US: Hepatitis C in HIV positive gay men at an all-time high

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  1. W6_bloke  20 Feb 2013, 7:34pm  Report
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    “The authors conclude that HIV positive gay men should be tested annually for hepatitis C”

    This is standard practice in most UK HIV clinics as is Hep B testing, often undertaken every 6 months, but most certainly annually.

    It used to be considered that Hep C transmission was only possible via blood to blood contact, often being associated with traumatic activities such as fisting, sharing of large anal toys, & of course IV drug use.

    There is considerable evidence to suggest unprotected anal sex is also an effective transmission route, although it is not well understood exactly why.

    Co-infection with HIV results in a considerable increase in Hep C progression, leading to liver stiffening / cirrhosis much earlier than would normally be seen in an HIV negative individual.

    Hep C treatment, for many is considerable debilitating, & there is always the risk that the treatment may fail.

    New protease inhibitors are helping to reduce failure rates, & reducing treatment times scales.

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  2. myself  21 Feb 2013, 9:26am  Report
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    The only reason WHY? are our beloved drugs and overflow of proteins from multiple partners. HIV and Hep C were never isolated in humans. Get over it and find some self respect in our sex behavior. It took me long time but it’s worthy.

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    1. Are you seriously suggesting that AIDS is caused by drugs and an “overflow of proteins”? You sound like just another deluded AIDS-Denialist with his head in the sand.

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  3. For those few people who choose to deny that HIV causes problems for people who receive the drug treatments:

    “Impaired physical function in middle-aged people living with HIV is associated with low reduced muscle mass, reduced bone mineral density and hormonal changes, according to research conducted in the United States and published in the online edition of the Journal of Acquired Immune Deficiency Syndromes. These are similar to the factors associated with frailty among elderly patients in the general population. The investigators stress the importance of improving muscle and bone mass and boosting certain hormone levels in people with lower physical functioning.”

    http://www.aidsmap.com/Classic-characteristics-of-old-age-associated-with-poor-physical-function-in-middle-aged-people-living-with-HIV/page/2572470/?ic=700100

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    1. W6_bloke  22 Feb 2013, 12:34pm  Report
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      This particular study identifies the importance of people living with HIV to look after their health rather more than if they were HIV negative. Low muscle mass & bone frailty is associated with inactivity, regardless of HIV status. In addition the study identifies that there was a high prevalence of smoking, drug & alcohol use amongst the participants which are all independent risk factors associated with bone fractures.

      Nowhere in the particular study was the effect of ARV’s considered. Untreated HIV changes bone mineral density as CAN treatment with Tenofovir (a component of Truvada, Atripla & Evipera). The effects of Tenofovir have been well studied & current thinking is that whilst bone mineral density is a potential side effect this effect tails off in the first 18 months of treatment with a Tenofovir containing regimen. Clinicians closely monitor bone health in patients here in the UK being treated with Tenofovir.

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      1. W6_bloke  22 Feb 2013, 12:46pm  Report
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        Studies from the US always need to be treated with caution in my view as they have much poorer outcomes due to the health care system.

        A 2011 CDC analysis suggests that of 1,780,350 of HIV positive individuals only 40% are retained in regular HIV care. 36% of the the +ve individuals are on ARV’s with only 28% acheving an undetectable viral load <200 copies of viral RNA per ml of blood.

        http://www.catie.ca/en/pif/spring-2013/hiv-treatment-cascade-patching-leaks-improve-hiv-prevention

        These results are in stark contrast to the treatment & care outcomes here in the UK, thus we have to be cautious as we are not comparing like with like. It is important that very specific studies are not used to make general points with regard to HIV outcomes.

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