096 - HIV News 3 March 2016

Surprises in cabotegravir PrEP study

Surprise results from the first phase 2 study of a long-lasting, injectable formulation of the integrase-inhibitor drug cabotegravir for use as pre-exposure prophylaxis (PrEP) in HIV-negative people.
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Long-acting injectable ARVs maintain viral suppression

A combination of two long-acting injectable antiretrovirals, cabotegravir and rilpivirine, given once every 4 or 8 weeks, maintained viral suppression as well as a standard oral ART regimen.
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Dolutegravir’s virologic efficacy in children with HIV

Dolutegravir (DTG) plus optimised background regimen (OBR) is safe, well tolerated and provides virologic efficacy in HIV-infected children from six to 12 years of age at 48 weeks.
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Single dose drug inhibits ART-induced bone loss

A single dose of the drug zoledronic acid was found to inhibit the bone loss that is common in HIV-infected patients and that is increased during the first two years of antiretroviral therapy (ART) found a study in Nature
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Better outcomes from accelerated HIV diagnosis

A programme to accelerate the process of HIV diagnosis, preparation and starting ART in SA led to a higher proportion of people initiating treatment and better health outcomes, according to results from the RapIT trial.
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Early TB treament not reducing mortality

A South African trial found that a strategy allowing primary care nurses to quickly provide empirical tuberculosis (TB) treatment for newly diagnosed people with advanced HIV disease at very high risk but without confirmed TB, did not lead to a major reduction in mortality. The paper was presented at the annual Conference on Retroviruses and Opportunistic Infections (CROI 2016).
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MEDICALBRIEF Issue No 0095 - HIV News 25 February 2016

Simple blood test could transform TB diagnosis

Researchers at Stanford University have identified a gene expression 'signature' that distinguishes patients with active tuberculosis from those with either latent tuberculosis or other diseases. The simple test works on an ordinary blood sample and can potentially be done under relatively basic field conditions.
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Accurate and cost-effective test of HIV drug resistance

A team from the University of the Western Cape (UWC) has created a programme that will rapidly, accurately and cost-effectively test HIV drug resistance.
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The Ring protects against HIV, find two large Africa studies

A vaginal ring containing the antiretroviral dapivirine, used for a month at a time, was safe and helped protect against HIV found the large-scale clinical ASPIRE trial.
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Simplifying is the main reason for changing ART

One of the main reasons individuals living with HIV discontinue their first antiretroviral therapy regimen is a desire to simplify their regimen, according to an Italian study.
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Telephonic intervention to support high risk patients

Retention in HIV care among patients with mental health and/or drug and alcohol problems can be improved with a telephone-based support intervention, but only if staff are able to establish regular contact.
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Challenges remain for HIV-infected individuals re-entering workplace

The likelihood of HIV-infected individuals receiving combination ART to engage in full- or part-time employment after a year of treatment significantly increased during the last 20 years, but hurdles remain.
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MEDICALBRIEF Issue No 0094 - HIV News 18 February 2016

Significant relationship between viral load and neurosyphilis risk

There was a significant relationship between HIV viral load and the risk of neurosyphilis, found a Polish study.
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Dexamethasone not reducing mortality in cryptococcal meningitis

For patients with HIV-associated cryptococcal meningitis, dexamethasone does not reduce mortality compared with placebo, according to a University of Oxford study.
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Research justifies transplants for HIV patients

Liver and kidney transplant can be justified for carefully selected HIV-positive patients, researcher from the US shows.
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MEDICALBRIEF Issue No 0093 - HIV News 0093 11 February 2015

Even moderate drinking more harmful

Moderate alcohol consumption is more harmful to people with HIV than uninfected individuals, raising the risk of both mortality and other negative health effects, found a Yale study.
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Social service spending lowers Aids deaths

A US study found that states with higher spending on social services and public health had significantly lower HIV/AIDS case rates and fewer AIDS deaths.
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Ban lifted on take-home HIV testing kits

Ban on pharmacists selling take-home HIV testing kits removed, says Pharmacy Council of South Africa.
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MEDICALBRIEF Issue No 0092 - HIV News 4 February 2016

Resistance to Tenofovir emerging in sub-Saharan Africa

Tenofovir (Viread) resistance appears to be emerging frequently among HIV patients facing virologic failure, with resistant strains affecting as many as 60% of sub-Saharan Africans with the infection who failed first-line ART, according to a multicentre retrospective study.
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Impact of the Swiss Statement on HIV transmission

The 2008 so-called 'Swiss Statement' on HIV-health remains persuasive a full eight years later, argues Professor Pietro Vernazza, an infectious diseases specialist, in a Swiss Medical Weekly report.
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Poly-pharmacy link to non-continuous ART

HIV patients taking a large number of medications for non-HIV conditions are at increased risk of stopping or changing their ART.
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Early ART start to prevent later cognitive decline

Individuals who start HIV treatment very soon after contracting the virus may be at lesser risk of later cognitive decline.
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Cumulative use of ARVs increases liver disease risk

The cumulative use of several antiretrovirals, including d-drugs Zerit, Videx, Viread and Agenerase, were independently associated with increased rates of end-stage liver disease and hepatocellular carcinoma among adults with HIV.
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MEDICALBRIEF Issue No 0091 - HIV News 28 January 2016

The role of progestins in HIV acquisition

Injectable progestin-only contra ceptives and high endogenous progesterone use are both associated with an increased number of HIV target cells at the cervix, which may help explain the reported increase of HIV in women with high exposure to progestin.
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Fast disease progression may mean slow immune recovery

People with HIV who experience fast disease progression with a rapid drop in their CD4 T-cell count may be less likely to regain a normal CD4 level after starting ART.
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Answering the ‘lost to follow-up’ problem

A large study in Uganda, Kenya and Tanzania explores why people enrolled in antiretroviral treatment programmes across three African countries are 'lost to follow-up'
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PrEP to curb new infections among MSM

Pre-exposure prophylaxis (PrEP) could help dramatically reduce the new HIV infection rate among MSM, according to a London School of Hygiene & Tropical Medicine study.
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MEDICALBRIEF Issue No 0090 - HIV News 21 January 2016

PrEP has a safety profile comparable to aspirin

Truvada as pre-exposure prophylaxis (PrEP) against HIV has comparable safety to aspirin, at least for the short- and medium-term.
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ABIVAX clinical study delivers ‘positive’ results

Pharmaceutical company ABIVAX has claimed 'positive top-line efficacy and safety results' from its phase II clinical study in HIV patients of ABX464 which is a first-in-class, novel, small molecule that inhibits the biogenesis of viral RNA.
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Switching HIV-positive children to efavirenz-based therapy

Among HIV-infected children exposed to nevirapine for prevention of mother-to-child transmission and with initial viral suppression with ritonavir-boosted lopinavir–based therapy, switching to efavirenz-based therapy did not result in significantly higher rates of viral rebound or failure.
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How patients are offered HIV test is crucial

How you offer patients an HIV test has a significant impact on the likelihood of them accepting tests, University of California research found.

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MEDICALBRIEF Issue No 0089 - HIV News 14 Jan 2016

Hunger cuts chances of sustained viral suppression

In Uganda, food insecurity was associated with 62% lower odds of achieving and sustaining viral suppression among HIV infected woman during pregnancy and breastfeeding.
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Improving TB Outcomes

Treatment regimens including more potentially effective drugs than the minimum of five currently recommended by WHO may encourage improved response to treatment in patients with MDR TB.

And a University of Cape Town study found that all-cause 8-week mortality is reduced by 18% by implementing rapid point-of-care urine-based testing for TB, to guide rapid treatment initiation in hospitalised HIV-positive people with signs of TB.
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Discontinuing Cotrimoxazole not recommended in malaria regions

Cotrimoxazole (CTX) discontinuation is inferior to CTX continuation among ART-treated, immune-reconstituted HIV-infected adults living in a malaria-endemic region, according to a Kenya trial by researchers from the Walter Reed Army Institute of Research, the University of Washington, and the Kenya Medical Research Institute.
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Those taking salvage ARVs can safely leave out nukes

Individuals taking salvage ARV regimens can safely leave out nucleoside reverse transcriptase inhibitors (NRTIs or nukes).
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Sub-type contributions to Tx outcomes

Variations in drug-resistant mutations appeared to correspond with specific sub-type designations in patients with HIV who failed first-line treatment.
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Efficacy of TAF and TDF for hepatitis B

A pair of phase 3 studies have shown that tenofovir alafenamide (TAF) suppresses hepatitis B virus as well as the current tenofovir disoproxil fumarate (TDF) formulation, but with less detrimental effects on the kidneys and bones.
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Doubling of CVD mortality risk in HIV

Proportionate cardiovascular disease (CVD) mortality more than doubled among HIV-infected adults in the US between 1999 and 2013, according to a Northwestern University study.
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MEDICALBRIEF Issue No 0088 - HIV News 10 December 2015

MCC approves Truvada as pre exposure prophylaxis in SA

SA's Medicines Control Council (MCC) approved the use of Truvada for pre-exposure prophylaxis (PrEP).
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Truvada PrEP as-needed provides protection from HIV

In a Canadian study into the prevention of HIV transmission, people who took Truvada, as needed, were 86% less likely to contract the disease than those who took a placebo.
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Largest survey on women living with HIV

The gender-based violence (GBV) and mental health issues faced by women living with HIV after their diagnosis are both very high and have a huge impact on their lives.
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Health and developmental risks of ARVs in pregnancy

Taking combination antiretroviral drugs during pregnancy does not increase the overall risk of these adverse outcomes in babies born to mothers living with HIV. However, zidovudine (AZT) was linked to about 70% higher risk for metabolic problems in these children, found Harvard research.
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Targeted interventions to reduce risky behaviour

Young men who have sex with men and have detectable levels of the human immunodeficiency virus (HIV) were more likely to report condomless anal sex, including with a partner not infected with HIV, than virologically suppressed young men who have sex with men.
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MEDICALBRIEF Issue No 0087 - HIV News 3 December 2015

Long-term impact of HIV-associated wasting

HIV-infected survivors of wasting may represent a population of adults at increased risk for physical function decline.
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PrEP advocates bemoan drug approval delays

HIV activists ask, in a Mail&Guardian report, whether in delaying the implementation of pre-exposure prophylaxis (PrEP), has South Africa failed to embrace the wisdom of science?
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Expanding ART key to ending HIV/AIDS – WHO

On World AIDS Day the World Health Organisation emphasised that expanding antiretroviral therapy to all people living with HIV is key to ending the Aids epidemic within a generation.
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MEDICALBRIEF Issue No 0085 - HIV News 19 November 2015

Low-volume GPs deliver poorer ART outcomes

Patients of doctors treating fewer than 20 HIV-positive outpatients per year had sub-optimal ART outcomes, and also received poor quality of care, found a US study.

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IAPAC’s best practice guidelines issued

The International Association of Practitioners in AIDS Care (IAPAC), has issued a set of guidelines that aims to establish a common set of best practices to ensure that as many people living with HIV as possible are diagnosed, cared for, receive treatment and achieve undetectable viral loads.
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Biomarkers predict post-treatment controllers

Only four out of nearly 5000 people receiving care at US military facilities were found to exhibit immune control after starting ART, achieving viral suppression and interrupting treatment. A related study identified several biomarkers that may help predict who will be post-treatment controllers.
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Support for expanding PrEP

The rate of acquiring HIV was extremely low in a study where pre-exposure prophylaxis (PrEP) medication was dispensed.
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Counselling significantly reduces risk

Counselling for HIV sero-discordant couples can achieve significant reductions in risk behaviour, according to the results of a Ugandan study.
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MEDICALBRIEF Issue No 0084 - HIV News 12 November 2015

SA Post Exposure Prophylaxis Guideline Updated

The new Guideline on the management of occupational and non-occupational exposure to the human immunodeficiency virus and recommendations for post-exposure prophylaxis: 2015 Update, published by the Southern African HIV Clinicians Society, is now available.
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The risk of HIV disease progression and hormonal contraception

Hormonal implants and injectable contraceptives were associated with a reduced mortality risk, and use of injectables delayed the need for antiretroviral therapy (ART).
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Higher risk with persistent low-level viremia

People living with HIV who have a detectable but low viral load may continue to have a higher risk of AIDS-related events, but their likelihood of experiencing serious non-AIDS events including heart, liver and kidney disease did not appear to increase, according to a pair of Italian studies.
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Strong evidence of PrEP efficacy for transgender women

University of California researchers have identified strong evidence of efficacy for transgender women when PrEP is used consistently.
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MEDICALBRIEF Issue No 0083 - HIV News 5 Nov 15

ARV treatment sees AIDS mortality drop in SA

After peaking in 2007, Aids mortality in SA has decreased but HIV/Aids remains the leading cause of death in SA.
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Study supports switch to Efavirenz in children

A US-SA paediatric study provides support for a switch from a boosted Lopinavir regimen to an Efavirenz based regimen in children exposed to nevirapine for prevention of mother-to-child transmission.
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Single tablet TAF regimen successful

A single-tablet regimen containing the new tenofovir alafenamide (TAF) – to be marketed as Genvoya – suppressed HIV as well as a coformulation containing the older tenofovir disoproxil fumarate.
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Dual long acting ART injections maintain viral suppression

ViiV Healthcare's Phase IIb study LATTE 2 found that the investigational formulations of cabotegravir and rilpivirine were comparable in maintaining viral suppression rates to a three-drug oral regimen.
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Good result from maturation inhibitor trial

Bristol-Myers Squibb's next-generation maturation inhibitor BMS-955176 demonstrated good antiviral activity against HIV subtypes B and C in a short proof-of-concept study and appeared to be safe and well-tolerated.
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MEDICALBRIEF Issue No 0082 - HIV News 29 Oct 2015

AIDS denialism still sowing death in SA

The story of the HIV denialist movement demonstrates that scientific agreement is not necessarily enough – thousands died because conspiracy theories were able to outrun the facts, writes author Charlie Jane Anders in a Gizmodo report.
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EMA limits lipoatrophy and lactic acidosis warnings to zidovudine, stavudine and didanosine.

The European Medicines Agency (EMA) has updated the advice on the risk of body fat changes and lactic acidosis with medicines for the treatment of HIV.
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Trial puts SA at epicentre of HIV/AIDS research

SA put at epicentre of HIV vaccine research with a trial that will inject powerful antibodies proven to neutralise most strains.
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Search for simpler, easier HIV drug regimens

Dolutegravir monotherapy is an investigational treatment option. Despite few failures with low viral load rebound, resistance mutations to integrase inhibitor occurred in patients on dolutegravir monotherapy.
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Lifetime care will save lives — US modelling

A computer model predicts that strengthening a handful of efforts to keep people with HIV in lifetime care, along with more rigorous testing, would potentially avert a projected 752,000 new HIV infections and 276,000 Aids deaths in the US alone over the next 20 years.
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MEDICALBRIEF Issue No 0081 - HIV News 22 Oct 2015

Many patients in US not receiving recommended tx regimens

A third of HIV patients on antiretroviral therapy (ART) do not have sustained viral suppression and many are not receiving regimens recommended by the latest US treatment guidelines.
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Elite controllers as model for potential HIV cure

Elite controllers may be best human model to understand how the immune system is able to control HIV.
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MEDICALBRIEF Issue No 0080 - HIV News 15 October 2015

Initial response predicts post-treatment control

The way patients' immune systems initially responded to HIV infection could provide an indication of whether they might go on to achieve an extended period of remission following anti-retroviral therapy (ART).
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Increased cancer risk for those living with HIV

People living with HIV remain at risk of AIDS-defining cancers and also have higher rates of several non-AIDS cancers than the general population.
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Fostemsavir demonstrates good antiviral activity

HIV attachment inhibitor fostemsavir, which prevents the virus from binding to T-cells, demonstrated good antiviral activity and was well-tolerated at 24 weeks.
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Improved outcomes from switch to TAF regimen

Treatment-experienced HIV patients who switched to a tenofovir alafenamide-based regimen maintained virologic suppression and saw significant improvements in renal and bone safety.
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SA needs deep pockets to fight HIV/AIDS

Preventative HIV/AIDS strategies may add to the state’s financial burden as it looks at rolling out pre-exposure prophylaxis.
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MEDICALBRIEF Issue No 0079 - HIV News 8 October 2015

WHO releases new guidelines on HIV treatment

The World Health Organisation (WHO) has issued sweeping new guidelines that worldwide could put 9m more people on HIV drugs.
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‘Event driven’ PrEP preferred

A US and Canada survey reveals that on the whole HIV-negative men would rather take pre-exposure prophylaxis (PrEP) intermittently.
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The exclusion of women from clinical trials

Although women make up roughly half of HIV cases, they remain largely excluded from clinical trials testing drugs, vaccines and potential cures for the virus.
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Yale video shows in real time how HIV spreads

A Yale University team devised a way to watch how retroviruses like HIV actually spread in in a living organism.
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Robustness of SA’s HIV test kits questioned

The robustness of the screening processes for SA's HIV test kits has been called into question following revelations of up to 69% false positives.
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MEDICALBRIEF Issue No 0076 - HIV News 1 Oct 2015

ART is improving prognosis of older HIV patients

The prognosis of older HIV-positive patients has improved substantially during the era of combination antiretroviral therapy (cART), according to Danish research.
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Life-threatening comorbidities increasing

An increasing proportion of patients with HIV are experiencing cardiovascular conditions, renal impairment and other life-threatening comorbidities.
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FDA’s new paediatric weight band for atazanavir

The US Federal Drug Administration (FDA) has approved a new paediatric weight band for atazanavir oral powder.
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MEDICALBRIEF Issue No 0075 - HIV News 23 Sep 2015

Single tablet of elvitegravir, cobicistat, emtricitabine and tenofovir effective for HIV positive women

An ART regimen consisting of once-daily Stribild may be safer and more effective than the standard multidrug combination treatment.
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Silicon vaginal ring able to release PREP drug for up to 50 days

French researchers have developed a vaginal silicone ring that delivers molecules that act on both HIV and herpes virus.
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MEDICALBRIEF Issue No 0074 - HIV News 3 September 2015

Young MSM in the US less likely to be tested for HIV

Young US men who have sex with men have the highest risk for HIV infection, but only one in five has ever been tested for HIV, a much lower rate than testing for non-adolescents, reports a national Northwestern Medicine study.
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Low survival rate for HIV/HCV patients in NYC

About a quarter of people in a New York City cohort who had HIV and hepatitis C virus (HCV) died over a ten-year period – a 'strikingly low' survival rate.
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Risk of preterm delivery and low birth weight for pregnant women on HAART

Highly active ART (HAART) before or during pregnancy may increase the risk for adverse birth outcomes, such as preterm delivery and low birth weight, compared with other ART for HIV.

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MEDICALBRIEF Issue No 0073 - HIV News 26 August 2015

Agricultural intervention improves HIV outcomes in Kenya

A multifaceted farming intervention can reduce food insecurity while improving HIV outcomes in patients in Kenya, according to a randomised, controlled trial.
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High risks of HIV and unintended pregnancies among adolescent women

Two-thirds of adolescent women worldwide do not have access to contraceptives, according to a Guttmacher Institute report.
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Bone density decrease in some Truvada patients

Researchers found a small but statistically significant decrease in bone mineral density in the hip and spine for HIV-seronegative patients taking Truvada daily for pre-exposure prophylaxis.
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Amfar launches PEPFAR funding information website

Amfar, the foundation for Aids Research, has launched a new website to access President's Emergency Plan for AIDS Relief funding data.
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Low engagement from HIV+ postpartum women

HIV-positive women in Philadelphia, who have recently given birth have low rates of engagement with HIV care, US investigators report.
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Poor follow-up rates among HIV+ SA mothers

Only half of HIV-positive mothers in Cape Town townships who received antenatal care and prevention of mother-to-child transmission services are receiving ART 36 months after giving birth.
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MEDICALBRIEF Issue No 0072 - HIV News 19 August 2015

Treatment outcomes for patients with pretreatment HIV drug resistance

Pre-treatment HIV drug resistance in sub-Saharan Africa was associated with a nearly fourfold increase in switching to second-line ART, but did not influence mortality or Aids-related events.
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Poor adherence due to fear of interactions between ART and illicit drugs and alcohol

Beliefs about possible toxic interactions between ART and illicit drugs are causing large numbers of people living with HIV who use drugs to intentionally miss their HIV treatment, US investigators report.
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Dual ART effective after induction with triple therapy

The oral antiretroviral regimen of cabotegravir plus rilpivirine effectively maintained viral suppression after induction therapy in HIV-1 patients who were ART-naive, multi-centre Phase 2 trial found.
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HIV-associated Hodgkin’s lymphoma

Patients with HIV-associated Hodgkin's lymphoma had a similar prognosis to non-HIV infected Hodgkin's lymphoma patients when treated with combined ART and doxorubicin, bleomycin, vinblastine and dacarbazine treatment.
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MEDICALBRIEF Issue No 0071 - HIV News 12 Aug 2015

ART significantly reduces TB risk in SA

Starting antiretroviral therapy (ART) significantly reduces the risk of tuberculosis (TB) for patients in South Africa.
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Social interventions improve retention of mothers with HIV

Peer- and community-based interventions can significantly increase early antenatal clinic visits and retention in care of mothers with HIV, according to two large multi-country studies.
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NIH project for year-long, implantable drug for HIV prevention

The US National Institutes of Health (NIH) is funding a project to develop and test an implantable drug delivery system to protect high-risk individuals from HIV infection for up to a year at a time.
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SA’s DoH recalls defective HIV tests

Defective HIV tests have been recalled countrywide by the Department of Health (DoH).
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MEDICALBRIEF Issue No 0070 - HIV News 5 August 2015

Amphotericin B safe when prescibed with Tenofovir

Amphotericin B, an antifungal agent commonly used in AIDS patients with cryptococcal meningitis, can be used safely in conjunction with tenofovir (TDF) antiretroviral therapy (ART), according to a study presented at the 8th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2015).
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Benefits of switching to TAF

People who switch from the current version of tenofovir to tenofovir alafenamide (TAF) – a new formulation that reaches higher levels in HIV-infected cells – maintained undetectable viral load and saw improvements in liver function biomarkers and bone density, according to a pair of studies presented at the recent Eighth International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2015).
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Hormonal contraception effective in HIV-postive women

Contrary to limited evidence suggesting ART may reduce the effectiveness of contraceptive methods, notably implants, the data showed implants to be highly effective compared to no contraception and more effective than injectables or oral contraceptive pills.
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MEDICALBRIEF Issue No 0069 - 29 July 2015

Empiric TB treatment in advanced HIV not better than giving ART and isoniazid

Giving treatment for tuberculosis to all people with very advanced HIV disease at the time they start antiretroviral therapy, before a laboratory diagnosis of TB does not reduce the risk of death compared to giving antiretroviral therapy and isoniazid preventive therapy.
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One in 10 living with HIV – Stats SA

Around one in 10 South Africans are living with HIV, according to the latest report by Statistics SA.
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Paying to prevent HIV has mixed results

Two large African trials on cash pay-outs to prevent HIV delivered mixed results. Both were based on research that has shown the longer a young girl remains in school, the less likely she is to get HIV.
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Doravirine as effective as efavirenz

Merck's doravirine was found to be as effective as efavirenz at suppressing HIV replication and half as many study participants experienced drug-related side-effects, as well as being less likely to stop treatment prematurely.
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HIV maturation inhibitor well-tolerated

The next-generation HIV maturation inhibitor BMS-955176 was well-tolerated and suppressed HIV viral load as well as standard antiretroviral therapy when used in a combination with atazanavir (Reyataz) in a 28-day study.
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MEDICALBRIEF Issue No 0068 - HIV News 15 July 2015

WHO to issue new HIV treatment guidelines

The World Health Organisation (WHO) will issue new HIV treatment guidelines later this year recommending treatment for all, regardless of CD4 cell count.
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Three second-line ART regimens equally effective

Three second-line antiretroviral therapy (ART) regimens are equally safe and effective for patients in Africa, investigators report.
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Latest Antiretroviral Pipeline Report

The antiretroviral pipeline features compounds in phase II/III development that might bring important improvements for treatment. These include Gilead Science’s TAF and ViiV Healthcare’s cabotegravir (in oral and long-acting injection formulations). Of particular interest for the important group of people with resistance to current drugs, Bristol-Myers Squibb has an attachment inhibitor, fostemsavir, and a maturation inhibitor, BMS-955176, and Merck is progressing with the non-nucleoside reverse transcriptase inhibitor (NNRTI) doravirine.
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Successful adherence to PrEP in SA

A clinical study at the Desmond Tutu HIV Foundation’s funded by the US National Institutes of Health has found that young, single black women in South Africa adhered to a daily pre-exposure prophylaxis (PrEP) regimen.
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Latest Pipeline Report on Hepatitis C

The evolution of hepatitis C virus treatment has been 'swift, dazzling, and unprecedented'.
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Latest Pipeline Report on TB

The prevailing 'limited response' to TB remains entrenched, even with two new drugs conditionally approved and a new global strategy.

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African HIV treatment beats some rich nations

Some African countries are now providing effective HIV treatment to a greater proportion of their HIV-positive citizens than the US.
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MEDICALBRIEF Issue No 0067 - HIV News 15 July 2015

SA’s updated HIV counselling and testing guidelines

SA's Health department has released the National HIV Counselling and Testing Policy Guidelines, 2015.
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Treatment close to home more effective

People with HIV who were receiving their HIV treatment in community-based ART adherence clubs close to or in a patient’s home demonstrated extremely high rates of retention in care and adherence to treatment.
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Early ART can prevent millions of deaths

Results from a new study indicate that millions of Aids-related deaths could be averted in high HIV burden countries – an estimated 3.4 million in the countries of Nigeria and South Africa alone – with improved and earlier access to antiretroviral therapy (ART).
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Middle-aged and elderly suffer if ART delayed

Delaying antiretroviral therapy may have especially serious consequences for middle-aged and elderly HIV-positive people, found a US study.
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MEDICALBRIEF Issue No 0066 - HIV News 8 July 2015

The HIV vulnerabilities of adolescents

Adolescents have lower coverage of HIV testing and subsequent prevention of mother-to-child (PMTCT) services, as well as significantly higher early vertical transmission rates compared with adults, according to findings from three South African national surveys.
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Scale-up of HIV treatment lessens stigma

In the high-prevalence countries of sub-Saharan Africa, the scale-up of HIV treatment appears to have resulted in a lessening of stigmatising attitudes.
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Shingles vaccine efficacy of 97.2%

GlaxoSmithKline data from a randomised phase III study of its investigational vaccine for the prevention of shingles, HZ/su, showed vaccine efficacy exceeding 90%.
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MEDICALBRIEF Issue No 0065 - 01 July 2015

UK releases new draft treatment guidelines

Everyone with HIV who is prepared to take antiretroviral treatment should receive it, regardless of CD4 cell count, new draft British HIV Association treatment guidelines recommend.
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SA women predisposed to contracting HIV

Women in South Africa might be biologically predisposed to contracting HIV, explaining in part why local women are among the world's most susceptible.
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Lack of food security impacts on viral loads

People who don't have enough food to eat are less likely to have an undetectable viral load than other people living with HIV, according to a longitudinal study from New York City.
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More schooling lessens risk of contracting HIV

Longer secondary schooling substantially reduces the risk of contracting HIV, particularly for girls, according to new research from Botswana.
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World must ‘drastically accelerate’ efforts – UNAIDS

Countries most affected by HIV must focus on stopping new infections and expanding access to antiretroviral treatment or risk the epidemic rebounding.
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SA releases new STI management guidelines

The SA Department of Health has released new guidelines for the management of sexually transmitted infections (STIs).

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TB and HIV-related illness top causes of death

Tuberculosis (TB) and HIV-related illnesses were the leading causes of death among young people in 2013, reports Statistics South Africa.
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MEDICALBRIEF Issue No 0064 - HIV News 24 June 2015

Sequence of immunisations to prevent HIV

A sequence of immunisations might be the most promising route to an HIV vaccine, rather than a single shot, according to multi-institutional US research.
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Anti-HIV response links to reduced infection risk

Research has found that some individuals exposed to HIV-1, but who remain uninfected, have a certain pattern of virus-specific immune responses that differentiated them from individuals who became infected.
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Young women and girls remain the most vulnerable

A new UNAIDS report makes it clear that those most vulnerable to the decades-long pandemic continue to be young women and adolescent girls in Africa.
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Kenyan activists want HIV lists destroyed

Human rights activists have gone to court to get Kenya's government to destroy data listing HIV positive children.
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MEDICALBRIEF Issue No 0063 - HIV News 17 June 2015

The rising costs of HIV treatment

With 3.1m people on antiretrovirals, South Africa has the world's largest ARV programme, but the cost of sustaining it will more than double in the next two decades. Led by University of Witwatersrand health economist Dr Gesine Meyer-Rath, the research found that SA's HIV programme will cost about R40bn each year by 2033 — more than double the R21bn budgeted in the next financial year.
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Survey shows worsening stock-outs

South Africa's drug stock-out problems have worsened, according to a survey by the civil society coalition Stop Stock-outs that was released at the recent SA Aids Conference 2015. And, the Mail & Guardian reports, the findings are in stark contrast with Health Minister Aaron Motsoaledi’s earlier claims that "there is no shortage of ARVs".
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SA launches HIV guidelines app

South Africa's Health ministry has launched a free app that puts the country's HIV guidelines at the fingertips of health workers and patients. Developed by The Open Medicine Project, the app allows access to the latest national guidelines via smart phones or tablets and these are automatically updated.
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Small piece of elite controller puzzle is found

Dendritic cells of elite controllers are better able to detect the presence of HIV which enables them to stimulate the generation of T cells specifically targeting the virus.
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Confronting stigma is key to tackling HIV

Stigma is at the heart of tackling SA's HIV/AIDS challenges, according to a new survey.
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HIV risk for women in lesbian relationships

Lesbians have been ignored in the fight against HIV because of the myth that they are not at risk of contracting the virus.
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MEDICALBRIEF Issue No 0062 - HIV News 10 June 2015

35% five year mortality risk after AIDS-defining illness in San Francisco

Although treatment advances have dramatically reduced deaths from opportunistic infections, a study drawing on 30 years of data found 35% of Aids patients diagnosed with their first opportunistic infection from 1997 to 2012 in San Francisco died within five years.
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HIV risk in New York linked to societal issue

For young gay and bisexual men, the risk of HIV infection is linked with societal issues, found a New York University study.

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FDA’s approves lopinavir/ritonavir oral pellets for children

Infants and young children living with HIV will finally have access to an improved formulation of an antiretroviral treatment, following the US Food and Drug Administration's tentative approval of lopinavir/ritonavir oral pellets.
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MEDICALBRIEF Issue No 0061 - HIV News 03 June 2015

START study finds clear benefits to early HIV treatment

People with HIV should be put on antiretroviral drugs as soon as they learn they are infected, US health officials said as they announced that they were halting the Strategic Timing of AntiRetroviral Treatment (START) study because its benefits were already so clear. Data already showed that those who got treatment immediately were 53% less likely to die during the trial or develop Aids or a serious illness than those who waited.

The Desmond Tutu HIV Foundation (DTHF) Clinical Trials Unit, a major participant in START with the largest number of participants of any site worldwide, said the results would have a considerable impact on the management of future HIV treatment.
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Wide variety of non-typical early symptoms

A Swiss study of those diagnosed during early HIV infection found that a quarter of them presented a wide variety of non-typical early symptoms of HIV infection, many of them serious and a few life-threatening.
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Genital tract bacteria increases infection risk

The most common bacterial community in the genital tract among healthy South African women not only is significantly different from that of women in developed countries but also leads to elevated levels of inflammatory proteins.
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High mother-to-child transmission risk for women who seroconvert during pregnancy

There is a high risk of HIV seroconversion during pregnancy for women in South Africa, investigators report.
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MEDICALBRIEF Issue No 0060 - HIV News 27 May 2015

Lower dose of Tenofovir safe and effective in renal impairment

A reduced tenofovir (Viread) dose of 150mg daily appears to be a safe and effective treatment for people with HIV who have moderate renal impairment, investigators from Thailand report.

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Viral suppression with 85% adherence rates

Some modern treatment regimens can achieve viral suppression with adherence rates as low as 85%, investigators from the US Veteran Ageing Cohort Study report.

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Microclinics improve rural HIV care

A study found significant benefits to microclinics – an innovative intervention that mobilised rural Kenyan HIV patients' informal social networks to support their staying in care.
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MEDICALBRIEF Issue No 0058 - HIV News 13 May 2015

High Hepatitis C rate in African HIV patients

In the largest study of its kind to date, researchers found high levels of infection with hepatitis C (HCV) across Africa, particularly in people infected with HIV.
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The National Student Sexual Health, HIV Knowledge, Attitude and Behaviour Survey (2014)

The first SA National Student Sexual Health HIV Knowledge, Attitude and Behaviour Survey has highlighted some complacency in how HIV-Aids is tackled at higher education institutions.
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HIV increases risk of hardening arteries

HIV infection is associated with an increased risk of hardening of the arteries, a US study finds.

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MEDICALBRIEF Issue No 0057 - HIV News 6 May 2015

Protein vaccine could boost immune system

A vaccine containing a protein necessary for virus replication can boost an HIV-infected patient's immune system, according to recent clinical research.
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Non-disclosure has no effect on HIV outcomes

A large UK survey found that those who chose not to disclose their HIV status were no more likely to suffer from depression or anxiety, to have difficulty adhering to ARV therapy or to have worse HIV outcomes.
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Gender equality encourages safer sex

HIV-positive South African women under the age of 26 were more likely to have used a c ondom during their last episode of in tercourse if they had more gender-equal views.
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Unintended consequences of circumcision

A study of HIV-infected men in Uganda has identified an unintended consequence of male circumcision: a possible increased risk of infecting female partners during healing.
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MEDICALBRIEF Issue No 0056 - HIV News 29 April 2015

Outcomes no better with single-pill regimens

One pill a day HIV treatments have the same rates of virological failure, drug resistance and side-effects as multiple tablet regimens, according to a meta-analysis.
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Community-based programmes lauded

Strengthening and expanding community-based approaches to delivering HIV treatment is vital to the long-term success of the Aids response, according to a report by Médecins sans Frontières (MSF) and UNAIDS.
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HIV and Aids workplace initiatives must be integrated

HIV and Aids workplace initiatives should be integrated into national Aids programmes and a wide range of health approaches, including occupational safety and health, says a report by the International Labour Organisation (ILO) in South Africa.
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Resistance to PrEP can occur

Recent data suggest that resistance to pre-exposure prophylaxis (PrEP), while rare, can occur with both treatment initiation during acute seronegative infection and in PrEP breakthrough infections.
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Possible congenital heart defect risk from AZT

First trimester exposure to retrovir was associated with congenital heart defects, according to results of the ANRS-EPF French Peri-natal Cohort and the nested PRIMEVA randomised trial.
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MEDICALBRIEF Issue No 0055 - HIV News 22 April 2015

Annual CD4 count monitoring suffices for some

Annual CD4 count monitoring may be sufficient for people taking antiretroviral treatment who have a suppressed viral load and a CD4 count above 250 cells/mm3, investigators report.
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High BP finding in HIV kids ‘alarming’

An Emory University study found the prevalence for high blood pressure was 'a potentially alarming' 20% among a cohort of children with HIV.

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Statin trial to test cardio risk in HIV patients

Researchers have begun enrolling participants in a multi-centre international clinical trial to test whether statin administration can reduce the risk for major adverse cardiovascular events, such as heart attacks, strokes, and heart disease, in people with HIV.
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MEDICALBRIEF Issue No 0054 - HIV News 15 April 2015

US updates HIV treatment guidelines

The US Department of Health has released updated HIV treatment guidelines that remove Atripla and Norvir–boosted Reyataz plus Truvada from 'recommended' regimens for treatment-naive people with HIV to an 'alternative' category.
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Gilead files for drug combination approval

Gilead Sciences has filed for US Food and Drug Administration (FDA) approval of a new version of the dual-combination HIV antiretroviral (ARV) Truvada containing tenofovir alafenamide fumarate which is less toxic to the bones and kidneys.
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Encouraging discovery on transmitted HIV drug resistance

A multicentre study has identified four key mutations involved in creating strains of drug-resistant HIV, which the researchers say is spreading at a more modest rate than once feared.
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Experimental therapy reduces virus in blood

In the first results to emerge from HIV patient trials of a new generation of so-called broadly neutralising antibodies, Rockefeller University researchers have found the experimental therapy can dramatically reduce the amount of virus present in a patient’s blood.
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Drug combination effective with syphilis

A daily combination of high-dose amoxicillin and probenecid was an effective syphilis treatment in patients with HIV infection, according to results of a retrospective, observational study.
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MEDICALBRIEF Issue No 0053 - HIV News 8 April 2015

ART effectiveness in ‘real world’ China setting

A China study shows that antiretroviral therapy (ART) may not be as effective at suppressing HIV and preventing onward transmission in 'real world' settings as it is in the best clinical practice.
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US barriers to ARV therapy

Up to 60% of persons living with HIV (PLHA) in the US are neither taking antiretroviral therapy (ART) nor well engaged in HIV primary care, with racial/ethnic minorities more likely to experience barriers. Only 30% achieved 'viral suppression'.
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HIV accelerates age-related illnesses by a decade

HIV-infected adults can develop the illnesses of ageing – some cancers, renal and kidney disease, frailty, osteoporosis and neuro-cognitive disease – approximately a decade earlier than their uninfected peers.

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MEDICALBRIEF Issue No 0051 - HIV News 25 March 2015

Pre-treatment resistance and virologic failure

Pre-treatment resistance and HIV-1 sub-type appear to be independently linked to virologic failure in HIV patients undergoing ART in resource-limited settings, according to results from the PEARLS trial.
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Drug combination effective

A combination of two once-daily oral antiretrovirals – the next-generation integrase inhibitor cabotegravir and the approved NNRTI rilpivirine – was as effective as an efavirenz-based regimen as maintenance therapy to keep viral load suppressed.
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New three-drug TB regimen shows promise

A new tuberculosis (TB) drug regimen designed to improve options for TB therapy eliminated more bacteria from sputum than standard therapy and did so at a faster rate, according to data from a phase 2b clinical trial in SA and Tanzania.
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Some weight gain linked to lower HIV mortality

A weight gain of 4-9 kilograms was associated with lower mortality in normal-weight, HIV-infected individuals. However, there was no benefit in gaining weight for patients who were overweight or obese at the start of treatment.
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PrEP cost-saving more than thought

The cost of pre-exposure prophylaxis (PrEP) to prevent HIV infections against the lifetime total cost of one HIV infection finds that, using Canadian figures, PrEP would be cost-saving under most scenarios, even if the overall lifetime cost of HIV care falls.
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MEDICALBRIEF Issue No 0050 - HIV News 18 March 2015

New approach to HIV care reduces deaths

A new approach to care for patients with advanced HIV in Tanzania and Zambia, combining community support and screening for cryptococcal meningitis, has reduced deaths by 28% – research suggests that a simple low-cost intervention could be an effective approach to reducing HIV-related deaths in Africa.
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Lessons from CROI 2015

Dr Joel Gallant has spoken about five important lessons learned at the CROI 2015 conference on the prevention of HIV and the future clinical implications of some of the major studies that were presented.
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Promising HIV-1 and HSV-2 studies

US research has found a powerfully effective vaccine against herpes viruses that might also be a good candidate as a vaccine vector for other mucosal diseases, particularly HIV and tuberculosis. In separate research it was found valacyclovir reduces HIV-1 levels – even when patients do not have herpes.
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Longer HIV survival triggers insurer payout

As people with HIV live longer than expected, Old Mutual plans to release reserves it has built up in its funeral insurance policies, to the benefit of lower-income customers.
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MEDICALBRIEF Issue No 0049 - HIV News 11 March 2015

HIV attachment inhibitor ‘well tolerated’

Fostemsavir, a first-in-class HIV attachment inhibitor that stops the virus from binding to and entering cells, was well-tolerated and demonstrated good antiviral activity, a study has shown.
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Viral load associated with fat gain

HIV infection or inflammatory changes associated with it may be responsible for fat accumulation and body fat redistribution, rather than HIV drugs, according to Case Western University research.
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Young UK men in the dark over HIV

Three quarters of young men in the UK who are gay or bisexual don't receive any information about same-sex relationships at school, with two thirds going without HIV testing advice.
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SA ‘game-changer’ in TB diagnosis

Drawing inspiration from veterinary medicine, researchers at the SA Tuberculosis Vaccine Initiative, the University of Cape Town and the University of Washington, have developed a new approach to detect tuberculosis (TB) – easy-to-obtain oral swab samples.
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MEDICALBRIEF Issue No 0048 - HIV News 4 March 2015

ART and INH prophylaxis reduces morbidity

Early HIV treatment, combined with therapy to prevent tuberculosis, sharply reduced morbidity in a randomised trial in Côte d’Ivoire.
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Maturation Inhibitor demonstrates high potency

A second-generation HIV maturation inhibitor, BMS-955176, demonstrated good safety and high potency, including activity against viral strains that were not susceptible to an earlier drug in this class, researchers have reported.
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FDA approves single tablet regimen

The US Food and Drug Administration has approved Triumeq, ViiV Healthcare’s single-tablet, triple-combination antiretroviral (ARV) regimen, as a first-line therapy to treat HIV.
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US-funded abstinence programmes fail

Nearly $1.3bn spent on US-funded programmes to promote abstinence and faithfulness in sub-Saharan Africa had no significant impact, an analysis of sexual behaviour data has shown.
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ART boosts post-operative survival rates

Post-operative mortality rates were low among patients infected with HIV who are receiving ART, and those mortality rates were influenced as much by age and poor nutritional status as CD4 cell counts.
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Combo regimen lowers mother-child transmission

The World Health Organisation recommendation of three-drug antiretroviral treatment during pregnancy leads to a significantly lower rate of mother-to-child HIV transmission, a seven-country randomised study as shown.
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PrEP successes in Europe and Canada

Two studies of PrEP in gay men and trans women in England, France and Canada have demonstrated that the availability of pre-exposure prophylaxis (PrEP) reduced the rate of infection by 86%.
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Study first to combine PrEP and ART

Giving both pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) to heterosexual couples where one partner has HIV can almost eliminate the chance of infection in the HIV-negative partner.
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Need for repeat testing in pregnancy

A large proportion of women in sub-Saharan Africa who are at high risk of transmitting HIV to their infants during breastfeeding are likely still to be undiagnosed, a large three-country survey found.
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Vaginal microbicide gel disappoints

FACTS 001, a South African study testing the efficacy against HIV of a vaginal microbicide gel found it was not efficacious enough to overcome the barriers to adherence posed by participants' lifestyles and especially their youth.
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Stopping cotrimoxazole during ART raises risk

Stopping cotrimoxazole prophylaxis in people taking antiretroviral therapy (ART) increases the risk of serious bacterial infections and malaria, even at high CD4 cell counts.
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MEDICALBRIEF Issue No 0047 - HIV News 25 February 2015

Transmission is by ‘undiagnosed and untreated’

Individuals infected but undiagnosed with HIV and diagnosed but not yet in medical care accounted for more than 90% of the estimated 45,000 United States HIV transmissions in 2009.
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Liver disease and TB common in HIV patients

Liver disease and tuberculosis were common in a cohort of adult South African patients with HIV, according to data from a retrospective John Hopkins study.
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HIV vaccine trial starts in SA

An NIH-led safety and efficacy trial of an experimental HIV vaccine regimen has begun in SA, with experimental vaccines from Sanofi Pasteur and Novartis.
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Novel drug candidate in fight against Aids

Scientists from the Scripps Research Institute have announced the creation of a novel drug candidate that is so potent and universally effective against HIV, it might work as part of an unconventional vaccine.
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Promising treatment for HCV/HIV patients

Two studies using interferon-free drug regimens for HIV patients with hepatitis C virus (HCV) resulted in high rates of sustained virologic response, which is a lack of detectable HCV RNA at least 12 weeks after completion of treatment.
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First HIV strain influences immune disruption

The strain of HIV someone is first infected with and its capacity to replicate in the body, can have a lasting influence on how the virus disrupts the immune system, according to a Zambia-Emory HIV Research Project study.
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MEDICALBRIEF Issue No 0046 - HIV News 18 February 2015

Hope for HIV/Aids patients with kidney disease

HIV-positive people with renal failure who get a donated kidney from another person with HIV/Aids fare as well as patients who get one from an uninfected donor, according to a South African study.
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Aggressive recombinant Cuba variant of HIV

Researchers at KU Leuven's Laboratory for Clinical and Epidemiological Virology report a recombinant form of HIV observed in patients in Cuba that shortens drastically the healthy phase and triggers rapid progression to Aids.
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Biomarkers help identify treatment strategies

Botswana-UPenn Partnership research shows that advanced HIV/TB patients are a heterogeneous population that should not be treated uniformly with response to immune interventions and that biomarkers can help identify treatment options.
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Call to reinstate SA’s HIV/Aids committee

SA civil society groups, including the Desmond Tutu HIV Foundation, have renewed their demand that the Joint Committee on HIV and Aids be reinstated.
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MEDICALBRIEF Issue No 0045 - HIV News 11 February 2015

Sub-Saharan CD4 counts not rising

A Harvard study has found that the average CD4 count in sub-Saharan African people diagnosed with HIV has not risen since 2002. Neither has the average CD4 count on initiation of treatment.
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Guidelines recommend fracture risk screening

Screening for fracture risk should be a routine part of HIV care for all over-40s, recommend new international guidelines.
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Insights into possible HIV vaccinations

An MIT investigation suggest that sequentially administering different forms of a potential HIV vaccine could stimulate a stronger immune response than delivering a cocktail of these variants all at once.
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VOICE failure opens debate on how to research in Africa

The surprising failure of a large clinical trial of HIV-prevention methods in Africa – known by the acronym VOICE has opened an ethical debate about how to run such studies in poor countries.
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Study explains slow mixing of HIV variants

Most HIV epidemics are still dominated by the first strain that entered a particular population. New research offers an explanation of why the global mixing of HIV variants is so slow.
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How HIV enters the brain

HIV relies on proteins expressed by a type of immune cell, called 'mature monocytes', to enter the brain during infection, causing inflammation and memory/cognitive problems.
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