Poor progress against drug-resistant TB, letting science inform policy, and more…

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The following is a compilation of recent articles and reports making headlines in HIV and TB news.

Poor progress means multidrug-resistant tuberculosis continues to spread and cost lives: In a new report evaluating drug-resistant tuberculosis treatment scale up, Médecins Sans Frontières, Partners in Health and the Treatment Action Group reveal the “sluggish” efforts to combat the disease by the governments of those countries most severely affected by multidrug-resistant TB (MDR-TB).   “Over the past ten years, an estimated five million new cases of MDR-TB have occurred, with one and a half million lives lost,” according to a joint press release. In addition to government complacency, unpredictable and expensive drug supplies, donors failing to make TB a priority, a lack of global and regional support to build diagnostic, treatment and care capacity were listed as major stumbling blocks to successfully addressing drug resistant TB.         

Atazanavir Concentration in Hair Is the Strongest Predictor of Outcomes on Antiretroviral Therapy: In a recent issue of the journal Clinical Infectious Diseases, authors discuss results from the Women’s Interagency HIV Study in which small hair samples were collected from a large cohort of HIV-infected and at-risk uninfected women. Investigators analyzed atazanavir hair concentrations for those receiving the drug, and found that hair levels were the strongest predictor of suppression.  “Low antiretroviral exposure in hair may trigger interventions prior to failure or herald virologic failure in settings where measurement of viral loads is unavailable. Monitoring hair antiretroviral concentrations may be useful for prolonging regimen durability,” according to the article.

UAB professor taking lead in global effort against drug-resistant TB, HIV: University of Alabama at Birmingham (UAB) researcher Adrie Steyn, PhD, has been recruited to work at a brand new TB research facility in Durban, South Africa, according to UAB News. The KwaZulu-Natal Research Institute for Tuberculosis and HIV is a collaboration between the Howard Hughes Medical Institute, which has donated $60 million to the endeavor, and the University of KwaZulu-Natal. “‘We plan to study the mechanisms of micro-bacterial persistence, or dormancy. How does it escape drug therapy? How do we develop new vaccines?,’” Steyn said

AIDS: Let Science Inform Policy: In an editorial in the journal Science, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, argues that with the evidence of the HPTN 052 trial that shows that HIV-infected persons on antiretroviral therapy are more than 96 percent less likely to transmit the virus to their uninfected partner than those who are not on treatment, major investments in combating the disease are warranted and necessary . “The fact that treatment of HIV-infected adults is also prevention gives us the wherewithal, even in the absence of an effective vaccine, to begin to control and ultimately end the AIDS pandemic,” Fauci writes. Access to the journal article is free with site registration.

New Combo Therapy May Prevent TB, Save Lives in People with HIV: Millions of people worldwide with latent tuberculosis (TB) could avoid developing the full-blown infection with a simpler and shorter antibiotic regimen, according to a new study involving 1,148 South African men and women co-infected with the TB bacterium and HIV. Investigators initiated trial participants on one of three new treatment regimens and followed them for up to six years to track whose TB infections remained dormant.  While none was considered “superior” to the current gold standard of 300 mg of the antibiotic isoniazid taken daily for six months, 900 mg each of the newer antibiotic rifapentine along with isoniazid once weekly for three months worked just as well, and should do so for those not infected with HIV as well. The study appears in the July 7 issue of the New England Journal of Medicine.

Bridging the Divide: The latest supplement to the Journal of Acquired Immunodeficiency Syndromes aims to address contentious issues given the global economic crisis and competing health priorities by tackling such topics as integrating HIV and maternal health services, scaling up chronic care systems, and why the scale up of HIV treatment worked despite weak health systems. The supplement has been made available free to the public for online consumption. Included is a commentary entitled “No Need for Apologies” by Dr. Wafaa El-Sadr, AIDS activist Gregg Gonsalves and Dr. Peter Mugyeni arguing that, “The time is right to recommit to the goal of universal access to HIV prevention and treatment while garnering the lessons learned from HIV programming and building on the platform it has established in confronting other health threats.”

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