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Richard Pizzi is editor of The Hospitalist. He has been an editor at Frontline Medical Communications since 2015, and previously served as editor of MDedge publications Hospitalist News and ID Practitioner. He has also worked as an editor and in editorial management roles for HIMSS Media, MedTech Media, and the American Association for Clinical Chemistry. Follow him on Twitter @richpizzi
Hepatitis Outlook: September 2016
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.
A recent study suggested that hepatitis B virus (HBV)-DNA testing should be considered routinely in monitoring drug-induced liver injury, and also in other clinical implications associated with occult hepatitis B virus infection.
German researchers said that stopping or interrupting treatment with nucleos(t)ide analogues in noncirrhotic patients with HBeAg-negative chronic hepatitis B should be further investigated as a strategy to accelerate HBsAg loss.
Despite its high variability, the hepatitis C virus (HCV) is under strict evolutionary constraints, most probably to keep its genes and proteins functional during the replication cycle, according to a study in Virus Evolution.
The high burden of chronic hepatitis B virus infection in Asian countries is a major challenge for the incorporation of national programs to prevent chronic HBV complications within health care systems, according to a meta-analysis in the International Journal of Infectious Diseases.
Recent research suggests that a transition to newer direct acting antivirals is urgently needed in Rwanda and sub-Saharan Africa more generally to improve treatment outcomes for hepatitis C virus–infected patients.
Ribavirin is an effective treatment for hepatitis E virus (HEV) infection, according to a recent review study, but further studies are required to determine which other antiviral agents are of clinical utility in treating HEV in the minority of patients who do not respond to ribavirin.
Robust HEV-specific T-cell responses generated during acute disease predominantly target open reading frame 2 (ORF2), according to a study in Hepatology, but decline in magnitude and polyfunctionality over time. The authors said that defining HEV T-cell targets will be important for the investigation of HEV-associated autoimmune disease.
A recent study indicated that the variability in estimates of spontaneous viral clearance of hepatitis C virus infection – between HIV-positive men who have sex with men and people who inject drugs – has an impact on HIV coinfection and HCV reinfection.
A French study found that the rate of patients failing to return for the results of HIV, HBV, HCV, and syphilis testing is a problem, but the use of currently available technologies, such as phone texting, might be a partial solution in conjunction with rapid tests for diagnosis.
In chronic hepatitis C virus infection, the preferential association of HCV with B cells is mediated by the complement system, mainly through complement receptor 2 (CD21), in conjunction with the CD19 and CD81 complex, according to a study in Hepatology.
An Italian study found that virological response at week 8 of pegylated interferon and ribavirin therapy in hepatitis C–infected children could be considered a reliable predictor of sustained virologic response.
A recent study found that interferon treatment increased, rather than decreased, hepatitis C virus long double-stranded RNA (dsRNA) in patients. The authors said this unexpected finding suggests that HCV produces dsRNA in response to interferon, potentially to antagonize antiviral defenses.
A vaccine study in Argentina found that single-dose universal hepatitis A immunization in 1-year-old children resulted in sustained immunologic protection for up to 9 years.
A Japanese study found that CD14+ monocyte-derived galectin-9 increases NK cell cytotoxicity in chronic hepatitis C virus infection, which might be associated with liver injury and persistent infection.
Sofosbuvir and ribavirin for 6 weeks was not effective among people with recent hepatitis C virus infection, according to results from the DARE-C II study.
A study in Hepatology found that a single broadly neutralizing antibody can prevent acute hepatitis C virus infection without inducing the emergence of resistance-associated variants (RAVs), and may complement direct-acting antivirals to reduce the emergence of RAVs.
Vaccination with DTPa-HBV-IPV/Hib (diphtheria-tetanus-acellular pertussis–hepatitis B–inactivated poliovirus/Haemophilus influenza type b) in infancy induces sustained seroprotection and immune memory against hepatitis B virus, a recent study found, as revealed by the strong anamnestic response to the hepatitis B vaccine challenge in 12- to 13-year-old adolescents.
Chronic hepatitis C virus infection appears to disrupt the milieu of soluble inflammatory mediators even after viral clearance, investigators found, indicating HCV cure does not lead to complete immunological restitution.
Among the largest U.S. community-based real-world cohort of Asian chronic hepatitis C virus genotype 6 patients treated with all-oral sofosbuvir/ledipasvir without ribavirin, sustained viral response at 12 weeks was similar to SVR12 reported in clinical trials, validating current HCV genotype 6 treatment guideline recommendations.
Lower serum albumin and higher AST appear to be important mortality risk factors in HIV/HCV-coinfection, but much less so in HIV-monoinfected individuals, reported a study in the journal AIDS.
A retrospective study of 11 European pediatric HIV cohorts found a high proportion of patients coinfected with hepatitis C virus and suffering from progressive liver disease, which investigators said underscores the need for close monitoring and for earlier and more effective HCV treatment.
Chinese investigators have developed and validated a novel classification and regression tree (CART) analysis model that they say is superior to the model for end-stage liver disease (MELD) for predicting 3-month mortality of patients with acute-on-chronic hepatitis B liver failure.
A study in Lancet Infectious Diseases confirmed that injection drug use is a major contributor to the global burden of disease for HIV, hepatitis C, and hepatitis B.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.
A recent study suggested that hepatitis B virus (HBV)-DNA testing should be considered routinely in monitoring drug-induced liver injury, and also in other clinical implications associated with occult hepatitis B virus infection.
German researchers said that stopping or interrupting treatment with nucleos(t)ide analogues in noncirrhotic patients with HBeAg-negative chronic hepatitis B should be further investigated as a strategy to accelerate HBsAg loss.
Despite its high variability, the hepatitis C virus (HCV) is under strict evolutionary constraints, most probably to keep its genes and proteins functional during the replication cycle, according to a study in Virus Evolution.
The high burden of chronic hepatitis B virus infection in Asian countries is a major challenge for the incorporation of national programs to prevent chronic HBV complications within health care systems, according to a meta-analysis in the International Journal of Infectious Diseases.
Recent research suggests that a transition to newer direct acting antivirals is urgently needed in Rwanda and sub-Saharan Africa more generally to improve treatment outcomes for hepatitis C virus–infected patients.
Ribavirin is an effective treatment for hepatitis E virus (HEV) infection, according to a recent review study, but further studies are required to determine which other antiviral agents are of clinical utility in treating HEV in the minority of patients who do not respond to ribavirin.
Robust HEV-specific T-cell responses generated during acute disease predominantly target open reading frame 2 (ORF2), according to a study in Hepatology, but decline in magnitude and polyfunctionality over time. The authors said that defining HEV T-cell targets will be important for the investigation of HEV-associated autoimmune disease.
A recent study indicated that the variability in estimates of spontaneous viral clearance of hepatitis C virus infection – between HIV-positive men who have sex with men and people who inject drugs – has an impact on HIV coinfection and HCV reinfection.
A French study found that the rate of patients failing to return for the results of HIV, HBV, HCV, and syphilis testing is a problem, but the use of currently available technologies, such as phone texting, might be a partial solution in conjunction with rapid tests for diagnosis.
In chronic hepatitis C virus infection, the preferential association of HCV with B cells is mediated by the complement system, mainly through complement receptor 2 (CD21), in conjunction with the CD19 and CD81 complex, according to a study in Hepatology.
An Italian study found that virological response at week 8 of pegylated interferon and ribavirin therapy in hepatitis C–infected children could be considered a reliable predictor of sustained virologic response.
A recent study found that interferon treatment increased, rather than decreased, hepatitis C virus long double-stranded RNA (dsRNA) in patients. The authors said this unexpected finding suggests that HCV produces dsRNA in response to interferon, potentially to antagonize antiviral defenses.
A vaccine study in Argentina found that single-dose universal hepatitis A immunization in 1-year-old children resulted in sustained immunologic protection for up to 9 years.
A Japanese study found that CD14+ monocyte-derived galectin-9 increases NK cell cytotoxicity in chronic hepatitis C virus infection, which might be associated with liver injury and persistent infection.
Sofosbuvir and ribavirin for 6 weeks was not effective among people with recent hepatitis C virus infection, according to results from the DARE-C II study.
A study in Hepatology found that a single broadly neutralizing antibody can prevent acute hepatitis C virus infection without inducing the emergence of resistance-associated variants (RAVs), and may complement direct-acting antivirals to reduce the emergence of RAVs.
Vaccination with DTPa-HBV-IPV/Hib (diphtheria-tetanus-acellular pertussis–hepatitis B–inactivated poliovirus/Haemophilus influenza type b) in infancy induces sustained seroprotection and immune memory against hepatitis B virus, a recent study found, as revealed by the strong anamnestic response to the hepatitis B vaccine challenge in 12- to 13-year-old adolescents.
Chronic hepatitis C virus infection appears to disrupt the milieu of soluble inflammatory mediators even after viral clearance, investigators found, indicating HCV cure does not lead to complete immunological restitution.
Among the largest U.S. community-based real-world cohort of Asian chronic hepatitis C virus genotype 6 patients treated with all-oral sofosbuvir/ledipasvir without ribavirin, sustained viral response at 12 weeks was similar to SVR12 reported in clinical trials, validating current HCV genotype 6 treatment guideline recommendations.
Lower serum albumin and higher AST appear to be important mortality risk factors in HIV/HCV-coinfection, but much less so in HIV-monoinfected individuals, reported a study in the journal AIDS.
A retrospective study of 11 European pediatric HIV cohorts found a high proportion of patients coinfected with hepatitis C virus and suffering from progressive liver disease, which investigators said underscores the need for close monitoring and for earlier and more effective HCV treatment.
Chinese investigators have developed and validated a novel classification and regression tree (CART) analysis model that they say is superior to the model for end-stage liver disease (MELD) for predicting 3-month mortality of patients with acute-on-chronic hepatitis B liver failure.
A study in Lancet Infectious Diseases confirmed that injection drug use is a major contributor to the global burden of disease for HIV, hepatitis C, and hepatitis B.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.
A recent study suggested that hepatitis B virus (HBV)-DNA testing should be considered routinely in monitoring drug-induced liver injury, and also in other clinical implications associated with occult hepatitis B virus infection.
German researchers said that stopping or interrupting treatment with nucleos(t)ide analogues in noncirrhotic patients with HBeAg-negative chronic hepatitis B should be further investigated as a strategy to accelerate HBsAg loss.
Despite its high variability, the hepatitis C virus (HCV) is under strict evolutionary constraints, most probably to keep its genes and proteins functional during the replication cycle, according to a study in Virus Evolution.
The high burden of chronic hepatitis B virus infection in Asian countries is a major challenge for the incorporation of national programs to prevent chronic HBV complications within health care systems, according to a meta-analysis in the International Journal of Infectious Diseases.
Recent research suggests that a transition to newer direct acting antivirals is urgently needed in Rwanda and sub-Saharan Africa more generally to improve treatment outcomes for hepatitis C virus–infected patients.
Ribavirin is an effective treatment for hepatitis E virus (HEV) infection, according to a recent review study, but further studies are required to determine which other antiviral agents are of clinical utility in treating HEV in the minority of patients who do not respond to ribavirin.
Robust HEV-specific T-cell responses generated during acute disease predominantly target open reading frame 2 (ORF2), according to a study in Hepatology, but decline in magnitude and polyfunctionality over time. The authors said that defining HEV T-cell targets will be important for the investigation of HEV-associated autoimmune disease.
A recent study indicated that the variability in estimates of spontaneous viral clearance of hepatitis C virus infection – between HIV-positive men who have sex with men and people who inject drugs – has an impact on HIV coinfection and HCV reinfection.
A French study found that the rate of patients failing to return for the results of HIV, HBV, HCV, and syphilis testing is a problem, but the use of currently available technologies, such as phone texting, might be a partial solution in conjunction with rapid tests for diagnosis.
In chronic hepatitis C virus infection, the preferential association of HCV with B cells is mediated by the complement system, mainly through complement receptor 2 (CD21), in conjunction with the CD19 and CD81 complex, according to a study in Hepatology.
An Italian study found that virological response at week 8 of pegylated interferon and ribavirin therapy in hepatitis C–infected children could be considered a reliable predictor of sustained virologic response.
A recent study found that interferon treatment increased, rather than decreased, hepatitis C virus long double-stranded RNA (dsRNA) in patients. The authors said this unexpected finding suggests that HCV produces dsRNA in response to interferon, potentially to antagonize antiviral defenses.
A vaccine study in Argentina found that single-dose universal hepatitis A immunization in 1-year-old children resulted in sustained immunologic protection for up to 9 years.
A Japanese study found that CD14+ monocyte-derived galectin-9 increases NK cell cytotoxicity in chronic hepatitis C virus infection, which might be associated with liver injury and persistent infection.
Sofosbuvir and ribavirin for 6 weeks was not effective among people with recent hepatitis C virus infection, according to results from the DARE-C II study.
A study in Hepatology found that a single broadly neutralizing antibody can prevent acute hepatitis C virus infection without inducing the emergence of resistance-associated variants (RAVs), and may complement direct-acting antivirals to reduce the emergence of RAVs.
Vaccination with DTPa-HBV-IPV/Hib (diphtheria-tetanus-acellular pertussis–hepatitis B–inactivated poliovirus/Haemophilus influenza type b) in infancy induces sustained seroprotection and immune memory against hepatitis B virus, a recent study found, as revealed by the strong anamnestic response to the hepatitis B vaccine challenge in 12- to 13-year-old adolescents.
Chronic hepatitis C virus infection appears to disrupt the milieu of soluble inflammatory mediators even after viral clearance, investigators found, indicating HCV cure does not lead to complete immunological restitution.
Among the largest U.S. community-based real-world cohort of Asian chronic hepatitis C virus genotype 6 patients treated with all-oral sofosbuvir/ledipasvir without ribavirin, sustained viral response at 12 weeks was similar to SVR12 reported in clinical trials, validating current HCV genotype 6 treatment guideline recommendations.
Lower serum albumin and higher AST appear to be important mortality risk factors in HIV/HCV-coinfection, but much less so in HIV-monoinfected individuals, reported a study in the journal AIDS.
A retrospective study of 11 European pediatric HIV cohorts found a high proportion of patients coinfected with hepatitis C virus and suffering from progressive liver disease, which investigators said underscores the need for close monitoring and for earlier and more effective HCV treatment.
Chinese investigators have developed and validated a novel classification and regression tree (CART) analysis model that they say is superior to the model for end-stage liver disease (MELD) for predicting 3-month mortality of patients with acute-on-chronic hepatitis B liver failure.
A study in Lancet Infectious Diseases confirmed that injection drug use is a major contributor to the global burden of disease for HIV, hepatitis C, and hepatitis B.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
Hepatitis Outlook: August 2016
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.
A study in Hepatology has provided a preclinical risk assessment paradigm with which to better understand cardiovascular drug-drug interaction risk for hepatitis C–virus infected patients treated with sofosbuvir in combination with other direct acting antivirals and the antiarrhythmic drug amiodarone.
A Japanese study found that, although levels of Wisteria floribunda agglutinin-positive Mac-2-binding protein could be a useful indicator of liver fibrosis in patients with hepatitis B or C infection, WFA+-M2BP levels in the two groups significantly differed, even in the same degree of fibrosis.
Interferon-free, guideline-tailored therapy with direct-acting antivirals is highly effective and safe for hepatitis C virus–associated mixed cryoglobulinemia patients, according to a recent study.
Another recent study found that pegylated interferon (PegIFN) intensification in hepatitis B “e” antigen (HBeAg)-positive coinfected patients did not lead to increased clearance rates of HBeAg or hepatitis B surface antigen quantification (qHBsAg), despite faster declines of antigen levels while on PegIFN.
A study in HIV Medicine found that, under real-life conditions, treatment of patients infected with hepatitis C virus and of patients coinfected with HCV/HIV with all-oral direct-acting antiviral combinations led to high and similar rates of sustained virological response 12 weeks after the end of therapy.
Hepatitis B virus coinfection was the most important risk factor for liver fibrosis and cirrhosis in HIV-infected patients, and should be diagnosed early in HIV care to optimize treatment outcomes, a recent study showed.
Immunity persisted 24 months after a single dose of inactivated hepatitis A vaccine and live attenuated hepatitis A vaccine was administered to school-age children, according to a study published in Human Vaccines & Immunotherapeutics.
A hepatitis C treatment scale-up strategy in Rhode Island could reduce cirrhosis cases and liver-related deaths by 78.9% and 72.4%, respectively, by 2030, according to a study in Epidemiology and Infection.
Viral blipping is a frequent event during nucleoside analogue treatment of patients with chronic hepatitis B virus infection, a study found, although it did not lead to any clinically significant outcomes and thus may not require more frequent blood work and patient visits in clinical practice.
A study of liver and spleen stiffness in hepatitis C virus–infected patients – with advanced liver disease and sustained virologic response after interferon-free treatment – found that improvement of liver stiffness may be due to reduced necroinflammation, and to a lesser extent regression of cirrhosis. Improvement was more pronounced between therapy baseline and end of treatment than therapy baseline and 24 weeks after end of treatment.
From 2000 to 2011, 4,346 adults who died in New York City had a report of a hepatitis B virus infection (0.7%), according to a study in Epidemiology and Infection. Of the HBV-infected decedents, 1,074 (25%) were HIV coinfected. Fifty-five percent of HBV monoinfected and 95% of HBV/HIV coinfected decedents died prematurely, the researchers found.
Prison-based hepatitis C virus treatment achieves outcomes similar to those of community-based treatment, according to a study in the Journal of Viral Hepatitis, with those not released or transferred during treatment doing particularly well.
Treatment interventions to curb the hepatitis C virus epidemic among HIV-infected men who have sex with men are effective if high-risk behavior does not increase as it has during the last decade, according to a study in Hepatology.
The results of an international quality control study underline the urgent need to improve methods used to monitor hepatitis Delta virus viremia.
An investigation of a hepatitis E virus genotype 4 outbreak in Zhejiang Province, China, found that the outbreak was most likely caused by contaminated tap water rather than food.
A German study found that short treatment with 8 weeks of sofosbuvir and ledipasvir seems highly effective and safe in well-selected hepatitis C virus mono- and HIV/HCV-coinfected patients in a real-world setting.
A study of historical events fueling the cross-continental spread of hepatitis C virus epidemics said drivers for the epidemic were the advent of intravenous medical therapies and devices, growth in the heroin trade, and population mixing during armed conflicts.
AGA Resource
Through the AGA Roadmap to the Future of Practice, AGA offers a Hepatitis C Clinical Service line to support high-quality patient care, which is available at http://www.gastro.org/patient-care/conditions-diseases/hepatitis-c.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.
A study in Hepatology has provided a preclinical risk assessment paradigm with which to better understand cardiovascular drug-drug interaction risk for hepatitis C–virus infected patients treated with sofosbuvir in combination with other direct acting antivirals and the antiarrhythmic drug amiodarone.
A Japanese study found that, although levels of Wisteria floribunda agglutinin-positive Mac-2-binding protein could be a useful indicator of liver fibrosis in patients with hepatitis B or C infection, WFA+-M2BP levels in the two groups significantly differed, even in the same degree of fibrosis.
Interferon-free, guideline-tailored therapy with direct-acting antivirals is highly effective and safe for hepatitis C virus–associated mixed cryoglobulinemia patients, according to a recent study.
Another recent study found that pegylated interferon (PegIFN) intensification in hepatitis B “e” antigen (HBeAg)-positive coinfected patients did not lead to increased clearance rates of HBeAg or hepatitis B surface antigen quantification (qHBsAg), despite faster declines of antigen levels while on PegIFN.
A study in HIV Medicine found that, under real-life conditions, treatment of patients infected with hepatitis C virus and of patients coinfected with HCV/HIV with all-oral direct-acting antiviral combinations led to high and similar rates of sustained virological response 12 weeks after the end of therapy.
Hepatitis B virus coinfection was the most important risk factor for liver fibrosis and cirrhosis in HIV-infected patients, and should be diagnosed early in HIV care to optimize treatment outcomes, a recent study showed.
Immunity persisted 24 months after a single dose of inactivated hepatitis A vaccine and live attenuated hepatitis A vaccine was administered to school-age children, according to a study published in Human Vaccines & Immunotherapeutics.
A hepatitis C treatment scale-up strategy in Rhode Island could reduce cirrhosis cases and liver-related deaths by 78.9% and 72.4%, respectively, by 2030, according to a study in Epidemiology and Infection.
Viral blipping is a frequent event during nucleoside analogue treatment of patients with chronic hepatitis B virus infection, a study found, although it did not lead to any clinically significant outcomes and thus may not require more frequent blood work and patient visits in clinical practice.
A study of liver and spleen stiffness in hepatitis C virus–infected patients – with advanced liver disease and sustained virologic response after interferon-free treatment – found that improvement of liver stiffness may be due to reduced necroinflammation, and to a lesser extent regression of cirrhosis. Improvement was more pronounced between therapy baseline and end of treatment than therapy baseline and 24 weeks after end of treatment.
From 2000 to 2011, 4,346 adults who died in New York City had a report of a hepatitis B virus infection (0.7%), according to a study in Epidemiology and Infection. Of the HBV-infected decedents, 1,074 (25%) were HIV coinfected. Fifty-five percent of HBV monoinfected and 95% of HBV/HIV coinfected decedents died prematurely, the researchers found.
Prison-based hepatitis C virus treatment achieves outcomes similar to those of community-based treatment, according to a study in the Journal of Viral Hepatitis, with those not released or transferred during treatment doing particularly well.
Treatment interventions to curb the hepatitis C virus epidemic among HIV-infected men who have sex with men are effective if high-risk behavior does not increase as it has during the last decade, according to a study in Hepatology.
The results of an international quality control study underline the urgent need to improve methods used to monitor hepatitis Delta virus viremia.
An investigation of a hepatitis E virus genotype 4 outbreak in Zhejiang Province, China, found that the outbreak was most likely caused by contaminated tap water rather than food.
A German study found that short treatment with 8 weeks of sofosbuvir and ledipasvir seems highly effective and safe in well-selected hepatitis C virus mono- and HIV/HCV-coinfected patients in a real-world setting.
A study of historical events fueling the cross-continental spread of hepatitis C virus epidemics said drivers for the epidemic were the advent of intravenous medical therapies and devices, growth in the heroin trade, and population mixing during armed conflicts.
AGA Resource
Through the AGA Roadmap to the Future of Practice, AGA offers a Hepatitis C Clinical Service line to support high-quality patient care, which is available at http://www.gastro.org/patient-care/conditions-diseases/hepatitis-c.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.
A study in Hepatology has provided a preclinical risk assessment paradigm with which to better understand cardiovascular drug-drug interaction risk for hepatitis C–virus infected patients treated with sofosbuvir in combination with other direct acting antivirals and the antiarrhythmic drug amiodarone.
A Japanese study found that, although levels of Wisteria floribunda agglutinin-positive Mac-2-binding protein could be a useful indicator of liver fibrosis in patients with hepatitis B or C infection, WFA+-M2BP levels in the two groups significantly differed, even in the same degree of fibrosis.
Interferon-free, guideline-tailored therapy with direct-acting antivirals is highly effective and safe for hepatitis C virus–associated mixed cryoglobulinemia patients, according to a recent study.
Another recent study found that pegylated interferon (PegIFN) intensification in hepatitis B “e” antigen (HBeAg)-positive coinfected patients did not lead to increased clearance rates of HBeAg or hepatitis B surface antigen quantification (qHBsAg), despite faster declines of antigen levels while on PegIFN.
A study in HIV Medicine found that, under real-life conditions, treatment of patients infected with hepatitis C virus and of patients coinfected with HCV/HIV with all-oral direct-acting antiviral combinations led to high and similar rates of sustained virological response 12 weeks after the end of therapy.
Hepatitis B virus coinfection was the most important risk factor for liver fibrosis and cirrhosis in HIV-infected patients, and should be diagnosed early in HIV care to optimize treatment outcomes, a recent study showed.
Immunity persisted 24 months after a single dose of inactivated hepatitis A vaccine and live attenuated hepatitis A vaccine was administered to school-age children, according to a study published in Human Vaccines & Immunotherapeutics.
A hepatitis C treatment scale-up strategy in Rhode Island could reduce cirrhosis cases and liver-related deaths by 78.9% and 72.4%, respectively, by 2030, according to a study in Epidemiology and Infection.
Viral blipping is a frequent event during nucleoside analogue treatment of patients with chronic hepatitis B virus infection, a study found, although it did not lead to any clinically significant outcomes and thus may not require more frequent blood work and patient visits in clinical practice.
A study of liver and spleen stiffness in hepatitis C virus–infected patients – with advanced liver disease and sustained virologic response after interferon-free treatment – found that improvement of liver stiffness may be due to reduced necroinflammation, and to a lesser extent regression of cirrhosis. Improvement was more pronounced between therapy baseline and end of treatment than therapy baseline and 24 weeks after end of treatment.
From 2000 to 2011, 4,346 adults who died in New York City had a report of a hepatitis B virus infection (0.7%), according to a study in Epidemiology and Infection. Of the HBV-infected decedents, 1,074 (25%) were HIV coinfected. Fifty-five percent of HBV monoinfected and 95% of HBV/HIV coinfected decedents died prematurely, the researchers found.
Prison-based hepatitis C virus treatment achieves outcomes similar to those of community-based treatment, according to a study in the Journal of Viral Hepatitis, with those not released or transferred during treatment doing particularly well.
Treatment interventions to curb the hepatitis C virus epidemic among HIV-infected men who have sex with men are effective if high-risk behavior does not increase as it has during the last decade, according to a study in Hepatology.
The results of an international quality control study underline the urgent need to improve methods used to monitor hepatitis Delta virus viremia.
An investigation of a hepatitis E virus genotype 4 outbreak in Zhejiang Province, China, found that the outbreak was most likely caused by contaminated tap water rather than food.
A German study found that short treatment with 8 weeks of sofosbuvir and ledipasvir seems highly effective and safe in well-selected hepatitis C virus mono- and HIV/HCV-coinfected patients in a real-world setting.
A study of historical events fueling the cross-continental spread of hepatitis C virus epidemics said drivers for the epidemic were the advent of intravenous medical therapies and devices, growth in the heroin trade, and population mixing during armed conflicts.
AGA Resource
Through the AGA Roadmap to the Future of Practice, AGA offers a Hepatitis C Clinical Service line to support high-quality patient care, which is available at http://www.gastro.org/patient-care/conditions-diseases/hepatitis-c.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
Ebola research update: September 2016
The struggle to defeat Ebola virus disease continues globally, although it may not always make the headlines. To catch up on what you may have missed, here are some notable news items and journal articles published over the past few weeks that are worth a second look.
, according to a study of EVD patients treated in the United States.
An analysis of the 2014 Ebola virus disease outbreak in Nigeria found that early detection of cases, an efficacious incident management system, and rapid case management with on-site mobilization and training of local professionals were important to better outcomes, prompt containment, and no infection among EVD care-providers.
Viral genome sequence data uniquely reveals the 2013-2016 epidemic of Ebola virus disease in West Africa to be “a heterogeneous and spatially dissociated collection of transmission clusters of that were of varying size, duration, and connectivity,” according to a recent study.
A case study of Lassa fever involved the development of a mathematical framework which was applied to try to determine how much of disease transmission was from animal to human and how much was from human to human. This knowledge can be used to “infer human disease risk based on knowledge of infection patterns in the animal reservoir host and the contact mechanisms required for transmission to humans.”
A decontamination protocol that relies on the use of both peracetic acid and hydrogen peroxide fumigation was proposed for a biosafety level 3 field laboratory as a part of an Ebola treatment center in Guinea. Inoculated stainless steel disks of bioindicators containing spores of Geobacillus stearothermophilus were used to control the protocol.
A survey in New Zealand indicated that a future Ebola outbreak would have “large social and economic consequences” because judging from survey responses, a large percentage of the population would avoid social contact, such as going to work, school, and social events, to protect their health, according to a study in Disaster Medicine and Public Health Preparedness. Survey respondents also indicated a willingness to receive a vaccine.
Investigators identified contact tracing as an important determinant of the 2014-2015 Ebola epidemic’s behavior in Guinea. Also, early availability of Ebola treatment unit beds was key in limiting the number of Ebola cases.
The WHO Ebola Response Team said that empirical and modeling studies performed during the West African Ebola virus disease epidemic have demonstrated that large epidemics of EVD can be prevented, that “a rapid response can interrupt transmission and restrict the size of outbreaks, even in densely populated cities.”
In 2015, the first nationwide semen testing and counseling program for male Ebola survivors, the Men’s Health Screening Program, was established in Liberia, according to a report in MMWR. Researchers said involvement with the survivor community, communication, and flexibility were key to the program’s success.
A $13 million NIH grant to study how the Ebola virus replicates has been awarded to a team at Washington University, St. Louis.
A recent study found that vector delivery of two antibody components of the ZMapp product works in mice against systemic and airway challenge with a mouse-adapted strain of Ebola virus. The authors say this platform “provides a generic manufacturing solution and overcomes some of the delivery challenges associated with repeated administration of the protective protein.”
U.S. Army researchers based at Fort Detrick, Md., are developing relationships with Ebola survivors in Uganda, who the researchers believe may hold the key to a vaccine or treatment for the infection because many Ugandans have survived the epidemic.
A qualitative study in PLOS Current Outbreaks found that the preparedness of U.S. health care volunteers in the West Africa Ebola deployment was inadequate. The authors said effective policies and practices must be developed and implemented to properly protect the health and well-being of volunteers.
Investigators hypothesized that cannabidiol, based on its pharmacological effects and favorable safety profile, should be considered as a treatment for individuals with post-Ebola sequelae because it can reduce pain and inflammation.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
The struggle to defeat Ebola virus disease continues globally, although it may not always make the headlines. To catch up on what you may have missed, here are some notable news items and journal articles published over the past few weeks that are worth a second look.
, according to a study of EVD patients treated in the United States.
An analysis of the 2014 Ebola virus disease outbreak in Nigeria found that early detection of cases, an efficacious incident management system, and rapid case management with on-site mobilization and training of local professionals were important to better outcomes, prompt containment, and no infection among EVD care-providers.
Viral genome sequence data uniquely reveals the 2013-2016 epidemic of Ebola virus disease in West Africa to be “a heterogeneous and spatially dissociated collection of transmission clusters of that were of varying size, duration, and connectivity,” according to a recent study.
A case study of Lassa fever involved the development of a mathematical framework which was applied to try to determine how much of disease transmission was from animal to human and how much was from human to human. This knowledge can be used to “infer human disease risk based on knowledge of infection patterns in the animal reservoir host and the contact mechanisms required for transmission to humans.”
A decontamination protocol that relies on the use of both peracetic acid and hydrogen peroxide fumigation was proposed for a biosafety level 3 field laboratory as a part of an Ebola treatment center in Guinea. Inoculated stainless steel disks of bioindicators containing spores of Geobacillus stearothermophilus were used to control the protocol.
A survey in New Zealand indicated that a future Ebola outbreak would have “large social and economic consequences” because judging from survey responses, a large percentage of the population would avoid social contact, such as going to work, school, and social events, to protect their health, according to a study in Disaster Medicine and Public Health Preparedness. Survey respondents also indicated a willingness to receive a vaccine.
Investigators identified contact tracing as an important determinant of the 2014-2015 Ebola epidemic’s behavior in Guinea. Also, early availability of Ebola treatment unit beds was key in limiting the number of Ebola cases.
The WHO Ebola Response Team said that empirical and modeling studies performed during the West African Ebola virus disease epidemic have demonstrated that large epidemics of EVD can be prevented, that “a rapid response can interrupt transmission and restrict the size of outbreaks, even in densely populated cities.”
In 2015, the first nationwide semen testing and counseling program for male Ebola survivors, the Men’s Health Screening Program, was established in Liberia, according to a report in MMWR. Researchers said involvement with the survivor community, communication, and flexibility were key to the program’s success.
A $13 million NIH grant to study how the Ebola virus replicates has been awarded to a team at Washington University, St. Louis.
A recent study found that vector delivery of two antibody components of the ZMapp product works in mice against systemic and airway challenge with a mouse-adapted strain of Ebola virus. The authors say this platform “provides a generic manufacturing solution and overcomes some of the delivery challenges associated with repeated administration of the protective protein.”
U.S. Army researchers based at Fort Detrick, Md., are developing relationships with Ebola survivors in Uganda, who the researchers believe may hold the key to a vaccine or treatment for the infection because many Ugandans have survived the epidemic.
A qualitative study in PLOS Current Outbreaks found that the preparedness of U.S. health care volunteers in the West Africa Ebola deployment was inadequate. The authors said effective policies and practices must be developed and implemented to properly protect the health and well-being of volunteers.
Investigators hypothesized that cannabidiol, based on its pharmacological effects and favorable safety profile, should be considered as a treatment for individuals with post-Ebola sequelae because it can reduce pain and inflammation.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
The struggle to defeat Ebola virus disease continues globally, although it may not always make the headlines. To catch up on what you may have missed, here are some notable news items and journal articles published over the past few weeks that are worth a second look.
, according to a study of EVD patients treated in the United States.
An analysis of the 2014 Ebola virus disease outbreak in Nigeria found that early detection of cases, an efficacious incident management system, and rapid case management with on-site mobilization and training of local professionals were important to better outcomes, prompt containment, and no infection among EVD care-providers.
Viral genome sequence data uniquely reveals the 2013-2016 epidemic of Ebola virus disease in West Africa to be “a heterogeneous and spatially dissociated collection of transmission clusters of that were of varying size, duration, and connectivity,” according to a recent study.
A case study of Lassa fever involved the development of a mathematical framework which was applied to try to determine how much of disease transmission was from animal to human and how much was from human to human. This knowledge can be used to “infer human disease risk based on knowledge of infection patterns in the animal reservoir host and the contact mechanisms required for transmission to humans.”
A decontamination protocol that relies on the use of both peracetic acid and hydrogen peroxide fumigation was proposed for a biosafety level 3 field laboratory as a part of an Ebola treatment center in Guinea. Inoculated stainless steel disks of bioindicators containing spores of Geobacillus stearothermophilus were used to control the protocol.
A survey in New Zealand indicated that a future Ebola outbreak would have “large social and economic consequences” because judging from survey responses, a large percentage of the population would avoid social contact, such as going to work, school, and social events, to protect their health, according to a study in Disaster Medicine and Public Health Preparedness. Survey respondents also indicated a willingness to receive a vaccine.
Investigators identified contact tracing as an important determinant of the 2014-2015 Ebola epidemic’s behavior in Guinea. Also, early availability of Ebola treatment unit beds was key in limiting the number of Ebola cases.
The WHO Ebola Response Team said that empirical and modeling studies performed during the West African Ebola virus disease epidemic have demonstrated that large epidemics of EVD can be prevented, that “a rapid response can interrupt transmission and restrict the size of outbreaks, even in densely populated cities.”
In 2015, the first nationwide semen testing and counseling program for male Ebola survivors, the Men’s Health Screening Program, was established in Liberia, according to a report in MMWR. Researchers said involvement with the survivor community, communication, and flexibility were key to the program’s success.
A $13 million NIH grant to study how the Ebola virus replicates has been awarded to a team at Washington University, St. Louis.
A recent study found that vector delivery of two antibody components of the ZMapp product works in mice against systemic and airway challenge with a mouse-adapted strain of Ebola virus. The authors say this platform “provides a generic manufacturing solution and overcomes some of the delivery challenges associated with repeated administration of the protective protein.”
U.S. Army researchers based at Fort Detrick, Md., are developing relationships with Ebola survivors in Uganda, who the researchers believe may hold the key to a vaccine or treatment for the infection because many Ugandans have survived the epidemic.
A qualitative study in PLOS Current Outbreaks found that the preparedness of U.S. health care volunteers in the West Africa Ebola deployment was inadequate. The authors said effective policies and practices must be developed and implemented to properly protect the health and well-being of volunteers.
Investigators hypothesized that cannabidiol, based on its pharmacological effects and favorable safety profile, should be considered as a treatment for individuals with post-Ebola sequelae because it can reduce pain and inflammation.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
HIV research update: Late September 2016
A great volume of HIV and AIDS research enters the medical literature every month. It’s difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
Plasma lopinavir concentrations predicted viral outcomes in HIV-infected children receiving lopinavir-based antiretroviral therapy, a recent study demonstrated. Investigators said their findings support a minimum target concentration of greater than and equal to 1 mg/L of lopinavir to ensure sustained viral suppression.
Most antiretroviral-naive HIV-positive children experienced recovery of both weight for age and height for age over the 24 months following initiation of antiretroviral therapy (ART), according to results of a recent study. There was no significant difference between those receiving lopinavir/ritonavir and ART that was not based on nucleoside reverse transcriptase inhibitors (NNRTIs).
Even in an environment of easy access to antiretroviral therapy for HIV patients, many challenges still exist at the implementation stage of early ART, investigators for a study in AIDS Care reported. The authors said intense efforts in both patient and physician education will be required if the benefits of early ART are to be achieved at the individual and population level.
CD4+ and CD8+ T-cell immune activation and exhaustion are greater in HIV-infected youth, compared with matched controls, according to results of a recent study, while monocyte subpopulations are not changed even though there is a high soluble CD14 level.
The first documented HIV cure was based on a stem cell approach, and authors of a study in AIDS Research & Therapy say “there is reasonable hope that this unique case will not stand alone in the future.”
A study in HIV Clinical Trials found that telmisartan use is linked with an increase in circulating endothelial progenitor cells in older HIV-positive individuals who have cardiovascular disease risk factors.
The National Institutes of Health has given funding for a research network to promote the health and well-being of adolescents and young adults who are infected with HIV or at risk for HIV infection.
A study in the Lancet HIV found high levels of HIV pretreatment drug resistance in Mexico, and non-NNRTI pretreatment drug resistance significantly reduced the efficacy of first-line ART regimens that were based on these drugs.
The production of interleukin-1 beta by innate immune cells after stimulations of Toll-like receptors and bacillus Calmette-Guerin was correlated with different tuberculosis recurrence outcomes in ART-treated patients, according to a recent study.
Antiretroviral therapy during acute HIV infection, consisting of once daily emtricitabine/tenofovir/efavirenz, resulted in rapid and sustained viral suppression with high rates of patients staying in care and on ART, in a cohort including a large proportion of young men who have sex with men.
A recent study of cognitively impaired HIV-positive adults found that “higher self-efficacy, greater perception of treatment-related support, a stable medication regimen, stable stress levels, and absence of current stimulant use” predicted the best patient adherence to ART.
Viral suppression rates among HIV-infected children on ART in low- and middle-income countries were “low and were considerably poorer” than those previously found in adults in such countries and children in high-income countries, according to a recent study.
A study in Clinical Infectious Diseases found higher concentrations of inflammatory biomarkers among HIV RNA–suppressed men who reported less than 100% combination ART adherence, compared with more adherent men.
Any heavy alcohol consumption was associated with all-cause mortality among HIV-infected individuals, while only recent heavy consumption was associated with liver-related mortality, according to a study in HIV Medicine.
Family planning clinics, an important source of health care for young women, may be a natural setting for HIV preexposure prophylaxis discussion and roll-out, especially for women who have a history of intimate partner violence, according to a study in AIDS Care.
A relatively high rate of preliminary discontinuation of the antiretroviral dolutegravir (DGV) due to intolerability was detected in a recent study of combination ART. In particular, DGV was stopped more frequently if the regimen included abacavir.
Virologic failure rates in children and adolescents were high in a Tanzanian HIV study, with the majority of antiretroviral therapy–failing children harboring drug resistance–associated mutations (DRM) of HIV. The authors said viral load monitoring is urgently needed to maintain future treatment options for the millions of African children living with HIV.
In a recent study, virologically suppressed, HIV-infected adults with creatinine clearance 30-69 mL/min who switched from tenofovir disoproxil fumarate (TDF) to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF), had “stable creatinine clearance, significant and durable improvements in proteinuria, albuminuria, and tubular proteinuria, and significant increases in hip and spine bone mineral density.” It appears that the latter therapy is appropriate for HIV-infected individuals with mild to moderately impaired renal function.
Lower serum albumin and higher AST appear to be key mortality risk factors in HIV/HCV coinfection, but not as important in HIV-monoinfected individuals, according to a study in the journal AIDS.
A retrospective study of 11 European pediatric HIV cohorts found a high proportion of patients coinfected with hepatitis C virus who had progressive liver disease, which investigators said highlights the need for close monitoring and earlier and more efficacious hepatitis C virus therapy.
A study in Lancet Infectious Diseases confirmed that injecting drug use is a major contributor to the global burden of disease for HIV, hepatitis C, and hepatitis B. In 2013, an estimated 10 million disability-adjusted life-years were linked to exposure to HIV, hepatitis C, and hepatitis B via injecting drug use, the investigators reported.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
A great volume of HIV and AIDS research enters the medical literature every month. It’s difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
Plasma lopinavir concentrations predicted viral outcomes in HIV-infected children receiving lopinavir-based antiretroviral therapy, a recent study demonstrated. Investigators said their findings support a minimum target concentration of greater than and equal to 1 mg/L of lopinavir to ensure sustained viral suppression.
Most antiretroviral-naive HIV-positive children experienced recovery of both weight for age and height for age over the 24 months following initiation of antiretroviral therapy (ART), according to results of a recent study. There was no significant difference between those receiving lopinavir/ritonavir and ART that was not based on nucleoside reverse transcriptase inhibitors (NNRTIs).
Even in an environment of easy access to antiretroviral therapy for HIV patients, many challenges still exist at the implementation stage of early ART, investigators for a study in AIDS Care reported. The authors said intense efforts in both patient and physician education will be required if the benefits of early ART are to be achieved at the individual and population level.
CD4+ and CD8+ T-cell immune activation and exhaustion are greater in HIV-infected youth, compared with matched controls, according to results of a recent study, while monocyte subpopulations are not changed even though there is a high soluble CD14 level.
The first documented HIV cure was based on a stem cell approach, and authors of a study in AIDS Research & Therapy say “there is reasonable hope that this unique case will not stand alone in the future.”
A study in HIV Clinical Trials found that telmisartan use is linked with an increase in circulating endothelial progenitor cells in older HIV-positive individuals who have cardiovascular disease risk factors.
The National Institutes of Health has given funding for a research network to promote the health and well-being of adolescents and young adults who are infected with HIV or at risk for HIV infection.
A study in the Lancet HIV found high levels of HIV pretreatment drug resistance in Mexico, and non-NNRTI pretreatment drug resistance significantly reduced the efficacy of first-line ART regimens that were based on these drugs.
The production of interleukin-1 beta by innate immune cells after stimulations of Toll-like receptors and bacillus Calmette-Guerin was correlated with different tuberculosis recurrence outcomes in ART-treated patients, according to a recent study.
Antiretroviral therapy during acute HIV infection, consisting of once daily emtricitabine/tenofovir/efavirenz, resulted in rapid and sustained viral suppression with high rates of patients staying in care and on ART, in a cohort including a large proportion of young men who have sex with men.
A recent study of cognitively impaired HIV-positive adults found that “higher self-efficacy, greater perception of treatment-related support, a stable medication regimen, stable stress levels, and absence of current stimulant use” predicted the best patient adherence to ART.
Viral suppression rates among HIV-infected children on ART in low- and middle-income countries were “low and were considerably poorer” than those previously found in adults in such countries and children in high-income countries, according to a recent study.
A study in Clinical Infectious Diseases found higher concentrations of inflammatory biomarkers among HIV RNA–suppressed men who reported less than 100% combination ART adherence, compared with more adherent men.
Any heavy alcohol consumption was associated with all-cause mortality among HIV-infected individuals, while only recent heavy consumption was associated with liver-related mortality, according to a study in HIV Medicine.
Family planning clinics, an important source of health care for young women, may be a natural setting for HIV preexposure prophylaxis discussion and roll-out, especially for women who have a history of intimate partner violence, according to a study in AIDS Care.
A relatively high rate of preliminary discontinuation of the antiretroviral dolutegravir (DGV) due to intolerability was detected in a recent study of combination ART. In particular, DGV was stopped more frequently if the regimen included abacavir.
Virologic failure rates in children and adolescents were high in a Tanzanian HIV study, with the majority of antiretroviral therapy–failing children harboring drug resistance–associated mutations (DRM) of HIV. The authors said viral load monitoring is urgently needed to maintain future treatment options for the millions of African children living with HIV.
In a recent study, virologically suppressed, HIV-infected adults with creatinine clearance 30-69 mL/min who switched from tenofovir disoproxil fumarate (TDF) to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF), had “stable creatinine clearance, significant and durable improvements in proteinuria, albuminuria, and tubular proteinuria, and significant increases in hip and spine bone mineral density.” It appears that the latter therapy is appropriate for HIV-infected individuals with mild to moderately impaired renal function.
Lower serum albumin and higher AST appear to be key mortality risk factors in HIV/HCV coinfection, but not as important in HIV-monoinfected individuals, according to a study in the journal AIDS.
A retrospective study of 11 European pediatric HIV cohorts found a high proportion of patients coinfected with hepatitis C virus who had progressive liver disease, which investigators said highlights the need for close monitoring and earlier and more efficacious hepatitis C virus therapy.
A study in Lancet Infectious Diseases confirmed that injecting drug use is a major contributor to the global burden of disease for HIV, hepatitis C, and hepatitis B. In 2013, an estimated 10 million disability-adjusted life-years were linked to exposure to HIV, hepatitis C, and hepatitis B via injecting drug use, the investigators reported.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
A great volume of HIV and AIDS research enters the medical literature every month. It’s difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
Plasma lopinavir concentrations predicted viral outcomes in HIV-infected children receiving lopinavir-based antiretroviral therapy, a recent study demonstrated. Investigators said their findings support a minimum target concentration of greater than and equal to 1 mg/L of lopinavir to ensure sustained viral suppression.
Most antiretroviral-naive HIV-positive children experienced recovery of both weight for age and height for age over the 24 months following initiation of antiretroviral therapy (ART), according to results of a recent study. There was no significant difference between those receiving lopinavir/ritonavir and ART that was not based on nucleoside reverse transcriptase inhibitors (NNRTIs).
Even in an environment of easy access to antiretroviral therapy for HIV patients, many challenges still exist at the implementation stage of early ART, investigators for a study in AIDS Care reported. The authors said intense efforts in both patient and physician education will be required if the benefits of early ART are to be achieved at the individual and population level.
CD4+ and CD8+ T-cell immune activation and exhaustion are greater in HIV-infected youth, compared with matched controls, according to results of a recent study, while monocyte subpopulations are not changed even though there is a high soluble CD14 level.
The first documented HIV cure was based on a stem cell approach, and authors of a study in AIDS Research & Therapy say “there is reasonable hope that this unique case will not stand alone in the future.”
A study in HIV Clinical Trials found that telmisartan use is linked with an increase in circulating endothelial progenitor cells in older HIV-positive individuals who have cardiovascular disease risk factors.
The National Institutes of Health has given funding for a research network to promote the health and well-being of adolescents and young adults who are infected with HIV or at risk for HIV infection.
A study in the Lancet HIV found high levels of HIV pretreatment drug resistance in Mexico, and non-NNRTI pretreatment drug resistance significantly reduced the efficacy of first-line ART regimens that were based on these drugs.
The production of interleukin-1 beta by innate immune cells after stimulations of Toll-like receptors and bacillus Calmette-Guerin was correlated with different tuberculosis recurrence outcomes in ART-treated patients, according to a recent study.
Antiretroviral therapy during acute HIV infection, consisting of once daily emtricitabine/tenofovir/efavirenz, resulted in rapid and sustained viral suppression with high rates of patients staying in care and on ART, in a cohort including a large proportion of young men who have sex with men.
A recent study of cognitively impaired HIV-positive adults found that “higher self-efficacy, greater perception of treatment-related support, a stable medication regimen, stable stress levels, and absence of current stimulant use” predicted the best patient adherence to ART.
Viral suppression rates among HIV-infected children on ART in low- and middle-income countries were “low and were considerably poorer” than those previously found in adults in such countries and children in high-income countries, according to a recent study.
A study in Clinical Infectious Diseases found higher concentrations of inflammatory biomarkers among HIV RNA–suppressed men who reported less than 100% combination ART adherence, compared with more adherent men.
Any heavy alcohol consumption was associated with all-cause mortality among HIV-infected individuals, while only recent heavy consumption was associated with liver-related mortality, according to a study in HIV Medicine.
Family planning clinics, an important source of health care for young women, may be a natural setting for HIV preexposure prophylaxis discussion and roll-out, especially for women who have a history of intimate partner violence, according to a study in AIDS Care.
A relatively high rate of preliminary discontinuation of the antiretroviral dolutegravir (DGV) due to intolerability was detected in a recent study of combination ART. In particular, DGV was stopped more frequently if the regimen included abacavir.
Virologic failure rates in children and adolescents were high in a Tanzanian HIV study, with the majority of antiretroviral therapy–failing children harboring drug resistance–associated mutations (DRM) of HIV. The authors said viral load monitoring is urgently needed to maintain future treatment options for the millions of African children living with HIV.
In a recent study, virologically suppressed, HIV-infected adults with creatinine clearance 30-69 mL/min who switched from tenofovir disoproxil fumarate (TDF) to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF), had “stable creatinine clearance, significant and durable improvements in proteinuria, albuminuria, and tubular proteinuria, and significant increases in hip and spine bone mineral density.” It appears that the latter therapy is appropriate for HIV-infected individuals with mild to moderately impaired renal function.
Lower serum albumin and higher AST appear to be key mortality risk factors in HIV/HCV coinfection, but not as important in HIV-monoinfected individuals, according to a study in the journal AIDS.
A retrospective study of 11 European pediatric HIV cohorts found a high proportion of patients coinfected with hepatitis C virus who had progressive liver disease, which investigators said highlights the need for close monitoring and earlier and more efficacious hepatitis C virus therapy.
A study in Lancet Infectious Diseases confirmed that injecting drug use is a major contributor to the global burden of disease for HIV, hepatitis C, and hepatitis B. In 2013, an estimated 10 million disability-adjusted life-years were linked to exposure to HIV, hepatitis C, and hepatitis B via injecting drug use, the investigators reported.
rpizzi@frontlinemedcom.com
On Twitter @richpizzi
HIV research update: Early September 2016
A great volume of HIV and AIDS research enters the medical literature every month. It’s difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
The frequency of safety monitoring for HIV pre-exposure prophylaxis (PrEP) might need to be different between age groups, according to a recent study, and pharmacological measures can monitor for toxic effects as well as adherence.
A European research group found a beneficial effect of starting antiretroviral therapy before adolescence in perinatally infected individuals, and starting young people on boosted protease inhibitors, to maximize treatment response during this transitional stage of development.
Chinese investigators found that an online social entrepreneurship testing (SET) model to promote HIV and syphilis self-testing among Chinese men who have sex with men was acceptable and feasible, and they say that the model adds a new testing platform to the current testing service system.
A review analysis found that dolutegravir 50 mg given once daily, combined with an active background drug, is a better choice than raltegravir- or efavirenz-based regimens for treatment of HIV-1 infection, in terms of both efficacy and safety.
A recent study found that HIV suppression restores lung mucosal HIV-specific CD4+ T-cell multifunctional immunity and CD4:CD8 balance, often resolving CD8+ alveolitis in active smokers.
A study in Clinical Infectious Diseases found that only the Framingham general cardiovascular Risk Score (FRS) accurately estimated the risk of cardiovascular disease risk events in HIV patients, while the American College of Cardiology/American Heart Association Pooled Cohort equations (PCE), and the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) study equation underestimated risk.
A study in AIDS Care found a high burden of mental health disorders among harder-to-reach people living with HIV/AIDS (PHA), and suggests that PHA with at least one mental health disorder diagnosis are disproportionately affected by sexual violence and stigma.
Neurocognitive declines in HIV-positive patients may vary by domains of functioning and disparities may exist across subpopulations of the seropositive aging population, according to a recent study, and these challenges may exist even in those actively engaged in HIV care.
A high rate of recent HIV infection is potentially resulting in progressive deterioration of the overall HIV epidemic among men who have sex with men in China, according to a study in Infectious Diseases of Poverty. The authors said targeted interventions to address high-risk men who have sex with men including those having multiple partners, history of recreational drug use, and syphilis or HSV-2 infection are needed.
A recent study indicated that the variability in estimates of spontaneous viral clearance of hepatitis C virus infection – between HIV-positive men who have sex with men and people who inject drugs – suggests the impact of HIV coinfection and HCV reinfection.
A study published in the journal AIDS found that despite substantially higher CD4% at initiation of antiretroviral therapy, viral suppression was significantly slower among infants than older children.
Grip strength decline is accelerated in HIV-infected men, which may signal decreased life expectancy and lower quality of life with aging, according to an analysis by the Multicenter AIDS Cohort Study.
A study in HIV Medicine found that reference curves for CD4 T-cell count response aid the evaluation of the immune response in HIV-positive patients early after antiretroviral therapy initiation that leads to viral control.
According to WHO standards, Rwanda antenatal clinic HIV serosurveillance is ready to transition to prevention of mother to child transmission (PMTCT)-based serosurveillance.
Oxidized lipoproteins may contribute to persistent immune activation in HIV patients on antiretroviral therapy, a new study found.
A French study found that the rate of patients failing to return for the results of HIV, HBV, HCV, and syphilis testing is a problem, but the use of currently available technologies, such as phone texting, might be a partial solution in conjunction with rapid tests for diagnosis.
A 12-city U.S. research project on pre-exposure prophylaxis for HIV found that young men who have sex with men may need PrEP access in youth-friendly settings with tailored adherence support and potentially augmented visit schedules.
On Twitter @richpizzi
A great volume of HIV and AIDS research enters the medical literature every month. It’s difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
The frequency of safety monitoring for HIV pre-exposure prophylaxis (PrEP) might need to be different between age groups, according to a recent study, and pharmacological measures can monitor for toxic effects as well as adherence.
A European research group found a beneficial effect of starting antiretroviral therapy before adolescence in perinatally infected individuals, and starting young people on boosted protease inhibitors, to maximize treatment response during this transitional stage of development.
Chinese investigators found that an online social entrepreneurship testing (SET) model to promote HIV and syphilis self-testing among Chinese men who have sex with men was acceptable and feasible, and they say that the model adds a new testing platform to the current testing service system.
A review analysis found that dolutegravir 50 mg given once daily, combined with an active background drug, is a better choice than raltegravir- or efavirenz-based regimens for treatment of HIV-1 infection, in terms of both efficacy and safety.
A recent study found that HIV suppression restores lung mucosal HIV-specific CD4+ T-cell multifunctional immunity and CD4:CD8 balance, often resolving CD8+ alveolitis in active smokers.
A study in Clinical Infectious Diseases found that only the Framingham general cardiovascular Risk Score (FRS) accurately estimated the risk of cardiovascular disease risk events in HIV patients, while the American College of Cardiology/American Heart Association Pooled Cohort equations (PCE), and the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) study equation underestimated risk.
A study in AIDS Care found a high burden of mental health disorders among harder-to-reach people living with HIV/AIDS (PHA), and suggests that PHA with at least one mental health disorder diagnosis are disproportionately affected by sexual violence and stigma.
Neurocognitive declines in HIV-positive patients may vary by domains of functioning and disparities may exist across subpopulations of the seropositive aging population, according to a recent study, and these challenges may exist even in those actively engaged in HIV care.
A high rate of recent HIV infection is potentially resulting in progressive deterioration of the overall HIV epidemic among men who have sex with men in China, according to a study in Infectious Diseases of Poverty. The authors said targeted interventions to address high-risk men who have sex with men including those having multiple partners, history of recreational drug use, and syphilis or HSV-2 infection are needed.
A recent study indicated that the variability in estimates of spontaneous viral clearance of hepatitis C virus infection – between HIV-positive men who have sex with men and people who inject drugs – suggests the impact of HIV coinfection and HCV reinfection.
A study published in the journal AIDS found that despite substantially higher CD4% at initiation of antiretroviral therapy, viral suppression was significantly slower among infants than older children.
Grip strength decline is accelerated in HIV-infected men, which may signal decreased life expectancy and lower quality of life with aging, according to an analysis by the Multicenter AIDS Cohort Study.
A study in HIV Medicine found that reference curves for CD4 T-cell count response aid the evaluation of the immune response in HIV-positive patients early after antiretroviral therapy initiation that leads to viral control.
According to WHO standards, Rwanda antenatal clinic HIV serosurveillance is ready to transition to prevention of mother to child transmission (PMTCT)-based serosurveillance.
Oxidized lipoproteins may contribute to persistent immune activation in HIV patients on antiretroviral therapy, a new study found.
A French study found that the rate of patients failing to return for the results of HIV, HBV, HCV, and syphilis testing is a problem, but the use of currently available technologies, such as phone texting, might be a partial solution in conjunction with rapid tests for diagnosis.
A 12-city U.S. research project on pre-exposure prophylaxis for HIV found that young men who have sex with men may need PrEP access in youth-friendly settings with tailored adherence support and potentially augmented visit schedules.
On Twitter @richpizzi
A great volume of HIV and AIDS research enters the medical literature every month. It’s difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
The frequency of safety monitoring for HIV pre-exposure prophylaxis (PrEP) might need to be different between age groups, according to a recent study, and pharmacological measures can monitor for toxic effects as well as adherence.
A European research group found a beneficial effect of starting antiretroviral therapy before adolescence in perinatally infected individuals, and starting young people on boosted protease inhibitors, to maximize treatment response during this transitional stage of development.
Chinese investigators found that an online social entrepreneurship testing (SET) model to promote HIV and syphilis self-testing among Chinese men who have sex with men was acceptable and feasible, and they say that the model adds a new testing platform to the current testing service system.
A review analysis found that dolutegravir 50 mg given once daily, combined with an active background drug, is a better choice than raltegravir- or efavirenz-based regimens for treatment of HIV-1 infection, in terms of both efficacy and safety.
A recent study found that HIV suppression restores lung mucosal HIV-specific CD4+ T-cell multifunctional immunity and CD4:CD8 balance, often resolving CD8+ alveolitis in active smokers.
A study in Clinical Infectious Diseases found that only the Framingham general cardiovascular Risk Score (FRS) accurately estimated the risk of cardiovascular disease risk events in HIV patients, while the American College of Cardiology/American Heart Association Pooled Cohort equations (PCE), and the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) study equation underestimated risk.
A study in AIDS Care found a high burden of mental health disorders among harder-to-reach people living with HIV/AIDS (PHA), and suggests that PHA with at least one mental health disorder diagnosis are disproportionately affected by sexual violence and stigma.
Neurocognitive declines in HIV-positive patients may vary by domains of functioning and disparities may exist across subpopulations of the seropositive aging population, according to a recent study, and these challenges may exist even in those actively engaged in HIV care.
A high rate of recent HIV infection is potentially resulting in progressive deterioration of the overall HIV epidemic among men who have sex with men in China, according to a study in Infectious Diseases of Poverty. The authors said targeted interventions to address high-risk men who have sex with men including those having multiple partners, history of recreational drug use, and syphilis or HSV-2 infection are needed.
A recent study indicated that the variability in estimates of spontaneous viral clearance of hepatitis C virus infection – between HIV-positive men who have sex with men and people who inject drugs – suggests the impact of HIV coinfection and HCV reinfection.
A study published in the journal AIDS found that despite substantially higher CD4% at initiation of antiretroviral therapy, viral suppression was significantly slower among infants than older children.
Grip strength decline is accelerated in HIV-infected men, which may signal decreased life expectancy and lower quality of life with aging, according to an analysis by the Multicenter AIDS Cohort Study.
A study in HIV Medicine found that reference curves for CD4 T-cell count response aid the evaluation of the immune response in HIV-positive patients early after antiretroviral therapy initiation that leads to viral control.
According to WHO standards, Rwanda antenatal clinic HIV serosurveillance is ready to transition to prevention of mother to child transmission (PMTCT)-based serosurveillance.
Oxidized lipoproteins may contribute to persistent immune activation in HIV patients on antiretroviral therapy, a new study found.
A French study found that the rate of patients failing to return for the results of HIV, HBV, HCV, and syphilis testing is a problem, but the use of currently available technologies, such as phone texting, might be a partial solution in conjunction with rapid tests for diagnosis.
A 12-city U.S. research project on pre-exposure prophylaxis for HIV found that young men who have sex with men may need PrEP access in youth-friendly settings with tailored adherence support and potentially augmented visit schedules.
On Twitter @richpizzi
FDA to streamline development of antimicrobials, susceptibility test devices
The Food and Drug Administration has released a draft guidance document intended to help drug sponsors and device manufacturers coordinate the development of new antimicrobial drugs and antimicrobial susceptibility test devices (ASTs).
The FDA said it wants the guidance document, entitled “Coordinated Development of Antimicrobial Drugs and Antimicrobial Susceptibility Test Devices,” to help harmonize “development of these products such that the AST device could be cleared either at the time of new drug approval or shortly thereafter.” The agency acknowledged in the guidance document that development of antimicrobial drugs and ASTs – which test for in vitro susceptibility of bacterial pathogens isolated from clinical specimens to antimicrobials – has traditionally occurred independently, with AST device development “often initiated following drug approval.” A coordinated approach to developing new antimicrobial drugs with AST devices ideally would minimize the time between the approval of a new antimicrobial drug and clearance of an AST device.
The FDA highlighted three key goals of the guidance document:
• Describe interactions between antimicrobial drug sponsors and AST device manufacturers to help improve coordinated development of a new antimicrobial drug and an AST device to streamline the clearance process.
• Explain the considerations for submitting separate applications to the Center for Drug Evaluation and Research and the Center for Devices and Radiological Health when seeking to facilitate clearance of an AST device as close in time as possible to antimicrobial drug approval.
• Emphasize that the review of the new antimicrobial drug product and AST device(s) will remain independent, and that coordinated development does not influence the review timelines for either product.
The FDA will accept comments and suggestions on the draft guidance document within 60 days of publication in the Federal Register.
On Twitter @richpizzi
The Food and Drug Administration has released a draft guidance document intended to help drug sponsors and device manufacturers coordinate the development of new antimicrobial drugs and antimicrobial susceptibility test devices (ASTs).
The FDA said it wants the guidance document, entitled “Coordinated Development of Antimicrobial Drugs and Antimicrobial Susceptibility Test Devices,” to help harmonize “development of these products such that the AST device could be cleared either at the time of new drug approval or shortly thereafter.” The agency acknowledged in the guidance document that development of antimicrobial drugs and ASTs – which test for in vitro susceptibility of bacterial pathogens isolated from clinical specimens to antimicrobials – has traditionally occurred independently, with AST device development “often initiated following drug approval.” A coordinated approach to developing new antimicrobial drugs with AST devices ideally would minimize the time between the approval of a new antimicrobial drug and clearance of an AST device.
The FDA highlighted three key goals of the guidance document:
• Describe interactions between antimicrobial drug sponsors and AST device manufacturers to help improve coordinated development of a new antimicrobial drug and an AST device to streamline the clearance process.
• Explain the considerations for submitting separate applications to the Center for Drug Evaluation and Research and the Center for Devices and Radiological Health when seeking to facilitate clearance of an AST device as close in time as possible to antimicrobial drug approval.
• Emphasize that the review of the new antimicrobial drug product and AST device(s) will remain independent, and that coordinated development does not influence the review timelines for either product.
The FDA will accept comments and suggestions on the draft guidance document within 60 days of publication in the Federal Register.
On Twitter @richpizzi
The Food and Drug Administration has released a draft guidance document intended to help drug sponsors and device manufacturers coordinate the development of new antimicrobial drugs and antimicrobial susceptibility test devices (ASTs).
The FDA said it wants the guidance document, entitled “Coordinated Development of Antimicrobial Drugs and Antimicrobial Susceptibility Test Devices,” to help harmonize “development of these products such that the AST device could be cleared either at the time of new drug approval or shortly thereafter.” The agency acknowledged in the guidance document that development of antimicrobial drugs and ASTs – which test for in vitro susceptibility of bacterial pathogens isolated from clinical specimens to antimicrobials – has traditionally occurred independently, with AST device development “often initiated following drug approval.” A coordinated approach to developing new antimicrobial drugs with AST devices ideally would minimize the time between the approval of a new antimicrobial drug and clearance of an AST device.
The FDA highlighted three key goals of the guidance document:
• Describe interactions between antimicrobial drug sponsors and AST device manufacturers to help improve coordinated development of a new antimicrobial drug and an AST device to streamline the clearance process.
• Explain the considerations for submitting separate applications to the Center for Drug Evaluation and Research and the Center for Devices and Radiological Health when seeking to facilitate clearance of an AST device as close in time as possible to antimicrobial drug approval.
• Emphasize that the review of the new antimicrobial drug product and AST device(s) will remain independent, and that coordinated development does not influence the review timelines for either product.
The FDA will accept comments and suggestions on the draft guidance document within 60 days of publication in the Federal Register.
On Twitter @richpizzi
Ebola research update: August 2016
The struggle to defeat Ebola virus disease continues globally, although it may not always make the headlines. To catch up on what you may have missed, here are some notable news items and journal articles published over the past few weeks that are worth a second look.
Plasmodium species parasitemia is associated with an increase in the probability of surviving Ebola virus infection, according to a study in Clinical Infectious Diseases. The authors said more research is needed to understand the molecular mechanism underlying this phenomenon and translate it into treatment options for Ebola virus infection.
A recent study found that a structured doffing protocol for health care providers wearing personal protective equipment, using a trained monitor and alcohol-based hand rub, protects against enveloped Ebola virus self-contamination. The authors noted that doffing protocols protective against all viruses need to incorporate highly effective glove and hand hygiene agents.
A reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for postmortem Ebola virus disease (EVD) testing was found useful as an EVD diagnostic testing method in the field or remote areas, according to a study in Guinea.
A structural study of the Ebola virus glycoprotein (GP) gene provides a detailed picture of the accessible Ebola virus glycoprotein landscape, according to investigators, and a structural basis to evaluate patient and vaccine antibody responses toward differently structured products of the GP gene.
A community-based strategy of social mobilization and community engagement was effective in case detection and reducing the extent of Ebola transmission in Sierra Leone, according to a report in Infectious Diseases of Poverty.
The Center of Excellence for Emerging Zoonotic and Animal Diseases, or CEEZAD, at Kansas State University, will use a $2.3 million grant from the U.S. Department of Defense to study the safety in livestock of a newly developed vaccine to protect humans from the Ebola Zaire virus.
An NIH study found that there is no difference in virus stability between the two strains of Zaire Ebola virus from the 1976 and 2013 outbreaks, and that viable virus can be recovered from an aerosol 180 minutes after it is generated.
According to a study in PLOS Medicine, the associations between war trauma and both EVD risk behaviors and EVD prevention behaviors may be mediated through two key mental health variables: depression and PTSD symptoms.
Inovio Pharmaceuticals announced its intention to more than double study enrollment to further characterize and identify in humans the most optimal immunization regimen using intradermal delivery of its preventive Ebola DNA vaccine.
Ordering clusters in a step-wedge Ebola virus vaccine trial based on the cluster’s underlying risk of infection, as predicted by a spatial model, can increase the statistical power of a stepped-wedge cluster study, according to a study in PLOS Neglected Tropical Diseases.
A Guinean study found that in survivors of EVD, CD16+ monocytes were activated during recovery, coincident with viral clearance, which suggests an important role of this cell subset in EVD pathophysiology.
Examining proactive vaccination strategies for Ebola prevention and response is critical to advancing development of vaccine production and administration technologies that could be instrumental to mitigating future Ebola outbreaks, according to an analysis in PLOS Neglected Tropical Diseases.
A study of the clinical features of Ebola virus disease in Sierra Leone showed that a better awareness of risk factors for death could be used to group EVD patients at greatest risk into dedicated wards with more intensive medical support.
Contact with individuals who died of EVD at home in rural communities in Liberia and Guinea resulted in more secondary infections than did contact with individuals admitted to Ebola treatment units, according to a study in Emerging Infectious Diseases.
A study of the 2014 Ebola virus disease outbreak in the Congo found that cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history.
A study published in Nature Microbiology demonstrated that researchers were able to protect nonhuman primates against a lethal Ebola Sudan infection when treatment began 4 days following infection.
Treatment of patients infected with Ebola virus disease in Sierra Leone with favipiravir (T-705) was associated with prolonged survival and markedly reduced viral load, according to a recent study, which makes a case for further randomized controlled trials of T-705 for treating EVD.
A study in the Journal of Infectious Diseases found that convalescent sera alone are not sufficient for providing 100% protection against lethal Zaire Ebola virus infection when administered at the onset of viremia.
On Twitter @richpizzi
The struggle to defeat Ebola virus disease continues globally, although it may not always make the headlines. To catch up on what you may have missed, here are some notable news items and journal articles published over the past few weeks that are worth a second look.
Plasmodium species parasitemia is associated with an increase in the probability of surviving Ebola virus infection, according to a study in Clinical Infectious Diseases. The authors said more research is needed to understand the molecular mechanism underlying this phenomenon and translate it into treatment options for Ebola virus infection.
A recent study found that a structured doffing protocol for health care providers wearing personal protective equipment, using a trained monitor and alcohol-based hand rub, protects against enveloped Ebola virus self-contamination. The authors noted that doffing protocols protective against all viruses need to incorporate highly effective glove and hand hygiene agents.
A reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for postmortem Ebola virus disease (EVD) testing was found useful as an EVD diagnostic testing method in the field or remote areas, according to a study in Guinea.
A structural study of the Ebola virus glycoprotein (GP) gene provides a detailed picture of the accessible Ebola virus glycoprotein landscape, according to investigators, and a structural basis to evaluate patient and vaccine antibody responses toward differently structured products of the GP gene.
A community-based strategy of social mobilization and community engagement was effective in case detection and reducing the extent of Ebola transmission in Sierra Leone, according to a report in Infectious Diseases of Poverty.
The Center of Excellence for Emerging Zoonotic and Animal Diseases, or CEEZAD, at Kansas State University, will use a $2.3 million grant from the U.S. Department of Defense to study the safety in livestock of a newly developed vaccine to protect humans from the Ebola Zaire virus.
An NIH study found that there is no difference in virus stability between the two strains of Zaire Ebola virus from the 1976 and 2013 outbreaks, and that viable virus can be recovered from an aerosol 180 minutes after it is generated.
According to a study in PLOS Medicine, the associations between war trauma and both EVD risk behaviors and EVD prevention behaviors may be mediated through two key mental health variables: depression and PTSD symptoms.
Inovio Pharmaceuticals announced its intention to more than double study enrollment to further characterize and identify in humans the most optimal immunization regimen using intradermal delivery of its preventive Ebola DNA vaccine.
Ordering clusters in a step-wedge Ebola virus vaccine trial based on the cluster’s underlying risk of infection, as predicted by a spatial model, can increase the statistical power of a stepped-wedge cluster study, according to a study in PLOS Neglected Tropical Diseases.
A Guinean study found that in survivors of EVD, CD16+ monocytes were activated during recovery, coincident with viral clearance, which suggests an important role of this cell subset in EVD pathophysiology.
Examining proactive vaccination strategies for Ebola prevention and response is critical to advancing development of vaccine production and administration technologies that could be instrumental to mitigating future Ebola outbreaks, according to an analysis in PLOS Neglected Tropical Diseases.
A study of the clinical features of Ebola virus disease in Sierra Leone showed that a better awareness of risk factors for death could be used to group EVD patients at greatest risk into dedicated wards with more intensive medical support.
Contact with individuals who died of EVD at home in rural communities in Liberia and Guinea resulted in more secondary infections than did contact with individuals admitted to Ebola treatment units, according to a study in Emerging Infectious Diseases.
A study of the 2014 Ebola virus disease outbreak in the Congo found that cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history.
A study published in Nature Microbiology demonstrated that researchers were able to protect nonhuman primates against a lethal Ebola Sudan infection when treatment began 4 days following infection.
Treatment of patients infected with Ebola virus disease in Sierra Leone with favipiravir (T-705) was associated with prolonged survival and markedly reduced viral load, according to a recent study, which makes a case for further randomized controlled trials of T-705 for treating EVD.
A study in the Journal of Infectious Diseases found that convalescent sera alone are not sufficient for providing 100% protection against lethal Zaire Ebola virus infection when administered at the onset of viremia.
On Twitter @richpizzi
The struggle to defeat Ebola virus disease continues globally, although it may not always make the headlines. To catch up on what you may have missed, here are some notable news items and journal articles published over the past few weeks that are worth a second look.
Plasmodium species parasitemia is associated with an increase in the probability of surviving Ebola virus infection, according to a study in Clinical Infectious Diseases. The authors said more research is needed to understand the molecular mechanism underlying this phenomenon and translate it into treatment options for Ebola virus infection.
A recent study found that a structured doffing protocol for health care providers wearing personal protective equipment, using a trained monitor and alcohol-based hand rub, protects against enveloped Ebola virus self-contamination. The authors noted that doffing protocols protective against all viruses need to incorporate highly effective glove and hand hygiene agents.
A reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for postmortem Ebola virus disease (EVD) testing was found useful as an EVD diagnostic testing method in the field or remote areas, according to a study in Guinea.
A structural study of the Ebola virus glycoprotein (GP) gene provides a detailed picture of the accessible Ebola virus glycoprotein landscape, according to investigators, and a structural basis to evaluate patient and vaccine antibody responses toward differently structured products of the GP gene.
A community-based strategy of social mobilization and community engagement was effective in case detection and reducing the extent of Ebola transmission in Sierra Leone, according to a report in Infectious Diseases of Poverty.
The Center of Excellence for Emerging Zoonotic and Animal Diseases, or CEEZAD, at Kansas State University, will use a $2.3 million grant from the U.S. Department of Defense to study the safety in livestock of a newly developed vaccine to protect humans from the Ebola Zaire virus.
An NIH study found that there is no difference in virus stability between the two strains of Zaire Ebola virus from the 1976 and 2013 outbreaks, and that viable virus can be recovered from an aerosol 180 minutes after it is generated.
According to a study in PLOS Medicine, the associations between war trauma and both EVD risk behaviors and EVD prevention behaviors may be mediated through two key mental health variables: depression and PTSD symptoms.
Inovio Pharmaceuticals announced its intention to more than double study enrollment to further characterize and identify in humans the most optimal immunization regimen using intradermal delivery of its preventive Ebola DNA vaccine.
Ordering clusters in a step-wedge Ebola virus vaccine trial based on the cluster’s underlying risk of infection, as predicted by a spatial model, can increase the statistical power of a stepped-wedge cluster study, according to a study in PLOS Neglected Tropical Diseases.
A Guinean study found that in survivors of EVD, CD16+ monocytes were activated during recovery, coincident with viral clearance, which suggests an important role of this cell subset in EVD pathophysiology.
Examining proactive vaccination strategies for Ebola prevention and response is critical to advancing development of vaccine production and administration technologies that could be instrumental to mitigating future Ebola outbreaks, according to an analysis in PLOS Neglected Tropical Diseases.
A study of the clinical features of Ebola virus disease in Sierra Leone showed that a better awareness of risk factors for death could be used to group EVD patients at greatest risk into dedicated wards with more intensive medical support.
Contact with individuals who died of EVD at home in rural communities in Liberia and Guinea resulted in more secondary infections than did contact with individuals admitted to Ebola treatment units, according to a study in Emerging Infectious Diseases.
A study of the 2014 Ebola virus disease outbreak in the Congo found that cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history.
A study published in Nature Microbiology demonstrated that researchers were able to protect nonhuman primates against a lethal Ebola Sudan infection when treatment began 4 days following infection.
Treatment of patients infected with Ebola virus disease in Sierra Leone with favipiravir (T-705) was associated with prolonged survival and markedly reduced viral load, according to a recent study, which makes a case for further randomized controlled trials of T-705 for treating EVD.
A study in the Journal of Infectious Diseases found that convalescent sera alone are not sufficient for providing 100% protection against lethal Zaire Ebola virus infection when administered at the onset of viremia.
On Twitter @richpizzi
FDA adds lurasidone contraindication to HIV drug labels
The Food and Drug Administration has updated the labels on certain HIV drugs to include a contraindication for lurasidone (Latuda), an antipsychotic medication.
Lurasidone is used to treat depressive episodes in bipolar I disorder (bipolar depression) and schizophrenia in adults. The contraindication was added because of “the potential for serious and/or life-threatening reactions,” according to the FDA.
The labels on the following pharmaceutical products will be updated to reflect the change:
Aptivus (tipranavir)
Crixivan (indinavir)
Genvoya (elvitegravir, cobicistat, emtricitabine, tenofovir alafenamide)
Invirase (saquinavir)
Kaletra (lopinavir/ritonavir)
Lexiva (fosamprenavir): Lurasidone is contraindicated because of the potential for serious and/or life-threatening reactions if fosamprenavir is coadministered with ritonavir.
Norvir (ritonavir)
Prezista (darunavir)
Reyataz (atazanavir): Lurasidone is contraindicated because of the potential for serious and/or life-threatening reactions if atazanavir is coadministered with ritonavir.
Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate)
Viracept (nelfinavir)
Labels for Evotaz (atazanavir/cobicistat) and Prezcobix (darunavir/cobicistat) already include a contraindication for lurasidone, the FDA announcement noted.
On Twitter @richpizzi
The Food and Drug Administration has updated the labels on certain HIV drugs to include a contraindication for lurasidone (Latuda), an antipsychotic medication.
Lurasidone is used to treat depressive episodes in bipolar I disorder (bipolar depression) and schizophrenia in adults. The contraindication was added because of “the potential for serious and/or life-threatening reactions,” according to the FDA.
The labels on the following pharmaceutical products will be updated to reflect the change:
Aptivus (tipranavir)
Crixivan (indinavir)
Genvoya (elvitegravir, cobicistat, emtricitabine, tenofovir alafenamide)
Invirase (saquinavir)
Kaletra (lopinavir/ritonavir)
Lexiva (fosamprenavir): Lurasidone is contraindicated because of the potential for serious and/or life-threatening reactions if fosamprenavir is coadministered with ritonavir.
Norvir (ritonavir)
Prezista (darunavir)
Reyataz (atazanavir): Lurasidone is contraindicated because of the potential for serious and/or life-threatening reactions if atazanavir is coadministered with ritonavir.
Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate)
Viracept (nelfinavir)
Labels for Evotaz (atazanavir/cobicistat) and Prezcobix (darunavir/cobicistat) already include a contraindication for lurasidone, the FDA announcement noted.
On Twitter @richpizzi
The Food and Drug Administration has updated the labels on certain HIV drugs to include a contraindication for lurasidone (Latuda), an antipsychotic medication.
Lurasidone is used to treat depressive episodes in bipolar I disorder (bipolar depression) and schizophrenia in adults. The contraindication was added because of “the potential for serious and/or life-threatening reactions,” according to the FDA.
The labels on the following pharmaceutical products will be updated to reflect the change:
Aptivus (tipranavir)
Crixivan (indinavir)
Genvoya (elvitegravir, cobicistat, emtricitabine, tenofovir alafenamide)
Invirase (saquinavir)
Kaletra (lopinavir/ritonavir)
Lexiva (fosamprenavir): Lurasidone is contraindicated because of the potential for serious and/or life-threatening reactions if fosamprenavir is coadministered with ritonavir.
Norvir (ritonavir)
Prezista (darunavir)
Reyataz (atazanavir): Lurasidone is contraindicated because of the potential for serious and/or life-threatening reactions if atazanavir is coadministered with ritonavir.
Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate)
Viracept (nelfinavir)
Labels for Evotaz (atazanavir/cobicistat) and Prezcobix (darunavir/cobicistat) already include a contraindication for lurasidone, the FDA announcement noted.
On Twitter @richpizzi
Hepatitis Outlook: August 2016
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.
A study in Hepatology has provided a preclinical risk assessment paradigm with which to better understand cardiovascular drug-drug interaction risk for hepatitis C–virus infected patients treated with sofosbuvir in combination with other direct acting antivirals and the antiarrhythmic drug amiodarone.
A Japanese study found that, although levels of Wisteria floribunda agglutinin-positive Mac-2-binding protein could be a useful indicator of liver fibrosis in patients with hepatitis B or C infection, WFA+-M2BP levels in the two groups significantly differed, even in the same degree of fibrosis.
Interferon-free, guideline-tailored therapy with direct-acting antivirals is highly effective and safe for hepatitis C virus–associated mixed cryoglobulinemia patients, according to a recent study.
Another recent study found that pegylated interferon (PegIFN) intensification in hepatitis B “e” antigen (HBeAg)-positive coinfected patients did not lead to increased clearance rates of HBeAg or hepatitis B surface antigen quantification (qHBsAg), despite faster declines of antigen levels while on PegIFN.
A study in HIV Medicine found that, under real-life conditions, treatment of patients infected with hepatitis C virus and of patients coinfected with HCV/HIV with all-oral direct-acting antiviral combinations led to high and similar rates of sustained virological response 12 weeks after the end of therapy.
Hepatitis B virus coinfection was the most important risk factor for liver fibrosis and cirrhosis in HIV-infected patients, and should be diagnosed early in HIV care to optimize treatment outcomes, a recent study showed.
Immunity persisted 24 months after a single dose of inactivated hepatitis A vaccine and live attenuated hepatitis A vaccine was administered to school-age children, according to a study published in Human Vaccines & Immunotherapeutics.
A hepatitis C treatment scale-up strategy in Rhode Island could reduce cirrhosis cases and liver-related deaths by 78.9% and 72.4%, respectively, by 2030, according to a study in Epidemiology and Infection.
Viral blipping is a frequent event during nucleoside analogue treatment of patients with chronic hepatitis B virus infection, a study found, although it did not lead to any clinically significant outcomes and thus may not require more frequent blood work and patient visits in clinical practice.
A study of liver and spleen stiffness in hepatitis C virus–infected patients – with advanced liver disease and sustained virologic response after interferon-free treatment – found that improvement of liver stiffness may be due to reduced necroinflammation, and to a lesser extent regression of cirrhosis. Improvement was more pronounced between therapy baseline and end of treatment than therapy baseline and 24 weeks after end of treatment.
From 2000 to 2011, 4,346 adults who died in New York City had a report of a hepatitis B virus infection (0.7%), according to a study in Epidemiology and Infection. Of the HBV-infected decedents, 1,074 (25%) were HIV coinfected. Fifty-five percent of HBV monoinfected and 95% of HBV/HIV coinfected decedents died prematurely, the researchers found.
Prison-based hepatitis C virus treatment achieves outcomes similar to those of community-based treatment, according to a study in the Journal of Viral Hepatitis, with those not released or transferred during treatment doing particularly well.
Treatment interventions to curb the hepatitis C virus epidemic among HIV-infected men who have sex with men are effective if high-risk behavior does not increase as it has during the last decade, according to a study in Hepatology.
The results of an international quality control study underline the urgent need to improve methods used to monitor hepatitis Delta virus viremia.
An investigation of a hepatitis E virus genotype 4 outbreak in Zhejiang Province, China, found that the outbreak was most likely caused by contaminated tap water rather than food.
A German study found that short treatment with 8 weeks of sofosbuvir and ledipasvir seems highly effective and safe in well-selected hepatitis C virus mono- and HIV/HCV-coinfected patients in a real-world setting.
A study of historical events fueling the cross-continental spread of hepatitis C virus epidemics said drivers for the epidemic were the advent of intravenous medical therapies and devices, growth in the heroin trade, and population mixing during armed conflicts.
On Twitter @richpizzi
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.
A study in Hepatology has provided a preclinical risk assessment paradigm with which to better understand cardiovascular drug-drug interaction risk for hepatitis C–virus infected patients treated with sofosbuvir in combination with other direct acting antivirals and the antiarrhythmic drug amiodarone.
A Japanese study found that, although levels of Wisteria floribunda agglutinin-positive Mac-2-binding protein could be a useful indicator of liver fibrosis in patients with hepatitis B or C infection, WFA+-M2BP levels in the two groups significantly differed, even in the same degree of fibrosis.
Interferon-free, guideline-tailored therapy with direct-acting antivirals is highly effective and safe for hepatitis C virus–associated mixed cryoglobulinemia patients, according to a recent study.
Another recent study found that pegylated interferon (PegIFN) intensification in hepatitis B “e” antigen (HBeAg)-positive coinfected patients did not lead to increased clearance rates of HBeAg or hepatitis B surface antigen quantification (qHBsAg), despite faster declines of antigen levels while on PegIFN.
A study in HIV Medicine found that, under real-life conditions, treatment of patients infected with hepatitis C virus and of patients coinfected with HCV/HIV with all-oral direct-acting antiviral combinations led to high and similar rates of sustained virological response 12 weeks after the end of therapy.
Hepatitis B virus coinfection was the most important risk factor for liver fibrosis and cirrhosis in HIV-infected patients, and should be diagnosed early in HIV care to optimize treatment outcomes, a recent study showed.
Immunity persisted 24 months after a single dose of inactivated hepatitis A vaccine and live attenuated hepatitis A vaccine was administered to school-age children, according to a study published in Human Vaccines & Immunotherapeutics.
A hepatitis C treatment scale-up strategy in Rhode Island could reduce cirrhosis cases and liver-related deaths by 78.9% and 72.4%, respectively, by 2030, according to a study in Epidemiology and Infection.
Viral blipping is a frequent event during nucleoside analogue treatment of patients with chronic hepatitis B virus infection, a study found, although it did not lead to any clinically significant outcomes and thus may not require more frequent blood work and patient visits in clinical practice.
A study of liver and spleen stiffness in hepatitis C virus–infected patients – with advanced liver disease and sustained virologic response after interferon-free treatment – found that improvement of liver stiffness may be due to reduced necroinflammation, and to a lesser extent regression of cirrhosis. Improvement was more pronounced between therapy baseline and end of treatment than therapy baseline and 24 weeks after end of treatment.
From 2000 to 2011, 4,346 adults who died in New York City had a report of a hepatitis B virus infection (0.7%), according to a study in Epidemiology and Infection. Of the HBV-infected decedents, 1,074 (25%) were HIV coinfected. Fifty-five percent of HBV monoinfected and 95% of HBV/HIV coinfected decedents died prematurely, the researchers found.
Prison-based hepatitis C virus treatment achieves outcomes similar to those of community-based treatment, according to a study in the Journal of Viral Hepatitis, with those not released or transferred during treatment doing particularly well.
Treatment interventions to curb the hepatitis C virus epidemic among HIV-infected men who have sex with men are effective if high-risk behavior does not increase as it has during the last decade, according to a study in Hepatology.
The results of an international quality control study underline the urgent need to improve methods used to monitor hepatitis Delta virus viremia.
An investigation of a hepatitis E virus genotype 4 outbreak in Zhejiang Province, China, found that the outbreak was most likely caused by contaminated tap water rather than food.
A German study found that short treatment with 8 weeks of sofosbuvir and ledipasvir seems highly effective and safe in well-selected hepatitis C virus mono- and HIV/HCV-coinfected patients in a real-world setting.
A study of historical events fueling the cross-continental spread of hepatitis C virus epidemics said drivers for the epidemic were the advent of intravenous medical therapies and devices, growth in the heroin trade, and population mixing during armed conflicts.
On Twitter @richpizzi
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.
A study in Hepatology has provided a preclinical risk assessment paradigm with which to better understand cardiovascular drug-drug interaction risk for hepatitis C–virus infected patients treated with sofosbuvir in combination with other direct acting antivirals and the antiarrhythmic drug amiodarone.
A Japanese study found that, although levels of Wisteria floribunda agglutinin-positive Mac-2-binding protein could be a useful indicator of liver fibrosis in patients with hepatitis B or C infection, WFA+-M2BP levels in the two groups significantly differed, even in the same degree of fibrosis.
Interferon-free, guideline-tailored therapy with direct-acting antivirals is highly effective and safe for hepatitis C virus–associated mixed cryoglobulinemia patients, according to a recent study.
Another recent study found that pegylated interferon (PegIFN) intensification in hepatitis B “e” antigen (HBeAg)-positive coinfected patients did not lead to increased clearance rates of HBeAg or hepatitis B surface antigen quantification (qHBsAg), despite faster declines of antigen levels while on PegIFN.
A study in HIV Medicine found that, under real-life conditions, treatment of patients infected with hepatitis C virus and of patients coinfected with HCV/HIV with all-oral direct-acting antiviral combinations led to high and similar rates of sustained virological response 12 weeks after the end of therapy.
Hepatitis B virus coinfection was the most important risk factor for liver fibrosis and cirrhosis in HIV-infected patients, and should be diagnosed early in HIV care to optimize treatment outcomes, a recent study showed.
Immunity persisted 24 months after a single dose of inactivated hepatitis A vaccine and live attenuated hepatitis A vaccine was administered to school-age children, according to a study published in Human Vaccines & Immunotherapeutics.
A hepatitis C treatment scale-up strategy in Rhode Island could reduce cirrhosis cases and liver-related deaths by 78.9% and 72.4%, respectively, by 2030, according to a study in Epidemiology and Infection.
Viral blipping is a frequent event during nucleoside analogue treatment of patients with chronic hepatitis B virus infection, a study found, although it did not lead to any clinically significant outcomes and thus may not require more frequent blood work and patient visits in clinical practice.
A study of liver and spleen stiffness in hepatitis C virus–infected patients – with advanced liver disease and sustained virologic response after interferon-free treatment – found that improvement of liver stiffness may be due to reduced necroinflammation, and to a lesser extent regression of cirrhosis. Improvement was more pronounced between therapy baseline and end of treatment than therapy baseline and 24 weeks after end of treatment.
From 2000 to 2011, 4,346 adults who died in New York City had a report of a hepatitis B virus infection (0.7%), according to a study in Epidemiology and Infection. Of the HBV-infected decedents, 1,074 (25%) were HIV coinfected. Fifty-five percent of HBV monoinfected and 95% of HBV/HIV coinfected decedents died prematurely, the researchers found.
Prison-based hepatitis C virus treatment achieves outcomes similar to those of community-based treatment, according to a study in the Journal of Viral Hepatitis, with those not released or transferred during treatment doing particularly well.
Treatment interventions to curb the hepatitis C virus epidemic among HIV-infected men who have sex with men are effective if high-risk behavior does not increase as it has during the last decade, according to a study in Hepatology.
The results of an international quality control study underline the urgent need to improve methods used to monitor hepatitis Delta virus viremia.
An investigation of a hepatitis E virus genotype 4 outbreak in Zhejiang Province, China, found that the outbreak was most likely caused by contaminated tap water rather than food.
A German study found that short treatment with 8 weeks of sofosbuvir and ledipasvir seems highly effective and safe in well-selected hepatitis C virus mono- and HIV/HCV-coinfected patients in a real-world setting.
A study of historical events fueling the cross-continental spread of hepatitis C virus epidemics said drivers for the epidemic were the advent of intravenous medical therapies and devices, growth in the heroin trade, and population mixing during armed conflicts.
On Twitter @richpizzi
HIV research update: Late August 2016
A large volume of HIV and AIDS research enters the medical literature every month. It can be difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
Emotion dysregulation in people with HIV/AIDS may interact with HIV symptom severity to negatively impact certain aspects of quality of life, according to a study in AIDS Care.
Concurrent multitype HPV infection is common in HIV-seropositive women and frequency rises as CD4 count declines, a recent study revealed, but multitype infection does not increase precancer risk.
A study published in HIV Clinical Trials found an association between increased homocysteine plasma level and shortened prothrombin time in HIV-infected patients.
Lower levels of gamma-linolenic acid are associated with lower CD4 counts in HIV patients and an increased risk of death or hospitalization, a recent study revealed. The authors said the results suggest a potential for using n6-fatty acids to improve outcomes from antiretroviral therapy.
A recent study found that the early spread of HIV virus from blood plasma to genital tract, and the complex viral interplay between these compartments, suggests that viral eradication efforts will require monitoring viral subpopulations in anatomic sites and viral trafficking during the course of infection.
A study of aviremic HIV-2–infected individuals in Guinea-Bissau revealed that increased frequencies of CD4+ T cells with an activated/exhausted phenotype correlate with exacerbated immunodeficiency.
Treatment interventions to curb the hepatitis C virus epidemic among HIV-infected men who have sex with men could be effective if high-risk behavior does not increase as it has during the last decade, according to a study in Hepatology.
A German study found that short treatment with 8 weeks of sofosbuvir and ledipasvir seems highly effective and safe in selected hepatitis C virus mono- and HIV-HCV–coinfected patients in a real-world setting.
A study of antiretroviral treatment in Swaziland found the attrition rate to be 10.3% in 16,423 participants that initiated ART in 2012.
Mycobacterium tuberculosis in HIV-infected patients had lower expression of the DosR regulon genes, a critical metabolic and immunomodulatory switch induced by nitric oxide, carbon monoxide, and hypoxia, according to a study in the Journal of Infectious Diseases.
The influence of the Affordable Care Act on insurance coverage for HIV patients and other factors affecting HIV care likely varies by jurisdiction, reported a study in AIDS Care.
A Danish study found that HIV-exposed uninfected children had an increased risk of overall hospital admission mainly due to observation/nonspecific diagnoses, not to infectious disease.
A recent study found that mobile technology is a promising approach to intervention delivery for both younger and older HIV-positive black men who have sex with men.
Interventions or programmatic decisions regarding preconception counseling methods for young women living with HIV are necessary and potentially transferable between populations, new research suggests.
A meta-analysis in HIV Medicine found that the life expectancy of HIV-positive people after starting combination antiretroviral therapy (cART) improved over time. The authors said monitoring life expectancy into the future is important to assess how changes to cART guidelines will affect patient long-term outcomes.
Involving people living with HIV/AIDS as patient instructors (PHA-PIs) reduced HIV-related stigma among medical students and increased comfort in providing HIV-related care, according to a study published in AIDS Care.
A recent study found a benefit of antidepressant treatment in people with HIV, depression, and alcohol use, and found no evidence that either alcohol use or illicit drug use moderates the antidepressant treatment response.
It is possible to successfully integrate a patient retention protocol into the existing infrastructure of an HIV clinic and reengage a majority of out-of-care patients into medical care, according to investigators in North Carolina.
On Twitter @richpizzi
A large volume of HIV and AIDS research enters the medical literature every month. It can be difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
Emotion dysregulation in people with HIV/AIDS may interact with HIV symptom severity to negatively impact certain aspects of quality of life, according to a study in AIDS Care.
Concurrent multitype HPV infection is common in HIV-seropositive women and frequency rises as CD4 count declines, a recent study revealed, but multitype infection does not increase precancer risk.
A study published in HIV Clinical Trials found an association between increased homocysteine plasma level and shortened prothrombin time in HIV-infected patients.
Lower levels of gamma-linolenic acid are associated with lower CD4 counts in HIV patients and an increased risk of death or hospitalization, a recent study revealed. The authors said the results suggest a potential for using n6-fatty acids to improve outcomes from antiretroviral therapy.
A recent study found that the early spread of HIV virus from blood plasma to genital tract, and the complex viral interplay between these compartments, suggests that viral eradication efforts will require monitoring viral subpopulations in anatomic sites and viral trafficking during the course of infection.
A study of aviremic HIV-2–infected individuals in Guinea-Bissau revealed that increased frequencies of CD4+ T cells with an activated/exhausted phenotype correlate with exacerbated immunodeficiency.
Treatment interventions to curb the hepatitis C virus epidemic among HIV-infected men who have sex with men could be effective if high-risk behavior does not increase as it has during the last decade, according to a study in Hepatology.
A German study found that short treatment with 8 weeks of sofosbuvir and ledipasvir seems highly effective and safe in selected hepatitis C virus mono- and HIV-HCV–coinfected patients in a real-world setting.
A study of antiretroviral treatment in Swaziland found the attrition rate to be 10.3% in 16,423 participants that initiated ART in 2012.
Mycobacterium tuberculosis in HIV-infected patients had lower expression of the DosR regulon genes, a critical metabolic and immunomodulatory switch induced by nitric oxide, carbon monoxide, and hypoxia, according to a study in the Journal of Infectious Diseases.
The influence of the Affordable Care Act on insurance coverage for HIV patients and other factors affecting HIV care likely varies by jurisdiction, reported a study in AIDS Care.
A Danish study found that HIV-exposed uninfected children had an increased risk of overall hospital admission mainly due to observation/nonspecific diagnoses, not to infectious disease.
A recent study found that mobile technology is a promising approach to intervention delivery for both younger and older HIV-positive black men who have sex with men.
Interventions or programmatic decisions regarding preconception counseling methods for young women living with HIV are necessary and potentially transferable between populations, new research suggests.
A meta-analysis in HIV Medicine found that the life expectancy of HIV-positive people after starting combination antiretroviral therapy (cART) improved over time. The authors said monitoring life expectancy into the future is important to assess how changes to cART guidelines will affect patient long-term outcomes.
Involving people living with HIV/AIDS as patient instructors (PHA-PIs) reduced HIV-related stigma among medical students and increased comfort in providing HIV-related care, according to a study published in AIDS Care.
A recent study found a benefit of antidepressant treatment in people with HIV, depression, and alcohol use, and found no evidence that either alcohol use or illicit drug use moderates the antidepressant treatment response.
It is possible to successfully integrate a patient retention protocol into the existing infrastructure of an HIV clinic and reengage a majority of out-of-care patients into medical care, according to investigators in North Carolina.
On Twitter @richpizzi
A large volume of HIV and AIDS research enters the medical literature every month. It can be difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
Emotion dysregulation in people with HIV/AIDS may interact with HIV symptom severity to negatively impact certain aspects of quality of life, according to a study in AIDS Care.
Concurrent multitype HPV infection is common in HIV-seropositive women and frequency rises as CD4 count declines, a recent study revealed, but multitype infection does not increase precancer risk.
A study published in HIV Clinical Trials found an association between increased homocysteine plasma level and shortened prothrombin time in HIV-infected patients.
Lower levels of gamma-linolenic acid are associated with lower CD4 counts in HIV patients and an increased risk of death or hospitalization, a recent study revealed. The authors said the results suggest a potential for using n6-fatty acids to improve outcomes from antiretroviral therapy.
A recent study found that the early spread of HIV virus from blood plasma to genital tract, and the complex viral interplay between these compartments, suggests that viral eradication efforts will require monitoring viral subpopulations in anatomic sites and viral trafficking during the course of infection.
A study of aviremic HIV-2–infected individuals in Guinea-Bissau revealed that increased frequencies of CD4+ T cells with an activated/exhausted phenotype correlate with exacerbated immunodeficiency.
Treatment interventions to curb the hepatitis C virus epidemic among HIV-infected men who have sex with men could be effective if high-risk behavior does not increase as it has during the last decade, according to a study in Hepatology.
A German study found that short treatment with 8 weeks of sofosbuvir and ledipasvir seems highly effective and safe in selected hepatitis C virus mono- and HIV-HCV–coinfected patients in a real-world setting.
A study of antiretroviral treatment in Swaziland found the attrition rate to be 10.3% in 16,423 participants that initiated ART in 2012.
Mycobacterium tuberculosis in HIV-infected patients had lower expression of the DosR regulon genes, a critical metabolic and immunomodulatory switch induced by nitric oxide, carbon monoxide, and hypoxia, according to a study in the Journal of Infectious Diseases.
The influence of the Affordable Care Act on insurance coverage for HIV patients and other factors affecting HIV care likely varies by jurisdiction, reported a study in AIDS Care.
A Danish study found that HIV-exposed uninfected children had an increased risk of overall hospital admission mainly due to observation/nonspecific diagnoses, not to infectious disease.
A recent study found that mobile technology is a promising approach to intervention delivery for both younger and older HIV-positive black men who have sex with men.
Interventions or programmatic decisions regarding preconception counseling methods for young women living with HIV are necessary and potentially transferable between populations, new research suggests.
A meta-analysis in HIV Medicine found that the life expectancy of HIV-positive people after starting combination antiretroviral therapy (cART) improved over time. The authors said monitoring life expectancy into the future is important to assess how changes to cART guidelines will affect patient long-term outcomes.
Involving people living with HIV/AIDS as patient instructors (PHA-PIs) reduced HIV-related stigma among medical students and increased comfort in providing HIV-related care, according to a study published in AIDS Care.
A recent study found a benefit of antidepressant treatment in people with HIV, depression, and alcohol use, and found no evidence that either alcohol use or illicit drug use moderates the antidepressant treatment response.
It is possible to successfully integrate a patient retention protocol into the existing infrastructure of an HIV clinic and reengage a majority of out-of-care patients into medical care, according to investigators in North Carolina.
On Twitter @richpizzi
