A report on Sarah Fidler’s presentation “Approaches towards a cure for HIV”
Sarah Fidler opened her lecture on HIV cure by provocatively asking – with the advances in drug therapy in the last decade, do we even need a cure? Of course with the financial costs of ARVs in addition to the potential impacts of ageing with HIV, a cure is ideal.
The sterilising cure, used 9 years ago in the Berlin patient, has been thus far unreproducible. Redefining our expectations is an important first step to recognise the potential for products in the pipeline. Aiming therefore for a “functional cure”, one with a very low sustained viral load, could be achievable. This would allow for host control of viral replication without continued treatment, immune function restored, as well as stabilised, HIV-induced inflammation reduced, and very low risk of transmission to others.
A report on Julia Del Amo’s presentation “HIV and Migration: a renewed challenge”
Julia del Amo challenged our assumptions about HIV and migrants, with particular focus on Europe. Some migrants arrive to their destination country already living with HIV, either acquiring it in their port of origin or during their journey. However, the number of men who acquire HIV after they migrate is startling.
There are steadily increasing numbers of MSM who are diagnosed within the first year of living in their destination country (up 58% since 2007), while people who are heterosexual and newly diagnosed is declining (down 36% from 2007). Moreover, in migrants from sub-Saharan Africa who are found to have HIV a year after arrival, approximately 72% of MSM and 50% of heterosexual migrants acquired HIV post-migration. This is determined using a validated method of estimating acquisition.
A report on Erica Peter's presentation "Interactive Case Study: HIV-HCV and PWIDS"
Dr Erica Peters, a local Glasgow ID physician, has seen a disturbing rise in the incidence of HIV (133 in the last few years, 1/3 women) in the population of people who inject drugs in Glasgow: many are co-infected with HCV. This population poses challenges for decision-making on drug therapy given that many people in this population are both taking both prescribed and recreational drugs.
A report on Victoria Pilkington's "Meta-analysis of the risk of Grade 3/4 or serious adverse events in 12 randomised trials of PrEP (n=15,678)"
Since its presention at HIV Glasgow, there has been a lot of coverage of the meta-analysis of PrEP presented by Dr Victoria Pilkington of Imperial College, London (e.g. ow.ly/ALap30mppiv). The story has been re-told through a variety of medical and non-medical media emphasising the bottom line: TDF/FTC as PrEP is safe. As we know, there are an increasing number of PrEP prescriptions in North America, Australia, and Western Europe with the global estimated number of people taking PrEP to be around 300 000.