As the first full day of presentations at the 2019 Conference on Retroviruses and Opportunistic Infections (CROI) began to wrap up, we spoke with Dr. Carl Dieffenbach about some of the new HIV research highlights presented, including the case of a patient reported to be possibly cured of HIV infection. Dr. Dieffenbach is the Director of the Division of AIDS at NIH’s National Institute of Allergy and Infectious Diseases (NIAID). He also discussed the promising findings from a large study evaluating a “universal test and treat” strategy, as well as other results showing improved viral suppression and retention in care when point-of-care viral load testing is offered. Watch Dr. Dieffenbach’s conversation with his colleague Anne Rancourt:
An HIV "Cure"?
Research findings presented at CROI about the case of a patient who has sustained HIV remission without antiretroviral therapy for 18 months after having received a stem cell transplant have made headlines around the world. Dr. Dieffenbach explained the case and what it means for people living with HIV today. He noted that the patient had a serious form of cancer that was treated with a stem cell transplant from a donor with a particular genetic mutation that makes it difficult for HIV to infect immune cells. Stem cell transplant is an intensive procedure used to address serious conditions in the absence of other treatment options and is not scalable for widespread use, Dr. Dieffenbach emphasized. He put the case in the context of ongoing efforts to develop an HIV cure. Later, Dr. Dieffenbach observed, “Today, a widely available cure remains elusive. Treatment is the best method of ensuring long-term health.” View the presentation by Dr. Ravindra Gupta of University College London.
PopART Study Finds Promise in “Universal Test and Treat” Strategy
Dr. Dieffenbach also reviewed results from the large clinical trial called “Population Effects of Antiretroviral Therapy to Reduce HIV Transmission” (PopART), or HPTN 071, which were presented at the Conference. Sponsored by NIAID and funded primarily by the President’s Emergency Plan for AIDS Relief (PEPFAR), PopART was conducted in 21 urban and peri-urban communities in Zambia and South Africa. It found that conducting population-wide, home-based HIV testing and offering treatment to those diagnosed with HIV—a strategy often referred to as “universal test and treat”—resulted in high rates (70%) of viral suppression and a 30% reduction in new HIV infections. The researchers concluded that such a strategy could help control the epidemic in certain settings. Read a news release from NIAID about the PopART study.
Benefits of Point-of-Care Viral Load Testing
Finally, Dr. Dieffenbach discussed viral load—a measure of the amount of HIV in the body—and its importance for HIV care and treatment. He highlighted a study that found that the availability of point-of-care viral load testing significantly improved HIV viral suppression and retention in care in South Africa, partly by ensuring rapid receipt of viral load results to patients and their providers. The researchers, led by Dr. Paul Drain of the University of Washington, concluded that increasing access to point-of-care viral load testing could help to achieve goals for increasing the proportion of people living with HIV who are virally suppressed in many areas in southern Africa where less than 50% of people with HIV have achieved viral load suppression. View the presentation of findings by Dr. Paul Drain.
The annual CROI conference, taking place in Seattle this week, has gathered basic, translational, and clinical scientists from more than 70 countries. They are sharing and discussing the latest studies, notable developments, and best research methods in the ongoing battle against HIV, AIDS, and related infectious diseases. Visit the conference website for abstracts, session descriptions, webcasts, and other materials being released over the course of the coming week.