Treatment refusal in South Africa, what’s lacking in HIV vaccine research, and more…

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The following “What We’re Reading” selection is a compilation of recent articles and reports making headlines in HIV and TB news.

One in Five Refusing ART in Soweto, Even When in Need: “One in five newly diagnosed [antiretroviral therapy (ART)] eligible adults attending the Zazi Testing Center, Perinatal HIV Research Unit (PHRU) in Soweto, South Africa refused to start free ART, provided onsite, within two months of diagnosis,” according to an article on AIDSMAP by reporter Carol Leach-Lemens. She reported on a cross-sectional analysis, published in the journal AIDS, by Ingrid T. Katz and colleagues. Most refusing treatment said they were “too healthy,” despite the median CD4 cell count of 110.   

Quick Follow-Up Testing Increases Rate Seeking Antiretroviral Treatment: As reported in The New York Times, a study in the latest edition of The Lancet, “Effect of point-of-care cd4 cell count tests on retention of patients and rates of antiretroviral therapy initiation in primary health clinics: an observational cohort study,” finds that patient loss to follow up is reduced when a simple, point-of-care CD4 cell count test is readily available. “The median time from enrolment to antiretroviral therapy (ART) initiation reduced from 48 days to 20 days, primarily because of a reduction in the median time taken to complete cd4 staging, which decreased from 32 days to 3 days,” according to the study abstract. Loss to follow up of HIV patients before ART initiation can exceed 50 percent in low-income settings.

HIV Vaccine Development – Improving on Natural Immunity: In a perspective article in the New England Journal of Medicine, Margaret Johnston, PhD, joins Director of the National Institute of Allergy and Infectious Diseases Anthony Fauci, MD, to review recent advancements in the search for an HIV vaccine, and the missing element. “A key goal for an effective HIV vaccine is to induce in the recipient a response that differs qualitatively, quantitatively, or both from that induced by natural infection — a response that has been referred to as ‘unnatural immunity.’… Since HIV infection does not naturally induce broadly neutralizing antibodies, a key challenge is inducing such antibodies,” according to the article.

MSMGF Launches HIV Drug Chart in Seven Languages: The Global Forum on Men who have Sex with Men (MSMGF) has developed a drug chart including all approved and generic medications for HIV treatment, with dosing and side effects information, available in seven different languages: Arabic (PDF), Chinese (PDF), English, French, Portuguese, Russian (PDF) and Spanish. “We recognize that there is a shortage of this kind of treatment information tailored to the needs of [men who have sex with men] with careful attention to regional strengths and differences, especially for MSM in the Global South,” according to the organization’s press release.

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