Leading HIV Expert Live-Blogs From IAS 2015
July 22, 2015
Benjamin Young, M.D., Ph.D., is the chief medical officer of the International Association of Providers of AIDS Care (IAPAC), an expert in TheBody.com's "Ask the Experts" forums, and a highly respected HIV clinician-researcher. He was also one of the estimated 6,000-plus members of the global HIV workforce attending IAS 2015 in Vancouver. Below is a collection of his thoughts from the conference, beginning with the most recent. (All times are Pacific Daylight Time.)
Wednesday, July 22, 6:24 a.m.
Leaving lovely Vancouver for my home in the mountains of Colorado. I'll miss her beautiful vistas, friendly people and great food.
IAS 2015 will be remembered as historic -- perhaps as historic as the 1996 Vancouver meeting that showed the world that HIV suppression was possible. Now we know that antiretroviral therapy (ART) is so highly effective that all people living with HIV should be offered treatment. Doing so will prevent cancer, illness, death (START study) and transmission (HPTN 052).
WAVES: A Women-Only HIV Treatment Study
Tuesday, July 21, 2:41 p.m.
A late-breaker poster was presented today on the WAVES study -- the first-ever fully powered, randomized study conducted only in women to examine initial treatment regimens for HIV. It was presented by my colleague Kathleen Squires.
The poster compares Stribild to Truvada plus ritonavir-boosted atazanavir; it's notable for being the first Stribild study to date showing statistical superiority over another regimen commonly used in first-line treatment. It's also notable for having enrolled many subjects from Russia and Uganda. Now, if only a Russian or Ugandan investigator were given the opportunity to present the data.
Tuesday, July 21, 2:10 p.m.
One of the great things about these international conferences is having the opportunity to reconnect with old friends and colleagues from around the world: Kenly Sikwese (of Zambia), who I photographed while he was speaking on stage about the START study; Drs. Oka and Nishijima (of Japan); Santiago Moreno (of Spain); and Alla Volokha (of Ukraine, who I unfortunately did not snap a picture of).
Next-Gen Tenofovir Still Looks Strong
Tuesday, July 21, 11:30 a.m.
A new set of presentations on TAF -- tenofovir alafenamide fumarate, the tenofovir prodrug -- by Gilead's teams continues to reaffirm its effectiveness and improvements in bone safety, and probable improvements in kidney safety. With the looming FDA approval of E/C/F/TAF (that's clinical shorthand for a new version of Stribild in which the old tenofovir is replaced with TAF), the real issues will be pricing and how this will compare with abacavir for bone safety.
As noted by Liz Highleyman of HIVandHepatitis.com, it's remarkable how these sessions on antiretroviral studies used to be the highlight of HIV conferences. Now, there are empty seats.
Hats Off to Vancouver's Harm Reduction
Tuesday, July 21, 9:43 a.m.
Evan Woods is giving a plenary talk about Vancouver's world-class needle/syringe exchange and harm reduction research programs, which include the Insite safe injection setting.
Vancouver's efforts in this area are among the best in the world. If only others (e.g., the Russian Federation -- or Indiana) could have followed evidence-based best practice, so that many cases of HIV (and hepatitis) could have been prevented.
Will We Do It?
Monday, July 20, 2:47 p.m.
HIV Treatment Is HIV Prevention
Monday, July 20, 2:45 p.m.
Final results of the HPTN 052 study: No linked sexual HIV transmissions from a positive partner on stable antiretroviral therapy to their negative partner. Ever. Zero. Zilch. HIV treatment is prevention. Proved.
Symptomatic or Not, ART's for You; Now What?
Monday, July 20, 11:34 a.m.
The long-awaited START study results were just presented to a standing-room-only ballroom. This study provides the last word on whether antiretroviral therapy benefits asymptomatic HIV-positive people with normal CD4 counts.
The results: Even among otherwise-healthy patients, ART decreased cancer, serious illness and death. With no apparent increase in drug toxicity. Question answered. Period.
The real issue is whether the global community of governments, providers and people living with HIV will care enough to advocate for, and implement, programs that provide treatment to everyone who's diagnosed. Those who obstruct these efforts will be viewed in the years to come as responsible for the needless suffering and deaths of hundreds of thousands of people.
Saturday, July 18, 7:36 p.m.
Somber to be watching Linda-Gail Bekker, the deputy director of the Desmond Tutu HIV Centre, present IAPAC's evidence-based guidelines on improving the HIV treatment environment.
We're here for a pre-conference workshop to discuss the UNAIDS 90-90-90 targets. After his death, I inherited Joep Lange's responsibility as the treatment section chair for the IAPAC guidelines on improving the HIV care continuum. It would have been better that he were here, but I trust and hope that we will do honor to his memory and vision.
Sneak Peek at Updated WHO HIV Treatment Guidelines
Saturday, July 18, 7:17 p.m.
Here in a pre-conference event, the International HIV Treatment as Prevention Workshop. Gottfried Hirnschall, who directs the HIV department of the World Health Organization (WHO), is previewing updated 2015 WHO antiretroviral guidelines, which won't be officially released until later this year.
Here's a sneak peak: Looks like the guidelines will support antiretroviral therapy at any CD4 count, option B+ for pregnant women, and the use of the integrase inhibitor dolutegravir in both first- and second-line therapy. Interim recommendations should be available in September, but the fully updated WHO guidelines report won't be available until December.
The Time for Universal HIV Treatment Is Now
Saturday, July 18, 5:05 p.m.
My thoughts from today's IAS 2015 pre-conference workshop with UNAIDS: Malawi, Swaziland, South Africa, Rwanda, Botswana and Kenya are all nations with huge demonstration projects that show us how possible it is to close in on UNAIDS 90-90-90 targets in the lowest-income nations with the highest HIV prevalence.
The time to implement universal HIV treatment is now. The time to demand political and community will is now. We can learn/evaluate as we go, rather than wait for more studies; the health and lives of millions are at stake while we cogitate.
This article was provided by TheBodyPRO. It is a part of the publication The 8th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention.
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