This Week in PLOS Medicine: Integrating Mental Health & HIV Care, Colon & Gastric Cancer, & Essential Pediatric Medicines

The following new articles are published in PLOS Medicine this week:

Continuing with the series providing a global perspective on integrating mental health, Sylvia Kaaya and colleagues discuss the importance of integrating mental health interventions into HIV prevention and treatment platforms. Clinical depression, alcohol abuse, and HIV-associated neurocognitive disorders are highly prevalent in people living with HIV and have negative consequences for treatment outcomes and cost of care.

The prognosis and treatment for colorectal cancer depend on five pathological stages (0–IV), each of which has a different treatment option and five year survival rate. Pierre Laurent-Puig and colleagues present a novel transcriptome-based classification of colon cancer associated with prognosis that is based on molecular subtypes, clinical and pathological factors, and common DNA alterations. These findings could help classify colorectal cancer into six robust molecular subgroups that might help identify robust prognostic genetic signatures, new prognostic subgroups, and targets for future drug development.

Jennifer Yeh and colleagues examine how changes in Helicobacter pylori and smoking trends in the last few decades contribute to past and future incidence of gastric cancer (specifically intestinal-type noncardia gastric adenocarcinoma, NCGA). Combined with a fall in smoking rates, almost half of the observed fall in rates of intestinal-type NCGA cancer in US men between 1978 and 2008 was attributable to the decline in infection rates of H. pylori. The full benefits will take several decades to be realized, and further discouragement of smoking and reduction of H. pylori infection should be priorities for gastric cancer control.

David Sinclair and colleagues discuss their experience at the Ghana National Drugs Programme’s review of the international evidence base for five priority pediatric medicines. The authors report that applying the global recommendations to Ghana was not straightforward for any of the five medicines, despite evidence of important clinical benefits, because of the unproven effect of the drugs in African settings and the scant information on cost effectiveness and the supply chain. This project demonstrates why transparent information on the evidence supporting global recommendations on pediatric medicines should be easily accessible to policy makers.

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