The Scan by 2 Minute Medicine®: Fighting HIV: A New Strategy, Drug Cocktails for the Youth, AI in IVF Clinics?, Healthcare Cyberattacks

The Scan by 2 Minute Medicine® is a pop-culture medical newsletter and exclusive benefit for 2 Minute Medicine Plus subscribers.

We begin with talking about a new cure strategy for HIV. Then we discuss issues revolving around psychotropic polypharmacy in youth. After that, we take a look at a new method to improve IVF treatments. Finally, we go over the recent cyberattack at UnitedHealth’s Change Healthcare and its consequences.

Fighting HIV: A New Strategy

The story: At Super Bowl 2024, Usher revealed Alicia Keys as one of his surprise guests who joined him in performing “If I Ain’t Got You” and “My Boo” on stage. Despite the TikTok rumours about Alicia Keys being born with HIV, the R&B singer is not HIV-positive. She is, however, significantly involved in HIV/AIDs advocacy work and in 2003, she co-founded “Keep a Child Alive” to provide treatment and other support to children suffering from HIV/AIDS.

How have HIV treatment options changed over time?

In 1987, the FDA approved the first drug to treat HIV, known as azidothymidine (AZT). However, AZT was associated with side effects such as low blood cell counts and liver damage. Moreover, the cost of AZT was prohibitive as it was the most expensive drug in history at the time. Additionally, AZT was not very effective as monotherapy due to the virus mutating and developing drug resistance. In 1995, the first anti-HIV (antiretroviral) medication from a different drug class (saquinavir) was approved by FDA and a year later, a medication from another drug class (nevirapine) was approved. Since 1996, combination therapy consisting of different drug classes known as highly active antiretroviral therapy (HAART) became the standard therapy which was revolutionary in effectively treating HIV.

As discussed, there has been a lot of progress since the early 90s, when Freddie Mercury, the beloved Queen’s vocalist, and Ron Woodroof, whose fight for access to AIDs treatment was depicted in the movie “Dallas Buyers Club”, passed away due to AIDs. Current antiretrovirals have significantly increased the life expectancy of individuals with HIV and reduced disease transmission. However, these medications are not curative and are associated with toxicities that may require drug discontinuation and hence induce drug resistance to HIV.

Will HIV be cured?

Earlier this year, a new paper in The Journal of Infectious Diseases discussed a potential new cure strategy for HIV. Researchers have explored restoring NK cells, a type of blood cells that kill infected and cancer cells, as part of an HIV cure strategy. They found this strategy well-tolerated and saw a moderate decrease in HIV-producing cells in lymph nodes when infused to persons with HIV. While further studies are needed to investigate the efficacy of this method, this might be an important step towards fighting HIV and curing the disease.

Drug Cocktails for the Youth

“Girl, Interrupted”, is a 1999 movie which narrates the experience of an 18-year-old Susanna Kaysen as a patient admitted in an American psychiatric hospital in 1967. Susanna criticizes how mental disorders are treated and questions the over-reliance on medications to treat patients. While dramatized in the movie, there might be some truth in over-prescribing American children: from the period 1999-2004 to 2011-2015, the number of American youth treated with multiple psychotropic drugs increased from 101,836 to 293,492, i.e. over 180%.

According to a 2024 study conducted by the University of Maryland, the odds of psychotropic polypharmacy (defined as taking 3 or more psychiatric medications) among youths aged 17 years or younger enrolled in Medicaid increased by 4% per year from 2015 to 2020. The rates were higher among youth with disability and in foster care.

These findings are concerning as the long-term effects of psychotropic polypharmacy on the developing brain are not well known. Moreover, polypharmacy increases the risks of drug-drug interactions. As such, monitoring the number of prescribed psychotropic medications in youth is critical. Moreover, the reliability of diagnostic criteria used to assess children and adolescents as well as treatment guidelines should be carefully evaluated and updated to minimize over-diagnosing and over-prescribing the youth.

AI in IVF Clinics?

On February 22, the province of British Columbia (BC) announced that beginning April 1, 2025, the government will begin funding one cycle of in-vitro fertilization (IVF). This is a great opportunity for BC residents seeking fertility treatments considering the cost of one IVF cycle in Canada is between $15,000-$20,000.

IVF, the main type of assisted reproductive technology (ART), involves a complex series of procedures that involves fertilizing eggs in a lab before implantation into the uterus. Identifying the lab-grown embryos that have the best chance of a successful pregnancy is very challenging, hence patients undergoing multiple treatment cycles. In a new study published earlier this year, researchers from the University of California San Diego School of Medicine have developed a non-invasive approach for predicting the quality of lab-grown embryos. In this novel method, genetic material fragments left behind in the liquid cultures in which young embryos are grown are analyzed. The data is then used to train a machine learning algorithm to predict the morphology of embryos based on the produced genetic material.  While more research is needed, such an approach can improve the efficiency of IVF treatments.

From Paris Hilton to Michelle Obama, many celebrities have been open about conceiving their children through IVF. As per CDC, in 2021, about 238,126 patients had over 400,000 ART cycles in the United States which resulted in 97,128 live-born infants. As childbearing is being delayed, the age-related infertility rates and the demand for ART are expected to increase as well.

Healthcare Cyberattacks

Since February 21, a nationwide cyberattack on Change Healthcare’s systems has led to severe prescription processing disruptions at pharmacies in the US. Following the hack, many pharmacies could not transmit insurance claims and pharmacists reported “significant backlogs of prescriptions,” which they were unable to process. However, over 90% of pharmacies in the country have now implemented electronic workarounds for electronic claims processing. Healthcare cyberattacks are costly: from 2022 to 2023, the number of Americans who were affected by breaches of health information increased from 44 million to 106 million. In other words, about 1 in 3 individuals.

Healthcare cyberattacks are not limited to the US. Since 2015, at least 14 major cyberattacks on Canadian health information systems have occurred, most of which involved ransomware and the rest, data leaks.

From Aldus Huxley’s “1984” to the Sci-Fi TV series “Black Mirror”, abusing personal data and its consequences has been discussed extensively in literature and movies. Due to the value of personal health information, health organizations are financially lucrative targets for cyberattacks, as such, maintaining a strong cybersecurity posture is critical.

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