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.

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.

E-cigarette manufacturer Juul is being sued by 3 school districts; virus linked as potential cause of acute flaccid myelitis; HIV prevention drugs will be available without prescription in California

The FDA has approved Gilead’s second HIV prevention pill, Descovy, for at-risk adults and adolescents weighing at least 35 kg, excluding those who are at risk of HIV due to vaginal sex because the efficacy of Descovy has not been assessed in this population.

The findings indicate that the initiation of tuberculosis preventive therapy isoniazid during pregnancy carries greater risk than initiation of the treatment during the postpartum period.

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.

The study, which followed 51 people with HIV who received kidney transplants from deceased donors with HIV in South Africa, found that the transplants produced long-term success, with high rates of overall survival and kidney graft survival after 5 years.

According to the researchers, the long noncoding RNA, when turned off or deleted, eliminates dormant HIV reservoirs that persist even when patients adhere here to their antiretroviral therapy regimen and are virally suppressed.

Among 206 people visiting a county HIV clinic between 2006 and 2013, there was an overall 17.5% prevalence of transmitted drug resistance.

This week, the top managed care stories included Purdue Pharma filing for bankruptcy; new data showing the number of people who get screened for HIV at least once falls far short of what CDC recommends; findings that most US hospital markets are now highly concentrated.

The researchers of the study argue that emergency departments (EDs) should not just be leveraged to diagnose HIV; they must also be proactive and initiate treatment, as well as facilitate follow-up case management and linkage to care outside of the ED.

The researchers found that HIV significantly increases the risk of atrial fibrillation—a leading cause of stroke—at the same rate as or higher than known risk factors, including diabetes and hypertension.

Using national electronic health record information on more than 40 million patients over a 20-year period, researchers have found that the proportion of Americans older than 18 years who have had a prior HIV test could be as low as 6.4%. However, they noted several limitations of their analysis.

Cumulative viral load was associated with increased risk of kidney disease, suggesting that early viral suppression could decrease incidence of disease.

The proportion of people living with HIV with more than 90% adherence to antiretroviral therapy (ART) increased from 33.5% in 2001 to 52.4% in 2010.

New subgroup analyses from the phase 3 EMERALD trial are supporting the safety and efficacy of switching treatment-experienced, virally suppressed patients to the therapy.

Here are the top 5 articles for the month of August.

This week, the top managed care stories included a huge ruling against one opioid maker and a settlement offer from another; an expert panel calling for broader screening for hepatitis C; a review showing there are more fatal events linked to a multiple sclerosis drug than previously known.

The researchers, who used autopsy reports of 252 people who died of AIDS in New York City between 1984 and 2016, found that infections associated with the virus are still the leading cause of death for the patient population in the state.

Using 2 decades' worth of data, researchers were able to identify disparities in HIV outcomes across more than 25,000 people living with HIV in Tennessee.

An analysis of data from between 2010 and 2017 found that Medicaid expansion promoted HIV testing without increasing HIV risk behavior among nonelderly adults.

Women participating in a randomized clinical trial were able to significantly reduce their alcohol intake regardless of medication assignment and subsequently improve rates of viral suppression.

The panel voted against recommending the prevention pill for use in cisgender women due to inadequate data on efficacy in this patient population.

This week, the top managed care stories included the Trump administration looking to bar legal immigrants from using public benefits; a study in The American Journal of Managed Care® finding that a law to limit surprise medical bills is working; data on Affordable Care Act enrollment showing the effect of subsidies.

Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.

The viewpoint paints a picture of a challenge that is 2-fold: a growing amount of people are injecting opioids in rural communities, which is an emerging risk factor for HIV transmission, and these communities often lack the infrastructure or resources to prevent, diagnose, and treat HIV.

Researchers found that they were able to use a small molecule called ZL0580 to modify bromodomain-containing protein 4 to suppress HIV.

From preadolescence to young adulthood, the rate of self-reported nonadherence increased from 31% to half of study participants. Concurrently, the prevalence of a detectable viral load increased from 16% to 40%.

Federal regulators have caught on to a growing trend of clinical trials asking participants to pay to enroll; Canada's main pharmaceutical lobby group is asking the government to respond to US drug importation plans before Canada experiences drug shortages; with more HIV incidence than any other region, the South is turning to telemedicine to treat people living with the infection.