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Brainstorm Health: HIV Organ Transplants, Artificial Iris Approval, New Jersey Individual Mandate

Good afternoon and happy Friday, readers—This is Sy.

Getting an organ transplant is not, to put it lightly, a convenient or pleasant process. Beyond the obvious (and dangerous) hassle of having invasive surgery to correct for a devastating illness or injury, organs are simply hard to come by. People on the kidney transplant waiting list—which consists of 101,000 out of the 123,000 Americans waiting for an organ in any given year, according to the National Kidney Foundation—have less than a 17% chance of actually getting a transplant they desperately need. About 12 people in the U.S. die every day waiting for a kidney.

The situation is even more difficult for Americans with HIV, who face regulatory hurdles to receiving organ transplants. But a group of researchers hopes to help these patients with a new study aiming to prove the safety and effectiveness of transplants between HIV-positive people.

The National Institutes of Health (NIH) funded project follows the passage of the HOPE Act, which was signed into law by former President Barack Obama in 2013. That legislation rolled back decades-long restrictions on HIV-positive people’s ability to donate organs; under the law, HIV-positive transplants are allowed for kidneys and livers if they’re done as part of a clinical study—like the new one being launched by NIH, which will track 160 kidney transplants, half of which will be done with HIV-positive organs. The hope is the results of this clinical research will end the regulatory stigma around these kinds of transplants once and for all.

Public health experts say it’s long past time that the U.S. reverse what amounts to a legal ban on HIV-positive organ donation. As Dr. Christine Durand, a John Hopkins professor leading the study, points out to NPR, 1.5% of U.S. patients receiving dialysis for advanced kidney disease carry the HIV virus, making the prospect of a new source of viable organs a key public health goal.

“Highly effective antiretroviral therapy and new antiviral drugs to treat hepatitis C have dramatically improved the health of people living with HIV, such that a young person newly diagnosed with HIV today can expect to live a nearly normal lifespan,” said National Institute of Allergy and Infectious Diseases (NIAID) director Dr. Anthony Fauci in a statement. “The HOPE Act of 2013 opened the door for researchers to explore a potential new source of donor organs for those living with HIV—a population with a significant and growing need for transplants. This study offers a chance to improve the health of those living with HIV, and increase the overall supply of transplantable organs.”

Read on for the day’s news, and have a wonderful weekend.

Sy Mukherjee


FDA approves first-ever artificial iris. The Food and Drug Administration (FDA) on Thursday announced the approval of the CustomFlex Artificial Iris—the first-ever prosthetic iris to be cleared in the U.S. for patients with certain kinds of eye damage. The device is made of thin, medical-grade silicon. (CBS News)

Liquid biopsy hyped at ASCO (again). Another year, another avalanche of hopeful talk about the ever-elusive “liquid biopsy.” This technology, being chased by upstarts like Guardant Health and GRAIL, promises to one day replace invasive and expensive tissue biopsies with simple blood tests that can help sniff out cancers by examining tumor fragments in the blood. Some physicians at the annual American Society of Clinical Oncology (ASCO) meeting that launched today (aka the biggest cancer conference in the world) are dubbing one such blood test for 10 cancer types as “potentially the holy grail of cancer research.” The study was presented at ASCO by Cleveland Clinic and Stanford researchers. (Tech Times)


Novartis readies sexism argument for migraine drug price pushback. Earlier this month, Swiss drug giant Novartis and partner Amgen won U.S. approval of a landmark migraine treatment that can actually prevents the painful headaches-on-steroids. The product, Aimovig, is part of a new class of migraine therapies—and it comes with a plus-size price. Which is why Novartis is gearing up for what it believes will be significant pushback from insurers and benefit managers with a very specific argument: Don’t dismiss the intense effects of a condition that mostly affects women. “We are tailoring quite a lot of our messages to this relevant population. We are extremely aware of this gender bias,” Novartis neuroscientist Dan Bar-Zohar tells Reuters in an interview. (Reuters)


New Jersey becomes second state to pass individual mandate. New Jersey this week became the second state—after Massachusetts way back in 2006—to pass an individual health insurance mandate. That requirement to carry insurance was nixed on the federal level as part of the sprawling tax law signed by President Trump at the end of 2017 (though it technically remains in effect until next year). Health care pundits have been wondering whether states will take it upon themselves to pass their own individual mandates in the wake of federal repeal, since the provisions are widely expected to lower premiums and keep more people on the insurance rolls; New Jersey is the first to fulfill that particularly policy prophecy. (Politico)

Romaine lettuce E. Coli outbreak claims more lives. The Centers for Disease Control (CDC) reports that four more deaths have been reported in conjunction with the Romaine lettuce E. Coli outbreak that led to a nationwide warning to avoid those leafy greens. While the lettuce is now safe to buy and consumer, according to public health agencies, its overall consequences are still dripping in, with 197 people now reported sick in 35 states. (TIME)


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Produced by Sy Mukherjee

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