News from IDWeek 2016

Do people living with HIV who have an undetectable viral load need to wear condoms?

In the face of extensive research showing that people living with HIV who are on antiretroviral therapy (ART) with stable undetectable viral load have an extremely low likelihood of transmitting the virus, a majority of participants at IDWeek 2016 in New Orleans thought they should still be advised to use condoms – a proportion that actually increased after a debate that laid out the evidence.

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Tenofovir alafenamide works well and improves kidney and bone markers in older people living with HIV

A co-formulation of tenofovir alafenamide (TAF) plus emtricitabine, used with a third antiretroviral drug, maintained viral suppression as well as tenofovir disoproxil fumarate (TDF) plus emtricitabine in older individuals, and was associated with improvements in kidney function and bone density, which may be of greater concern for this group, according to a presentation at the conference.

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Omega-3 fatty acids may reduce triglycerides and improve inflammation in people with HIV

Long-term use of omega-3 fatty acid supplements was associated with reduced levels of triglycerides and the inflammation biomarker C-reactive protein (CRP) in HIV-positive people with suppressed viral load, according to research presented at the conference.

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Dolutegravir regimen highly effective in clinical trial for women

A once-daily regimen containing the potent HIV integrase inhibitor dolutegravir worked better than an older atazanavir-containing regimen – with higher rates of viral suppression both overall and across race subgroups – in the ARIA trial, one of the few antiretroviral therapy studies to enrol only women, according to a presentation at the conference.

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Ibalizumab monoclonal antibody looks promising for people with drug-resistant HIV

Ibalizumab, an experimental monoclonal antibody with a unique mechanism of action, demonstrated good safety and promising efficacy in a small phase 3 study of people with extensive drug resistance who cannot be successfully treated with available therapies, according to a report at the conference.

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Men with HIV and men on PrEP in Boston see large increase in sexually transmitted infections

Rates of gonorrhoea, syphilis and chlamydia have risen steeply at Fenway Health in Boston since 2011, according to a presentation at the conference. Being HIV-positive men and using pre-exposure prophylaxis (PrEP) to prevent HIV were associated with higher risk of getting sexually transmitted infections (STIs), but more frequent STI testing and treatment could potentially help reduce the numbers.

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Electronic health records can help select candidates for HIV PrEP

A machine learning algorithm used to analyse electronic health records (EHRs) identified high-risk individuals who could potentially benefit from HIV pre-exposure prophylaxis (PrEP), according to a report presented at the conference. Out of 800,000 patients in a large EHR database, more that 8000 were found to be potential PrEP candidates.

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Other aidsmap news

Liver cancer risk reduced after hepatitis C treatment, but vigilance needed for aggressive cancers in months after treatment

People who are cured of hepatitis C after a course of direct-acting antiviral treatment do not have a higher risk of developing liver cancer (hepatocellular carcinoma), and probably have a reduced risk, studies from Italy and Canada presented at The Liver Meeting 2016 in Boston have shown.

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Real-world responses to HCV treatment among US veterans match best clinical trial results

Direct-acting antiviral treatment is curing people of hepatitis C infection in clinics at similar rates to those seen in clinical trials, and there don’t seem to be major differences between drug regimens, according to results of a large population study presented at The Liver Meeting 2016 in Boston this weekend.

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The ‘long tail’ problem: forthcoming injected-PrEP efficacy trial delayed due to persistence of drug in some volunteers

A study presented at last month’s HIV Research for Prevention (HIVR4P) conference in Chicago shows that in a minority of subjects who were given an experimental injectable drug as HIV pre-exposure prophylaxis (PrEP), the drug was still measurable in their body a full year after their last injection.

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NHS England loses appeal – it must consider providing PrEP

At the Court of Appeal in London, three judges confirmed that NHS England is responsible for providing PrEP. Key to the case is the fact that NHS England already commissions post-exposure prophylaxis (PEP) which is not substantially different to pre-exposure prophylaxis (PrEP).

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Smoking more harmful than HIV for people taking effective treatment, US study suggests

Smoking has the potential to shorten the life of a person taking HIV treatment by an average of six years, and is far more harmful to the life expectancy of people living with HIV than well-managed HIV infection itself, a US study reports this month in the Journal of Infectious Diseases.

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Four days on, three days off HIV treatment controls viral load in French pilot study

An experimental 'four days on, three days off' antiretroviral regimen kept viral load fully suppressed in 96% of people for 48 weeks in a French study presented at the International Congress on Drug Therapy in HIV Infection (HIV Glasgow).

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Darunavir/ritonavir & lamivudine matches triple-drug therapy

Simplifying antiretroviral therapy to a two-drug combination of lamivudine plus the protease inhibitor darunavir (Prezista) boosted by ritonavir is just as effective as a three-drug regimen in people with suppressed viral load, Spanish investigators reported at the International Congress on Drug Therapy in HIV infection (HIV Glasgow).

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Editors' picks from other sources

In a Trump presidency, portents of stigma and sickness for people living with HIV

from The Body

Do not listen when someone tells you it will all be okay. It will not. For people living with HIV and those that advocate alongside them, a Trump White House coupled with a Republican-controlled Congress is nothing less than a waking nightmare.

Trump victory puts Obamacare dismantling within reach

from Politico

Donald Trump’s ascension to the White House puts President Barack Obama’s Affordable Care Act – and health insurance for some 20 million Americans – in grave peril.

Explainer: the how, what and why of the latest HIV vaccine trial

from The Conversation

As the global quest for an HIV vaccine continues, Linda-Gail Bekker explains the significance of the latest large-scale trial underway in South Africa.

PrEP for African migrants in Europe? A research agenda

from The Lancet HIV (requires free registration)

Clinical trials and demonstration projects in Europe have focused solely on men having sex with men (MSM). In contrast to global PrEP research, Europe seems to have overlooked heterosexuals at risk of HIV, mostly sub-Saharan African migrants and other ethnic minorities from endemic regions. Research should urgently investigate how to offer PrEP to all people in need: how to stimulate demand, how to deliver it, and how to support adherence.