HIV diagnosis rates drop by a third over past 10 years.

Article from AMA Mourning Rounds, 7-22-14.

USA Today (7/20, Graham) reported that according to research presented at the International AIDS Conference and in a research letter published in the Journal of the American Medical Association, “the rate of diagnosis for HIV infections has fallen in the United States by a third over the past decade.” Covered in the report are “the years 2002-2011, when nearly 500,000 patients were diagnosed with HIV.” Investigators found “‘statistically significant decreases’ in diagnosis rates…in nearly every demographic group.”

The AP (7/20, Stobbe) reported, “The only group in which diagnoses increased was gay and bisexual men, the study found.” The study, which also found that “diagnosis rates dropped even as the amount of testing rose,” is based on HIV diagnosis data “from all 50 states’ health departments, which get test results from doctors’ office, clinics, hospitals and laboratories.”

Bloomberg News (7/19, Ostrow) pointed out that currently, “more than 1.1 million people in the US are…infected, according to the CDC,” approximately 16 percent of whom are not even aware they are infected. Even though “strides are being made to cut HIV, prevention and screening efforts aren’t adequately reaching a younger group…said” study author Amy Lansky, PhD, MPH, of the Centers for Disease Control and Prevention. Lansky, who is the CDC’s deputy director for Surveillance, Epidemiology and Laboratory Science in the Division of HIV/AIDS Prevention, said in a phone interview, “There’s a new generation that comes up and many don’t have first-hand experience with the devastation we saw in the earlier years.”

Also covering the story are the New York Daily News (7/21), the Washington Times (7/19, Wetzstein), Reuters (7/20, Simpson), the NBC News (7/20, Fox) website, HealthDay (7/20, Dotinga), MedPage Today (7/21, Smith) and AFP (7/19).

AIDS conference attendees discuss research efforts, mourn colleagues. The Wall Street Journal (7/21, A7, Stewart, Mckay, Subscription Publication) reports that researchers and advocates from all over the world who are attending the International AIDS Conference in Melbourne, Australia, are mourning six colleagues who died when their airplane was shot down last week over the separatist-held eastern portion of the Ukraine. Among the dead are Joep Lange, Jacqueline van Tongeren, Lucie van Mens, Martine de Schutter, Pim de Kuijer and Glenn Thomas. At the same conference, researchers are also discussing the recent discovery that a little girl in Mississippi who was thought to be cured of HIV still is infected. Commenting on that finding, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, called for the development of new tools to find out how and where HIV lurks in the bodies of those believed to have reached a state of remission.

The Los Angeles Times (7/19, Brown, Mai-Duc) reported that “H. Clifford Lane, deputy director for clinical research and special projects at the National Institutes of Health’s National Institute of Allergy and Infectious Diseases, worked with Lange on the HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT) project, which set up clinical research centers in Thailand. Lane said the effort epitomized Lange’s wide-ranging interests by managing to spawn new research and also deliver much-needed treatments to patients living in Thailand.”

Bloomberg News (7/19, Bennett, French, Saminather) reported, “Lange was ‘one of the first and one of the most prominent’ researchers and policy advocates on AIDS, said…Lane.” Lane also pointed out that “Lange helped push for access to life-saving antiretroviral treatments for people in developing countries.”

The NBC News (7/21, Fox) website reports that Lange “helped lead a gradual transformation of HIV researchers who saw more than just discovery and science was needed to tackle a pandemic that’s taken the lives of 25 million people and that infects 35 million more around the world.” Dr. Fauci, “himself one of the leaders in AIDS research,” said about Lange, “He was one of the scientist/activists. The fact that he was a scientist didn’t diminish his impact in the activist field.”

AFP (7/19, Ingham) reports, “Addressing a symposium on the search for a cure, Nobel prize winner Francoise Barre-Sinoussi said the death of Joep Lange…was a major setback.” Meanwhile, commenting on the Mississippi child who was found to have HIV after a 27-month remission, “Jack Whitescarver, director of the Office for AIDS Research at the US National Institutes of Health, said ‘this really demonstrates that we are still in the early days’ of research.”

Monkey study: HIV may form invulnerable strongholds in the body. The Los Angeles Times (7/20, Morin) reported in “Science Now” that “in a sobering discovery” reported in a research letter published online July 20 in the journal Nature, “researchers say that rapid treatment of HIV-like infections in monkeys failed to prevent the establishment of persistent viral reservoirs in as little as three days.”

Modest incentives may increase circumcision rate in HIV-endemic areas. MedPage Today (7/21, Susman) reports that according to research published simultaneously in the Journal of the American Medical Association and presented at the International AIDS Conference, “modest economic incentives appeared to increase the chance that uncircumcised men in HIV-endemic areas would undergo circumcision within a couple of months.” The study, which involved some 1,500 uncircumcised adult males in Kenya, revealed that “circumcision uptake was 6.6% among those offered food vouchers worth about $8.75 and 9% among those offered food vouchers worth about $15 when compared with men who were given vouchers of lesser values or no vouchers at all.” One of the study’s authors “disclosed support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.” AFP (7/21) also covers the study.

PrEP appears not to cause significant fetal harm. MedPage Today (7/20, Susman) reported that according to research published simultaneously in the Journal of the American Medical Association and presented at the International AIDS Conference, “antiretroviral therapy taken by uninfected women to prevent HIV transmission from infected male partners did not cause significant fetal harm or add risk to normal pregnancy.” The study, which involved 595 women on tenofovir, 565 women on emtricitabine and tenofovir, and 621 on placebo, found that “there was no statistically significant association between women receiving pre-exposure prophylaxis (PrEP) and those receiving placebo and the occurrence of pregnancy losses.”

Starting HIV therapy at home may increase treatment rates. MedPage Today (7/20, Smith) reported that according to research published simultaneously in the Journal of the American Medical Association and presented at the International AIDS Conference, “the option of starting HIV therapy at home, instead of going to an HIV clinic, increased the proportion of people who actually began treatment.” The 16,660-participant trial also revealed that “having that option…appeared to increase the proportion of people who reported a positive home test.”

Tesamorelin may help reduce abdominal, liver fat in HIV patients. MedPage Today (7/21, Susman) reports that according to research published simultaneously in the Journal of the American Medical Association and presented at the International AIDS Conference, “HIV-infected patients treated with a growth hormone releasing hormone analog achieved modest reductions in abdominal and liver fat.” The 54-patient study revealed that “treatment with tesamorelin (Egrifta) reduced visceral adipose tissue 34 cm² compared with a reduction of 8 cm² achieved by patients on placebo (P=0.005).” In addition, investigators “found the median change in lipid to water percentage – a marker of liver fat – was reduced by 2% in the patients on tesamorelin compared with a 0.9% increase among the placebo patients (P=0.003).” Currently, tesamorelin is the only medication approved by the FDA for the reduction of abdominal fat in patients taking antiviral medications against HIV.