News from EACS 2017

How a London clinic reduced new HIV infections by 90% and why more European cities can do the same

Scaling up HIV testing to reduce undiagnosed HIV infection requires a fundamental re-ordering of HIV testing services to make them more attractive to people at risk, and doing so can bring about enormous changes in HIV incidence and treatment uptake, delegates heard on the opening day of the 16th European AIDS Conference (EACS 2017) in Milan.


Up to a quarter of HIV-negative gay men attending three English clinics used PrEP in the last year

A prospective cohort study of gay men attending three clinics in southern England – 56 Dean Street and Mortimer Market Centre in London and the Brighton & Hove SHAC (Sexual Health & Contraception) service – have found that 23% of HIV-negative service users who responded to a follow-up questionnaire had used PrEP (pre-exposure prophylaxis) in the last year.


HIV diagnoses in English gay men have been falling since 2014

A new analysis by Public Health England of testing rates and HIV diagnoses from all of England’s sexual health clinics shows that the decline in diagnoses is England-wide, started at least a year before the decline was first noticed at London’s 56 Dean Street clinic, and is not restricted to gay men who test frequently.


High HIV incidence from non-primary partners and low PEP and PrEP use seen in PARTNER study

HIV incidence among the HIV-negative gay men in the PARTNER 1 and 2 studies, due to sex with partners outside the main relationship, was high, and very high in partners who admitted having condomless anal sex with non-primary partners, the conference heard.


European AIDS Clinical Society strengthens HPV vaccination advice

The European AIDS Clinical Society (EACS) has recommended HPV (human papillomavirus) vaccination for everyone living with HIV aged under 26 and men who have sex with men up to the age of 40.


Swiss study examines which years gay men decided to stop consistent condom use

An innovative study presented at the conference used a machine-learning algorithm (originally developed to help astronomers classify galaxies) to tease out whether there were specific groups of gay men within a large national cohort whose sexual risk behaviours followed similar trajectories over time, and if so, whether they were influenced by external factors such as new scientific data.


Survey of dating app users finds that PrEP usage has not increased in Europe in the last year

A study of men who have sex with men (MSM) conducted by the European Centre for Disease Prevention and Control (ECDC) in collaboration with the gay contact site Hornet has found that pre-exposure prophylaxis (PrEP) usage has not increased, on average, among its respondents over the proportion reported last year, when a similar survey was carried out.


Hepatitis C test-and-treat programme reduces HCV by two-thirds among men who have sex with men in Swiss HIV Cohort

A systematic policy of test-and-treat cured 99% of men who have sex with men with hepatitis C in the Swiss HIV Cohort in an 8-month period and reduced the prevalence of hepatitis C by almost two-thirds, Dominique Braun of the University Hospital, Zurich, reported at the conference.


High rate of hepatitis C reinfection in German men who have sex with men

Around one in seven gay and bisexual men cured of hepatitis C at major treatment centres in Germany has become reinfected since 2014, according to findings from the German Hepatitis C Cohort presented at the conference.


Symtuza as effective as multi-pill combination in previously untreated people with HIV

The single-pill combination of darunavir, cobicistat, tenofovir alafenamide and emtricitabine (Symtuza) is just as effective as a multi-pill combination of darunavir, cobicistat, emtricitabine and the older formulation of tenofovir (tenofovir disoproxil) in previously untreated people with HIV, Professor Chloe Orkin of the Royal London Hospital reported at the conference.


Fostemsavir controls viral load in half of people with highly drug-resistant HIV

Fostemsavir, a new experimental attachment inhibitor, suppressed viral load in over half of participants with extensive drug resistance when added to a background regimen selected by resistance testing, Max Lataillade of ViiV Healthcare reported at the conference.


Hepatitis C halved in Spanish people living with HIV in one year due to treatment

Spain is making dramatic progress towards eliminating hepatitis C in people living with HIV because of widespread use of direct-acting antivirals, Juan Berenguer of Hospital Gregorio Marañón, Madrid, reported at the conference.


People with HIV still expect a lower quality of life than their negative peers, European survey finds

A study commissioned by the drug company Gilead Sciences and conducted in five European countries has found that, compared with their HIV-negative peers, people with HIV still expect to die sooner and think they are less likely to achieve a long-term relationship.


New EACS treatment guidelines

Everyone with HIV and hepatitis C virus (HCV) co-infection should receive direct-acting antiviral treatment for hepatitis C and should receive the same treatment for hepatitis C as people with hepatitis C monoinfection, new European guidelines issued at the conference recommend.


ABX464 reduces HIV reservoir but doesn’t delay viral rebound

ABX464, a new drug that stimulates the clearance of HIV from infected cells, reduces the reservoir of HIV DNA in the body but does not delay the rebound in viral load when antiretroviral treatment is interrupted, Linos Vandekerckhove of the University of Ghent reported at the conference.


Boosted protease inhibitor and lamivudine provides effective maintenance treatment

HIV maintenance treatment with two drugs, a boosted protease inhibitor and lamivudine, is just as effective as three-drug treatment with a boosted protease inhibitor in people who already have fully suppressed viral load, a meta-analysis of clinical trials presented at the conference shows.


News from The Liver Meeting 2017

Curing hepatitis C with DAAs linked to 71% reduction in liver cancer

People who achieved a sustained response to hepatitis C treatment lowered their risk of hepatocellular carcinoma by around 70%, regardless of whether they were treated with new direct-acting antivirals (DAAs) or older interferon-based therapy, according to study results presented at The Liver Meeting 2017, the annual conference organised by the American Association for the Study of Liver Diseases (AASLD), in Washington, DC.


Daily aspirin therapy linked to lower liver cancer risk

People with hepatitis B virus who took an aspirin a day – often recommended to help prevent cardiovascular disease – had a lower risk of developing liver cancer, according to a study from Taiwan presented at the conference.


Hepatitis C testing linked to reduced opioid use among people who inject drugs

Getting tested for hepatitis C virus was associated with reduced drug use, especially among those who tested positive, but even people who tested negative saw some reduction, according to study results presented at the conference.


Maviret cures most people with HCV genotype 3 and those with cirrhosis

Glecaprevir and pibrentasvir, the two drugs in the recently approved Maviret co-formulation, demonstrated high sustained response rates for people with chronic hepatitis C virus (HCV) genotype 3 and for people with liver cirrhosis, according to a pair of reports presented at the conference.


HCV infection is rising among HIV-positive gay men in San Diego

Hepatitis C incidence is increasing among gay and bisexual men living with HIV in San Diego, according to the largest analysis of its kind done in the United States. Study results were presented at the conference.


Other aidsmap news

Healthcare workers living with HIV have different motivations for disclosing or concealing their HIV status

Nurses and other healthcare workers who are living with HIV have mixed reactions when they mention their HIV status to colleagues, according to a small Dutch study reported in the November/December issue of the Journal of the Association of Nurses in AIDS Care. Some healthcare workers disclosed because they expected a positive reaction or they felt the need to share a secret. Others concealed their HIV status because they feared a negative reaction or did not believe that disclosure was relevant or necessary.


People with HIV more likely to adhere to their antiretroviral therapy than treatment for other chronic health problems

Ageing HIV-positive people have significantly higher levels of adherence to their antiretroviral therapy than to medication taken for other chronic health problems, Swiss investigators report in HIV Medicine. The research also revealed that people living with HIV rated the necessity of their HIV treatment more highly than therapy for other illness and also had lower levels of concern about their antiretroviral treatment compared to therapy for co-morbid conditions.


Starting ART immediately after HIV diagnosis cuts mortality risk by two-thirds for people with high CD4 cell counts

People with a high CD4 cell count who start antiretroviral therapy (ART) immediately after diagnosis with HIV cut their 12-month mortality risk by two-thirds, according to research conducted in China and published in Clinical Infectious Diseases.


Global progress towards hepatitis C elimination still blocked by cost of treatment, lack of diagnosis

Nine countries – Australia, Brazil, Egypt, Georgia, Germany, Iceland, Japan, the Netherlands and Qatar – are on course to eliminate hepatitis C by 2030, according to data released at the World Hepatitis Summit in São Paulo, Brazil.


UK elimination of hepatitis C in jeopardy unless more patients found

Just one in three people with hepatitis C in the United Kingdom has been diagnosed according to the latest estimates released at this year’s World Hepatitis Summit in São Paulo, Brazil.


Editors’ picks from other sources

Vital microbicides may soon be out of reach

from Rewire

Whether, when, and how microbicide development proceeds depends on the US government, and the federal Division of AIDS has suggested this development may no longer be a priority. It’s wrong.

US: Trump policy harming Kenya, Uganda health services

from Human Rights Watch Health

Early effects of United States restrictions to global health aid include cuts to essential health services in Kenya and Uganda, Human Rights Watch said in a letter to US Secretary of State Rex Tillerson that was released in October. The changes have resulted in a loss of training and equipment from nongovernmental groups for government health clinics, and widespread confusion about implementation. Human Rights Watch sent its findings in advance of a six-month review by the State Department of these funding restrictions.

Canada: Debate over drug consumption sites might be coming to end

from CBC

In the space of two years, the number of supervised consumption sites approved to operate in Canada has gone from one to 22. “Whereas it took many, many years of advocacy and civil disobedience to establish a supervised injecting site in Vancouver, it’s become a lot less politicized, a lot less controversial and I think there are no really sane actors who are sitting around questioning whether there is a role for these initiatives anymore,” says Dr Thomas Kerr, a researcher at the University of British Columbia.

U=U taking off in 2017

from The Lancet HIV

U=U is a simple but hugely important campaign based on a solid foundation of scientific evidence. The clarity of the message will make it easier to promote the undeniable benefits of treatment.

GSK and Gilead go head to head as HIV drugs enter new phase

from Reuters

Gilead Sciences and GlaxoSmithKline (GSK) are heading for an HIV showdown, pushing rival treatment visions and competing products that are expected to hit the market in the next few months. Gilead is likely to secure the bigger near-term win, as it builds on a 20-year-old strategy of combining three drugs to control the virus, while GSK is placing a longer bet that its core drug is potent enough to work with just one other.

MSF secures deals for key hepatitis C medicines, price a fraction of branded drug

from Intellectual Property Watch

Médecins Sans Frontières (MSF, Doctors Without Borders) has announced that it has secured deals for two key generic hepatitis C medicines, sofosbuvir and daclatasvir, for as low as US$1.40 per day, or US$120 per 12-week treatment course.

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