Zika virus infection – Chile 19 April 2016

On 26 March 2016, the National IHR Focal Point of Chile notified PAHO/WHO of a confirmed case of sexual transmission of Zika virus; this is the first case acquired in continental Chilean territory where there is no presence of aedes [vector] mosquitoes.
The case (Person A) developed symptoms consistent with Zika virus disease: rash, retroauricular adenopathies, conjunctivitis, and arthritis on 4 February. Her partner (Person B) developed symptoms consistent with Zika virus disease after travelling to a country where local transmission of Zika virus is known.
Infection by Zika virus was confirmed for both cases IgM and IgG positive for Zika virus (Person A) and IgM and IgG positive for Zika virus, and negative for dengue IgM (Person B).

Public health response

Health authorities in Chile are taking the following measures:

• conducting social risk communication on safer sexual practices,
• advising travellers to areas where Zika virus is circulating to seek medical assistance if presenting symptoms associated with Zika virus infection after return
• All patients (male and female) with Zika virus infection and their sexual partners (particularly pregnant women) should receive information about the potential risks of sexual transmission of Zika virus, contraceptive measures and safer sexual practices, and should be provided with condoms when feasible. Women who have had unprotected sex and do not wish to become pregnant because of concern with infection with Zika virus should also have ready access to emergency contraceptive services and counselling.
• Sexual partners of pregnant women, living in or returning from areas where local transmission of Zika virus is known to occur, should use safer sexual practices or abstinence from sexual activity for the duration of the pregnancy.
• As most Zika virus infections are asymptomatic:
• Men and women living in areas where local transmission of Zika virus is known to occur should consider adopting safer sexual practices or abstaining from sexual activity.
• Men and women returning from areas where local transmission of Zika virus is known to occur should adopt safer sexual practices or consider abstinence for at least four weeks after return.
• { Registered.(Content From WHO) }

Legal highs 'may be linked' to rise in HIV in Glasgow area

 

Legal highs 'may be linked' to rise in HIV in Glasgow area

A drug misuse expert has warned that legal highs and lack of media attention may be contributing to an increase in HIV cases seen in the Glasgow area.

Health officials have warned people who take drugs about a near five-fold increase in HIV infections.
About 10 cases are linked to injecting in the Greater Glasgow and Clyde area each year - that rose to 47 last year.
Professor Neil McKeganey said legal highs could be a factor in more frequent high-risk injecting behaviour.
NHS Greater Glasgow and Clyde (NHSGGC) is now warning drug users of the dangers of sharing needles and advising anyone who injects to get tested.
For the first time in almost 30 years, new diagnoses of HIV related to drug injecting was at a comparable level among gay and heterosexual men.
Investigations into the outbreak highlighted that some drug users were sharing needles, syringes, spoons and water when preparing and injecting their drugs.
It has also highlighted that there is low awareness of the risks of HIV from doing so.

'Vitally important'

Dr Catriona Milosevic, consultant in public health medicine at NHSGGC, said it was "vitally important" that people who inject drugs do not share or reuse equipment.
She said: "This includes when injecting with close friends or partners - you can't guess whether someone has HIV, and they may have no symptoms and be unaware themselves.
"Everyone involved needs to use a new set of sterile injecting equipment every single time, including needles, syringes, water, filters, and spoons, to protect themselves and others. These are all available from injecting equipment services."
Dr Milosevic said the goal was to get people drug free, but until that is achieved the focus had to be on harm reduction.

Image copyright SPL

Prof McKeganey, of the Centre for Substance Use Research, said any increase in HIV cases was worrying.
He said: "Many people have lost the focus of attention on HIV - there hasn't been much in the media and people tend to think it's not there.
"Actually what we are seeing is an increase in injecting risk behaviour, more sharing of needles than in the past.
"That might be to do with new psychoactive substances, or legal highs, we know that people tend to inject much more frequently and there is evidence that it's a higher risk behaviour."

'Diagnosed early'

Although there is no cure for HIV, there are now treatments which reduce the virus to what doctors describe as "undetectable" levels.
Dr Milosevic added: "Recent discussions have highlighted that those at risk are not aware of the huge advancements made in HIV treatment - there is still a perception that a diagnosis of HIV is a 'death sentence'.
"If people are diagnosed and start treatment early, which requires a test, they can have a similar life expectancy as the rest of the population."

(News From BBC)

HIV update - 26th FEB 2017

Hepatitis C virus often found in semen

Researchers continue to investigate the biological mechanisms which could explain the ongoing epidemic of sexually transmitted hepatitis C in HIV-positive gay men.
Some studies have suggested that sexual transmission is mostly linked to sexual practices that involve some contact with blood (including tiny traces of blood you don’t notice). This makes sense as it is well known that hepatitis C is present in infectious quantities in blood. These sexual practices may include anal sex (especially when it goes on for a long time) as well as fisting and using sex toys.
Until now, it’s generally been thought that while hepatitis C may be present in semen, it’s usually at a low level that isn’t infectious.

Researchers took semen and blood samples from 33 gay men who had both HIV and hepatitis C. They found that one third of the men had detectable hepatitis C in their semen and that it was present in levels that were plausibly high enough to transmit the virus.
When individuals had high levels of hepatitis C in their blood (for example, soon after infection) they tended to have high levels in their semen. But this was not always the case – some men who had low levels of hepatitis C in their blood had high levels in their semen.
The results suggest that hepatitis C can be passed on during anal sex even when there has been no bleeding. They suggest that condoms can play an important role in preventing the transmission of hepatitis C.

Drug resistance in steep decline

The number of people with virus that is resistant to some anti-HIV drugs has fallen significantly in recent years,
A drug-resistant HIV strain is one which is less susceptible to the effects of one or more anti-HIV drugs. Having drug-resistant HIV limits the range of drugs you can use, but you will still usually be able to find an effective treatment.
Drug-resistant HIV can emerge if you regularly miss doses of your anti-HIV drugs or take them late.  Because HIV treatment is now easier to take, with fewer side-effects, resistance is less of a problem than it used to be.
Resistance can also develop when people take HIV treatment regimens which are not powerful enough to keep HIV under control – this was a problem in the 1990s, but is generally no longer an issue for people receiving care in the UK and similar countries.
Looking back at data on thousands of people living with HIV in Switzerland between 1999 and 2013, the researchers found that in 1999 there were 401 patients with a new case of drug resistance, including 69 people who had resistance to multiple drugs. Although many more people were living with HIV in 2013, there were only 23 new cases of drug resistance, including three people with resistance to multiple drugs.
These new cases of resistance in recent years are mostly due to resistant virus being sexually transmitted – individuals having resistant virus when first diagnosed with HIV.
Other people continue to have resistance to some drugs, as a legacy of problems with HIV treatment several years ago. Looking at those individuals who had resistant virus in 2013, most started to take HIV treatment before 2006. Only 15% of cases involved people who began HIV treatment after 2007.

People not taking treatment

Two recent studies shed light on the experiences of people who have chosen not to take HIV treatment or who have had difficulties taking treatment regularly. Researchers have called on clinicians and policy makers to pay more attention to the experiences of people who have fears or concerns about HIV treatment.
In an Australian study, some people were reluctant to start treatment for as long as they felt healthy and normal. They worried that starting treatment would make HIV feel more real rather than lessening its impact. The interviewees were aware of the evidence that HIV treatment reduces the infectiousness of people living with HIV and described feeling pressurised by friends and professionals to take treatment and ‘do the right thing’ for the sake of the wider community – a call that brought about ambivalence and resentment.
These people who had decided not to take treatment often said that they did not know anyone else who had HIV and was not taking treatment. They felt marginalised and silenced within groups of people living with HIV and by HIV support organisations.
In a separate study, researchers interviewed west African women living in London who had had difficulties adhering to their HIV treatment. Internalised stigma about HIV was an undercurrent in many of these women’s accounts, with some women feeling as negatively about the medications as about the illness they are used to treat. Several described HIV treatment as making them feel they were trapped in a monotonous life sentence. As one woman said, “They will tell you that you have to take it. It’s the words ‘for life’ I hate, I can’t stand it.”
But some interviewees talked about how their adherence and their health had improved, citing the support of family members and of doctors who treated them as equal partners. The researchers say that healthcare staff should educate patients about how HIV treatment works and fully involve them in decisions about treatment. They also say that, when possible, it’s helpful for people living with HIV to be open about their HIV status to friends and family, so that they are not isolated and can get support.

Editors' picks from other sources

Heterosexual identity crisis

from Positive Lite
Straight poz guy Joshua Middleton and the untold story of shame amongst straight men.

The graying of HIV: 1 in 6 new US cases are people older than 50

from Washington Post
Thousands of people 50 and older are diagnosed with HIV each year in the United States, a development that has significant consequences for the health care and social support they need and the doctors, counselors and others who provide it. Older people tend to be sicker when the infection is finally discovered. They usually have other health conditions that accompany ageing and often are too embarrassed to reveal their illness to family and friends.

Media outlets falsely claim that a cure for HIV may be only three years away

from Poz
A series of media outlets have erroneously reported that scientists may be just three years away from developing a cure for HIV. This false claim traces to an article published in the UK’s The Telegraph concerning researchers who recently succeeded in editing HIV’s genetic code out of immune cells in a laboratory setting.

Greed and the necessity for regulation

from TAG
The story of US drug pricing run amok isn’t just about corporate arrogance and avarice – it is also about government permissiveness and inaction.

Dengue Vaccine From WHO

Dengue vaccine research

Dengue is a mosquito-borne flavivirus disease that has spread to most tropical and many subtropical areas. The disease is caused by four closely related viruses, the Dengue viruses 1-4. There are no specific dengue therapeutics and prevention is currently limited to vector control measures. A dengue vaccine would therefore represent a major advance in the control of the disease.

Status of vaccine development

The first dengue vaccine, Dengvaxia (CYD-TDV) by Sanofi Pasteur, was first registered in Mexico in December, 2015. CYD-TDV is a live recombinant tetravalent dengue vaccine that has been evaluated as a 3-dose series on a 0/6/12 month schedule in Phase III clinical studies. It has been registered for use in individuals 9-45 years of age living in endemic areas.
The WHO Strategic Advisory Group of Experts (SAGE) on Immunization reviewed CYD-TDV in April 2016 and recommended countries consider introduction of the vaccine only in geographic settings (national or subnational) with high endemicity. A WHO vaccine position paper will be published outlining WHO recommendations in July 2016.
There are approximately five additional vaccine candidates under evaluation in clinical trials, including other live-attenuated vaccines, as well as subunit, DNA and purified inactivated vaccine candidates. Additional technological approaches, such as virus-vectored and VLP-based vaccines, are under evaluation in preclinical studies.
The growing global epidemic of dengue is of mounting concern, and a safe and effective vaccine is urgently needed. WHO expects vaccines to be an integrated part of the Global dengue prevention and control strategy (2012-2020)