HIV patients now face risk of cancers other than non-Hodgkin lymphoma

Rates of AIDS-defining cancers such as Kaposi sarcoma and non-Hodgkin lymphoma have significantly dropped over time in people living with HIV.

However an analysis of cancer rates in more than 33,000 people notified to the Australian National HIV Registry between 1982 and 2012 has shown infection-related, non-AIDS defining cancers have increased.

There was an elevated risk of most infection-related cancers compared with the general population, including increases in anal and liver cancer.

The study authors said delays in antiretroviral therapy (ART) initiation may have resulted in people developing moderate levels of immunosuppression, facilitating the early stages of anal carcinogenesis.

“Recent changes to guidelines recommending that ART should be commenced soon after HIV diagnosis may result in eventual declines in anal cancer incidence, although longer follow-up is require to observe this trend.”

“Optimising hepatitis B vaccination and screening and treatment of hepatitis B and hepatitis C infections in people living with HIV may decrease the risk of liver cancer,” they suggested.

Read more in HIV Medicine

National action plan launched for CVD and stroke

A national action plan to tackle cardiovascular disease and stroke has been released by the National Heart Foundation of Australia and Stroke Foundation.

The National Strategic Action Plan for Heart Disease and Stroke sets out four priority areas: Prevention and Early Detection, Diagnosis and Treatment, Support and Care, and Research, with targets for improvement within five years

The Plan is intended to be a roadmap to implement interventions that will tackle two of the major causes of preventable death in Australia, according to its developers.

The plan includes 11 major objectives, each with several action points, such as updating the Absolute Cardiovascular Risk Assessment Guidelines, and encouraging awareness of health checks for atrial fibrillation in the prevention and early detection priority area.

Objectives in the diagnosis and treatment priority area include improving equity in cardiac treatment and care through national standards, improving the delivery of emergency stroke treatment to rural, and remote Australians through telehealth, establishing standardised national, pre-hospital, time-critical responses to heart attack and stroke and implementing a national endovascular thrombectomy and thrombolysis plan. The roadmap also calls for improved access to specialised stroke units  and TIA clinics.

RACP calls for urgent action on COVID-19 vaccination for people with disability

The Royal Australasian College of Physicians (RACP) has serious concerns that people living with disability have not been prioritised for COVID-19 vaccinations, as states prepare to ease restriction in a matter of days.

The RACP has repeatedly raised concerns about the slow rollout of the COVID-19 vaccines to people with disability and the need to urgently prioritise this group. Disability care residents and staff were in the highest priority group for vaccination yet only 67% of residents and 59% disability screened workers are vaccinated.

People with disability are at increased risk of adverse outcomes if they are infected by COVID-19. A study in the UK reported that 58% of COVID-19 deaths were among people who had a disability, whilst another UK study found people with intellectual disability were eight times more likely to die of COVID-19 than the general population.

Dr Jacqueline Small, RACP President-elect and developmental paediatrician said: “The DRC report that people living with disability were deprioritised in the vaccine rollout is deeply concerning. We have had months to get this right. Now we are days away from states easing restrictions with less than half of NDIS participants aged 16 years and over fully vaccinated – that is really troubling.

“A coordinated connected response with inclusion of people with disability, local health districts, primary health networks and non-government organisations is needed urgently.”

A report released by the national organisation Children and Young People with Disability Australia has shown that over 70% of respondents experienced difficulties in securing vaccinations.

The RACP said the federal government must publish data on the COVID-19 vaccine rollout for people with disability to enable a quick response at a local level where gaps in accessibility are identified. This must include regular, up-to-date disaggregated data on the vaccination numbers for all people with disability, as at present only NDIS participant data is available publicly. It must also include the rates of COVID-19 infection and death amongst all people with disability.