July 31, 2015
This week we're highlighting more of the research that was presented at IAS 2015, including study results on two new drugs in development, cash-incentive programs for prevention, and approaches to increase treatment adherence. To beat HIV, you have to follow the science!
Study results on the new maturation inhibitor BMS-955176 (BMS-176) were presented at IAS 2015. Maturation inhibitors act at the last step of the HIV life cycle and keep the Gag protein from helping the virus to mature and become infectious. No drugs of this class have yet made it to market.
Results from a 24-week study comparing the new NNRTI (non-nucleoside reverse transcriptase inhibitor) doravirine (MK-1439) to efavirenz (Sustiva, Stocrin) were presented at IAS 2015. Both drugs were combined with tenofovir/emtricitabine.
After 24 weeks, 88.9% of patients on doravirine and 87% of those on efavirenz reached a viral load below 200 copies/mL. As for viral loads below 40 copies/mL, 73.1% of patients on doravirine and 72.2% of those on efavirenz reached this level. Additionally, the mean increase in CD4+ cell counts was 154 for the doravirine group and 146 cells for the efavirenz group.
Two clinical trials evaluating the impact of cash incentives on HIV incidence among adolescents in South Africa found that such incentives had no impact on HIV rates, while one saw a decrease in rates of herpes simplex virus.
In the first study, following about 3,000 high school students, the percentage of HIV infections was 1.8% in the cash-incentive group and 1.5% in the control group, which was too small to detect a statistical difference between the two groups. Meanwhile, the second study, which tested the hypothesis that providing conditional cash incentives to keep adolescent girls in school will reduce HIV risk, also found no impact of cash incentives on the risk of HIV acquisition.
HIV-negative individuals were more likely to adhere to pre-exposure prophylaxis (PrEP) when the regimen was taken daily compared to a time-driven (two times per week) or sex-driven (one bill before and one pill after sex) basis, according to a study presented at IAS 2015.
A second study found that text message adherence support was strongly associated with blood levels of the PrEP drug, suggesting that text-based systems might increase adherence.
Implementation of community-based "adherence clubs" in Cape Town, South Africa, helped 94% of approximately 2,000 people with HIV in the study to be retained in care, and 98% be virally suppressed after a year, according to a study presented at IAS 2015
Each adherence club, which includes approximately 30 people with HIV, was facilitated by a community health worker at a community center. The group met five times a year for usually an hour or less, and included a group counseling session and opportunity for participants to pick up pre-packaged antiretroviral therapy.
Is there a development this week in HIV research that you think we missed? Send us a tip!
Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com.
Follow Warren on Twitter: @WarrenAtTheBody.
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