Healthcare & Laboratory News

Infectious Disease Advisor (5/14, Nye) reports, “The risk for major bleeding in patients with HIV infection and atrial fibrillation (AF) on antiretroviral therapy is higher with the use of warfarin and rivaroxaban than with apixaban, highlighting the superior safety profile of apixaban in high-risk HIV populations.” Investigators came to this conclusion after evaluating “patients aged 50 years and older with HIV and AF who initiated anticoagulant therapy with warfarin, rivaroxaban, or apixaban between 2013 and 2020 for major bleeding-associated hospitalization.” The findings were published in JAMA Internal Medicine.

Reuters (5/14, Peyton) reports new data from South Africa’s National Health Laboratory Service (NHLS) indicate that “testing and monitoring of HIV patients across South Africa have fallen since the United States cut aid that funded health workers and clinics, with pregnant women, infants and youth the most affected.” Prior to the Trump Administration slashing aid earlier this year, the US “was funding 17% of the country’s HIV budget.” NHLS data showed “that viral load testing fell by up to 21% among key groups in the last two months, which four HIV experts said appeared to be due to the loss of U.S. funding.” Furthermore, “the number of viral load tests conducted for people aged 15-24 fell by 17.2% in April compared to April last year, after dropping 7.8% year-on-year in March. Total population testing was down 11.4% in April.” HIV experts added “that diagnostic testing was likely impacted by the funding cuts too, though that data was not available.”

Infectious Disease Advisor (5/14, Kuhns) reports that researchers have found that “the Jarisch-Herxheimer reaction (JHR) is a common but transient immune response following benzathine penicillin G treatment for early syphilis, particularly among individuals with secondary syphilis.” The investigators came to this conclusion after conducting “a prespecified secondary analysis of a randomized phase 4 clinical trial...to prospectively assess the incidence of JHR symptoms in adults with early syphilis following standard antibiotic therapy with benzathine penicillin G.” The findings were published in JAMA Network Open.

Reuters Legal (5/14, Brittain) reports Alnylam Pharmaceuticals on Tuesday “conceded defeat for now in a lawsuit against Pfizer and BioNTech over technology in their COVID-19 vaccine, asking a Delaware federal court on Tuesday to enter a judgment that they did not infringe Alnylam’s patents.” The move comes after US District Judge Colm Connolly “interpreted the company’s patents in a way that would not cover Pfizer and BioNTech’s vaccine. The company dropped a separate lawsuit over Moderna’s COVID-19 shots following a similar ruling favoring Moderna last year.” An Alnylam spokesperson “said the company was evaluating its options and may appeal.”

Endocrinology Advisor (5/13, Goldberg) reports a study found that “islet autoantibodies (auto-Ab) positivity is associated with faster diabetes development and β-cell dysfunction among children with acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP).” Researchers noted a “significant difference in the proportion of patients who had their first acute pancreatitis attack prior to islet testing between Ab-positive and Ab-negative groups (88% vs 98%; P =.02), although the severity of the first acute pancreatitis attack was similar between groups (mild, 56% vs 62%; moderate, 11% vs 17%; severe, 33% vs 21%).” Researchers concluded, “In children with ARP/CP, [Ab-positivity] was associated with higher risk of diabetes/diabetes development, and shorter time to diabetes development, suggesting that islet [Ab-positivity] is associated with β-cell dysfunction in this patient cohort.” The study was published in Diabetes Care.

MedPage Today (5/13, Robertson) reports the US Preventive Services Task Force (USPSTF) has “renewed its recommendation for early and universal screening for syphilis during pregnancy.” The recommendation, published in JAMA, is in line with its 2018 guidance and “endorsed early and universal screening for syphilis infection during pregnancy and screening at the first available opportunity if an individual is not screened in early pregnancy.” The task force wrote, “Using a reaffirmation process, the USPSTF concludes with high certainty that screening for syphilis infection in pregnancy has a substantial net benefit.”

Rheumatology Advisor (5/13, Kuhns) reports a study found that “red blood cell distribution width-coefficient of variation (RDW-CV) is an independent predictor of coronary artery disease (CAD) among children with Kawasaki disease, and its elevation is associated with lower hemoglobin and ferritin levels.” In multivariate analyses, researchers said that “RDW-CV remained a significant independent predictor of CAD.” The study authors concluded, “The observed association between RDW-CV and markers of iron metabolism, particularly in the CAD group, indicates that iron dysregulation may be a contributing factor in the pathophysiology of CAD.” The study was published in Pediatric Rheumatology.

Reuters (5/12, Rigby) reports Novartis will continue to manufacture “medicines for malaria and leprosy, even if it does not get orders as normal amid the global health funding crunch, its president of global health told Reuters in an interview.” Dr. Lutz Hegemann said, “We are not going to produce based on demand, because we know that these medicines are needed, and we need to be creative in finding ways to get them from the factory to patients.” The company “makes 28 million malaria treatment courses every year, and sells almost all of them a not-for-profit price to countries and groups,” including the US-government-funded President’s Malaria Initiative. The comments come as US initiatives funding global health scale back spending.

Infectious Disease Advisor (5/12, Nye) reports a study found that “metformin use does not significantly affect immune reconstitution among patients with HIV infection and comorbid type 2 diabetes.” Researchers observed that “in the 1.5 to 3.5 years after metformin initiation, 60% and 81% of patients with comorbid type 2 diabetes experienced increased CD4+ T-cell counts and increased CD4/CD8 ratio, respectively. The overall rate of patients in the control cohort who exhibited increased levels of these measurements over the same period was higher for CD4+ count (67%) but lower for CD4/CD8 ratio (77%).” In addition, further analysis “showed no significant trends among individuals with low CD4+ count and CD4/CD8 ratio at baseline.” Researchers concluded, “This study represents the longest follow-up on CD4 T cell count and CD4/CD8 ratio in PLWH [people living with HIV] treated with metformin.” The study was published in Open Forum Infectious Diseases.

Dermatology Advisor (5/12, Goldberg) reports a study found that “the risk for COVID-19 infection is increased among patients with atopic dermatitis (AD) across sex and age groups.” In addition, researchers observed younger patients “had a significantly greater chance of COVID-19 infection than older age groups.” Furthermore, patients with atopic dermatitis “who also had hypertension, diabetes mellitus, overweight, obesity, and ischemic heart disease were at a significantly higher risk for COVID-19 infection than patients with atopic dermatitis without these comorbidities.” They also found that “patients with AD who were treated with dupilumab had lower odds of COVID-19 infection than those treated with methylprednisolone, prednisone, or prednisolone,” but those “treated with dupilumab did not have significantly different odds compared with those treated with azathioprine.” The study was published in The Journal of Dermatology.