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HIV

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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.

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.

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.

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.

New York Governor Andrew Cuomo said that the state is on track to meet its goal of ending the HIV/AIDS epidemic in New York by 2020; lung damage exhibited by some patients as a result of vaping resembles the damage on lungs exposed to chemical spills or harmful gases; a federal judge has ruled that a Philadelphia nonprofit’s plan to open a supervised injection drug site for drug users does not break federal law.