Volume 14 Number 1/2 January/February 2013

Welcome to the first HTB issue of 2013.

We kick off with a World Health Organisation (WHO) statement emphasising that generic antiretroviral therapy is safe and effective. This was issued in response to a widely distributed article from the BBC perhaps implying otherwise, and explains its prominence as a treatment alert. As the NHS in the UK is on the brink of making significant savings using generic ARVs, clarity on their efficacy will be increasingly essential to maintain confidence in HIV care.

Our conference coverage starts with the 3rd International Workshop on HIV and Women. Now in its third year, this meeting is gaining in importance and gives an opportunity for in depth discussion on topics that are often lost or marginalised at larger meetings. One focus of the meeting was hormonal contraception. Why did it take so long to clarify that the 30 percent decrease in contraceptive hormone levels when they are taken with nevirapine does not appear to reduce the effectiveness of combined oral contraceptives?

A systematic review revealed minimum risk of heterosexual transmission, when the HIV positive partner has an undetectable viral load on ART. A recent joint statement from The British HIV Association (BHIVA) and the Expert Advisory Group on AIDS (EAGA) as well as one from the US Centers for Disease Control (CDC) on the prevention benefits of ART – both summarised in this issue – reinforce the earlier Swiss statement.

The 43rd Union World Conference on Lung Health included news on paediatric TB, including early pharmacokinetic data on second line drugs and plans for more rapid assessment of investigational ones for children. Other important TB news covered later in the issue is the FDA approval of bedaquiline for MDR TB: the first new tuberculosis drug in half a century; US funding for Xpert TB diagnostics and new UNITAID grants focus of paediatric TB.

The integrase inhibitor dolutegravir has been submitted to regulatory agencies and review articles on the complications of ART include an important study highlighting that mortality is driven more from smoking than HIV and that reduced bone mineral density may be prevelent prior to HIV infection.

Nathan Geffen takes a look at the implications of changing WHO antiretroviral guidelines to 500 threshold for starting treatment. And Richard Jeffery’s provides fascinating Basic Science updates.

Finally please consider supporting the AllTrials campaign, reported in Other News. This demands publication of all research results to help regulators, doctors and patients to make informed decisions about treatments.

HTB supplements

Two i-Base guides have been updated and reprinted in February 2013:

Both are already online and are available free, including in bulk to UK clinics. Please order online in the regular way.

Links to other websites are current at date of posting but not maintained.