Next week, 6,000 HIV researchers and experts are expected to make their way to Mexico City for the 10th International AIDS Society (IAS) Conference on HIV Science, which will take place July 21 to 24. The conference -- one of the most eagerly anticipated in the HIV research and advocacy community -- will feature more than 1,000 abstracts highlighting the latest findings in HIV treatment, prevention, and public health policy. Many of the most anticipated research results will answer questions in treatment and prevention for women in particular.
Outside of the science itself, conference-goers can expect greater diversity among presenters this year. Specifically, conference organizers made it a priority to invite more women and more young people to present their work.
More than half of the presenters will be women, said Carlos del Rio, M.D., a member of the IAS's board of directors. In addition, del Rio noted that the programming committee worked hard to make sure that there was a balance between the "known names" in HIV research and the "up-and-coming stars."
"We tried to get a lot of authors under the age of 40," he said, noting that the IAS programming committee will continue to keep diversity top of mind in 2019 and beyond.
[Editor's Note: As the study findings we previewed below were presented at IAS 2019, we updated this article with links to our coverage of each topic.]
Dolutegravir: More Clarity on Safety During Pregnancy
For many attendees, a top priority at IAS will be to learn more about the safety profile of dolutegravir (Tivicay, DTG), which was called into question after 2018 data from Botswana found a link between dolutegravir among people who are pregnant and newborn birth defects.
"I think one of the most exciting things presented [will be] updates on the dolutegravir and pregnancy issue," said del Rio. "That is a really hot topic right now."
Dolutegravir was on its way to becoming a cornerstone of HIV treatment guidelines in dozens of middle- and low-income countries, but the alarming data on potential birth defects prompted some countries to put those plans on hold.
At last year's International AIDS Conference in Amsterdam, researchers presented data from Botswana's Tsepamo study, which seemed to indicate a risk of neural tube defects in children born to cisgender women taking dolutegravir. Shortly thereafter, the World Health Organization (WHO) released new guidelines that encouraged contraception among cisgender women of childbearing age taking the drug.
Because many health authorities had already decided to recommend dolutegravir, the data were "like throwing a grenade" in the HIV public-health world, del Rio said.
Data presented at IAS 2019 will include an updated analysis from the Tsepamo study. Outside of that specific study, Botswana health facilities have been monitoring their patients for safety data, and some of those results will be presented as well.
Meanwhile, researchers from Brazil will present their own surveillance-based analysis on the safety of dolutegravir, and the WHO plans to release clarifying treatment guidance based on the summation of data collected so far.
[Jump to our IAS 2019 coverage: World Health Organization Updates Guidance on Dolutegravir After Reassuring Data Regarding Safety in Early Pregnancy]
ECHO: Hormonal Contraception and HIV Risk
Though updated dolutegravir data will be a highlight of IAS this year, another much-anticipated area of research is the many follow-up analyses to the recently published ECHO study. Last month, the ECHO results found that hormonal contraception does not increase cisgender women's risk of aquiring HIV.
These results assuage fears that the Depo Provera shot might lead to an increased risk of HIV infection. The study examined HIV risk among women using Depo Provera, copper intrauterine device, and levonorgestrel implant.
At IAS, attendees can expect to see data from three new abstracts, each of which will offer new and important implications from within the ECHO data. One will be a study analyzing the high rate of HIV infection overall among cisgender women and girls in South Africa, another will compare the rate of sexually transmitted infections (other than HIV) between the different contraception methods, and the third will dig into the patterns of pre-exposure prophylaxis (PrEP) use among the trial participants.
[Jump to our IAS 2019 coverage: Experts Flummoxed By Conflicting New Data on STIs, HIV, and Long-Term Contraception in Sub-Saharan Africa and Controversy Erupts Around Study on Contraception and HIV Risk]
HIV Medications in Development
According to del Rio, one of the most exciting treatment developments to watch out for this year is MK-8591, a new HIV nucleoside reverse transcriptase translocation inhibitor. Data will be presented on a Phase 2b randomized trial that includes the novel candidate as a first-line therapy.
"We're always on the lookout for newer, better, safer, more well-tolerated regimens," he said. If successful in clinical trials, MK-8591 "will be used in people with multidrug-resistant HIV."
IAS will feature at least two studies that were designed to assess the safety and efficacy of combination therapy dolutegravir plus lamivudine (3TC, Epivir) for patients who are initiating treatment and for people who would like to switch after achieving viral suppression on another regimen.
[Jump to our IAS 2019 coverage: What's New in HIV Treatment: A Report on Updates from IAS 2019 and The State of Cure Research for HIV and Hepatitis B: Similarities and Differences]
The HIV Prevention Research Pipeline
HIV prevention is always a major theme at IAS, and this year is no different. On the docket is data on an exciting new approach to PrEP delivery -- an implantable PrEP delivery system. This study, which uses MK-8591 as PrEP, is only a Phase 1 trial, but it should help guide future clinical research into this novel PrEP delivery method. The final results from an open-label study of the dapivirine vaginal ring will also be presented, potentially moving us closer to a vaginal prevention option.
Another novel, but potentially revolutionary, HIV prevention study that will be presented at IAS is the ASCENT trial, which is a Phase 2a vaccine study of two different mosaic-based vaccines among HIV-negative adults in Kenya, Rwanda, and the United States.
IAS presentations will also include a new analysis of the DISCOVER trial, which pits F/TDF (trade name Truvada) against the newer formulation, F/TAF (trade name Descovy), for PrEP.
[Jump to our IAS 2019 coverage: DISCOVER PrEP Trial Finds F/TAF Has Superior Load Time and Tail Compared to F/TDF and Does Descovy Really Work Better Than Truvada for PrEP? One Researcher Raises Questions About the DISCOVER Trial Results]