Breaking News

Why trans women have higher HIV rates, what osteoarthritis and Alzheimer's have in common, & and a dangerous cancer drug for kids

January 25, 2024
Reporter, Morning Rounds Writer
Good morning. We have the CDC's first report on the health of trans women, a surprising connection between Alzheimer's and osteoarthritis, and an update on a problematic cancer drug for children.

public health

CDC report explores why trans women have higher rates of HIV

Transgender women have a disproportionately high rates of HIV. While those data are solid, the "why" hasn't been systematically studied. For the first time, the CDC has collected behavioral data relevant to HIV prevention and risk. Its analysis suggests the social and economic marginalization — including violence, homelessness, and incarceration — that trans women experience could explain higher risk for HIV. The survey of more than 1,600 transgender women conducted at sites (where they were offered HIV testing) in seven U.S. cities in 2019 and 2020 found:

  • 42% tested positive for HIV: 62% of Black trans women, 35% of Hispanic and Latina trans women, and 17% of white trans women.
  • About 10% had been fired for being transgender and 32% had trouble getting a job for that reason, limiting health insurance options.
  • 60% experienced gender-based violence: verbal abuse (53%), physical abuse (26%), or sexual violence (15%) over the last year; almost 18% experienced suicidal ideation. 

STAT's Theresa Gaffney and Annalisa Merelli have more.


chronic disease

Osteoarthritis and Alzheimer's share a protein

If larger studies confirm this small study's provocative findings, it would connect two diseases without cures that afflict many of us as we age: Alzheimer's and osteoarthritis. Scientists say in a new Science Translational Medicine study that a protein implicated in Alzheimer's disease might also spur the breakdown of cartilage in joints — a hallmark of osteoarthritis. An analysis of tissue samples and joint fluid from 12 people with and without osteoarthritis revealed that those with osteoarthritis in the knee had four times as much APOE as the healthy controls. 

In the brain, APOE shuttles lipids between cells. One form, APOE4, is tied to a threefold greater risk of Alzheimer's. How it might erode the cartilage that cushions knee joints is unknown, but the researchers said APOE is secreted into joint fluid by the sickened parts of the knee. It's also unclear if there's any connection between APOE in the brain and the arthritic knee. STAT's Isabella Cueto has more.


cancer

FDA recommends monitoring CAR-T patients for new cancers

The FDA sent letters to drug manufacturers requiring that they include T cell malignancy risk on the warning label for all approved CAR-T products, STAT's Angus Chen tells us. In a perspective published yesterday in the New England Journal of Medicine, Nicole Verdun and Peter Marks from the FDA's Center for Biologics Evaluation and Research noted that more than 27,000 CAR-T doses have been administered in the U.S., and that as of Dec. 31, 2023, the FDA is aware of 22 cases of T-cell cancers that occurred following CAR-T administration. That suggested "the overall rate of T-cell cancers among people receiving CAR-T therapies appears to be quite low, even if all reported cases are assumed to be related to treatment," Verdun and Marks wrote.

Still, in three of these cases, genetic sequencing discovered the CAR gene in malignant cells. That also suggested the CAR-T product may have had a role in the cancer's development, Verdun and Marks wrote. The authors recommend that clinicians monitor CAR-T patients, including patients who received the therapy during a clinical trial, for new cancers for the rest of the patients' lives. Verdun and Marks encouraged clinicians to report any new malignancies in these patients to the FDA.



closer look

A year later, kids are still at risk from bad cancer drugs

flipEG_BIJ_Cancer_Drugs_3_WHO_logo

 Evangeline Gallagher/TBIJ 

Last January, the Bureau of Investigative Journalism, in partnership with STAT, revealed that at least a dozen brands of asparaginase, a key childhood chemotherapy drug, had failed quality tests, putting an estimated 70,000 children in more than 90 countries at risk. Update: A year later, almost nothing has changed. The WHO has issued no alert about the problematic cancer drug and national drug regulators around the world have not taken meaningful action, with both sides claiming communication breakdowns and a lack of evidence. 

Researchers in the U.S. and Africa have begun developing cheap, simple tests allowing doctors to check the quality of asparaginase. "This issue is something that needs to be addressed urgently," said Gregory Reaman, a scientific director at the U.S. National Cancer Institute. "These are children who are already sick, and have the potential for being cured. And yet they are given substandard drugs." Read more.


in the lab

Chronic Covid study shows how risk varies

New research in Science Translational Medicine on how long it can take immunocompromised people to clear the SARS-Cov-2 virus reminded me how cancer patients felt left behind in 2021 by others who were protected by what were new vaccines back then. Now that so many more people have put the pandemic in the rear-view mirror, those patients' stories are also receding. I talked with two co-authors of the paper to ask what they learned.

What does your new study say about the spectrum of risk?

Jacob Lemieux: Patients with mild or moderate immunocompromise do seem to clear the virus quite well. In some severely immunocompromised patients, something very different is going on. Some patients harbor these persistent infections — basically the breeding grounds for future viral variants. So there's both a medical concern for patients and a public health concern.

What's life like now for immunocompromised people?

Jonathan Li: They tell me that they're still very careful. These are the patients who feel like all their friends or family have moved on. They're not as protected by the vaccines. They have a hard time moving on.

Read the full interview.


health

About 1 in 8 Americans have hearing loss, depending where they live and work

Hearing loss at any age can hurt your health. Children might miss developmental milestones, adults might struggle at work, and elders might suffer from social isolation. A new CDC-funded report in Lancet Regional Health — Americas tells us 38 million people in the U.S. have lost hearing in both ears, increasing with age but also differing by where people live and work. Bilateral hearing loss rates are higher among men, Hispanic people, and rural residents. After mining, working in retail or restaurants are the two occupations tied most closely to hearing loss.

West Virginia, Alaska, Wyoming, Oklahoma, and Arizona had the highest rates of hearing loss; the District of Columbia, New Jersey, New York, Maryland, and Connecticut had the lowest. Noise in big cities appeared to be less harmful than rural life spent working outdoors with heavy machinery, riding ATVs, or hunting with firearms, the researchers suggest. Prevention works best, as in avoiding noise or wearing protection, and hearing aids can help if people can overcome barriers to get them, both in cost and stigma.


More around STAT
Check out more exclusive coverage with a STAT+ subscription
Read premium in-depth biotech, pharma, policy, and life science coverage and analysis with all of our STAT+ articles.

What we're reading

  • A PBM in Africa flips the industry's script in a bid to make people healthier, STAT
  • Raped, pregnant, and in an abortion ban state? Researchers gauge how often it happens, NPR

  • As biotech VCs struggle to raise money, some debate whether the worst is over, STAT
  • Unethical studies on Chinese minority groups are being retracted — but not fast enough, critics say, Nature

  • When it comes to policing pharma, the FTC says it's on 'an incredible winning streak,' STAT

Thanks for reading! More tomorrow,


Enjoying Morning Rounds? Tell us about your experience
Continue reading the latest health & science news with the STAT app
Download on the App Store or get it on Google Play
STAT
STAT, 1 Exchange Place, Boston, MA
©2024, All Rights Reserved.

No comments