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Antiretroviral Therapy and Treatment Strategies
HIVandHepatitis.com
Several New Candidates in HIV Drug Pipeline Discussed at Conference

This year's Conference on Retroviruses and Opportunistic Infections (CROI), held last month in Seattle, included presentations on several new investigational antiretroviral drugs in development, reflecting a more robust pipeline than we have seen in recent years.

HIVandHepatitis.com
Dolutegravir Monotherapy Fails to Maintain Viral Suppression

Dolutegravir used alone without other antiretrovirals was unable to keep viral load suppressed in some people who switched from a standard 3-drug combination regimen, according to research presented at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) last month in Seattle. But evidence continues to show that dolutegravir plus a single other drug can work well as maintenance therapy.

HIVandHepatitis.com
Integrase Inhibitors May Increase Risk of IRIS in Late Presenters for HIV Treatment

HIV integrase inhibitors such as dolutegravir and raltegravir may increase the risk of immune reconstitution inflammatory syndrome or IRIS, according to studies from the Netherlands and France presented last month at the Conference on Retroviruses and Opportunistic Infections in Seattle.

HIVandHepatitis.com
New HIV Capsid Inhibitors Show High Potency and Prolonged Activity in Early Studies

A novel type of antiretroviral drug that interferes with the assembly and disassembly of the HIV capsid, which encloses the genetic blueprint of the virus, may offer a new potent and long-acting treatment option if it continues to look promising in larger studies, according to a presentation at the Conference on Retroviruses and Opportunistic Infections this month in Seattle.

HIVandHepatitis.com
Treatment-as-Prevention Study Sees Substantial Drug Resistance, but No Impact on HIV Therapy

A study of the prevalence of transmitted drug resistance among participants in the ANRS 12249 trial of treatment as prevention, has found that a substantial minority of participants had HIV with drug resistance mutations. However, there was no evidence that pre-existing drug resistance had any impact on the success of treatment, according to a report at the Conference on Retroviruses and Opportunistic Infections this month in Seattle.

HIVandHepatitis.com
Monoclonal Antibodies Show Promise for HIV+ People with Few Treatment Options

A pair of long-acting monoclonal antibodies that prevent HIV from entering human cells -- ibalizumab and PRO 140 -- may offer new treatment options for people with highly resistant virus and limited treatment options, researchers reported at the Conference on Retroviruses and Opportunistic Infections (CROI) last week in Seattle.

HIVandHepatitis.com
New NNRTI Doravirine Shows Good Efficacy in Phase 3 Study

Doravirine, an investigational next-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) from Merck, reduced HIV viral load as well as boosted darunavir in a Phase 3 clinical trial of people starting antiretroviral therapy (ART) for the first time, but it had a better lipid profile, according to a late-breaking presentation at the Conference on Retroviruses and Opportunistic Infections last week in Seattle.

HIVandHepatitis.com
Efavirenz/Tenofovir/Emtricitabine Less Likely to Cause Adverse Birth Outcomes

Infants exposed to an antiretroviral regimen of tenofovir, emtricitabine, and efavirenz (Atripla) from conception experienced fewer adverse birth outcomes compared to those exposed to other 3-drug regimens, according to a study of births in Botswana presented at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) last week in Seattle.

HIVandHepatitis.com
Dual Antiretroviral Regimen Maintains Durable HIV Suppression after Switch

People who switched from standard antiretroviral therapy to a 2-drug regimen of dolutegravir (Tivicay) plus rilpivirine (Edurant) were able to maintain an undetectable viral load for 48 weeks in a pair of late-stage clinical trials, according to a late-breaking report at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) this week in Seattle.

HIVandHepatitis.com
Integrase Inhibitor Bictegravir Matches Dolutegravir for First-Line HIV Treatment

Bictegravir, an investigational integrase inhibitor from Gilead Sciences, was highly potent, well tolerated and worked as well as dolutegravir (Tivcay) in a Phase 2 clinical trial, according to study results presented at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) this week in Seattle and published online in The Lancet HIV.

HIVandHepatitis.com
Infants Treated Within Days of Birth Can Clear HIV Reservoir Rapidly

HIV viral load and viral DNA fall rapidly in infants who begin antiretroviral therapy (ART) within days of birth, a pair of South African studies have found, showing the potential for clearing the reservoir of HIV-infected cells -- but infants with such a dramatic response to treatment may be a minority. The findings were presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2017) this week in Seattle.

HIV Cure Research
HIVandHepatitis.com
How Does Vedolizumab Antibody Therapy Lead to Sustained Viral Remission?

HIV and its monkey cousin SIV can carry the alpha-4 beta-7 integrin receptor in their outer envelope, which helps the virus enter gut cells during early infection, according to research presented at the recent Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle. This finding may help explain how an antibody against alpha-4 beta-7 produced sustained viral remission in monkeys.

HIVandHepatitis.com
Timothy Brown, the Berlin Patient, Celebrates a Decade Cured of HIV

Participants at a Community HIV Cure Research Workshop on February 12, in advance of the Conference on Retroviruses and Opportunistic Infections in Seattle, held a "birthday" party for Timothy Ray Brown -- formerly known as the Berlin Patient -- to celebrate 10 years since the bone marrow transplant that would lead to the only known cure for HIV.

HIVandHepatitis.com
Bone Marrow Transplant Patient Off ART for 288 Days Without HIV Rebound

A HIV-positive bone marrow transplant recipient at the Mayo Clinic experienced prolonged viral remission lasting nearly 10 months -- longer than the so-called Boston patients -- after interrupting antiretroviral therapy (ART), according to a report at the Conference on Retroviruses and Opportunistic Infections this month in Seattle. Although his viral load eventually rebounded, his HIV reservoirs appeared to be reduced.

HIVandHepatitis.com
Spanish HIV Vaccine Induces Control Off ART in Nearly 40% of Recipients

A so-called "HIV Conserv" vaccine has, for the first time, produced significant prolonged viral control in a large minority of recipients once they were taken off antiretroviral therapy (ART). So far, 1 participant has stayed off ART for 7 months without having to resume it, according to a report at the Conference on Retroviruses and Opportunistic Infections last week in Seattle.

HIVandHepatitis.com
Infants Treated Within Days of Birth Can Clear HIV Reservoir Rapidly

HIV viral load and viral DNA fall rapidly in infants who begin antiretroviral therapy (ART) within days of birth, a pair of South African studies have found, showing the potential for clearing the reservoir of HIV-infected cells -- but infants with such a dramatic response to treatment may be a minority. The findings were presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2017) this week in Seattle.

HIV Prevention
HIVandHepatitis.com
Bacterial Vaginosis Does Not Affect Efficacy of Oral PrEP in Women

Research presented at the Conference on Retroviruses and Opportunistic Infections last month in Seattle found that the efficacy of oral pre-exposure prophylaxis (PrEP) for women was not affected by bacterial vaginosis (BV) -- the overgrowth in the vagina of untypical microbes. The effectiveness of PrEP in the Partners PrEP study was not significantly different in women with and without BV. This rules out BV as a possible cause for the lower effectiveness of oral PrEP in some studies of women compared to studies of men who have sex with men.

HIVandHepatitis.com
STI Rates Among PrEP Users Are High, But Evidence that PrEP Increases Them Is Inconclusive

A study of pre-exposure prophylaxis (PrEP) users presented at the Conference on Retroviruses and Opportunistic Infections this month in Seattle showed that they had very high rates of sexually transmitted infection (STI) diagnosis -- on the order of 20 times higher than among HIV-negative gay men in the general population. However, it is unclear whether STIs increased further after people went on PrEP.

HIVandHepatitis.com
Unique Case of PrEP Failure Without Drug Resistance Reported in Amsterdam

HIV pre-exposure prophylaxis (PrEP) appears to be nearly 100% effective if taken consistently. However, among tens of thousands of cases of PrEP preventing HIV, there have been a few reports of people who acquired HIV despite high adherence to PrEP and adequate drug levels, including one reported in a poster at the Conference on Retroviruses and Opportunistic Infections (CROI 2017) last week in Seattle.

HIVandHepatitis.com
STI Prophylaxis in PrEP Users Reduces Syphilis and Chlamydia, but Not Gonorrhea

Use of the antibiotic doxycycline as on-demand post-exposure prophylaxis by men who have sex with men taking part in the Ipergay HIV PrEP trial produced a 70% drop in chlamydia infections and a 73% drop in syphilis, but no reduction in gonorrhea, according to a late-breaking report at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) this week in Seattle.

HIV-Related Conditions and Complications
HIVandHepatitis.com
Better Depression Care Could Improve Outcomes for HIV Treatment Programs

Improved management of depression and other mental health problems has the potential to improve the outcomes of HIV treatment programs, Pamela Collins of the U.S. National Institute of Mental Health reported at the recent Conference on Retroviruses and Opportunistic Infections in Seattle. Mental health treatment should be integrated into HIV services in resource-limited settings, she said.

HIVandHepatitis.com
Long-Term Darunavir/Ritonavir Modestly Increases Risk of Cardiovascular Disease

Long-term use of the boosted protease inhibitor darunavir (Prezista) modestly increases the risk of cardiovascular disease, according to data from the ongoing D:A:D study presented to the recent Conference on Retroviruses and Opportunistic Infections. Investigators identified an independent association between cumulative use of the drug over 5 years and heart attack and stroke.

HIVandHepatitis.com
Bone Density Improves in People Who Switch from Tenofovir DF to Tenofovir Alafenamide

After 3 years, tenofovir alafenamide (TAF) for first-line HIV treatment was better at suppressing viral load and safer for the bones and kidneys than the older tenofovir disoproxil fumarate (TDF), researchers reported at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) last month in Seattle. Another study showed that people with low bone density who switched from TDF to TAF saw improved bone health, including a reduction in osteoporosis.

HIVandHepatitis.com
Studies Look at Brain and Cognitive Changes in People with HIV As They Age

People with HIV often show persistent signs of cognitive impairment and abnormalities in brain structure despite suppressive antiretroviral therapy (ART), but they do not appear to experience accelerated decline compared to HIV-negative people as they age, according to research presented at the Conference on Retroviruses and Opportunistic Infections last month in Seattle.

HIVandHepatitis.com
Stopping Smoking Cuts Risk of Some Cancers Quickly in People with HIV

Smoking probably contributes far more to the risk of cardiovascular disease in people with HIV than antiretroviral drug choice, viral load, or any factor linked to the virus, but stopping smoking leads to a rapid reduction in the risk of some cancers, according to results from a cluster of studies presented at the 2017 Conference on Retroviruses and Opportunistic Infections last week in Seattle.

HIVandHepatitis.com
Treatment or Watchful Waiting for Cervical Abnormalities in Women with HIV?

Close monitoring of earlier-stage cervical abnormalities (CIN-2) may be preferable to treatment for many women with HIV, a U.S. study suggests. The findings, presented at the Conference on Retroviruses and Opportunistic Infections this week in Seattle, show that CIN-2 regressed in over three-quarters of women taking antiretroviral therapy, without the need for CIN treatment. A higher CD4 count was associated with a lower likelihood that lesions would progress.

HIV Epidemiology and Access to Care
HIVandHepatitis.com
Finding Men with HIV -- and Keeping Them in Treatment

Specialized services to attract men to HIV testing and treatment may need to adopt several different formats in order to reach different sub-populations of men, suggesting there is no single service innovation that will boost uptake among men in sub-Saharan Africa, according to research from South Africa presented at last month’s Conference on Retroviruses and Opportunistic Infections.

HIVandHepatitis.com
1 in 5 HIV+ Men in U.K. Who Say They Are Heterosexual Caught HIV from Another Man

A genetic analysis of a large database of people with HIV in care in the U.K. shows that 18% of HIV-positive men who claim to be exclusively heterosexual in fact belong to clusters of linked infections that consist only of men. The data were presented by Manon Ragonnet-Cronin and colleagues from Edinburgh University at the recent Conference on Retroviruses and Opportunistic Infections in Seattle.

HIVandHepatitis.com
Simple Risk Score Can Identify Gay Men Who May Have Acute HIV Infection

A set of 7 simple questions about symptoms and risk factors identified three-quarters of gay men in Amsterdam who have acute (very recent) HIV infection, according to a study presented at the Conference on Retroviruses and Opportunistic Infections in Seattle last month. Using this risk score could identify gay men requiring HIV RNA testing, which can detect acute infections, in addition to HIV antibody testing.

HIVandHepatitis.com
Peer Navigators Improve Linkage to HIV Care and Retention in South African Study

Adults recently diagnosed with HIV who get help from peers to address personal barriers to care together with SMS check-in messages, appointment, and healthy living reminders had nearly twice the odds of being retained in care at 1 year of follow-up compared to those getting standard care at primary health clinics in South Africa according to findings presented at the recent Conference on Retroviruses and Opportunistic Infections.

HIVandHepatitis.com
Point-of-Care Testing Improves Infant HIV Diagnosis Rate, Treatment, and Retention HIV's Milder Cousin May Be Less Mild than Previously Thought

Using a point-of-care test to diagnose HIV in infants significantly improved retention in care, speeded up antiretroviral therapy (ART) initiation, and increased the proportion of infants who started treatment, a large randomized study in Mozambique has found. The results were presented at the 2017 Conference on Retroviruses and Opportunistic Infections last month in Seattle.

HIVandHepatitis.com
Will There Be a New Wave of HIV Among People Who Inject Drugs in the U.S.?

While there is little evidence yet for a crossover of HIV from gay men who inject drugs to heterosexuals, several studies presented at last month's Conference on Retroviruses and Opportunistic Infections in Seattle found that the conditions do exist for it to happen. And they find a new generation of heterosexual people who inject drugs (PWID) who are not connected to conventional drug services, are sharing needles, and are increasingly interested in methamphetamine.

HIVandHepatitis.com
How Should HIV Self-Testing Be Provided?

At a session on HIV self-testing at the Conference on Retroviruses and Opportunistic Infections this month in Seattle, researchers presented findings from studies looking at some of the unanswered questions about self-testing and how best to implement it, with examples from Malawi and the United States.

HIVandHepatitis.com
Time with Transmissible HIV Viral Load Has Fallen By Three-Quarters Since 2000

A study by the Centers for Disease Control and Prevention (CDC) presented at the recent Conference on Retroviruses and Opportunistic Infections in Seattle found that the proportion of time people with HIV in the U.S. spend in care but not virally suppressed has fallen from 40% to 10% in the last 15 years. The study also found that young people, black people, and people with public rather than private health coverage spent less time with viral load below 1500 copies/mL, the World Health Organization (WHO) threshold for HIV transmission.

HIVandHepatitis.com
Science, Community, and Political Will Can End HIV Epidemic, Says New York Commissioner

New York City’s strategy to end the HIV/AIDS epidemic is firmly rooted in science, was developed in conjunction with community activists, and has support from top-level political leaders, Demetre Daskalakis told a plenary audience at the Conference on Retroviruses and Opportunistic Infections last week in Seattle. "When you combine political will, biological interventions, and harm reduction, you can get to zero," he said.

HIVandHepatitis.com
New HIV Infections Fall in the U.S. but Disparities Remain

The number of annual new HIV infections in the U.S. fell by 18% overall since 2008, offering evidence that prevention and treatment efforts are having an impact, according to data from the Centers for Disease Control and Prevention (CDC) released to coincidence with presentations at the 2017 Conference on Retroviruses and Opportunistic Infections this week in Seattle. A closer look at the data, however, shows some notable differences across demographic groups and geographic regions.

HIVandHepatitis.com
Changes In Viral Suppression Over Time Reveal Disparities in HIV Care

Sustained viral suppression over the course of a year may be a better measure than the most recent viral load test result when it comes to understanding access to and engagement in HIV care, according a study by Centers for Disease Control and Prevention (CDC) researchers presented at the 2017 Conference on Retroviruses and Opportunistic Infections this week in Seattle.

HIVandHepatitis.com
A Combination of Factors Has Reduced HIV Infections in Hard-Hit Part of Africa

HIV incidence has started to tumble in the Rakai cohort, one of the best-studied groups of people in Africa, according to a report at the Conference on Retroviruses and Opportunistic Infections this week in Seattle. The annual HIV infection rate has fallen 40% in the last 4 years, researchers said. A combination of factors -- including wider availability of antiretroviral therapy, increased male circumcision, and later age of sexual debut in young people -- all appear to be contributing to this decline.

Hepatitis C and HIV/HCV Coinfection
HIVandHepatitis.com
Higher than Expected HCV Prevalence Among HIV-Negative Gay Men in Amsterdam PrEP Program

An unexpectedly high number of HIV-negative gay and bisexual men taking pre-exposure prophylaxis (PrEP) in Amsterdam were found to have hepatitis C virus (HCV) infection, suggesting HCV is being transmitted sexually between men with and without HIV, according to a presentation last month at the Conference on Retroviruses and Opportunistic Infections in Seattle.

HIVandHepatitis.com
DAA Therapy Cures HIV/HCV Coinfected People with Decompensated Cirrhosis or Transplants

HIV/HCV coinfected people with liver cirrhosis or liver failure, and those who received liver transplants, saw high rates of sustained virological response using interferon-free direct-acting antiviral (DAA) therapy for hepatitis C, according to 3 Spanish studies presented at the Conference on Retroviruses and Opportunistic Infections last month in Seattle.

HIVandHepatitis.com
Are HIV/HCV Coinfected People Cured with DAAs at Increased Risk for Liver Cancer?

HIV/HCV coinfected people who are successfully treated for hepatitis C using interferon-free direct-acting antiviral (DAA) therapy do not appear to have an increased likelihood of developing hepatocellular carcinoma (HCC), according to a study presented at the Conference on Retroviruses and Opportunistic Infections this month in Seattle.

HIVandHepatitis.com
Glecaprevir/Pibrentasvir for HCV Can Be Safely Administered with Common Antiretrovirals

AbbVie's investigational glecaprevir/pibrentasvir treatment for hepatitis C is not expected to interact with or require dose adjustment when taken with commonly used antiretroviral regimens, offering a new option for HIV/HCV coinfected people, according to a study presented at the Conference on Retroviruses and Opportunistic Infections this month in Seattle.

HIVandHepatitis.com
New HCV Infections Among HIV+ Gay Men Drop By Half After DAA Roll-Out in Netherlands

A little more than a year after the Netherlands instituted a policy allowing unrestricted access to direct-acting antivirals (DAAs) for the hepatitis C treatment, researchers have already seen a dramatic decline in acute HCV infections among one at-risk population, HIV-positive men who have sex with men, according to findings reported at the Conference on Retroviruses and Opportunistic Infections this week in Seattle.

Tuberculosis
HIVandHepatitis.com
Prednisone Reduces Risk of Developing TB-IRIS after Starting Antiretroviral Treatment

Prednisone reduces the risk of immune restoration inflammatory syndrome (IRIS) in people with HIV after starting tuberculosis (TB) treatment, a randomized trial called PredART has found. The results were presented last month at the Conference on Retroviruses and Opportunistic Infections in Seattle by Graeme Meintjes from the University of Cape Town in South Africa.

HIVandHepatitis.com
Isoniazid Preventive Therapy for TB Reduces Risk of Death for People Living with HIV

A 6-month course of isoniazid preventive treatment (IPT) for at the beginning of the Temprano trial in Ivory Coast reduced the risk of death by 37% over a mean follow-up period of 4.5 years, Anani Badje reported at the Conference on Retroviruses and Opportunistic Infections this month in Seattle.

HIVandHepatitis.com
Triple Tuberculosis Regimen Beats XDR-TB in First Trial

A regimen of three oral drugs given for 6 months was enough to clear extensively drug-resistant tuberculosis (XDR-TB) in 29 of the first 31 people to have completed the treatment course, Francesca Conradie of Sizwe Tropical Disease Hospital in Johannesburg reported at the 2017 Conference on Retroviruses and Opportunistic Infections last week in Seattle. If the results are replicated in a larger population, the findings could revolutionize the prospects for treating not just XDR-TB, but also more severe cases of multidrug-resistant tuberculosis (MDR-TB).