HIV

A vascular surgeon in Florida allegedly stole $26 million from insurers and the government; a new report finds many rural areas are still at risk of an HIV outbreak; new disposable flavored vape pens have largely replaced Juul use among teens.

Close to 80% of HIV-positive individuals are shown to be virally suppressed through their most recent test results, according to data from 2016 through 2018, as well as 32% to 63% of adults older than 24 years. Youth with a new HIV diagnosis, however, come in at only 12%.

Among the general population of the United States, 14.5% of HIV-positive individuals do not know their disease status. This rate increases to 51.5% of 13- to 24-year-olds, among whom men who have sex with men account for 80% of new HIV infections.

Enrollment in AIDS Drug Assistance Programs (ADAPs)–funded Qualified Health Plans (QHPs) is associated with viral suppression (VS) across states and demographic groups. People living with HIV who engage in care and have QHPs have a higher VS rate than those who received medications from direct ADAPs.

The Patent Trial and Appeals Board delivered a setback to Gilead Sciences, rejecting its attempt to invalidate a pair of Truvada patents owned by the CDC; Merck is spinning off some businesses in order to focus on its oncology drug pembrolizumab, including its biosimilars operations; Republican and Democratic governors are worried that a proposed CMS fiscal accountability rule for Medicaid will reduce access to healthcare.

The FDA launched a mobile-friendly, interactive database providing information on eligible HIV antiretroviral treatments available; an HIV vaccine trial by Fred Hutchinson Cancer Research Center ended after failing to provide protection from the virus; New Jersey Governor Phil Murphy established a coronavirus task force to manage the state’s preparedness and response to the virus.

Antiretroviral treatment (ART) is the regimen mainstay for everyone who has HIV, irrespective of infection duration. More than twice as many options for ART were available in 2018 as were offered in 2012—but this did not equal cheaper prices. Between 2012 and 2018, the average wholesale price for initial ART jumped 34% for most people with HIV.

The authors noted that pregnant women are typically excluded from clinical trials investigating the safety and tolerability of HIV medications.

Participants in Last Gift, an end-of-life HIV research program from UC San Diego, donate their blood and their bodies so researchers can uncover all the places that HIV hides, to both fight the disease and stop it. Before each autopsy, the following is read: “From our first breath to our last, each of us tells a unique story. Here, we honor our Last Gift participants for their altruism to further research into HIV and the human condition. We take this moment of silence to honor their gifts and express our gratitude for all the discoveries their selfless donations will yield.”

New York Attorney General Letitia James announced a lawsuit filed against 2 former chief executive officers of Turing Pharmaceuticals, now known as Vyera Pharmaceuticals: “Pharma Bro” Martin Shkreli, currently serving a 7-year sentence in federal prison for securities fraud, a crime that took place before the launch of Vyera, and his business partner Kevin Mulleady.

Chinese health authorities are testing an HIV drug, lopinavir and ritonavir, as a potential treatment for the new coronavirus; a debate is growing over the efficacy of the sole drug approved to prevent preterm birth; the Trump administration threatens to withhold Califonia’s federal funding due to its abortion coverage requirements.

Mucosa-associated invariant T cells (MAIT cells) are a subset of the T-cell population. Their function and activity during the acute stage of HIV infection adds to the knowledge of immune system activation at this stage and could lead to possible new treatment interventions.

Truvada and Descovy are both manufactured by Gilead Sciences and used to treat HIV-1 infection and as pre-exposure prophylaxis (PrEP) in adult and pediatric patients.

Although the researchers state that more studies are needed to validate their findings, they found that patients who also had HIV, HBV, or HCV who were being treated with ICI therapy had similar rates of efficacy and toxicity to patients without chronic viral infections.

Nigeria has a population of almost 204 million. Of those, 3.1% of adults, or 3.5 million, are living with HIV. The accompanying death anxiety of people living with HIV and AIDS has not been studied in depth.

There are 12 clinical trials underway investigating various combination treatments for HIV and AIDS, but a cure remains elusive. Few studies have attempted to qualify and quantify the risk HIV-positive individuals claim they would take if it meant a cure could result.

The report suggests that removing barriers to coverage, as well as reducing medication costs for people with private insurance, would help decrease cost-related nonadherence to HIV therapies.

The use of antiretroviral therapy has allowed patients with HIV to have a life expectancy that approaches the lifespan of those without HIV. Despite this progress, however, HIV-associated neurocognitive disorders remain prevalent, and range from mild problems with memory, language, and reasoning to more severe HIV-associated dementia.

HIV-positive individuals face greater risks of kidney and liver diseases, cardiovascular events, osteoporosis, hepatitis C, and cancer. Clinical trials and research advances into the cause and development of the comorbid conditions are needed.

People living with HIV/AIDS (PLWHA) may be at a greater risk for a variety of chronic illnesses and may require additional care as the older PLWHA population increases, a recent study suggested.

A second study, slated for next year, will continue these infants on antiretroviral treatment with 2 experimental monoclonal antibodies, hoping the medications produce viral suppression—and testing the effects of temporarily stopping them—so that they don’t have to eventually initiate the standard triplet therapy that most older patients typically take. For adults, most treatments for HIV come from the cancer field, and are inflammatory, and are not safe enough to apply in children. An ongoing debate is when is it appropriate to begin these therapies in children.

It is important to take into account individual complexities such as comorbidities and pill burden when selecting antiretroviral therapy regimens for individuals living with HIV.

A recent commentary discusses the need to uncover diagnostic and prognostic biomarkers for HIV-associated neurocognitive disorder (HAND).

Activists seek to block Gilead’s patent extension for HIV drug tenofovir alafenamide; 2.1 million teens are using 1 or more tobacco products; African American and low-income mothers are less likely to seek treatment for postpartum depression.

The cost of the expensive treatment varies, based on insurance coverage or lack thereof, and is often out of financial reach of the uninsured.