New and Noteworthy
15 year study shows benefits of harm reduction programs in Vancouver
Harm reduction programs in Vancouver have reduced drug use and needle sharing, leading to fewer HIV and Hep C infections and increased access to addiction treatment, concludes the report “Drug Situation in Vancouver”. The report, published by the Urban Health Initiative of the B.C. Centre for Excellence in HIV/AIDS, presents the results of a study of the scope and extent of drug use in the Downtown Eastside of Vancouver between 1996 and 2011. The study found that there were fewer people sharing needles in 2011 than in 1996 and that there were fewer new infections of HIV and hepatitis C related to sharing needles. Also, more people were accessing methadone treatment in 2011 than in 1996. “Harm reduction — not a war on drugs — has reduced illicit drug use and improved public safety in what was once Ground Zero for an HIV and overdose epidemic that cost many lives,” say researchers. (CTVnews.ca, June 2013, in English)
12 weeks of telaprevir triple therapy adequate for some people with Hep C
Nearly 90% of people with a specific genetic variation called IL28B CC were cured of a chronic infection with hepatitis C virus genotype 1 with just 12 weeks of telaprevir (Incivek) plus peg-interferon and ribavirin, researchers reported at the EASL International Liver Congress (EASL 2013) in Amsterdam. The cure rate rose to 97% among people treated for 24 weeks (12 weeks of triple therapy with telaprevir followed by 12 weeks of peg-interferon and ribavirin). The IL28B gene carries the instructions for the body’s production of interferon, a part of the natural immune response to Hep C. People carry one of three different variations of the IL28B gene, with IL28 CC producing the strongest interferon response, and IL28B CT and IL28B TT producing weaker responses. People with the IL28B CC variation are more likely to be cured from treatment than people with the other gene variations. “High SVR rates from the study interim analysis suggest the potential for the defined IL28B CC patients with rapid virological response (undetectable Hep C virus in the body after 4 weeks of treatment) to shorten duration of telaprevir plus peg-interferon/ribavirin to 12 weeks,” the researchers concluded. (HIVandhepatitis.com, June 2013, in English)
HIV-positive MSM in London, England at high risk for Hep C reinfection
There is a high rate of hepatitis C reinfection among men who have sex with men (MSM) with HIV in London, England reported researchers in the journal AIDS. The participants of the small study were all men who were coinfected with HIV and Hep C and had cleared their initial Hep C infection spontaneously or through treatment. The study found that approximately one quarter of study participants were reinfected with Hep C and a small number of men were reinfected three times. The sexual transmission of Hep C among MSM living with HIV has been documented in Europe, the U.S. and Australia. Risk factors for sexual transmission of Hep C include sexually transmitted infections that cause breaks in the skin, unprotected anal sex, fisting, the use of sex toys and drug use. “We recommend enhanced surveillance of patients who have cleared Hep C infection to allow the early detection and treatment of any reinfection,” the investigators conclude. “In addition, we recommend directed education and prevention interventions to HIV-positive MSM with Hep C infection.”