Saturday 23rd January 2016- The Independent: Russian HIV cases reach record high of more than a million

‘More than a million Russians are now HIV-positive, as rates of infection in the country reach an all-time high.

Vadim Pokrovsky, the head of the Russian state Aids centre and an outspoken critic of the Kremlin’s conservative health policies, told Reuters that at at least 1 million and possibly as many as 1.5 million Russians were now HIV-positive.

This means that a little over 1 per cent of Russia’s 144,000,000 inhabitants now test positive for the virus, meaning that Russia has more cases of HIV per person than any other European country, save Estonia. By way of contrast, there are only around 100,000 individuals in the UK living with HIV.’

‘“The epidemic is gathering strength,” Mr Pokrovsky added. “Unfortunately, the measures that have been taken have clearly not been enough.”

There were 90,000 new cases in Russia in 2014, and the Aids centre further estimate that the number of HIV infections will reach 2 million by 2019. Since Russia’s first recorded case of HIV in 1987, around 204,000 people have died as a result of the virus.

57 per cent of Russians infected with the virus acquired it through drug use, with around 20 per cent of the country’s large number of known drug users testing positive for the disease. Russia has the largest number of intravenous drug users in the world – 1.8 million of them, according to a 2012 Lancet study.

Only around 30 per cent of Russians diagnosed with HIV currently receive the antriretroviral medication that their bodies need to stop the virus from multiplying.

Mr Pokrovsky told Reuters that he needed at least double the $475,000,000 being offered to him by the Kremlin to fight the disease. However, the Russian economy has been deflated by the collapse in oil prices and the imposition of Western sanctions, and there is likely to be even less public health funding available than before.’

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Russian HIV cases reach record high of more than a million

Thursday 26th November 2015- The Independent: HIV infections hit record level across Europe

‘The number of newly diagnosed HIV cases in Europe has hit an all-time high of 142,000, it has been revealed.

The World Health Organisation said the figure was the largest the continent had suffered since case reports began in the 1980s.’

‘“Despite all the efforts to fight HIV, this year the European Region has reached over 142,000 new HIV infections, the highest number ever,” says Dr Zsuzsanna Jakab, WHO Regional Director for Europe.

“This is a serious concern”.

This rise of the epidemic is primarily attributed to Eastern Europe, where new diagnoses have more than doubled in the past decade.’

‘WHO says the increase in the Eastern region is mainly due to heterosexual transmission and injected drug use.

However, sex between men is still the most common mode of HIV transmission across the continent.

European Centre for Disease Prevention Control acting director Andrea Ammon said: “Europe has to scale up its efforts to reach out to this group. This includes looking at new strategies such as pre-exposure prophylaxis for HIV and access to care for EU citizens residing in other EU countries.”’

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HIV infections hit record level across Europe

Wednesday 18th November 2015- BBC News: HIV home-test kit launched in England

‘A free HIV home-testing kit has been launched across England as the latest figures show 18,100 people in the UK are unaware they have the infection.

The test, which can be ordered online, uses a small droplet of blood that is sent to a laboratory.

Public Health England (PHE) is urging more people to check their HIV status.

It says four in 10 people in the UK are diagnosed late – meaning treatment may be less effective and the disease can be spread unwittingly.’

‘Official figures for 2014 show 103,700 people have HIV in the UK.

And though rates are falling overall, PHE warns it is still a growing problem in certain communities.

Experts say improved treatment means that if people are diagnosed early on, they can have a life-expectancy that almost matches those who are HIV free.

Prof Kevin Fenton, at PHE, added: “With national HIV-testing week approaching, I would encourage all those at higher risk of HIV, such as men who have sex with men or people from black African communities, to seriously consider testing, especially as they are now able to order a home sampling kit free online.”

The kit involves a finger-prick blood test that is sent off to be analysed. Three to five days later, people are contacted with results.

If the test suggests HIV is likely, patients are asked to attend a sexual health clinic for a confirmatory check.

The free test will be available to anyone in England until 1 January 2016.’

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HIV home-test kit launched in England

Wednesday 2nd September 2015- BBC News: London clinic leaks HIV status of patients

‘A sexual health clinic mistakenly leaked the HIV status of nearly 800 patients, bosses admitted.

The 56 Dean Street clinic in London’s Soho sent out the names and email addresses of 780 patients when a newsletter was issued to people who attend the clinic.

Patients were supposed to be blind-copied into the email but instead details were sent as a group email.

It was down to a member of staff’s “human error”, the clinic said.

The Information Commissioner’s Office said it was aware of the incident and would be making inquiries.

The maximum fine for breaches of data protection is £500,000.’

See:

London clinic leaks HIV status of patients

HIV status of nearly 800 patients accidentally disclosed by NHS clinic- The Independent

Sexual health clinic ‘reveals HIV positive status of nearly 800 patients’- The Telegraph

London HIV clinic accidentally reveals hundreds of patients’ identities- The Guardian

Sunday 12th July 2015- The Lancet: Pregnancy outcomes in HIV-positive women in Ukraine, 2000–12 (European Collaborative Study in EuroCoord): an observational cohort study

Background

Women living with HIV are potentially at increased risk of adverse pregnancy outcomes, due to a range of factors, including immunosuppression, use of combination antiretroviral therapy (ART), and injecting drug use. Rates of mother-to-child transmission of HIV in Ukraine have declined to around 2–4%, but little is known about other pregnancy outcomes in this setting. We used data from an observational prospective cohort study to assess pregnancy outcomes among HIV-positive women in Ukraine.

Methods

The European Collaborative Study (ECS) in EuroCoord is a continuing cohort study, established in Ukraine in 2000. Eligible women are those with a diagnosis of HIV infection before or during pregnancy (including intrapartum) who deliver liveborn babies at seven sites. Maternal sociodemographic, HIV-related, and delivery (mother and infant) data were collected with study-specific questionnaires. We used Poisson regression models to identify factors associated with preterm delivery (before 37 weeks’ gestation) and small weight for gestational age (less than the tenth percentile of weight for gestational age), based on complete cases.

Findings

Between January, 2000, and July, 2012, data were collected on 8884 HIV-positive mother and liveborn infant pairs. Median maternal age was 26·5 years (IQR 23·1–30·3). 832 (11%) women had WHO stage 3 or 4 HIV and 1474 (17%) had a history of injecting drug use. 7348 (83%) had received antenatal ART. Among 7435 for whom ART type was available, 4396 (50%) had received zidovudine monotherapy and 2949 (33%) combination ART. Preterm delivery was seen in 780 (9%, 95% CI 8–9) of 8860 births overall and in 77 (9%, 7–11) of 889 babies with small size for gestational age. Factors associated with preterm delivery were history of injecting drug use (adjusted risk ratio 1·64, 95% CI 1·38–1·95), no ART (2·94, 2·43–3·57 vs zidovudine monotherapy), antenatal combination ART (1·40, 1·14–1·73 vs zidovudine monotherapy), WHO stage 4 HIV (2·42, 1·71–3·41 vs WHO stage 1), and being in the most socially deprived group (1·38, 1·11–1·71). Small size for gestational age was associated with history of injecting drug use (adjusted RR 1·39, 95% CI 1·16–1·65), most socially deprived (1·32, 1·09–1·61), no ART (1·60, 1·32–1·94 vs zidovudine monotherapy), and antenatal combination ART (1·33, 1·12–1·60 vs zidovudine monotherapy).

Interpretation

Some risk factors for adverse pregnancy outcomes were directly associated with HIV and treatment and others were shared with the general antenatal population. Monitoring of pregnancy outcomes in Ukraine will be important as use of antenatal combination ART increases.

 

See:

Pregnancy outcomes in HIV-positive women in Ukraine, 2000–12 (European Collaborative Study in EuroCoord): an observational cohort study

Tuesday 30th June 2015- World Health Organisation: WHO validates elimination of mother-to-child transmission of HIV and syphilis in Cuba

‘Cuba today became the first country in the world to receive validation from WHO that it has eliminated mother-to-child transmission of HIV and syphilis.

“Eliminating transmission of a virus is one of the greatest public health achievements possible,” said Dr Margaret Chan, WHO Director-General. “This is a major victory in our long fight against HIV and sexually transmitted infections, and an important step towards having an AIDS-free generation” she added.’

‘Every year, globally, an estimated 1.4 million women living with HIV become pregnant. Untreated, they have a 15-45% chance of transmitting the virus to their children during pregnancy, labour, delivery or breastfeeding. However, that risk drops to just over 1% if antiretroviral medicines are given to both mothers and children throughout the stages when infection can occur. The number of children born annually with HIV has almost halved since 2009 – down from 400 000 in 2009 to 240 000 in 2013. But intensified, efforts will be required to reach the global target of less than 40 000 new child infections per year by 2015.’

Related Articles:

WHO validates elimination of mother-to-child transmission of HIV and syphilis in Cuba

Cuba first to ​eliminate mother-to-baby HIV transmission- The Guardian

Cuba stamps out mother-to-child HIV- BBC News

 

Friday 1st May 2015- The Scientist: Miraculous Activist

‘Timothy Ray Brown, commonly referred to as the “Berlin patient,” does not want to be the only person cured of AIDS.’

‘Blood tests led to a bone marrow biopsy, which led to a diagnosis of acute myeloid leukemia. From there a remarkable series of circumstances—some fortuitous, others debilitating—catapulted Brown into medical history: to this day he remains the only person who has been cured of AIDS.

Cure is not a word the HIV/AIDS community throws around lightly. “Nobody would dare to use the word ‘cure’ before this happened,” says James Hoxie, an HIV researcher at the University of Pennsylvania. But Brown’s cure “has generated an entirely new field of science that we boldly call cure or eradication research. It’s n=1, but it transformed our way of thinking about AIDS.” It has also profoundly impacted Brown, and not just in terms of his health. His remarkable medical history has turned the unassuming translator from Washington State into a jet-setting celebrity whose very existence, as Hoxie says, gives people hope.’

‘The oncologist that Brown contacted for treatment in 2006 was Gero Hütter.’ ‘About one percent of people with European heritage have a natural immunity to HIV that stems from a homozygous mutation (called delta32) in the gene for the CCR5 coreceptor on T cells. The mutation cripples the receptor’s function, thereby blocking HIV from using CCR5 to enter cells. Brown was in need of a bone marrow transplant to treat his leukemia, and Hütter had the wild idea that perhaps he could find a donor with the delta32 mutation whose stem cells could replace Brown’s immune system—and treat not only his malignancy, but maybe his HIV infection as well.’

Related Articles:

Miraculous Activist

Hidden Menace

Tuesday 24th February 2015- The Independent: HIV pill: Scientists hail discovery of ‘game-changer’ that cuts the risk of infection among gay men by 86%

‘Results of a major UK trial of pre-exposure prophylaxis (PrEP) have been described as “extremely exciting” and a “game-changer” by leading specialists.’

‘An estimated 2,800 gay men acquired HIV in the UK in 2013 and the rate of new infections has remained high for a decade. Six per cent of gay and bisexual men are now living with HIV, rising to 13 per cent in London.’

‘The Proud study [funded by government agencies, the Medical Research Council and Public Health England] found that PrEP cut the risk of HIV infection among gay men considered to be at high risk by an unprecedented 86 per cent. The Proud trial, which took place across 12 NHS trusts in Brighton, London, York, Manchester, Birmingham and Sheffield, was set up to provide real-world evidence on the pill’s effectiveness, and to answer outstanding questions, such as whether providing it would lead to reduced use of condoms. Among the 276 men given PrEP immediately, there were only three HIV infections in the first year of the study, compared with 19 among the deferred group.’

‘The pill used in the trial, Truvada, is a combination of two antiretroviral drugs which has previously been used to treat HIV infection. Developed by Gilead, its newly established ability to prevent as well as treat the virus marks a major turning point in efforts to combat HIV among high-risk groups.’

‘With evidence of its effectiveness now established, it will have to consider whether the pills, which will cost £423 per month for each patient, will be cost-effective, and what the criteria should be for accessing them.’

PrEP has been available to at-risk groups in the United States since 2012.’

See:

HIV pill: Scientists hail discovery of ‘game-changer’ that cuts the risk of infection among gay men by 86%

Wednesday 29th October 2014- The Guardian: Low HIV and Aids rates saw west Africa ‘miss out on health investment’

While the Ebola epidemic rages across Africa, a detailed survey has been revealed in the Guardian to have denied West Africa a significant health investment due to the reduced HIV rates.

‘A major project called Indepth, which has looked at the causes of death of more than 110,000 people in 13 countries shows that health improved generally in those given substantial international aid to try to turn around the HIV and Aids epidemic. But west Africa, with severe poverty and low healthcare standards but relatively little HIV, did not benefit.’

‘Just as Aids focused minds and money 15 years ago, so Ebola should now. Whitworth [‘Dr Jimmy Whitworth, head of population health at the Wellcome Trust which funded the project’] said he hoped that as healthcare in west Africa now had the world’s attention, it could keep it. “Otherwise we’re left as a global community with a real achilles heel with inadequate services,” he said.’

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Low HIV and Aids rates saw west Africa ‘miss out on health investment’