News from aidsmap

Faster action on adherence is needed after viral load becomes detectable, researchers warn global treatment programmes

Low-level HIV viral load, above the limit of detection, is an important warning signal for future treatment failure and World Health Organization guidelines on spotting treatment failure need to be revised to encourage greater vigilance and swifter action by healthcare providers in lower- and middle-income settings, investigators report in The Lancet Infectious Diseases.


Smoking causes one in five cancers in people with HIV in North America

A fifth of all cancers in people receiving HIV care in North America between 2000 and 2015 was due to smoking, according to US research published this month in advance online by the journal AIDS.


Smoking reduces survival after liver cancer diagnosis for people with viral hepatitis

People with viral hepatitis who smoked were three times more likely to die after being diagnosed with liver cancer (hepatocellular carcinoma, HCC), according to a study of Swiss patients published in Liver International.


Long-acting injectable ARVs are convenient and private, study participants report

HIV-positive people who took injectable cabotegravir + rilpivirine every four or eight weeks as antiretroviral therapy found it more convenient and discreet than daily pills, also feeling that it eliminated a “daily reminder of living with HIV”, Deanna Kerrigan and colleagues report in PLOS One.


Hepatitis C treatment highly effective in harder-to-treat people with HIV co-infection, Spanish real-life study shows

Hepatitis C virus (HCV) treatment using direct-acting antivirals (DAAs) is highly effective and safe in harder-to-treat people with HIV co-infection, Spanish researchers report in AIDS. A sustained virological response (SVR), or cure, was observed in 93% of people and only 0.4% stopped treatment because of adverse events. The large proportion of people had advanced fibrosis or had taken a previous course of HCV therapy. Liver cirrhosis/liver stiffness were the only factors associated with treatment failure and use of ribavirin increased the risk of side-effects.


Attitudes towards men who ‘bareback’ are a barrier to wider use of PrEP

Two new qualitative studies from Toronto shed light on how stigma affects the uptake of pre-exposure prophylaxis (PrEP) and the experience of taking it. In the first, young gay men acknowledged that they did not always use condoms but did not see themselves as the kind of ‘barebacker’ for whom they thought PrEP was intended.


Withdrawing Depo-Provera contraceptives would result in more lives lost than HIV infections prevented

Even if Depo-Provera and other contraceptive injections raise the risk of HIV infection, withdrawing them from use in African countries would greatly increase maternal mortality, a modelling study has shown. The loss of life due to pregnancy complications and unsafe abortions would far outweigh the number of HIV infections prevented, according to the study published in the December issue of Global Health: Science and Practice.


New ‘mini-pillbox’ device could deliver three HIV drugs in a single once-weekly dose

A new oral device that is taken once a week in a capsule could deliver two or three antiretroviral drugs and significantly reduce the risk of missing does or of developing drug resistance, according to research published in Nature Communications.


Twice the rate of bone loss among ART-treated women than men

Bone mineral density declines twice as quickly among HIV-positive women than HIV-positive men, according to Italian research published in the online edition of the Journal of Acquired Immune Deficiency Syndromes. The study is the largest ever analysis of long-term changes in bone mineral density (BMD) in HIV-positive people, over three-quarters of whom had an undetectable viral load at baseline. Several other modifiable risk factors were also associated with reductions in BMD, including hepatitis C virus infection (HCV), treatment with tenofovir (TDF), low vitamin D levels and lack of physical exercise.


Editors’ picks from other sources

HIV-positive man can become a commercial pilot

from BBC News

An HIV-positive man who was told he could not train as a commercial pilot will be allowed to begin training after a U-turn by aviation officials.

U=U laggards draw fire from the community

from Positive Lite

The global U=U picture is good, but community activists are stepping up the heat on organisations which have been slow to embrace it. Today the spotlight is on Greater than AIDS, GNP+, and in Canada, the Ontario AIDS Network.

NIH study supports use of short-term HIV treatment interruption in clinical trials

from National Institutes of Health

A short-term pause in HIV treatment during a carefully monitored clinical trial does not lead to lasting expansion of the HIV reservoir nor cause irreversible damage to the immune system, new findings suggest.

Children exposed to drugs, violence experience higher incidence of HIV as adults

from MD Mag

Evidence suggests that exposure to certain types of mental and physical stress in adolescence may make it more likely that as adults they will practice behaviours that increase the risk of HIV infection.

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