J&J developing immunization against HIV

From Bloomberg.com

is preparing to test an experimental HIV vaccine in the U.S. and Europe in a move toward developing the first immunization against the deadly disease after decades of frustration.

Some 3,800 men who have sex with men will receive a regimen of shots in a study that’s planned to be launched later this year, Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said in an interview. The agency and the HIV Vaccine Trials Network of testing sites will collaborate with J&J’s Janssen unit on the effort.

Since cases first began to gain notice in the early 1980s, scientists have been searching fruitlessly for a vaccine against the virus that causes AIDS and kills close to 1 million people worldwide annually. Efforts are continuing with at least two other promising candidates in late-stage studies.

Most Americans not tested for HIV

From CNN

Most Americans have never been tested for HIV, the virus that attacks and weakens a person’s immune system.

The US Centers for Disease Control and Prevention is hoping to change that.
According to a new report, the agency found that fewer than 40% of people in the United States have been screened for HIV. It recommends that all people 13 to 64 be tested at least once.
Fifty jurisdictions across the country are responsible for more than half of all HIV diagnoses, yet only 35% of the people recommended for testing in those areas were screened in the previous year, the CDC says. And fewer than 30% of people across the country with the highest risk of acquiring HIV were tested in that period.
“Diagnosis and treatment are the first steps toward affording individuals living with HIV a normal life expectancy,” CDC Director Dr. Robert Redfield said in a statement. “As we encourage those at risk for HIV to seek care, we need to meet them in their journey. This means clearing the path of stigma, finding more comfortable ways of delivering health services, as well as learning from individuals already in treatment so the journey becomes easier for others who follow.”
To find HIV testing near you, go the CDC testing locator. Most locations are free.

Once a month treatment for HIV on the horizon

According to the U.S. Centers for Disease Control and Prevention, 38,000 people in the U.S. were newly infected with HIV in 2017. For more than 15 years, the first line of therapy has been a suite of antiretroviral drugs in pill form, taken once a day. Although this treatment has transformed HIV from a certain killer to a chronic disease in much of the developed world, there are problems. For example, some people have trouble taking their pill every day. Therefore, pharmaceutical companies are developing injectable HIV drugs that target different components of the virus and can be administered once every few weeks, writes Senior Editor Megha Satyanarayana.

Currently, at least nine long-acting injectable therapies for HIV are in clinical development. Recently, ViiV Healthcare released data from two Phase III clinical trials of a combination treatment of two drugs that inhibit different parts of the virus. When given as an intramuscular injection, the therapy was as effective as pills and persisted in the body for at least a month.

Read the full article.

Former Act Up atavist searching for new ways to halt epidemics

From the New York Times

Last fall, the MacArthur Foundation announced their annual “genius awards.” One name in particular stood out: Gregg Gonsalves, 55, an assistant professor of microbial diseases at the Yale School of Public Health.

In the 1980s, Dr. Gonsalves was a leading member of the AIDS advocacy group Act Up; he went on to found or support a number of domestic and international AIDS organizations.

The foundation cited his contributions in “training a new generation of researchers who, like himself, work across public health and human rights sectors, scholarly research, and activism to correct disparities in global public health.”

Read the interview with Dr. Gonsalves on NYTimes.com.

New immunotherapy kills HIV: Pitt Men’s Study participants “vital to the success of this study”

In a first on the quest to cure HIV, University of Pittsburgh Graduate School of Public Health scientists report today in EBioMedicine that they’ve developed an all-in-one immunotherapy approach that not only kicks HIV out of hiding in the immune system, but also kills it. The key lies in immune cells designed to recognize an entirely different virus.

The discovery, made in the laboratory using cells from people with HIV, is yet to be tested in clinical trials, but could lead to the development of a vaccine that would allow people positive for HIV to stop taking daily medications to keep the virus in check.

“A lot of scientists are trying to develop a cure for HIV, and it’s usually built around the ‘kick and kill’ concept – kick the virus out of hiding and then kill it,” said senior author Robbie Mailliard, Ph.D., assistant professor of infectious diseases and microbiology at Pitt Public Health. “There are some promising therapies being developed for the kill, but the Holy Grail is figuring out which cells are harboring HIV so we know what to kick.”

Antiretroviral therapy (ART) typically controls HIV infections so well that the virus is virtually undetectable in the blood and cannot easily infect other people. But if a person with HIV stops taking the daily regimen of medications, which come with many side-effects, the virus can rage back and turn into full-blown AIDS. This is because the virus goes into a latent, inactive phase where it incorporates itself into the DNA of certain immune cells called “T helper cells,” and lurks while a person is taking ART.

Mailliard and his team decided to look at a different virus that also goes latent and infects more than half of adults – and 95 percent of those with HIV: Cytomegalovirus (CMV), which can cause eye infections and other serious illnesses, but is usually controlled by a healthy immune system.

“The immune system spends a lot of time keeping CMV in check; in some people, 1 one out of every 5 T cells are specific to that one virus,” said co-author Charles Rinaldo, Ph.D., professor and chair of Pitt Public Health’s Department of Infectious Diseases and Microbiology. “That got us thinking – maybe those cells that are specific to fighting CMV also make up a large part of the latent HIV reservoir. So we engineered our immunotherapy to not only target HIV, but to also activate CMV-specific T helper cells.”

To run the experiment, the team needed blood – and lots of it – from people with HIV controlled by ART. Nearly two dozen participants stepped up from the Pitt Men’s Study, the Pittsburgh  site of the Multicenter AIDS Cohort Study (MACS), a research study of the natural history of treated and untreated HIV/AIDS in men who have sex with men.

“The MACS participants were vital to the success of this study,” said first author Jan Kristoff, M.S., a doctoral candidate at Pitt Public Health. “You have to collect a lot of blood to find T cells latently infected with functional HIV in people on ART – it could be as few as 1 out of every 10 million cells. So the men would sit for as long as four hours hooked up to a machine that processed their blood and came back multiple times to give more samples.”

Read more on the UPMC Website.

Dr. Anthony Fauci discusses the case of the London Patient

From NBC News

Dr. Anthony Fauci, one of the nation’s top HIV/AIDS doctors, cautioned that the highly publicized case of the so-called London Patient — the second person in the world confirmed to be cured of HIV infection — does not mean a widely available cure is on the horizon anytime soon.

“To think that bone marrow transplantation is going to be a scalable, feasible, safe way to treat infections is really, unfortunately, misleading, because it is not,” Fauci, director of the National Institute for Allergy and Infectious Disease, said Tuesday on MSNBC.

The ‘London Patient’ was cured of HIV in the process of being treated for a much deadlier disease: Hodgkin’s Lymphoma. This cancer of the lymphatic system can be treated with a risky bone marrow transplant from a donor whose marrow matches. “This was really his last chance of survival,” Dr. Ravindra Gupta, the patient’s doctor, told Reuters.

Watch the video here.

 

HRC: The Black & African American LGBTQ Youth Report

From the Human Rights Campaign...

In 2017, the Human Rights Campaign Foundation partnered with researchers at the University of Connecticut to conduct a groundbreaking survey of over 12,000 LGBTQ youth and capture their experiences in their families, schools, social circles and communities. More than 1,600 Black and African American LGBTQ youth responded to the survey.

This resource presents data collected from these youth, shedding light on their challenges and triumphs encountered while navigating multiple, intersecting identities. This report utilizes the full sample (any respondent who answered more than 10 percent of the survey) and provides more detail than is captured in the 2018 Youth Report.

Find out more.

NIAID review: HIV undetectable = untransmittable

HIV positive people with an undetectable viral load cannot sexually transmit HIV. That’s the unequivocal conclusion from one of the leading health agencies in the US.

Researchers from the National Institute of Allergy and Infectious Diseases (NIAID) undertook a review of recent research. Their conclusion is simple: Undetectable = Untransmittable (U=U). It’s the same message now backed by over 300 health agencies all around the world.

The results of the NIAID review were published yesterday in the Journal of the American Medical Association (JAMA). One of the reports co-authors is NIAID Director, Dr Anthony Fauci. He is widely regarded as one of the world’s leading HIV experts.

In a statement, NIAID called evidence for Undetectable = Untransmittable ‘overwhelming’. Not only does getting those diagnosed with HIV on to Antiretroviral Therapy (ART) ensure their long term health. But it also significantly reduces HIV transmission rates. This is because those with the virus suppressed in their body cannot pass it on.

The authors pointed to research that looked at over 77,000 examples of condomless sex between serodiscordant male couples. One half of the couple had HIV and the other did not. There was not a single transmission of the virus from the HIV positive person to the negative person.

Read the full article.

HIV strikes Black gay men more, despite safer behaviors

“Our study illuminates how HIV disparities emerge from complex social and sexual networks and inequalities in access to medical care for those who are HIV-positive,” said senior study author Brian Mustanski. He is director of the Northwestern Institute for Sexual and Gender Minority Health and Wellbeing at Northwestern University’s Feinberg School of Medicine in Chicago.

“Their social and sexual networks are more dense and interconnected, which from an infectious disease standpoint makes infections transmitted more efficiently through the group,” Mustanski explained in a university news release.

“That, coupled with the higher HIV prevalence in the population, means any sexual act has a higher chance of HIV transmission,” he added.

If this trend continues, 1 out of every 2 black gay men will become infected with HIV at some point in life, compared to 1 in 5 Hispanic gay men and 1 in 11 white gay men, according to the U.S. Centers for Disease Control and Prevention.

In the study, researchers analyzed data from more than 1,000 gay men, aged 16 to 29, in Chicago.

Among their other findings: black gay men were less likely to have close relationships with their sexual partners, more likely to have hazardous marijuana use, and more likely to have experienced more stigma, trauma and childhood sexual abuse. White gay men were more likely to have alcohol problems.

The study was published Dec. 4 in the Journal of Acquired Immunodeficiency Syndromes.

For more information, check out the U.S. Centers for Disease Control and Prevention.

NIH study: combination antibody treatment for HIV

From Medicalxpress.com

A clinical trial testing infusions of combination antibodies in people living with HIV has begun at the National Institutes of Health. The early-phase clinical trial will evaluate whether periodic infusions of two highly potent, HIV-specific, broadly neutralizing antibodies (bNAbs)—3BNC117 and 10-1074—are safe in people living with HIV. The study also will gather preliminary data on how effectively the bNAb infusions, delivered together every two to four weeks, suppress HIV following discontinuation of antiretroviral therapy (ART).

Read the full article.