The effect of delayed HIV diagnosis on life expectancy, drug resistant cases of TB increasing worldwide, and more…

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

Quantifying the Effect of Delayed HIV Diagnosis on Life Expectancy: This article in AIDS details a computer simulation model that predicts changes in life expectancy based on when a patient is diagnosed with HIV, assuming antiretroviral treatment initiation according to current guidelines. Those diagnosed earlier (at a CD4 count around 400 cells/mm3) had a projected life expectancy three years longer than those diagnosed at a CD4 count around 150 cells/mm3. In a commentary by Dr. Carlos del Rio in Journal Watch HIV/AIDS Clinical Care, he states “Clearly, more effort must be put into identifying HIV-infected individuals at higher CD4-cell counts, linking them to care, and starting them on ART — both for their own well-being and for the sake of public health.”

AIDS Prevention Inspires Ways to Make Circumcisions Easier: This article in The New York Times examines medical devices being used to make the process of voluntary medical male circumcisions (MCs) for the prevention of HIV transmission faster, cheaper and safer. In particular, the piece examines the PrePex and the Shang Ring devices, which the World Health Organization currently is evaluating.  Several studies have shown MC to reduce a man’s chance of acquiring HIV through vaginal sex by up to 60 percent, and the protective benefit lasts over time. Efforts are underway in areas of sub-Saharan African with high HIV prevalence, low rates of MC and predominantly heterosexual epidemics to circumcise 20 million adolescent and adult men by 2015 to help slow the spread of HIV.

End of AIDS Is in Sight, If Funds Are There for It: This recent Boston Globe editorial highlights HIV “treatment as prevention” as a key scientific breakthrough in 2011 that could effectively end the spread of HIV. “But just as science is on the verge of winning the battle, financial resources and political will are flagging. 2010 was the first year that HIV/AIDS funding around the world decreased,” according to the editorial. In a letter to the editor in response, Dr. Ken Mayer argues that the U.S. must play a leadership role – both in meeting financial commitments to the Global Fund to Fight AIDS, Tuberculosis and Malaria and scaling up antiretroviral treatment through the U.S. PEPFAR program.

HIV Experts Propose New Pathway for Conducting Phase 3 Drug Trials: The Forum for Collaborative HIV Research released a scientific paper Tuesday in the journal AIDS (“Novel Clinical Trial Designs for the Development of New Antiretroviral Agents”) outlining a new approach for conducting Phase 3 HIV clinical trials that will demonstrate improvements in both treatment experienced and treatment naïve patients. “…The paper summarizes the insights of specialists from the Food and Drug Administration, European Medicines Agency, academia, the patient advocacy community and industry that overcoming the current difficulties in conducting new HIV drug trials requires moving from the large-scale study model to a new approach where clinical improvements are demonstrated through a sequence of short, step-wise efficacy and safety studies,” according to a press release.

Multidrug-Resistant TB Cases Increasing Worldwide: A report in the February Bulletin of the World Health Organization (WHO) reported cases of multidrug-resistant tuberculosis (MDR-TB) reached an all time high in 2009 and 2010. “MDR-TB is increasing most rapidly in Botswana, at 10.9 percent per year; Peru, at 19.4 percent per year; and the Republic of Korea, with an increase of 4.3 percent per year. The Republic of Korea is also recording a 7.4 percent annual increase in new TB cases,” according to an article in Medscape.  The study authors point out it is hard to know the full extent of the problem due to a lack of data from many countries – particularly large parts of Russia and India, as well as large portions of Africa, Eastern Europe and central Asia.

Don’t stop now: How underfunding the Global Fund impacts the HIV response: A new report by the International HIV/AIDS Alliance warns that the $2 billion shortfall in funding announced recently by The Global Fund to Fight AIDS, Tuberculosis and Malaria could create an HIV/AIDS crisis. The Fund cuts will result in millions having to go without HIV services, which might result in people dying while waiting for treatment, according to the report. “After 30 years our joint efforts were turning the HIV epidemic around and for the first time it became conceivable to plan for a world without AIDS. But in just a few short months the situation looks very different and we are in serious danger of losing the gains made,” Alliance Executive Director Alvaro Bermejo said in a statement.

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