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EPIDEMICS
Study finds promise toward treating HIV and hep C
by Staff Writers
Washington (AFP) July 19, 2014


In US, HIV diagnoses drop -- except among some gay men
Washington (AFP) July 19, 2014 - The rate of HIV diagnoses in the United States has dropped more than 30 percent over the past decade, but is on the rise among certain gay men, researchers said Saturday.

Men who have sex with men and who are aged between 13 and 24 saw the biggest rise -- a 132.5 percent increase in the rate of HIV diagnoses -- said the report in the Journal of the American Medical Association.

Gay men aged 45 and older were also increasingly diagnosed with HIV.

Meanwhile, the rate of HIV diagnoses fell among other groups, including heterosexual women and injection drug users.

Overall, the rate of HIV diagnosis in the United States dropped 33 percent from 2002-2011, said the study led by Anna Satcher Johnson of the Division of HIV/AIDS Prevention at the US Centers for Disease Control and Prevention.

Researchers examined data collected by the National HIV Surveillance System of the CDC, which is based on mandated reporting of HIV cases in all 50 states and the District of Columbia.

During the period of 2002-2011, 493,372 people in the United States were diagnosed with HIV.

The annual diagnosis rate fell by 33.2 percent, from 24.1 per 100,000 population in 2002 to 16.1 in 2011, said the study.

While statistically significant decreases surfaced in most every demographic group, no changes were seen among Asians or Native Hawaiians and other Pacific Islanders.

Among men who have sex with men, diagnoses "remained stable overall," but when they were separated by age group, certain growth trends became apparent.

Meanwhile, HIV fell among men aged 35-44.

"Among men who have sex with men, unprotected risk behaviors in the presence of high prevalence and unsuppressed viral load may continue to drive HIV transmission," said the study.

Researchers also noted that HIV testing was expanded during the study period, which can often result in an initial surge in diagnoses, but it was unclear if this was driving the rise among some men.

The findings are published in the July 23/30 issue of JAMA that focuses on HIV/AIDS and coincides with the International AIDS Conference in Melbourne, Australia.

A new hepatitis C drug has shown early promise in patients whose infection with both HIV and hepatitis C has made them traditionally difficult to treat, said a study Saturday.

Patients were given Gilead Sciences' sofosbuvir, a drug approved for the US market in 2013 that has stirred controversy due to its high price tag -- about $1,000 per pill, along with another well-known drug, ribavirin.

The study in the Journal of the American Medical Association's (JAMA) July 23/30 issue included just over 220 people who were treated for either 12 or 24 weeks.

Most of the patients -- between 67 percent and 94 percent depending on the type of hepatitis C they had and whether they had ever been treated for it before -- saw their liver disease disappear and stay away for 12 weeks after they stopped treatment.

The measurement scientists used was known as sustained virologic response (SVR), or what is clinically considered a "cure" of hepatitis C, a serious and often chronic liver disease.

The study ended 12-weeks after treatment ended, so responses beyond that point are unknown.

As many as seven million people worldwide are infected with both human immunodeficiency virus and hepatitis C, according to background information in the article.

Treating both infections is difficult because patients have needed to use interferon for hepatitis C, which interacts poorly with antiretroviral drugs for HIV suppression.

Seven of the 223 in this study discontinued the treatment because of adverse events, most commonly fatigue, insomnia, headache, and nausea.

Researchers noted that the study was not the most rigorous kind. Doctors knew what they were prescribing to patients, and the participants were not randomized to a comparison treatment or placebo.

However, patients "had high rates of sustained HCV virologic response 12 weeks after cessation of therapy," said the study led by Mark Sulkowski of Johns Hopkins University.

"Further studies of this regimen in more diverse populations of coinfected patients are needed."

An accompanying editorial by Michael Saag of the University of Alabama School of Medicine said the drug combination is a "quantum leap forward" in treatment but that its cost remains too high for widespread use.

"When combined with ribavirin, the average wholesale price of a 12-week course of treatment is $94,500 and $189,000 for a 24-week course," he wrote.

"The world simply cannot afford to pay on a 'cost per cure' basis," he added.

"Hopefully, competition among the new products coming to market in the next 18 months will result in substantially lower pricing for the drugs."

Some 100 on board crashed Malaysia flight were AIDS workers: reports
Melbourne (AFP) July 18, 2014 - As many as 100 of those killed on a Malaysia Airlines plane that crashed in Ukraine were delegates heading to Australia for a global AIDS conference, unconfirmed reports said Friday.

The Australian broadsheet and the Sydney Morning Herald both said that more than one-third of the nearly 300 who died were AIDS researchers, health workers and activists en route to Melbourne.

The Herald said those attending a pre-conference meeting in Sydney were told that around 100 of their colleagues were on the plane that went down, including former International AIDS Society president Joep Lange.

The Australian reported that delegates to the 20th International AIDS Conference in Melbourne, which is due to begin on Sunday, were to be informed that 108 of their colleagues and family members died on MH17.

The International AIDS Society has confirmed that "a number of our colleagues and friends" were killed, but has not said how many.

Asked by reporters whether 108 people attending the conference were on the flight from Amsterdam to Kuala Lumpur, International AIDS Society president Francoise Barre-Sinoussi said she was not sure.

"We don't have the confirmation (of numbers)," she said.

"We don't know how many were on that flight."

Organisers of the conference in Melbourne said it would go ahead regardless.

"The decision to go on, we were thinking about them because we know it's really what they would have liked us to do," said Barre-Sinoussi.

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Related Links
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EPIDEMICS
AIDS could be wiped out by 2030: UN
Geneva (AFP) July 16, 2014
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