Thursday, 29 February, 2024
HomeHIV ResearchStudies reported at the Conference on Retroviruses and Opportunistic Infections in Boston...

Studies reported at the Conference on Retroviruses and Opportunistic Infections in Boston include…

The rollout of antiretroviral therapy in rural SA has resulted in a rapid recovery of life expectancy for HIV-infected individuals, with women appearing to have benefited more than men, reports [s]MedPage Today[/s]. [b]Dr Till Barninghausen from Harvard School of Public Health[/b], and colleagues found that since 2004, overall longevity for childhood survivors of HIV-infection in the region has risen from about age 50 to age 60. However, in men longevity has gone from 46 to 55 years, while in women it has increased from 50 to 64 years. ‘We see that the benefits of HIV-therapy in rural South Africa are highly unequal,’ Barnighausen said. ‘Men are being left out.’ In a rural area northeast of Durban – considered the epicentre of the HIV epidemic in the country – researchers have tracked more than 90,000 individuals as to their HIV status, socioeconomic status, and a host of other demographic and health variables. Commenting on the results, Barnishausen said that his research team determined that women are 2.5 times more likely to utilise antiretroviral therapy than men, and that may explain part of the story.

S ex with older men is not placing women under 30 at higher risk of HIV infection in rural SA, and relationships with older men may even be protecting women over 30 from infection. An [s]Aidsmap[/s] report says this is according to results from an eight-year study presented by [b]Guy Harling of the Africa Centre for Health and Population Studies[/b]. The report says although cross-sectional studies of HIV prevalence have suggested that younger women are placed at high risk of HIV infection as a result of relationships with older men in sub-Saharan Africa, this is the first study to follow women over a long period and to look at HIV incidence and age of s exual partners. Harling said that campaigns in many African countries that seek to discourage or even stigmatise age-different relationships may prove to be an inefficient use of resources, or may even prove counter-productive. He suggested that the reduced risk in older women may be a consequence of extensive social networks that allow older women to make a careful choice of partner. It is also possible that younger women are less likely to choose an older partner in a rural area of widespread poverty, or may have fewer opportunities to encounter an older partner than in an urban area.

A community-based self-testing programme achieved 76% uptake of HIV testing in urban Malawi, with very high accuracy of test reading and linkage to care, researchers from [b]Malawi, Liverpool School of Tropical Medicine and London School of Hygiene and Tropical Medicine[/b] have reported. Self-testing for HIV using the [s]OraQuick[/s] oral fluid test is already available in the US and is likely to be approved for use in Europe in 2014, and is already available on a formal or informal basis in many low- and middle-income countries, but there is still limited evidence on its large-scale use. An [s]Aidsmap[/s] report notes that the Malawian study is the first large evaluation of the acceptability and utility of self-testing in a resource-limited setting.

Two new studies released by [s]Epicentre[/s], the research arm of the international medical humanitarian organisation Médecins [b]Sans Frontières (MSF)[/b] point to reductions in new HIV infections in areas where HIV treatment has been scaled up. These studies are among the very few that look at large-scale antiretroviral therapy rollout in real-world high-HIV-burden settings in sub-Saharan Africa, and its possible impact on reducing new infections. ‘Studies like ours are essential to get a close-up picture of the epidemic,’ said [b]Dr Helena Huerga[/b], the lead researcher of the SA study. ‘Our study tells us the situation on the ground is better than we expected, but it also points to exactly where we need to target our interventions to maximise the impact. As we can see, the older the treatment programme, the better the impact seems to be in reducing transmission, so this is a real signal to the global health community to keep pushing forward with HIV treatment on a large scale and get treatment to as many people as possible, as soon as possible.’

A strategy to genetically modify cells from people infected with HIV could become a way to control the virus that causes Aids without using antiviral drugs. [s]Business Recorder[/s] reports that this is according to results from the small study of the [b]Sangamo BioSciences[/b] therapy, known by the code name SB-728-T issued in the [b]New England Journal of Medicine[/b], the first publication of data from a human trial of a technology called ‘gene editing.’ The report says the technique is designed to disrupt a gene, CCR5, used by HIV to infect T-cells, the white blood cells that fight viral infections. A patient's cells are removed and processed to alter the DNA that codes for the CCR5 receptor. The altered cells are multiplied and tested, then infused back into the patient. The Phase 1 trial, led by the [b]University of Pennsylvania[/b], enrolled 12 HIV patients. The study's main goal was safety, but it also showed that the modified T-cells persisted and the presence of HIV DNA decreased, the researchers said.

Promising preliminary results from a trial of [b]Merck’s MK-5172 and MK-8742[/b], given with or without ribavirin, showed that the combination therapy was as safe in treating genotype 1 of hepatitis C virus (HCV) among those co-infected with HIV as it was among those mono-infected with hep C. An [s]AidsMed[/s] report notes that the treatment appears to boast near-perfect success rates. Results from the C-WORTHY study, which is a Phase II, randomised, dose-responsive, parallel-group, multiple-site, open-label trial comparing various difficult-to-treat populations among a group of 450 people with hep C, were presented at the Boston conference.
[link url=http://www.medpagetoday.com/MeetingCoverage/CROI/44681]Full MedPage Today report [/link]
[link url=http://www.ncbi.nlm.nih.gov/pubmed/23842131]Research[/link]
[link url=http://www.aidsmap.com/Younger-women-not-at-higher-risk-of-HIV-from-relationships-with-older-men-South-African-study-finds/page/2833922]Full Aidsmap report [/link]
[link url=http://www.croiwebcasts.org/console/player/22285?mediaType=slideVideo&]Presentation[/link]
[link url=http://www.aidsmap.com/Self-testing-encourages-very-high-uptake-of-HIV-testing-in-Malawi-study/page/2833910]Full Aidsmap report [/link]
[link url=http://allafrica.com/stories/201403071292.html]Full MSF press release [/link]
[link url=http://www.epicentre.msf.org/en/adults-receiving-hiv-care-start-antiretroviral-therapy-sub-saharan-africa-patient-outcomes-and-ass-0]Research[/link]
[link url=http://www.brecorder.com/general-news/172/1161297]Full Business Recorder report[/link]
[link url=http://www.nejm.org/doi/full/10.1056/NEJMoa1300662]NEMJ article[/link]
[link url=http://www.aidsmeds.com/articles/Merck_coinfected_1667_25254.shtml]Full AidsMed report[/link]
[link url=http://online.wsj.com/article/PR-CO-20140305-912652.html]See also The Wall Street Journal[/link]
[link url=http://clinicaltrials.gov/show/NCT01717326]Research[/link]

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