HIV

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.

The Medical Monitoring Project (MMP)—a national population-based behavioral and clinical surveillance system of adults diagnosed with HIV in the United States—provides information for monitoring progress of national treatment and prevention goals and is the only source of annual population-based data of those with HIV, according to a recent report.

Predisposing risk factors include less than a high school education and hepatitis C coinfection.

Under the ACA, patients with HIV in Medicaid expansion states have greater access to care.

A House committee approves a bill to ban all flavored tobacco products; anal cancer rates are on the rise; the debate continues over competing healthcare measures.

A recent study, published by JMIR Research Protocols, demonstrated the effectiveness of implementing a digital HIV care navigation intervention for young racial and ethnic minority men and transwomen.

Greater rates of adherence and persistence seen among patients on a single-tablet regimen.

The report emphasizes the need for maximizing the implementation and improving treatment and prevention tools to fight HIV because adherence challenges remain.

HHS takes action against Gilead; a report on fears of seasonal workers in Montana; the latest CDC data on preventable deaths show differences between urban and rural areas.

CDC recommends that young men who have sex with men have an HIV test every 6 months.

A new review published in The Lancet describes the future landscape of therapeutics in development for what the authors call the next generation of HIV prevention, or PrEP 2.0.

The National Institutes of Health (NIH) has announced plans to invest at least $100 million over the next 4 years to develop gene-based therapies for 2 diseases: HIV and sickle cell disease. The Bill and Melinda Gates Foundation will also contribute $100 million to the goal of advancing these potential cures, with an aim toward providing affordable, globally available treatment that will be accessible to patients in low-resource settings.

As HIV infection becomes a chronic illness, assessing psychosocial status regularly and implementing effective interventions aimed at related problems as they arise may be particularly important for people living with HIV to improve their health-related quality of life, a study suggests.

While targeted testing for HIV has helped more individuals to be diagnosed and treated, the CDC recommends routine, universal HIV screening for all individuals aged 13 years to 64 years as a way to reach populations who may be less likely to seek out or participate in HIV testing. Emergency departments (EDs) in particular may play an important role in universal screening, as evidenced by the experience of 2 academic EDs in San Diego, California.

As a result of the study, investigators suggested expanding the indication for tesamorelin (Egrifta) to include people living with HIV who have been diagnosed with nonalcoholic fatty liver disease (NAFLD), a comorbidity in HIV.

While antiretroviral therapy (ART) can suppress HIV infection, ART cannot completely eradicate HIV, which remains in a latent reservoir in CD4-positive T cells during treatment; discontinuation of ART leads to rapid rebound of the virus. This reservoir forms even when ART is initiated early on in the infection, and while the most widely accepted model of how the reservoir forms involves infection of a CD4-positive T cell as it transitions to a resting state, the dynamics and timing of the reservoir’s formation have been largely unknown.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included an effort by the Trump administration to bolster Medicare Advantage; an abortion case from Louisiana reached the Supreme Court; the study of adapting to changing oxygen levels wins the Nobel Prize.

Once the bill goes into effect in January 2020, pharmacists will be able to provide pre-exposure prophylaxis for at least a 30-day supply and up to a 60-day supply and a complete course of post-exposure prophylaxis without a prescription.