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HIV Patient Zero Cleared by Science

HIV Patient Zero Cleared by Science

One of the most demonised patients in history – Gaetan Dugas – has been convincingly cleared of claims he spread HIV to the US, say scientists. Mr Dugas, a homosexual flight attendant, gained legendary status in the history of HIV/Aids when he became known as Patient Zero. But a study, in the journal Nature, showed he was just one of thousands of infected people in the 1970s. It also showed New York was a crucial hub for the spread of the virus. Aids only started to be recognised in 1981 when unusual symptoms started appearing in gay men. But researchers were able to look further back in time by analysing stored blood samples, some of them containing HIV, from hepatitis trials in the 1970s. The team at the University of Arizona developed a new method to reconstruct the genetic code of the virus in those patients. And after screening 2,000 samples from New York and San Francisco, the researchers were able to get eight complete HIV genetic codes. That gave scientists the information they needed to build HIV’s family tree and trace when it arrived in the US. Dr Michael Worobey, one of the researchers, said: “The samples contain so much genetic diversity that they could not have originated in the late 1970s. “We can place the most precise dates on the origins of the US epidemic at about 1970 or 1971.” The researchers also analysed the genetic code of human immunodeficiency virus taken from Mr Dugas’s blood. Like a failed paternity test, the results showed that the virus in his blood was not the “father” of the US...
July 2016 Briefing – HIV & AIDS

July 2016 Briefing – HIV & AIDS

Here are highlights of the most important developments in HIV & AIDS for July 2016. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice. American Red Cross Says Blood Donations Needed Urgently TUESDAY, July 26, 2016 (HealthDay News) — The American Red Cross says it has an urgent need for blood donations, with less than a five-day supply of blood on hand to help those who need it. More Information Medical Students Often Track Progress of Former Patients TUESDAY, July 26, 2016 (HealthDay News) — Many U.S. medical students use electronic health records to track the progress of their former patients and confirm the accuracy of their diagnoses, according to research letter published online July 25 in JAMA Internal Medicine. Full Text Editorial ‘Walking Meetings’ Feasible Strategy for Employee Wellness MONDAY, July 25, 2016 (HealthDay News) — Converting a single weekly meeting to a walking meeting can help raise work-related physical activity levels of white-collar workers, according to a report published online June 23 in the U.S. Centers for Disease Control and Prevention’s Preventing Chronic Disease. Full Text Shared Drug Snorting Straws May Transmit Hepatitis C Virus FRIDAY, July 22, 2016 (HealthDay News) — Sharing snorting straws for noninjection drug use may be a source for hepatitis C virus (HCV) transmission, according to research published in the August issue of Obstetrics & Gynecology. Full Text (subscription or payment may be required) Rapid HIV Transmission Seen in Injection Drug Users in Rural U.S. THURSDAY, July 21, 2016 (HealthDay News) — The...
Trends in HIV Care

Trends in HIV Care

The National Health and Nutrition Examination Survey (NHANES) has provided statistics on the health and nutritional status of non-institutionalized, civilian Americans through household interviews and standardized physical examinations since 1971. Beginning in 1999, approximately 5,000 people are examined every year, with data publically released every 2 years. Monitoring national trends in HIV prevalence and associated risk factors using NHANES data can help increase understanding of the health behaviors and characteristics influencing these trends. Doing so, however, requires assessing data over a period of many years because of the relatively low prevalence of HIV in the general population. For a report published by the CDC, Geraldine M. McQuillan, PhD, and colleagues assessed NHANES data from 2007 to 2012 in order to describe the association of HIV status with key risk factors and examine the prevalence of antiretroviral therapy (ART) use among HIV-infected adults. “For NHANES, people aged 18 to 59 in the general population are surveyed in 15 communities every year,” explains Dr. McQuillan. “A questionnaire asks about demographics, including age, race/ethnicity, household income, and health conditions. Participants also undergo a complex examination that includes phlebotomy to test for, among other things, HIV.” Due to the low prevalence of HIV in the general population, Dr. McQuillan and colleagues could only assess a few measurements among those with the infection. These included, gender, age, race/ethnicity, education, poverty index, and health insurance status. Other factors assessed in the study included whether or not patients had received healthcare in the past 12 months, the number of lifetime sexual partners, the presence of the herpes simplex antibody, a same-sex sexual contact history, a sexually...
Needle Exchange Cuts HIV Transmission

Needle Exchange Cuts HIV Transmission

Research has shown that needle exchange programs can effectively lower the risk of HIV transmission among injection drug users. In 1988, Congress passed legislation prohibiting the use of federal funding for any activities associated with needle exchange. While states and localities were able to use their own revenue to fund such programs, in 1998, the United States Congress passed legislation prohibiting the District of Columbia from using its municipal revenue to fund these programs. Until Congress lifted the ban in 2007, these policies limited access to needle exchange in the city.   A Big Impact “Following the policy change in Washington, DC, it was important to determine whether or not it was going to make a difference,” says Monica S. Ruiz, PhD, MPH. “Clinicians need to know the impact of this policy change on people’s ability to access services.” For a study published in AIDS and Behavior, Dr. Ruiz and colleagues used existing surveillance data from the Department of Health in Washington, DC from September 1996 through December 2011 to project the impact of needle exchange access on the number of new HIV cases associated with injection drug use (IDU). “We used mathematical modeling to estimate the number of infections there would have been without the policy change in order to see if there was a significant difference between that and the number of cases that actually occurred,” Dr. Ruiz explains. “Interrupted time series analyses were used to control for other factors, such as HIV-focused educational campaigns.” The investigators estimated that about 120 infections were averted as a result of the policy change. In the 2 years following the...
CME: Examining AIDS-Defining Opportunistic Infections

CME: Examining AIDS-Defining Opportunistic Infections

Studies have shown that AIDS-defining opportunistic infection (AIDS-OIs) were a leading cause of mortality and morbidity among patients with HIV prior to the advent of antiretroviral therapy (ART) in 1997. Despite substantial improvements in the treatment of HIV and OIs during the last 2 decades, data indicate that OIs remain a major contributor of HIV-related morbidity and mortality. Previous research has provided unclear results regarding the outcomes of HIV patients with OIs, and few were population-based. Recent estimates of survival following an AIDS-OI in the United States are lacking.   OI Survival Analysis To examine whether survival following an OI has improved with advancements in HIV treatment, John T. Brooks, MD, and colleagues had a study published in the Journal of Infectious Diseases. The authors used HIV surveillance data to estimate survival probabilities after a first OI diagnosis among adults with AIDS in San Francisco during three treatment eras: 1981-1986, 1987-1996, and 1997-2012. “Most patients meet the AIDS criteria from a national surveillance perspective based on their CD4 cell count,” explains Dr. Brooks, “but the San Francisco Department of Public Health has continuously monitored the clinical courses of all people infected with AIDS in the city, including survival after an OI.” The health department has collected data on initial and subsequent OIs—as well as CD4 cell counts, viral loads, immunizations received—and demographic information for nearly 21,000 patients through follow-ups approximately every 18 to 24 months. “We found that survival has markedly increased following an AIDS-OI since 1981,” says Dr. Brooks (Figure). “The 5-year survival probability increased from 7% in 1981-1986 to 65% in 1997-2012.” The researchers suspect that this...
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