A study published earlier this month concluded that the people with HIV have as high as a two-fold increased risk of developing melanoma (a serious type of skin cancer) when compared to the general population, adding to the already heady list of non-AIDS-defining cancers known to disproportionately affect this population.
This shouldn't suggest, however, that all cancers are of marked concern to people living with HIV. In fact, researchers from Kaiser Permanente in California have reported this week that HIV-infected men have a 27% lesser risk of developing prostate cancer than their non-infected counterparts -- this after taking into account such potential confounders as age, race, diabetes, smoking, alcohol and substance use.
The data was collected from 17,424 HIV-positive and 182,799 HIV-negative men who had entered into care from 1996 to 2006.
It has been well documented that people with long-term HIV infection run a greater risk of developing a number of non-AIDS-defining cancers, among them anal cancer, Hodgkin's disease, and liver cancers. Over the course of recent years, researchers have been investigating the causes and incidences of these occurrences -- finding that, in some cancers, the risk is significantly higher, while others have either lower or no statistical difference risk at all.
Investigators in the U.K. and Australia have now added melanoma (a serious type of skin cancer) to the list of high-risk cancers seen in people with HIV. The systematic review and meta-analysis, the results of which were published in this month's PLOS|One journal, has determined that HIV-infected individuals overall have a 26% increased risk for developing this potentially life-threatening cancer, with the risk increasing to over 50% in white-skinned individuals.
A total of 21 studies were included in the review, which were conducted between 1999 and 2013 and had a median follow-up time of between two to 10 years.
Since its acquisition of About.com in September 2012, IAC (the owners of Ask.com and The Daily Beast) have worked behind to scenes to re-envision the brand from the bottom up -- from its navigation and design to the content quality and layout. Their tireless efforts are soon to be seen in the relaunch of the company's "new look" Health Channel.
With its calming blue and white palette, sleek layout, and improved image content, the new Health Channel represents an enormous step forward in the evolution of the New York City-based internet giant, which today boasts over 90 million users per month and is currently ranked as the 84th most popular website in the world, according to Alexa.com.
Advocates and public health official welcomed a long-awaited recommendation by the U.S. Centers for Disease Control and Prevention (CDC), calling for the use of Truvada (tenofovir + emtricitabine) to reduce the risk of HIV transmission in populations considered at high risk of infection.
The guidelines recommend that doctors consider the use of the once-daily pill as pre-exposure prophylaxis (PrEP), a preventive strategy which is known to reduce HIV transmission risk by upwards of 75%. The groups targeted in the recommendation include men who have sex with men (MSM) who do not use condoms; HIV-negative individuals who regularly have sex with an HIV-positive person; injecting drug users (IDUs); or heterosexuals who have sex with high-risk partners.
The recommendations come at a time when many policy makers have become frustrated with the stagnating infection rate in the U.S., as well as the 20% rise infection rates among MSM from 2005 to 2011.
On the one hand, it seems pointless to toss one's hat into the ring and join the online tirade against L.A. Clipper's owner Donald Sterling. Watching his CNN interview with Anderson Cooper on Monday was simply a sad, sad spectacle, one which could easily dismissed as a misbegotten shot at redemption by an out-of-touch, armchair racist. It was a textbook debacle of almost Shakespearean scale, with every declaration by Sterling that "I am not a racist" sparking the immediate thought, "methinks ye protest too much."
That the interview took an unexpected (and protracted) turn to include Magic Johnson's HIV status was another issue altogether. Repeatedly, and almost painfully, Sterling suggested that HIV was a mark of Johnson's shame and personal irresponsibility, asking at one point, "Big Magic Johnson, what has he done? He's got AIDS. Did he do any business? Did he help anybody in South L.A.?"
Sterling further humiliated himself by declaring, "(Magic) has sex with every girl, then he catches HIV and is that someone we want to respect and tell our kids about? I think he should be ashamed of himself."
In advance of the May 25th premiere of the much-anticipated AIDS drama, The Normal Heart, HBO released an extended behind-the-scenes look at the making of the film. Based on the Tony Award-winning play by Larry Kramer, the film presents a dramatic account of the AIDS crisis in the early 1980s from the perspective of Kramer's playwright avatar, Ned Weeks.
Starring Mark Ruffalo, Julia Roberts, Matt Bomer, Jim Parsons and Taylor Kitsch, The Normal Heart is arguably a more accurate and complex depiction of the epidemic than was seen in last year's showier Dallas Buyer's Club, tracking the emergence of the disease in the gay community to the creation of a confrontational activist movement that would eventually become ACT UP (AIDS Coalition to Unleash Power).
Image courtesy of Home Box Office (HBO).
If there were ever any doubts that a country could achieve universal treatment coverage for its HIV-infected population, one need look no further than to the small equatorial country of Rwanda.
Known by many for the 1994 genocide that killed as many as one million of its citizens, Rwanda is reported to be the first country in the world to achieve such coverage. Today, 93% of those qualified for treatment under the World Health Organization (WHO) guidelines of 2009 are receiving it. In total, 2.9% of the Rwandan population (or roughly 210,00 people) is HIV-positive, of which more than 50% qualify for therapy.
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.
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").
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.