Top 5 Infectious Disease News of the Week—March 25, 2018

#5: Daily TB Therapy Superior to Thrice-Weekly in Patients with HIV

A recent study has shown that daily antituberculosis therapy (ATT) is more effective than a thrice-weekly regimen among HIV-positive patients with pulmonary tuberculosis (TB) who are receiving antiretroviral therapy. Daily treatment is also associated with a lower incidence of acquired rifampicin resistance (ARR).

Narendran Gopalan, DNB, DTCD, from the National Institute for Research in Tuberculosis in Chennai, India, and colleagues published the results of their randomized clinical trial online March 5, 2018 in JAMA Internal Medicine.

Among individuals who are HIV-positive—including those receiving antiretroviral treatment—tuberculosis is the most common presenting illness and the most common cause of death.

Read more about the study on antituberculosis therapy.

#4: Long-Term Antibiotic Use Linked to Higher Risk of Death from Heart Disease in Women

Preliminary research presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2018, has found that women who take antibiotics for long periods of time—especially later in life—appear to be at increased risk of death from heart disease.

It has been known for some time that antibiotic use can affect not only the target pathogen but also commensal microorganisms living in the human gut. The extent of the impact that antibiotics have depends on several factors, including the antibiotic being used, its mode of action, as well as the degree of resistance in the community.

Read more about antibiotic use and risk of heart disease.

#3: FDA Says Cell-Based Flu Vaccine May Be 20% More Effective Than Egg-Based Vaccine

The number of states reporting widespread flu activity continues to drop, according to the Centers for Disease Control and Prevention (CDC). According to the new FluView report for week 11 ending March 17, 2018, 17 states reported widespread flu activity, down from the previous week’s total of 26 states plus Puerto Rico. The proportion of outpatient visits for influenza-like illness also declined, going from 3.3% in week 10 to 2.7% in week 11, although the percentage remains above the national baseline of 2.2%. Health officials have also reported 5 new influenza-associated pediatric deaths, bringing the total number of pediatric flu deaths in the United States to 133 for the 2017-2018 flu season.

With the late season surge of influenza B virus, the CDC has reported that B viruses made up more than 57% of flu-positive respiratory specimens collected by public health and clinical laboratories. During week 1, influenza A viruses accounted for more than 83% of flu-positive respiratory specimens. A rise in influenza B is common late in a flu season and the CDC is warning that it’s causing a second wave of flu this season, which may lead to some individuals falling ill with the flu for a second time in one season.

Read the rest of this week’s flu update.

#2: Herpes Zoster Vaccine Subunit Prevents Herpes Zoster Episodes Following HSCT

A herpes zoster (HZ) subunit vaccine (Shingrix) effectively prevented episodes of HZ and other related complications among patients who had recently undergone autologous hematopoietic stem cell transplant (HSCT), according to the results of a phase 3 ZOE-HSCT trial presented at the 2018 BMT Tandem Meetings.

The vaccine reduced the risk of HZ by 68.2% (95% CI, 55.6%-77.5%; P <.0001) in high-risk recipients of HSCT. Improvements were also noted in cases of postherpetic neuralgia, HZ-related hospitalizations, and other complications, noted lead author Javier de la Serna, MD, PhD, of the Hospital Universitario 12 de Octubre in Madrid, Spain.

Read more about Shingrix and HSCT.

#1: Symfi Triple Combo Once-Daily HIV Treatment Receives FDA Approval

Another HIV drug combination developed by Mylan Pharmaceuticals has been approved by the US Food and Drug Administration (FDA).

The antiretroviral in question?

Symfi, a once-daily single-tablet regimen, which is comprised of efavirenz, lamivudine, and tenofovir disoproxil fumarate, in the form of 600 mg/300 mg/300 mg tablets. Symfi has been indicated as a complete treatment regimen for the treatment of HIV-1 infection in both adult and pediatric patients who weigh at least 40 kg, according to the announcement.

This comes on the heels of 2 other recently approved antiretrovirals (ARVs) developed by Mylan: Cimduo and Symfi Lo. Cimduo, comprised of lamivudine and tenofovir disoproxil fumarate, is a combination of nucleo(t)side reverse transcriptase inhibitors to be taken once-daily in the form of 300 mg/300 mg tablets; the drug is indicated to be used in combination with other ARV agents to treat adults and pediatric patients who have HIV-1 and weigh at least 35 kg. Symfi Lo tablets are another combination product comprised of efavirenz 400 mg, lamivudine 300 mg, and tenofovir disoproxil fumarate 300 mg. The recommended dose is 1 tablet, taken once-daily, on an empty stomach right before bed.

Mylan launched Symfi Lo in early March and expects to launch Cimduo and Symfi in the second quarter of 2018.

“Mylan has been on the forefront of bringing innovative delivery and dosage forms of ARVs to millions of patients in the developing world,” Rajiv Malek, president of Mylan, stressed in a recent statement. “We’ve already extended our reach to people in the United States living with HIV with the introduction of Symfi Lo and Cimduo. Adding Symfi to our portfolio further strengthens our commitment to investing in developing and manufacturing these important products.”

Read more about the recent FDA approval of Symfi.