CDC National Prevention Information Network (NPIN) sent this bulletin at 03/24/2014 04:00 PM EDT

HIV/Hepatitis/STD/TB News - CDC Prevention News Update

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CDCNPIN Prevention Newsletter 3/24/2014
National News

Patients, Advocates Hope to Ease a Visible Burden

International News

Russian Annexation of Crimea Threatens Drug Therapy for People Suffering from Addictions, Illnesses

Medical News

HPV-Positive Throat Cancer Could Be Signaled by Persistent Sore Throat and Increased Neck Mass

Local and Community News

Fighting Sexually Transmitted ‘Superbugs’ in Onslow County

News Briefs

Health Group Wants to Give Clean Syringes to Drug Users

Monday, March 24, is World Tuberculosis (TB) Day

National News

National News Patients, Advocates Hope to Ease a Visible BurdenMASSACHUSETTS :: HIV/AIDS
Boston Globe (03.24.2014) :: By Jeremy C. Fox
The Boston Globe reported that a bill introduced in the Massachusetts Legislature would require insurance companies in the state to pay for liposuction for HIV patients who have been disfigured from the effects of early HIV treatment. Liposuction is the only treatment for lipodystrophy, a side effect from toxicity to HIV treatments in the 1990s that caused large amounts of fat cells to gather around the neck and upper back. Many patients who suffer from “horse collar” or “buffalo hump” rarely leave their houses to avoid stares and whispers.

Rep. Carl M. Sciortino Jr. (D-Medford) and 21 other legislators sponsored the bill. Insurance companies traditionally have not paid for the treatment, saying that liposuction would be approved only if medically necessary. Infectious disease doctors argue that liposuction is medically necessary to treat lipodystrophy. The disease is not only cosmetic, as sufferers also have debilitating pain associated with posture and herniated disc issues.

Several lipodystrophy sufferers, as well as health experts, appeared before the legislature earlier this month to describe the stigma they have suffered that was brought on by drugs meant to prolong their lives. Rep. Michael A. Costello (D-Newburyport) said he was swayed by the testimonies. “It begs the question, why does insurance see this as cosmetic and not as medically necessary? I’m inclined to move it quickly,” he said. Sen. Anthony W. Petruccelli (D-East Boston) agreed the testimony was moving but lawmakers also must weigh costs health premiums would incur from a mandated procedure.

HIV activists argue that this type of bill is long overdue for patients who have been suffering with this disfigurement for decades. “It is completely unacceptable that in 2014 there are people with HIV who do not leave their homes and live as recluses, who are suicidally (sic) depressed,” said Bennett Klein, director of GLAD’s AIDS Law Project.

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International News

International News Russian Annexation of Crimea Threatens Drug Therapy for People Suffering from Addictions, IllnessesRUSSIA :: HIV/AIDS,TB,Viral Hepatitis
KyivPost (03.24.2014) :: By Lily Hyde
The Kyiv Post reported that Russia’s annexation of Crimea soon would halt an opioid substitution therapy (OST) program that supplied buprenorphine and methadone to 800 drug-addicted patients in Crimea. Participating in OST programs allowed long-term addicts to avoid illegal drugs, sustain a more normal life, and get medical treatment for related medical conditions like HIV and hepatitis.

Countries across the world use OST as part of a broader HIV prevention strategy. Ukraine had enrolled approximately 8,500 clients in OST programs since 2006, after a sharp increase in injection of homemade opium led to higher HIV incidence in the nation. Ukraine officials reported that OST and other harm reduction strategies had reduced new HIV infections from 7,127 cases in 2006 to 5,847 in 2013.

An armed escort delivered the substitution therapy drugs from Kharkiv to program sites in Ukraine. Since Russian soldiers and local self-defense and Cossack groups set up roadblocks on roads into Crimea on February 27, no new supplies have arrived on the peninsula. OST clients in Crimea expect substitution drugs to run out in approximately 10 days, since local pharmacies could not stockpile supplies. Roadblocks also affected the supply of medications essential for HIV and TB treatment.

Although the International HIV/AIDS Alliance, which managed OST programs in Ukraine, is trying to restart OST supplies to Crimea, Russian Federation law bans the use of opioid substitutes. Since Crimea voted to rejoin the Russian Federation, doctors and patients involved with OST could face prosecution. Vladimir Stroyevsky, head doctor of the Crimean Narcological Clinic, stated that the clinic already had reduced dosages for OST clients and would provide alternative programs such as rehabilitation or cognitive behavioral therapy. Thus far, Crimean clients were reluctant to move to mainland Ukraine to seek OST, because their families would have to find new means of support.

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Medical News

Medical News HPV-Positive Throat Cancer Could Be Signaled by Persistent Sore Throat and Increased Neck MassSOUTH CAROLINA :: STDs
Medical Daily (03.21.2014) :: By Chris Weller
Medical Daily reported on a study of the common symptoms of oropharyngeal (throat) cancer caused by the STD, human papillomavirus (HPV). The rate of oropharyngeal cancer is rising and according to Dr. Terry Day, director of the Head and Neck Cancer Program at Medical University of South Carolina, the cancer is occurring in young people. Whereas alcohol and smoking once were the main causes of throat cancer, CDC states that HPV now causes approximately 63 percent of oropharyngeal cancers, and that HPV-positive cancers are diagnosed in an estimated 2,370 women and 9,356 men each year, with white men the most likely to be diagnosed with HPV-positive cancer.

Since there is no blood test or Pap test to screen for this cancer, the researchers reviewed records of 88 patients newly diagnosed with HPV-positive oropharyngeal cancer to determine whether HPV-linked cancers have specific symptoms. Findings indicated that the most common symptoms were a lump in the neck (44 percent) and chronic sore throat (29 percent). The HPV-positive patients noticed the neck mass compared to the HPV-negative patients who mostly noticed the sore throat. Other symptoms include pain, difficulty swallowing, and difficulty opening the mouth, but these are also signs of HPV-negative cancer.

Day commented that clinicians need to inform patients about the possibility of throat cancer when they have a sore throat for more than two weeks, trouble swallowing, or a lump in the neck; the clinicians should refer these patients to a specialist for examination and biopsy. Day noted that this type of cancer has a good cure rate even when it has spread to the lymph nodes.

The full report, “Initial Symptoms in Patients With HPV-Positive and HPV-Negative Oropharyngeal Cancer,” was published online in the journal JAMA Otolaryngology—Head & Neck Surgery (2014; doi:10.1001/jamaoto.2014.141).

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Local and Community News

Local and Community News Fighting Sexually Transmitted ‘Superbugs’ in Onslow CountyNORTH CAROLINA :: STDs
JDNews.com (Jacksonville, NC) (03.23.2014) :: By Onslow County Health Department
JDNews.com reported that Onslow County ranked 10th among North Carolina counties in gonorrhea cases in 2013, according to the North Carolina Department of Health and Human Services. The county recorded 301 gonorrhea diagnoses last year and already has diagnosed and treated 167 cases in 2014. One reason Onslow County ranked high in gonorrhea cases was that the median age of Onslow residents was 26; the average age of people diagnosed with gonorrhea was between 20 and 25.

Public Health Nurse Cindy Bandy noted that in her 12 years as an Onslow County public health nurse, CDC had revised the recommended treatment regimen five times as gonorrhea strains developed resistance to antibiotics. Such “superbug” bacteria became immune to antibiotic treatment, often because people failed to take medications as prescribed or stopped taking antibiotics before medications had fully killed the bacteria. As a result, “stronger, more resilient bacteria” survived and mutated into superbugs.

Public Health Nurse Mary Christian recommended that patients take medications as prescribed and complete the regimen. If symptoms did not improve, Christian urged patients to contact their healthcare providers to obtain a different treatment. Onslow County provided confidential counseling and treatment for sexually transmitted infections (STIs) and could supply healthcare professionals to present STI information sessions. Call (910) 347–2154 to speak to an Onslow County Health Department STI nurse or to get information about STI services.

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News Briefs

News Briefs Health Group Wants to Give Clean Syringes to Drug UsersNEW YORK :: HIV/AIDS,Viral Hepatitis
WWNY-TV (Watertown, N.Y.) (03.22.2014)
WWNY-TV reported that local health organization Access Care and Resources (ACR) Health is in negotiations with the state to bring a syringe exchange program to Watertown, N.Y. The organization has had a program in Syracuse for two years and is hoping to bring the program to the northern area of the state. Users of injectable drugs such as heroin would bring in their used syringes and receive new ones, no questions asked. The goal of the program is to prevent the spread of infectious diseases such as HIV and hepatitis C. According to ACR Health Executive Director Michael Crinnin, the program helps addicts seek treatment for their addiction in some cases since program staff builds relationships with them.
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Monday, March 24, is World Tuberculosis (TB) DayWASHINGTON :: TB
Mercer Island Reporter (Wash.) (03.23.2014)
According to the Mercer Island Reporter, Washington’s King County Department of Public Health reported diagnosing and treating 114 county residents for active TB during 2013, averaging more than two cases per week for the year. According to the department, it reported another 100,000 with the latent form of the disease. The newly released 2013 data for King County reflect a slight increase in TB, but overall the disease rates are near an all-time low and demonstrate an extended trend of controlling the disease. In King County, however, 18 percent of individuals treated in 2013 were resistant to one of the TB drugs, according to the agency. In observance of World TB Day on March 24, and to better understand King County’s role in the global TB epidemic, the Washington Global Health Alliance and the TB Action Coalition will organize a presentation at Town Hall Seattle from 5:30 to 8:00 p.m. at 1119 8th Avenue in Seattle. In addition, the PBS program Frontline and Seattle’s KCTS-9 will broadcast the special report “TB, the Silent Killer” at 10:00 p.m. on March 25 and rebroadcast it at 3:00 a.m. on March 28.
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The CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention provides the above information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, viral hepatitis, other sexually transmitted diseases, and tuberculosis does not constitute CDC endorsement. The above summaries were prepared without conducting any additional research or investigation into the facts and statements made in the articles being summarized, and therefore readers are expressly cautioned against relying on the validity or invalidity of any statements made in these summaries. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/Hepatitis/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted above for full texts of the articles.

The Prevention News Update electronic mailing list is maintained by the National Prevention Information Network (NPIN), part of the Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Regular postings include the Prevention News Update, select articles from the Morbidity and Mortality Weekly Report series, and announcements about new NPIN products and services.

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