Sunday April 20, 2014
A debate has been raging on social media since the release of an op-ed last week in which Dr. Max Pemberton, a noted U.K.-based physician and author, stated that he'd "rather have HIV than diabetes."
While some might argue that the ensuing controversy has been something of a tempest in a teacup, several of our leading HIV/AIDS researchers have thrown themselves head-first into the fray.
On the one side, Dr. Kenneth Mayer of Harvard University believed that Pemberton's statement did a disservice to both diseases, particularly since HIV is transmittable disease with its own set of issues, while diabetes is not. Furthermore, Mayer argued that Pemberton, a mental health specialist, based his assertions on U.K. prevalence rates, where HIV affects around 77,000 people versus 1.1 million in the U.S.
On the other side, Dr. Joel Gallant of the HIV Medical Association believed that Pemberton didn't necessarily mean to diminish HIV as a "non-issue," but rather highlight the effectiveness of modern HIV therapy when compared to drugs used to treat diabetes.
Both sides are right.
Sunday April 13, 2014
As further evidence that Sovaldi (sofusbuvir) is a real game changer in treating hepatitis C (HCV) infection, early research from the U.S. National Institute of Allergy and Infectious Diseases (NIAID) has demonstrated that the combination of Sovaldi and the experimental HCV drug ledipasvir has resulted in a 100% cure rate in patients co-infected with HIV and HCV genotype 1.
Traditionally, people coinfected with HIV have not responded as well to interferon-based HCV therapies, so it has been considered vital to develop interferon-free therapies for this and other hard-to-treat groups.
The NIAID study was comprised of 50 HIV-positive individual, most of whom were in infected with HCV genotype 1a (considered one of the more difficult HCV types to treat). Participants were either on antiretroviral therapy (ART) or untreated with stable CD4 counts and low HIV viral loads. While 25% had advanced liver fibrosis, none had cirrhosis.
All participants were treated with Sovaldi/ledipasvir for a period of 12 weeks. By week four, 100% of both the treated and untreated group reached an undetectable HCV load, with continuing undetectable levels four weeks after termination of therapy (the definition of an HCV "cure").
Sunday April 13, 2014
At a time when many are a proclaiming that we, as a society, are overcoming the stigma and social barriers related to HIV, a new study from the University of Chicago suggests that we may still have some way to go.
According to the research published in the March 17th issue of Journal of the American Medical Association Internal Medicine, 49% of 1,351 Americans surveyed suspect that HIV was an intentional act of conspiracy linked to the U.S. Central Intelligence Agency (CIA). The study, which looked at medical conspiracy theories relating to HIV and other diseases, was part of an online survey conducted from August to September 2013.
The selection of participants was weighed to best represent the U.S. population by age, ethnic group, income and gender, while the results were correlated to determine how and if any of the beliefs affected a person's health behavior.
Among the findings:
- 49% either strongly believe or question whether the CIA deliberately infected a large number of African Americans under the guise of hepatitis vaccinations.
Sunday April 6, 2014
There has inarguably been no bigger turnaround in HIV public health policy than in South Africa, which emerged from the rampant AIDS denialism of former-President Thabo Mbeki to become what is today the world's largest and most ambitious public antiretroviral (ARV) initiative.
So profound has this turnaround been that the perception among some is that the South African HIV epidemic is largely under control or that we, as an international community, are somehow approaching the proverbial "end of the tunnel." And why shouldn't anyone believe this, given that many -- including Luis Loures of the Joint United Nations Programme on HIV/AIDS (UNAIDS) -- are now predicting that the end of the epidemic in nigh?
To be fair, many of the statistics support the argument. Since the start of the ARV roll-out in 2003, South Africa has made some incredible inroads, with the latest CDC data indicating an overall 25% drop in new infections and a 50% reduction in child HIV infections (the latter of which is largely due to highly effective mother-to-child interventions).
But that paints only a part of the picture. The fact is that, here in South Africa, the country remains at a critical crossroads, with not only the largest HIV population in the world (6.4 million), but massive obstacles yet to overcome.
Chief among these are the rising HIV prevalence rate which, according to the country's Human Science Research Council (HSRC), has increased from 10.6% in 2008 to 12.2% in 2012. While this figure is, in part, due to the increased longevity of those living with HIV, underlying it is the astonishing number of new infections each year. In 2012 alone, the HSRC reported 470,000 new diagnoses -- or nearly 1,100 new infections every day. That's 100,000 more than was seen just one year earlier in 2011.