The 23rd International AIDS Conference (AIDS 2020: Virtual) moved online this year. After the first full day of sessions at which HIV researchers from around the globe shared new scientific findings, HIV.gov spoke about some of the highlights with Carl Dieffenbach, Ph.D., director of the Division of AIDS at NIH’s National Institute of Allergy and Infectious Diseases (NIAID). He focused on two studies:
- Findings on the safety and effectiveness of a long-acting injectable form of pre-exposure prophylaxis (PrEP)
- A possible case of an adult in long-term HIV remission without a bone marrow transplant
View the interview below:
Here is additional information on the study findings that Dr. Dieffenbach highlighted:
- Data show long-acting injectable cabotegravir is even more effective in preventing HIV than daily oral Truvada. Final analysis of interim data from the NIH-sponsored HPTN 083 clinical trial found that a PrEP regimen containing an investigational long-acting form of the HIV drug cabotegravir injected once every 8 weeks was more effective than daily oral Truvada (TDF/FTC) at preventing HIV acquisition among cisgender men who have sex with men and transgender women who have sex with men. (NIH is also sponsoring a companion study, HPTN 084, which is evaluating long-acting injectable cabotegravir for HIV prevention in cisgender women in sub-Saharan Africa. That study began a year later than HPTN 083 and is continuing to gather data.) Presenting the HPTN 083 findings at AIDS 2020, Dr. Raphael Landovitz of UCLA noted that, overall, the rate of HIV acquisition among the 4,566 study participants was low. While the study found that both methods were highly effective for HIV prevention in the study population, the final data analysis indicated that cabotegravir had a superior protective effect, with 66% lower HIV incidence in the cabotegravir group. Among the 52 study participants who acquired HIV, 13 were in the cabotegravir group and 39 were in the Truvada group. Both products were safe and well-tolerated by the study participants. A long-acting, discreet PrEP option may be more desirable to some individuals who wish to use PrEP but find taking a daily pill challenging. Cabotegravir remains an investigational drug and is not yet approved by the FDA for HIV prevention. Read more about the HPTN 083 findings.
- Report describes first possible case of adult with HIV to achieve long-term remission without a bone marrow transplant. Dr. Ricardo Diaz of the University of Sao Paulo in Brazil revealed that a study participant has maintained long-term HIV remission (i.e., HIV remained suppressed in the absence of daily antiretroviral therapy) for 64 weeks after a structured treatment interruption. The participant is one of five individuals who had received an intensified multidrug antiretroviral therapy (ART) regimen for 48 weeks before the treatment interruption. The regimen included maraviroc and twice-daily nicotinamide, which are potentially latency reversing. (One of the main obstacles to curing HIV infection is that the virus can remain hidden and inactive [latent] inside certain cells of the immune system [such as CD4 cells] for months or even years. While HIV is in this latent state, the immune system cannot recognize the virus, and ART has no effect on it. Latency-reversing agents reactivate latent HIV within CD4 cells, allowing ART and the body's immune system to attack the virus.) While the findings from this case are exciting, Dr. Diaz and Dr. Dieffenbach both observed, they are preliminary, and further analyses and more time are necessary to state definitively whether the man has been cured of HIV. So far, the only two adults to have been cured of HIV received bone marrow transplants to treat cancers of the blood. Each was matched with a donor who had a genetic abnormality that gives rise to immune cells resistant to HIV. Such a procedure is not safe or scalable for widespread use, so researchers continue to explore whether the right combination of medications could offer a safer and less expensive path to long-term HIV remission.
AIDS 2020: Virtual
The first-ever virtual edition of the world’s largest conference on HIV is taking place from July 6-10. The International AIDS Conference was first convened during the peak of the AIDS epidemic in 1985. Now convening every other year and led by the International AIDS Society, the conference continues to provide a unique forum for the intersection of science, advocacy, and human rights, bringing together scientists, policy makers, healthcare professionals, people living with HIV, funders, media, and community. According to its organizers, each conference is an opportunity to strengthen policies and programs that ensure an evidence-based response to the epidemic.
For more information about what’s happening at the conference, visit:
- HIV.gov’s page dedicated to AIDS 2020: Virtual, where you can information about this week’s Live with Leadership conversations about the Ending the HIV Epidemic initiative and information about our other upcoming interviews with Dr. Dieffenbach.
- HIVHistory.org, which chronicles the nearly 40 years of the HIV response in the U.S. and around the world and highlights key moments of political action, scientific discovery, and community activism that have shaped the epidemic and the millions of lives that it has touched.
- The official conference website.