Incorporating telaprevir into treatment of acute genotype 1 HCV in HIV-infected men halved the treatment duration and increased the SVR rate. Larger studies should be done to confirm these findings. Clinicians should be alert to detect acute HCV infection of HIV-infected men to take advantage of this effective therapy and decrease further transmission in this epidemic.

Aim To argue that nurse practitioners have been under‐utilized generally in the current global health environment, creating barriers to achieving universal health coverage and the Sustainable Development Goals. Background Nurse practitioners are advanced practice nurses possessing expert knowledge and leadership skills that can be optimized to narrow disparities and ensure access to high‐quality health care globally. Nurses worldwide have been challenged to meet global public health needs in the context of COVID‐19 (SARS‐CoV‐2 virus), and there are early indications that nurse practitioners are being called upon to the full extent of their capabilities in the current pandemic. Sources of evidence PubMed; Google Scholar; the International Council of Nurses; World Health Organization; United Nations; and the experiences of the authors. Discussion Several international reports, nursing and health organizations have called for continued investment in and development of nursing to improve mechanisms that promote cost‐effective and universally accessible care. Expanding nurse practitioner scopes of practice across nations will leverage their clinical capacities, policy and advocacy skills, and talents to lead at all levels. Conclusion Ongoing empirical data and policy change is needed to enable the full scope and strategic utilization of nurse practitioners across healthcare systems and contexts. Implications for nursing practice, and nursing and health policy Widespread education regarding nurse practitioner capacities for interdisciplinary partners, policymakers and the public is needed. Policies that safely expand their roles are critical. Role titles and remuneration reflective of their scope and service are required to lead, sustain and grow the workforce internationally.

Context With better antiretroviral treatments (ART), persons living with HIV (PLWH) are living longer, healthier lives. Therefore, they also experience more medical comorbidities that come with normal aging, as well as side effects of multiple treatments and long-term sequelae of HIV. It can be hard to know whether symptoms reported by PLWH are related to comorbidities or are signs of HIV disease progression and possible treatment failure. Objectives The current study was designed to disentangle these issues by examining within-person symptom changes in data collected from a cohort of PLWH before the advent of highly efficacious ART. Methods This study was a secondary analysis of symptom reports in longitudinal data collected from 246 PLWH in 1992–1994. Multilevel modeling was used to test for changes over time in HIV-related symptom clusters. Analyses also tested the effects of person-level demographic covariates and co-occurring mental health symptoms on HIV symptoms, and examined the magnitude of within-person versus between-person variations in reported symptom severity. Results Two of six HIV-related symptom clusters, malaise/fatigue and nausea/vomiting, increased over time in the context of HIV disease progression, while the other four did not. Changes were independent of baseline disease severity or psychological covariates. There was substantial within-person variability in absolute symptom severity. Conclusion Relatively small but consistent changes in symptoms related to nausea or fatigue may suggest HIV disease progression, while changes in other HIV symptom clusters may instead be related to comorbidities or normal aging. Further research is recommended on symptom progression in PLWH.

BackgroundTreatment of HIV-infected men during early hepatitis C virus (HCV) infection with interferon results in a higher cure rate with a shorter duration of treatment than during chronic HCV infection. We recently demonstrated that this phenomenon applied to interferon-free treatment as well, curing most participants with short-course sofosbuvir and ribavirin. Due to the significantly higher potency of the ledipasvir/sofosbuvir (LDV/SOF) combination, we hypothesized that we would be more successful in curing early HCV infections using a shorter course of LDV/SOF than that used for treating chronic HCV infections.MethodsWe performed a prospective, open-label, consecutive case series study of 8 weeks of LDV/SOF in HIV-infected men with early genotype 1 HCV infection. The primary end point was aviremia at least 12 weeks after completion of treatment.ResultsWe treated 25 HIV-infected men with early sexually acquired HCV infection with 8 weeks of LDV/SOF, and all 25 (100%) were cured. Twelve (48%) reported sexualized drug use with methamphetamine.ConclusionsEight weeks of LDV/SOF cured all 25 HIV-infected men with early HCV infection, including those who were actively using drugs. Based on these results, we recommend treatment of newly HCV-infected men during early infection, regardless of drug use, to both take advantage of this 8-week treatment and to decrease further HCV transmission among this group of men.

Evidence suggests that persons living with HIV (PLWH) are at increased risk for anal cancer. Early detection of anal cancer is an important prevention measure, but screening rates have been low. This report describes the experience of a quality improvement initiative to increase anal cancer screening at an HIV-specialty clinic. Chart reviews were conducted for three time periods: baseline year, prior to program discussion; transition year, during planning; and implementation year, during program availability. Odds ratios using Fisher's exact test showed that the odds of receiving anal cancer screening increased significantly in the transition year, odds ratio (OR) = 2.859, 95% confidence interval (CI): [1.798; 4.546], Fisher's z = 4.40, p < 0.0001, and in the implementation year, OR = 7.446, 95% CI: [4.783; 11.588], Fisher's z > 8.2, p < 0.0001. Patients and clinicians reported high levels of satisfaction with the program. Referring clinicians were also more likely to discuss anal cancer screening.