Category Archives: Research

HIV, HIV care, Research

Fostemsavir: A new treatment option for extensive HIV drug resistance

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From TheBodyPro…

As 2020 draws to a close, we asked David Alain Wohl, M.D., a professor of medicine in the Division of Infectious Diseases at the University of North Carolina and a highly respected HIV clinician-researcher, to take stock of the year’s most momentous research developments and other critical events. In this exclusive series of articles, Wohl calls attention to 10 such developments that have tremendous short-term implications for our day-to-day efforts to improve HIV prevention, treatment, patient care, and policy in the U.S., and analyzes each development with his trademark wit and clinical savvy.

doctors doing research

“Looking for something we can rely on. There’s got to be something better out there,” Tina Turner sings in her 1980s pop hit “We Don’t Need Another Hero.” That song jumps into my head when I think about new HIV therapies, but in my mind, it’s framed as a question: Do we need another hero?

For those with few antiretroviral options, who are downing multiple pills to keep multidrug-resistant virus from replicating, the answer would be yes: We do need another antiretroviral hero.

Fortunately, the number of people living with HIV who are heavily treatment experienced and have few remaining antiretroviral options is fairly small. Among over 27,000 HIV-positive people in the U.S. who were treatment experienced and in care at one of the HIV clinics contributing to the U.S. Centers of AIDS Research Network of Integrated Clinical Systems (CNICS) cohort from 2000 to 2017, just 916 had limited treatment options (LTO)—a status defined as having two or fewer available antiretroviral classes, as well as two or fewer active drugs per class as determined by resistance testing. After 2007, the proportion of people with LTO fell; it has since remained less than 1% of the cohort’s antiretroviral experienced patients.

Still, for that 1%, things can be rough. Many are straddled with antiretroviral regimens that include pharmacological boosters, inconvenient dosing, and side effects. Some may even still fail to achieve virologic suppression. Therefore, U.S. Food and Drug Administration (FDA) approval of fostemsavir (brand name: Rukobia), an HIV attachment inhibitor, in July is welcome news to these patients and their providers.

Read the full article.

HIV, HIV Activism, Research

Scientists Debunk Myth That ‘Patient Zero’ Brought AIDS to America

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From PBS.org…

For more than 30 years, Gaétan Dugas was blamed for bringing the AIDS epidemic to the United States. A French-Canadian who died in 1984, Dugas was thought to have carried the disease to America and transmitted it to scores of sexual partners while working as a flight attendant.

AIDS protest banner

But this week, scientists finally cleared the name of the man who, in the history of the AIDS epidemic, came to be known as “Patient Zero.”

In a study published in the journal Nature, the researchers found that blood sampled from Dugas in 1983 contained the same strain of HIV that was infecting men in New York City as early as 1971 — three years before he arrived in the U.S. as an employee for Air Canada.

“In short, we found no evidence that Patient 0 was the first person infected by this lineage of HIV-1,” the researchers wrote.

The study builds on decades of research that has sought to answer the medical mystery of how exactly AIDS made its way to the U.S.

Read the full article on PBS.org.

HIV, HIV care, Research

If you’re HIV positive, the University of Pittsburgh would like to study your sleep

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The SASH study (Impact of Poor Sleep and Inflammation on the Adenosine Signaling Pathway in HIV Infection) seeks to understand how sleep can affect the health of people living with HIV.

man sleepingStudy participants complete questionnaires before and after getting a watch-like device similar to a Fitbit. Subjects wear the device for two weeks, to track their sleep patterns. Subjects also answer a few questions in a diary each morning about their sleep.

The study involves two visits to Montefiore Hospital. Each visit is about one hour in length. Participants will receive up to $100. Parking vouchers and/or bus fare will also be provided.

For more information, call the study team at 412-330-1453, or send an email to healthysleep@pitt.edu.

HIV, Research, Women's Health

HIV Prevention Efforts Utilize Salons in Black Communities

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From Nurse.com…

Researchers from Duke University School of Nursing in Durham, N.C., are turning to a ubiquitous locale — beauty salons — to help raise HIV prevention awareness among Black women in the South. Salons are often considered safe spaces for intimate conversations.

The numbers highlight the stark need: Black women, who make up 13% of the U.S. population, account for 64% of new HIV infections among U.S. women. They also make up 69% of all new HIV infections in the South, according to the Centers for Disease Control and Prevention.

image of Randolph
Schenita Randolph, RN

Schenita D. Randolph, PhD, MPH, RN, CNE, and her research partner, Ragan Johnson, DNP, APRN-BC, both assistant professors at Duke University, developed a strategy to help prevent HIV spread in their region by focusing on Black women who have not been exposed to the virus.

The strategy involves training stylists to start conversations about HIV, educating women about HIV prevention, and linking them to prevention medication (pre-exposure prophylaxis or PrEP).

The research team received two-year funding from Gilead Sciences, which manufactures the HIV prevention medication Truvada, to put a pilot program in place.

Randolph explained that 44% of the people who could benefit from PrEP in the U.S. are African American (500,000). However, only 1% in that group have been prescribed PrEP, despite evidence that if taken once a day it can lower a person’s risk for getting HIV through sex by more than 90%.

Read the full article.

Health Alerts, HIV, Research

Health Alert: Rates of new HIV infection still on the rise among specific groups

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From the Centers for Disease Control and Prevention…

In 2018, 37,968 people received an HIV diagnosis in the United States (US) and dependent areas. From 2014 to 2018, HIV diagnoses decreased 7% among adults and adolescents. However, annual diagnoses have increased among some groups.

Gay and bisexual men are the population most affected by HIV, with Black/African American, Hispanic/Latino gay and bi men having the highest rates of new infections.

info graphic showing rates of H I V infection with highest rates of infection in 2018
click no image for enlarged view

The number of new HIV diagnoses was highest among people aged 25 to 34.

info graphic showing age range of new H I V infections
click on image for enlarged view

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report 2020;31.

Research

Use your brain to help people with HIV

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Researchers at the University of Pittsburgh and the University of Nebraska Medical Center are looking for participants living with HIV, and participants not living with HIV, for a non-invasive brain imaging research study.

The purpose of the first research study is to investigate brain activity, cognitive functioning, and aging in those living with HIV versus those living without HIV. The human brain and cognitive abilities change as people age, and this research study aims to identify those changes.

The purpose of the second research study is to investigate how chronic cannabis use affects brain activity and cognitive functioning differently in people who are living with HIV and those who are not living with HIV.

sculpture of human head and brain
image courtesy of David Matos

To study the brain, researchers will be using a series of brain imaging tests, both of which are completely non-invasive.

There is no cost to you, and you will receive compensation for your time and travel expenses.

You may be eligible if:

  • You are between the ages of 19 and 72
  • You have not had a stroke or been diagnosed with any neurological or psychiatric disorder(s)
  • You are able to complete a series of mental tasks You are not pregnant or planning to become pregnant
  • You either regularly use cannabis or do not use cannabis

This research study is sponsored by the National Institute of Mental Health. For more information, please call 412-246-5590 or send an email to mindscan2019@gmail.com. You can also download the study brochure.

HIV, HIV care, Research

New cause of inflammation in people with HIV identified

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From MedicalXpress.com…

While current antiretroviral treatments for HIV are highly effective, data has shown that people living with HIV appear to experience accelerated aging and have shorter lifespans—by up to five to 10 years—compared to people without HIV. These outcomes have been associated with chronic inflammation, which could lead to the earlier onset of age-associated diseases, such as atherosclerosis, cancers, or neurocognitive decline.

Microscopic image of an HIV-infected T cell
Microscopic image of an HIV-infected T cell
Read the full article on MedicalXpress.com.
PrEP, Research

Survey of Gay and Bi PrEP Users Finds 1 in 10 Share Their Medication

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From Poz.com…

In a 2018 survey of men who have sex with men taking pre-exposure prophylaxis (PrEP) in three U.S. cities, about 10% reported sharing their medication with others.

PrEP pill This finding raises concerns that gay, bisexual and other men who have sex with men (MSM) may be accessing PrEP without receiving the medical monitoring that is supposed to go hand in hand with taking Truvada (tenofovir disoproxil fumarate/emtricitabine) or Descovy (tenofovir alafenamide/ emtricitabine) for HIV prevention—namely, HIV tests every three months and routine screening for sexually transmitted infections and kidney function.

As described in JAMA Network Open, Gordon Mansergh, PhD, a senior behavioral scientist in the Centers for Disease Control and Prevention’s Division of HIV and AIDS Prevention, conducted a cross-sectional analysis of responses from a 2018 smartphone-based survey of 755 HIV-negative MSM living in Detroit, Atlanta and New York.

Read the full article on Poz.com.

HIV, Prevention, Research

The Single Biggest Risk Factor for Gay, Bi Men Becoming HIV-Positive

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From the Advocate.com…

Of all those who became HIV-positive, over a third (36 percent) were persistent meth users. Men aged 36-45 reported the most meth use, and those living in Western states had the highest incidence of the drug.

image of a man with rainbow reflection across his facePersistent meth use is the biggest factor for seroconversion, researchers stated, followed by Black ethnicity and a syphilis diagnosis.

Researchers detailed the correlation between meth and HIV.

“Methamphetamine exacerbates HIV risk via increasing sexual libido while simultaneously reducing inhibitions,” the authors stated, according to AIDSMap. “Our findings highlight the need to address methamphetamine use and its associated risks among sexual and gender minorities, the likes of which may also serve to help end the HIV epidemic.”

Read the full article.

HIV care, Research

Large NIH Clinical Trial Illuminates Long-Term Health Effects of HIV

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From HIV.gov…

Initial data from a large NIH-supported clinical trial offer a detailed look at the health status of people aging with HIV around the world. With 7,770 participants enrolled in 12 countries across five continents, the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE ) is evaluating the ability of a statin medication, pitavastatin, to reduce the risk of heart disease among people with HIV. By leveraging data collected from this diverse group of study participants, researchers also are learning more about the long-term health effects of HIV. They report their initial findings in an August supplement for The Journal of Infectious Diseases.
[…]
For women, accelerated reproductive aging—a natural process that eventually leads to menopause—may heighten risk for heart disease and stroke. Among women with HIV in the REPRIEVE study, more advanced reproductive age was associated with two risk factors for cardiovascular disease: high waist circumference and high blood levels of hemoglobin. Women living in sub-Saharan Africa or Latin America and the Caribbean were more likely to experience accelerated reproductive aging than those living in high-income countries.

The initial REPRIEVE findings also provide insight into the relationship between HIV and heart disease among transgender people, about which little is known. Transgender people are disproportionately affected by HIV, and studies have suggested that hormone use as part of gender-affirming therapy may increase cardiovascular disease risk. By collecting data on gender identity and use of gender-affirming therapy, the REPRIEVE investigators aim to address this knowledge gap. Notably, their initial analysis revealed that high waist circumference was more common among transgender women, particularly those who were receiving gender-affirming therapy.

Read the full article on HIV.gov.