Updated HHS Adult and Adolescent Antiretroviral Treatment Guidelines Released
The HHS Panel on Antiretroviral Guidelines for Adults and Adolescents announces the release of the updated Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Key updates to the guidelines include additions and changes to the following guideline sections: What to Start: Significant changes to the list of Recommended, Alternative, and Other regimens for treatment-naive patients prompted by recent findings from clinical trials and cohort studies, as well as experience in clinical practice. Addition of a new table to assist clinicians in selecting an initial ARV regimen based on specific clinical scenarios and ARV-related considerations. Management of the Treatment-Experienced Patient: Expanded information on the management of patients failing first and second ART regimens, and new information about isolated CNS virologic failure and new onset neurologic symptoms. A new section to highlight information on poor CD4 cell recovery and persistent inflammation and the increased risk of morbidity. Drug Interactions: A new table outlining the mechanisms of interaction of ARV drugs. Updates to all drug-drug interaction tables, particularly to those related to ritonavir- or cobicistat-boosted ARV drugs. In addition, the Acute/Early HIV Infection, HIV-2 Infection, and HIV/Hepatitis C Virus (HCV) Coinfection sections have been updated to reflect the most recent information relevant to each section. For a complete preview...
The latest inquiry must discover how thousands of haemophiliacs contracted HIV or hepatitis C from blood products, and why it was covered up for so longIn two weeks ’ time Sir Brian Langstaff will take up his post as chair of thepublic inquiry into contaminated blood and contaminated blood products. Today, World Haemophilia Day, is the perfect occasion to remind Langstaff what the thousands of haemophiliac victims need from this inquiry if they are to get justice.In the 1970s and 1980s more than 4,600 haemophiliacs contracted HIV or hepatitis C after being infected by contaminated blood-clotting products. Much of the...
AbstractOpinion statementInitiating antiretroviral therapy (ART) in human immunodeficiency virus (HIV) elite controllers remains controversial, because current evidence does not definitively demonstrate that the benefits of ART outweigh risk in this patient population. However, it is the opinion of the authors that in developed countries, where first-line ART regimens have minimal toxicities, treatment of elite controllers should be strongly considered. Treatment of elite controllers has the potential to minimize the size of the HIV reservoir, which benefits elite controllers who choose to pursue future cure, dampen immune...
CONCLUSIONS: The HIV example provides helpful parallels for addressing challenges to expanding access to HCV DAAs. HCV treatment access - and harm reduction - should be massively scaled-up to meet the needs of PWID, and efforts should be made to tackle stigma and discrimination, and stop criminalization of drug use and possession. PMID: 29633580 [PubMed - in process]
CONCLUSIONS: There are certainly effective tools to combat the spread of viral hepatitis and treat infected individuals - yet how they are able to reach key populations, and the infrastructure required to do so, continue to represent the largest research gap when evaluating the progress towards elimination. Continuously adapted and informed research is required to establish the priorities in achieving elimination goals. PMID: 29633564 [PubMed - in process]
CONCLUSIONS: Achieving WHO HCV Elimination targets is potentially achievable among HIV-infected populations. Among HIV+ PWID, it likely requires HCV treatment scale-up combined with harm reduction for both HIV+ and HIV- populations. Among HIV+ MSM, elimination likely requires both HCV treatment and behaviour risk reduction among the HIV+ MSM population, the latter of which to date has not been observed. Lower HCV diagnostic and treatment costs will be key to ensuring scale-up of HCV testing and treatment without restriction, enabling elimination. PMID: 29633560 [PubMed - in process]
CONCLUSIONS: Patients who start antiviral treatment for chronic hepatitis C require a thorough clinical evaluation. There is a need for assessing factors that impact on the treatment schedule and duration or affect the pharmacokinetics of direct-acting antivirals. PMID: 29633552 [PubMed - in process]
Conclusion: Our results demonstrate a positive relationship between HIV-seropositivity and having access to a physician for regular HCV care, which is partially explained through increased frequency of engagement in health care. These findings highlight the need to address patterns of inequality in access to HCV care among PWID.
CONCLUSIONS: Generation Tomorrow has been successful in engaging students and community peers in HIV and HCV education, testing, and counseling, and has documented HIV and HCV positivity rates well above general community prevalence. PMID: 29606698 [PubMed - in process]
Robert Redfield, the new director of the Centers for Disease Control and Prevention, gave a deeply personal agencywide address Thursday in which he repeatedly underscored the importance of science and data and said CDC's most critical public health mission is to protect Americans “from that which we don't expect.” The 66-year-old Redfield, a longtime AIDS […]Related:Genetics may make some babies vulnerable to SIDS or ‘crib death,’ study saysFDA sued for delaying e-cigarette, cigar regulationsTesting for hepatitis C lags with baby boomers despite high infection rate
This document provides guidance on how to plan for an outbreak of HIV or hepatitis C among people who inject drugs (PWID), including considerations for developing an outbreak response plan to minimize the impact of the outbreak on the community and stop further transmission.