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In-Brief: November 16th, 2017

In Brief is NEAETC's news service covering the latest developments and educational resources about HIV, hepatitis, health disparities, and related topics. To subscribe, please click HERE.

Did You Know: The HIV Global Epidemic

Did you know that, as of 2016:  

·        Approximately 76 million people had been infected with HIV since the start of the global epidemic. ·        Of this total, nearly half (37 million people) were living with HIV.

·        Among those living with HIV, 34.5 million were adults (aged 15 years or older), while 2.1 million were children.

·        Nearly 20 million people were accessing antiretroviral therapy (ART).

In addition, during 2016:

·        An estimated 1.8 million people worldwide were newly infected with HIV. The annual number of new infections has declined about 15% globally since 2010.

·        About 1 million people died of AIDS-related illnesses. Global AIDS-related deaths have fallen by nearly half (48%) from the peak of about 1.9 million in 2005.

·        Globally, tuberculosis remains the leading cause of death among people living with HIV – accounting for one-third of all AIDS-related deaths.

·        Three-quarters (76%) of pregnant women living with HIV had access to ART to prevent transmission of HIV to their babies.

Ending the HIV/AIDS Pandemic  

“My Health, My Right” Is the Theme for UNAIDS World AIDS Day Campaign  

In the run-up to World AIDS Day (WAD) on December 1, UNAIDS recently announced its educational campaign theme for WAD 2017: “My Health, My Right.” According to UNAIDS, this year’s theme “focuses on the right to health and explores the challenges people around the world face in exercising their rights.” The agency notes that, when a person’s right to health is compromised, they are often unable to prevent disease effectively, or to gain access to treatment and care.  

“The most marginalized people in society, including sex workers, people who inject drugs, men who have sex with men, people in prisons, and migrants, are often the least able to access their right to health; they are also the most vulnerable to HIV.” UNAIDS has created a Right to Health campaign web page with suggestions for activities organizations and individuals can do to raise awareness about HIV/AIDS and commemorate WAD 2017. The page includes sections with key messages about the epidemic, tweets, and downloadable images for educational postcards and posters.

HIV Vaccine Will Likely Be Needed for a Durable End to the HIV/AIDS Pandemic

The development of an effective HIV preventive vaccine will likely be necessary to achieve a durable end to the HIV/AIDS pandemic, according to a recent commentary in JAMA by Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID). Fauci notes that, while effective global implementation of existing treatment and prevention tools, including antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP), could theoretically end the HIV/AIDS pandemic, reaching this goal is unlikely without a vaccine. More than 17 million people living with HIV worldwide are not receiving ART and are therefore at risk for infecting others.

In addition, while PrEP is highly effective in preventing HIV infection among persons at risk, only a small fraction of those who could benefit from PrEP are actually receiving it. Fauci cites modeling studies indicating that the pandemic could be curbed if current HIV treatment and prevention efforts are sustained and an HIV vaccine that is at least 50% effective is developed and deployed.

Viral Hepatitis

FDA Approves First Two-Dose Vaccine for Hepatitis B

Early this month, the U.S. Food and Drug Administration (FDA) approved Heplisav-B – a vaccine for preventing infections for all known subtypes of hepatitis B virus (HBV) in adults ages 18 and older. Heplisav-B, which was developed by Dynavax Technologies Corporation, is the first new HBV vaccine approved in the U.S. in more than 25 years. It is also the only two-dose HBV vaccine available for adults. The approval of Heplisav-B “provides an important new tool for reversing the unfortunate trend of increased acute hepatitis B infections in the U.S.,” noted Ryan Clary, the executive director of the National Viral Hepatitis Roundtable (NVHR).

Previously approved HBV vaccines have required three doses given over a six-month period for full protection against infection. However, nearly half of adults fail to complete the full three-dose series within one year. Heplisav-B’s compressed dosing schedule – two doses given over a one-month period – increase the likelihood that people will successfully complete the full vaccination series, according to NVHR.

Nine Countries Are on Course to Eliminate Hepatitis C by 2030

Nine countries – Australia, Brazil, Egypt, Georgia, Germany, Iceland, Japan, the Netherlands, and Qatar – are now on track to eliminate hepatitis C (HCV) by 2030, according to a report from the Polaris Observatory presented at the 2017 World Hepatitis Summit in Sao Paolo, Brazil. Viral hepatitis kills more than one million people worldwide each year, and over 300 million people are chronically infected with hepatitis B (HBV) or HCV. However, thanks to the development of highly effective direct acting antivirals (DAAs) for treating HCV and the increasing rates of HBV treatment and vaccination coverage globally, elimination of viral hepatitis has become a real possibility, according to the World Hepatitis Alliance.

“What we are seeing is that some countries, especially those with a high burden, are making the elimination of viral hepatitis a priority and are looking at innovative ways to do it,” noted Home Razavi, director of the Center for Disease Analysis in Lafayette, Colorado. “However, it will be nearly impossible for most other countries to meet the World Health Organization targets [for HBV and HCV elimination] without a huge scale-up in political will and access to diagnostics and treatment.”

In other news from the Summit, researchers reported that approximately 52 million children (those under 19 years old) are currently living with viral hepatitis worldwide. Of this total, 4 million are living with HCV and 48 million are living with HBV. Just 21 countries account for about 80% of the total cases of pediatric HCV infections, with the highest prevalence rates generally in developing nations. “We must act and treat as many children as possible,” urged professor Manal El-Sayed of Ain Shams University in Cairo, Egypt.

“The economic and social benefit of early HCV treatment in children is substantial. This includes avoiding disease progression, removing social stigma and improving activity and school performance, and reducing fatigue. However, the fundamental principle is to avoid transmission by adopting ‘cure as prevention’ at an early age and before high risk behaviors emerge that enable transmission.”

Health Communication and Social Media Blog Posts Focus on Health Literacy and Digital Communication Tools If you’re interested in health literacy, as well as the use of social media and other digital communication tools for health communication, then you may want to check out several recent posts on the blog site. In an October 30 post, Let’s Try to Keep It Simple, bloggers from the U.S. Centers for Disease Control and Prevention (CDC) describe the agency’s free online health literacy trainings for health professionals, and provide links to CDC’s HIV risk-reduction tool and its extensive library of consumer fact sheets on HIV and sexually transmitted diseases. Three other recent posts provide information about:

·’s free technical assistance to help health professionals use social media services and digital tools to advance HIV prevention, care, and treatment;

·        using Facebook Live and other digital tools to promote events for World AIDS Day and other national health observances; and

·        the potential for augmented reality and virtual reality technologies to change health communication in the coming years.

Other HIV/AIDS Resources

Two New HIV Reports from CDC

CDC recently issued two new publications focusing on the Ryan White HIV/AIDS Program (RWHAP) and the HIV continuum of care. HIV and AIDS Data through December 2015 Provided for the Ryan White HIV/AIDS Program, for Fiscal Year 2017 is a 17-page report summarizing HIV and AIDS prevalence and recent AIDS cases in U.S. states, dependent areas, eligible metropolitan areas, and eligible emerging communities for the RWHAP. The 64-page report, Social Determinants of Health and Selected HIV Care Outcomes Among Adults with Diagnosed HIV Infection in 32 States and the District of Columbia, 2015, provides detailed data on disease stages at the time of diagnosis, linkage to and receipt of HIV medical care, and viral suppression rates among people diagnosed with HIV infection in 32 states and D.C.

Updated Consumer Fact Sheets on the Side Effects of HIV Medicines

The AIDSinfo website has posted updated versions, in English and Spanish, of its consumer fact sheets concerning the side effects of antiretroviral drug treatment (ART). Each fact sheet begins with a bulleted summary of summary of the key topics covered, followed by more detailed information presented in a question-and-answer format. Please note: Although the conditions described in the fact sheets below may occur as side effects of ART, they are sometimes also caused or exacerbated by HIV infection itself, as well as a variety of other non-HIV-related factors.

·        HIV Medicines and Side Effects (Spanish version)

·        HIV and Diabetes (Spanish version)

·        HIV and Hepatotoxicity (Spanish version)

·        HIV and Hyperlipidemia (Spanish version)

·        HIV and Lactic Acidosis (Spanish version)

·        HIV and Lipodystrophy (Spanish version)

·        HIV and Osteoporosis (Spanish version)

·        HIV and Rash (Spanish version)

Special HIV Research Collection from PLOS Medicine

The open online journal PLOS Medicine is publishing a special collection of HIV research papers in installments this month. The new HIV collection covers advances in HIV prevention, treatment, and cure from researchers around the world. The first installment, published on November 7, includes papers about the HIV treatment cascade in Africa; the impact of starting antiretroviral treatment very early in the course of infection; HIV prevalence among transgender women and men who have sex with men; cardiovascular and kidney disease among persons living with HIV; and progress and challenges toward reaching global goals for ending the HIV/AIDS epidemic.