PEPFAR annual meeting updates, 4-drug 1-pill TB treatment, and more…

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The following is a compilation of recent articles and news pieces making headlines in HIV/TB and global health.

Community-Based Voluntary Counseling and Testing Ups HIV Testing Rates: A study reported on in The Lancet Infectious Diseases aims to assess ways in which HIV testing could be increased by exploring combinations of community mobilization, mobile community-based voluntary counseling and testing (VCT), and support after testing. “Project Accept” is underway in 10 communities in Tanzania, eight in Zimbabwe and 14 in Thailand. The study shows that community-based VCT improves HIV testing rates in remote areas as compared with standard clinic-based VCT, but couples are not taking up the service.

Effectiveness of Four-Drug TB Treatment Confirmed: A new study has found that a four-drug, fixed-dose combination of tuberculosis (TB) drugs in one pill is just as effective in treating TB as the standard 14-pill regimen. An easier-to-take drug regimen could increase drug compliance for the entire treatment course, thereby reducing the emergence of drug resistance. The randomized, controlled trial, led by the Stop TB Partnership’s Senior Scientist Dr. Christian Lienhardt, was conducted in 11 countries in Latin America, Africa and Asia and was reported in the Journal of the American Medical Association.

TB Discovery Paves Way for Drugs that Prevent Lung Destruction: According to an article in the Journal of Clinical Investigation, scientists have isolated the enzyme that allows tuberculosis to destroy lung tissue, opening the door for expedited treatment research. Enzyme inhibitors already exist that can treat the destructive enzyme, called MMP-1.  And although current TB treatments do not prevent the lung destruction that TB causes, study authors say more research could determine whether MMP inhibitors can prevent lung damage on a larger scale.

Antiretroviral Therapy and the Control of HIV-Associated Tuberculosis. Will ART Do It?: In an article in the International Journal of Tuberculosis and Lung Disease, authors argue that the potential of antiretroviral therapy (ART) for TB control is being squandered. ART reduces the risk of TB by 67 percent, halves TB recurrence rates, and reduces mortality risk by 64 to 95 percent in cohorts and prolongs survival in patients with HIV-associated drug-resistant TB. “Much earlier ART initiation with high coverage is required if ART is to substantially influence the incidence of TB,” according to the article. The paper examines the impact of ART within treatment cohorts on TB incidence rates, mortality and recurrence rates; the potential population-level impact of ART scale-up on the control of HIV-associated TB including drug-resistant disease; and the potential for secondary benefits for non-HIV infected individuals living in the same communities.

Updates from the PEPFAR Annual Meeting: U.S. Global AIDS Coordinator Eric Goosby, MD, is writing updates this week from the President’s Emergency Plan for AIDS Relief (PEPFAR) Annual Meeting in Johannesburg, South Africa. Tuesday’s post from the meeting opening, entitled “PEPFAR Support for a Country-Owned Continuum of Response to HIV/AIDS,” outlines PEPFAR’s work to support governments “in orchestrating national efforts to address the health needs of their citizens, and enabling the strong participation of civil society in those efforts.” You can check out the updates on the State Department’s blog “DipNote.”

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