Monthly Archives: November 2017

amfAR Releases Opioid & Health Indicators Database

HEAL Blog is the recipient of the ADAP Advocacy Association’s 2015-2016 ADAP Social Media Campaign of the Year Award
By: Marcus J. Hopkins, Blogger

amfAR, The Foundation for AIDS Research, has published their latest site, “Opioid & Health Indicators Database,” which pulls together, for each state, trends over time in opioid use and related infectious disease mortality, as well as state-by-state levels of Federal funding (Melville, 2017). The site was revealed at last week’s Association of Nurses in AIDS Care (ANAC) 2017 conference by Alana Sharp, MPH, from the Foundation of AIDS Research, a private organization that focuses on the various research and databases that informs their reporting.

AmfAR logo

Photo Source: amfAR

The website pulls together various data from a variety of sources and present this data for every state in the U.S., and puts them in the context of HIV, Hepatitis C (HCV), and the opioid crisis. This unique site is one of the first to actively connect these types of data in a user-friendly manner. They also make use of the supplemental data used to compile a list of 220 counties in the U.S. most at risk of HIV and/or HCV outbreaks due to a variety of similar circumstances that include: Drug Overdose Mortality, Prescription Opioid Sales, Mental Health Services, Insurance Coverage, Urgent Care Facilities, Vehicle Availability, Education, Income, Population Density, Poverty, Race/Ethnicity, Unemployment, Urban/Rural Status, and Buprenorphine Prescription Capacity (Van Handel, et al., 2016b).

Opioids Amplifying Impacts on HIV and HCV

Photo Source: opioid.amfar.org

From the front page, users select their either the state or congressional district from one of two dropdown boxes, and receive a fresh page that provides information. For states, the first page displays information on the Most Vulnerable Counties, taken from the Van Handel report, and after a click-thru, lands on a page that lists a considerably deep level of state statistics, including demographic data, HIV and/or HCV populations, opioid use statistics, healthcare-related statistics, and treatment and prevention services information, all of which are set against national statistics (e.g. – Percentage of People without Health Insurance (2015): West Virginia – 11.5%; National – 13.0%). After the numerical presentation, you can scroll down for more in depth coverage about state opioid policies, graphs of state health trends, Federal funding from various agencies, as well as a data explorer, that provides county-by-county HIV and HCV incidence and prevalence data broken, the same data by congressional districts, and by state for comparison.

If users select their congressional district, they’re asked to provide their zip/postal code, and are provided with a district profile providing numerical data similar to the state profile, and follows with the same graphic representation of data as presented on the state level, but Congressional district-specific.

This database, one of the first of its kind, helps provide a fantastic resource for state-level advocates and policy makers for informing good policy planning and crafting. For more information, please visit amfAR’s website at the following address: http://opioid.amfar.org.

References:

  • Melville, N.A. (2017, November 08). Opioid Crisis Inflaming Hep C, HIV in Hard-Hit Communities. New York, NY: Medscape, LLC: News: Conference News. Retrieved from: https://www.medscape.com/viewarticle/888219
  • Van Handel M.M., Rose C.E., Hallisey E.J., Kolling J.L., Zibbell J.E., Lewis B., Bohm M.K., Jones C.M., Flanagan B.E., Siddiqi A.E., Iqbal K., Dent A.L., Mermin J.H., McCray E., Ward J.W., & Brooks J.T. (2016b, November 01). County-Level Vulnerability Assessment for Rapid Dissemination of HIV or HCV Infections Among Persons Who Inject Drugs, United States. JAIDS Journal of Acquired Immune Deficiency Syndromes: November 1st, 2016 – Volume 73 – Issue 3 – p 323–331. doi: 10.1097/QAI.0000000000001098. Retrieved from: http://journals.lww.com/jaids/Citation/2016/11010/County_Level_Vulnerability_Assessment_for_Rapid.13.aspx
  • Van Handel M.M., Rose C.E., Hallisey E.J., Kolling J.L., Zibbell J.E., Lewis B., Bohm M.K., Jones C.M., Flanagan B.E., Siddiqi A.E., Iqbal K., Dent A.L., Mermin J.H., McCray E., Ward J.W., & Brooks J.T. (2016b, November 01). County-Level Vulnerability Assessment for Rapid Dissemination of HIV or HCV Infections Among Persons Who Inject Drugs, United States – Supplemental Appendix. JAIDS Journal of Acquired Immune Deficiency Syndromes: November 1st, 2016 – Volume 73 – Issue 3 – p 323–331. doi: 10.1097/QAI.0000000000001098. Retrieved from: http://download.lww.com/wolterskluwer_vitalstream_com/PermaLink/QAI/A/QAI_2016_06_29_VANHANDELM_QAIV16762_SDC1.pdf

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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HHS Releases New HIV Treatment Guidelines

HEAL Blog is the recipient of the ADAP Advocacy Association’s 2015-2016 ADAP Social Media Campaign of the Year Award
By: Marcus J. Hopkins, Blogger

The Department of Health and Human Services released updated Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV in October 2017, which included updates for best practices, treatment protocols and recommendations, which drugs not to use, treatment for virologic failure, regimen switching, adherence to the continuum of care, drug interactions, and Hepatitis B (HBV) and Hepatitis C (HCV) co-infection treatment guidelines.

Because emtricitabine (FTC – Truvada, Descovy, Stribild, Genvoya, Odefsey), lamivudine (3TC – Epivir, Epivir-HBV, Combivir, Kivexa, Trizivir), tenofovir disoproxil fumarate (TDF- Viread, Atripla, Complera, Stribild, Truvada), and tenofovir alafenamide (TAF – Genvoya, Odefsey, Descovy) have activity against both HIV and HBV, an Antiretroviral Therapy (ART) should include (TAF or TDF) plus (3TC of FTC) to fully suppress the viruses. Other HBV treatment regimens, including adefovir (Hepsera) alone or in combination with 3TC or FTC, are not recommended for patients co-infected with HIV/HBV.

Rx pill bottles and pills

Photo Source: HIVThrive.Com

HBV reactivation has been observed in persons with HBV infection during interferon-free HCV treatment. For that reason, all patients initiating HCV therapy should be tested for HBV. Persons with HCV/HIV coinfection and active HBV infection should receive two agents with anti-HBV activity prior to initiating HCV therapy.

For HCV, ART may slow the progression of liver disease related to HCV by preserving or restoring immune function and reducing HIV-related immune activation and inflammation. For most persons with HCV/HIV coinfection, including those with cirrhosis, the benefits of ART outweigh concerns regarding drug-induced liver injury. Therefore, ART should be initiated in all patients with HCV/HIV coinfection, regardless of CD4 T-cell count. All patients with HCV/HIV coinfection should be evaluated for HCV therapy and have their liver fibrosis stage assessed to inform the length of their therapy, ribavirin need (a concern with some regimens), and subsequent risk of hepatocellular carcinoma and liver disease complications

The document also includes an extensive list of the various drug interactions between HIV and HCV drugs, including the three newest HCV regimens, Epclusa, Vosevi, and Mavyret. HEAL Blog previously covered HCV and HIV drug interactions (Hopkins, 2016). While the document is clearly meant for medical and other healthcare professionals, if you would like more information, please check out the link below in the citation.

References:

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

 

 

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