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How many times have you started to have a conversation with someone about Hepatitis C only to have it blow up in your face? Have you ever heard someone say something about Hep C that didn't seem quite right to you? You were probably right something was amiss. A discussion about Hepatitis C can...
As per Wikipedia, the definition of a stigma is as follows: "Stigma is a word that originally means a "sign", "point", or "branding mark"." Wikipedia goes on to call stigma "A badge of shame, a physical mark of infamy or disgrace." Damn that w...
Recently, the CDC (Center for Disease Control) issued a statement that all Baby Boomers should be tested for Hepatitis C. The question often comes up as to why this particular segment of people is so vulnerable. What does being born between 1945 and 1965 have to do with Hepatitis C? What was di...
Buyer Beware! There are several snake oil salesmen out there who are claiming to have cured their own Hepatitis C with herbs, supplements and parking lot gravel. Okay, maybe not the parking lot gravel but it might as well be. What you need to remember is that there are two different types of...
Most every adult woman (and an occasional man) has enjoyed a manicure and a pedicure at a nail salon or spa. That 30 minute pedicure can be so relaxing but are you aware of the danger lurking in that nail salon? Although few individuals recognize the medical risks associated with this common pr...
Introduction.
Long-term use of antiretroviral therapy (ART) in HIV-positive persons may be challenged by the need for high-level adherence, development of drug resistance, toxicities, and cost. Treatment strategies conferring durable virological control, whilst minimising ART exposure are highly desirable. With this goal in mind, strategic interruption of ART was the focus of several studies [1]–[3].
However, interruption of ART is no longer a recommended strategy [2] and the level of HIV plasma viral load (pVL) following ART stop has been shown to reach levels comparable to pre-treatment values [2]–[4], increasing onward transmission risk [5].
Inaccessible reservoirs of latently-infected resting memory CD4 T-cells are hypothesised to be the major source contributing to viraemia rebound after stopping ART [6], [7].
Recent research has shown the dramatic effect of ART to prevent onward viral transmission [8], and mathematical models predict that it may potentially be possible to eliminate HIV infection at a population level with universal treatment coverage for all HIV-positive individuals, irrespective of CD4 count [9]. However, although not recommended, consideration of the potential impact of individuals choosing to stop ART could be considerable, and data are needed on subsequent viral rebound to better inform future transmission models. Furthermore, final results from SPARTAC suggested that ART initiated in primary HIV infection (PHI) was associated with a change in pVL set-point out to 60 weeks after stopping therapy [10] whilst the SMART trial reported that interruption of ART in chronic infection (CHI) was associated with an increased risk of all-cause mortality
The level of viral rebound following interruption of ART commenced in at different stages of HIV infection is, therefore, highly relevant from both a clinical and public health perspective and warrants further investigation.
We, therefore, wanted to compare the pVL changes observed after cessation of ART initiated in chronic HIV infection with those in PHI by comparing viral rebound between individuals enrolled in two protocol-indicated ART interruption studies; SPARTAC and SMART.
Abstract.
Objectives
The magnitude of HIV viral rebound following ART cessation has consequences for clinical outcome and onward transmission. We compared plasma viral load (pVL) rebound after stopping ART initiated in primary (PHI) and chronic HIV infection (CHI).
Design
Two populations with protocol-indicated ART cessation from SPARTAC (PHI, n = 182) and SMART (CHI, n = 1450) trials.
Methods
Time for pVL to reach pre-ART levels after stopping ART was assessed in PHI using survival analysis. Differences in pVL between PHI and CHI populations 4 weeks after stopping ART were examined using linear and logistic regression. Differences in pVL slopes up to 48 weeks were examined using linear mixed models and viral burden was estimated through a time-averaged area-under-pVL curve. CHI participants were categorised by nadir CD4 at ART stop.
Results
Of 171 PHI participants, 71 (41.5%) rebounded to pre-ART pVL levels, at a median of 50 (95% CI 48–51) weeks after stopping ART. Four weeks after stopping treatment, although the proportion with pVL≥400 copies/ml was similar (78% PHI versus 79% CHI), levels were 0.45 (95% CI 0.26–0.64) log10 copies/ml lower for PHI versus CHI, and remained lower up to 48 weeks. Lower CD4 nadir in CHI was associated with higher pVL after ART stop. Rebound for CHI participants with CD4 nadir >500 cells/mm3 was comparable to that experienced by PHI participants.
Conclusions
Stopping ART initiated in PHI and CHI was associated with viral rebound to levels conferring increased transmission risk, although the level of rebound was significantly lower and sustained in PHI compared to CHI.
Please sign the ATC Salvage Therapy Petition Join us in asking Congressman Alcee Hastings and Congresswomen Maxine Waters to send a ‘Dear Colleague’ letter to Anthony Fauci, Director of NIAID, asking for the federal facilitation of apricitabine (ATC). ATC is a phase III nucleoside reverse transcriptase inhibitor (NRTI) that has been shown to be safe and effective in treating people with HIV. It works against viruses that are resistant to several other nukes and could ...
Researchers from Johns Hopkins Children’s Center, the University of Mississippi Medical Center and the University of Massachusetts Medical School announced today at CROI2013 the discovery of the first infant functionally cured of HIV. The baby, a female now two and a half years old, received 3 HIV medications when brought to the hospital at 30 hours old. Viral load tests were performed during the first few weeks that showed a rapidly decreasing viral load which reached ...
At the 19th International AIDS Conference (AIDS 2012) in Washington D.C., the CDC reported that only 1 out of 4 HIV patients in the U.S. have HIV under control, which is defined as complete viral suppression. Warning bells should be ringing in the scientific and HIV advocacy communities. While much progress has been made in the last three decades in the treatment of HIV, tens of thousands of people living with HIV (PLWH) are currently struggling to construct viable treat...
Paige Rawl is 17 and HIV positive, but while her life has been shaped by HIV it isn't ruled by it. When Paige Rawl starts her senior year at Indianapolis’s Herron High School next month, she'll be cheer captain and a member of the student government and prom committee. This summer, the 17-year-old held down a part-time job at Hollister, hawking the popular Southern California-inspired clothing brand. The all-American girl — who happens to be HIV positive. Paige was in...
The HIV community has been abuzz with the August FDA approval of what had been termed “the Quad”, the second one-pill-once-a-day combination antiretroviral drug. Marketed by Gilead under the name Stribild, the drug contains two NRTIs (tenofovir and emtricitabine), an integrase inhibitor (elvitegravir) and an integrase booster (cobicistat) and is approved for use in treatment naïve patients with either drug resistant or wild type virus. In comparison to Atripla, the first...
Bristol-Myers Squibb Company (NYSE: BMY) today announced that the U.S. Food and Drug Administration (FDA) has approved a supplemental new drug application (sNDA) for SUSTIVA® (efavirenz), including dosing recommendations for...
California and other states would be pressured to amend or repeal criminal laws that single out HIV-positive people under a bipartisan bill co-authored and introduced this week by Rep. Barbara...
Mission Statement
At HIV Haven we wish to provide our readers with vital cutting edge information to help expand HIV knowledge and promote activism, particularly that which works towards an end to the HIV pandemic. It is our desire to bring to you the scientific, medical and social advances that given the appropriate attention and support, could change the course of the HIV pandemic, lessen the devastating effects of HIV and AIDS, better the quality and quantity of life for people living with HIV and even yield an eventual end to the HIV pandemic. We also provide the basics of HIV transmission and treatment.
We will focus on issues such as innovative drug development, strategic activist campaigns, HIV relationships and novel HIV and HIV cure research. We also will bring you advances in Hepatitis C (HCV), a common HIV co-infection. Whether you are living with HIV/AIDS, HIV and HCV, love someone who is, are an activist, advocate, researcher, physician or just an interested party, we hope here at HIV Haven we can help you find what you are looking for.
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More than 7 million Africans now take antiretroviral therapy, with nearly 1 million starting treatment in the last year, according to a new report by UNAIDS. In How Africa Turned AIDS Around,...
A rights activist, who is living with HIV, filed a test case in the newly constituted Constitutional Court on Thursday to highlight the challenges and ill treatment facing people living with the...
Makerere University Walter Reed Project (MUWRP) is this July launching another third Phase I trial to develop an HIV vaccine since 1999 when the first trial was launched. Phase I is the first...
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International AIDS Advocates Demand China Give $1 Billion to Global Fund DC Press Conference: Friday, May 24, 10:30am, National Press Club Noting that the world’s second-largest economy received...
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HIV patients who are forced to report to hospital every month for a prescription could be forced into a situation where they have to reveal their condition to an employer. HIV patients who are...
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Despite hepatitis B virus suppression provided by current drugs, many patients coinfected with hepatitis B and HIV have advanced liver fibrosis, according to new research. "Of the patients we had...
One day in late March, European finance and health ministry officials met at the OECD’s Paris office to discuss how healthcare systems are faring in times of austerity. On the second day of the...
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It is impossible to have a modern conversation about HIV and HIV stigma without having the term “undetectable” used, misused, and abused. Those involved in HIV activism certainly have strong...
AUSTRALIA is way behind the US and Europe in protecting medical workers from sharp objects, says a former US nurse who contracted HIV and hepatitis C through a needle injury. Dr Karen Daley, in...
Background: The resurgence of infectious syphilis in men who have sex with men (MSM) has been documented worldwide; however, HIV coinfection and syphilis reinfections in MSM in inner Sydney have not...
'Your Body Blueprint', a new campaign for people living with HIV has just been launched by AFAO. Based around an interactive website, the campaign is designed to encourage and support people...
DESPACHO GERAL, a Santos-based custom clearance agency for over twenty years, has successfully navigated the protocols for shipping the Spirit of Malabo to New York. The vessel departs today on...
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Top AIDS scientists are in Paris to mark the 30th anniversary of the detection of HIV. One of them is Sharon Lewin. Her work on latent HIV cells could lead to a cure, but she warns it's a "tough...
There was no fanfare on May 20, 1983 when Science published what is undoubtedly among the most important medical papers of the 20th century. In the usual dry prose, researchers from the Institut...
“It will take 10 years.” That is what researchers usually say when asked how much longer it will take to develop a safe and effective HIV vaccine.Some of the world’s brightest minds have been on...
Bottling up emotions is thought to harm both mind and body, but a new study suggests that the opposite extreme may be no better. In a study of thousands of heart attack patients, those who...
An explosion of cheap generic substitutes for widely used prescription drugs last year helped drive the first decline in pharmaceutical spending in the U.S. in nearly six decades. Drug makers...
An antibiotic-resistant strain of gonorrhea—now considered a superbug—has some analysts saying that the bacteria's effects could match those of AIDS. "This might be a lot worse than AIDS in the...
