This Week in HIV Research: Protease Inhibitor Monotherapy; Mortality Rates Among Youth With HIV; and New Hydrogel Condom

This week, a study finds that protease inhibitor monotherapy does not increase the risk of developing drug resistance, but questions remain whether it's viable as long-term maintenance therapy. The National Institutes of Health (NIH) announced a joint-initiative with pharmaceutical company GlaxoSmithKline to develop broadly neutralizing antibodies that work against HIV. Another study examines the rates of comorbidities and deaths among youth living with HIV in the United States. And a new condom goes one step further in preventing HIV transmission.

To beat HIV, you have to follow the science!


Protease Inhibitor Monotherapy Does Not Limit Future Treatment Options

Taking a boosted protease inhibitor regimen did not increase the risk of developing drug resistance when compared to a standard triple-drug regimen, according to a study published in The Lancet HIV.

The study randomized 587 virally suppressed patients on a triple-drug regimen to either maintain ongoing triple therapy (OT) or switch to a physician-selected protease inhibitor monotherapy (PI-mono) boosted with ritonavir (Norvir).

After three years, two participants (0.7%) in the OI group lost future drug options versus six participants (2.1%) in the PI-mono group, demonstrating noninferiority.

At the end of the study, 58% of the PI-mono group were still on monotherapy. Among those who switched back to combination therapy, 23% was for protocol-defined confirmed viral rebound and 4% for viral rebound not meeting protocol criteria.

NIH Launches Initiative to Develop Long-Acting HIV Treatment and Prevention Tools

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is partnering with GlaxoSmithKline (GSK) to form a new initiative for developing broadly neutralizing antibodies that work against HIV.

"This new partnership between our government scientists and GSK provides a pathway to accelerate the innovations needed to produce new and longer-acting agents for preventing and treating HIV," said NIAID director Anthony S. Fauci, M.D., according to the NIAID press release.


Changing Trends in Complications and Mortality Rates Among U.S. HIV-Positive Youth

Opportunistic infections and deaths have gone down among U.S. young people living with HIV in the combination antiretroviral therapy era, but death rates among this group remain significantly higher than the general population, according to a study published in Clinical Infectious Diseases.

The researchers found that the mortality rate for HIV-positive youth was 31.5 times higher than the U.S. general population. Deaths were associated with older age, lack of treatment, lower CD4+ cell counts and higher viral loads.

Additionally, complications with significantly increased rates included: substance or alcohol abuse, tuberculosis, diabetes, atypical mycobacterial infections, vitamin D deficiency, anxiety disorders and bone fractures.

HIV Prevention

On-Demand Pre-Exposure Prophylaxis Greatly Reduces HIV Transmission

People who took tenofovir/emtricitabine (Truvada) as needed around periods of sex were 86% less likely to contract HIV than those who took a placebo, according to final results of the IPERGAY study, published in the New England Journal of Medicine.

Last year, the IPERGAY study was halted early by the data safety monitoring board (DSMB) because of overwhelming evidence that on-demand pre-exposure prophylaxis (PrEP) greatly reduced the risk of HIV transmission.

New Condom Made From Hydrogel, Plant-Based Antioxidants Further Prevents HIV

Standard latex condoms already help prevent HIV transmission. But a new condom made from a strong, elastic polymer called hydrogel could take preventing transmission one step further. The condom, which is being developed by Mahua Choudhury, Ph.D., an assistant professor at Texas A&M University, will include a plant-based antioxidant that has anti-HIV properties. This would help prevent HIV transmission when a condom breaks.

"We are trying to find how fast the enmeshed antioxidant can release and we don't know if it will automatically release, or if you have to apply pressure," said Choudhury, according to a report by Texas A&M Health Science Center. The condom is currently going through the patent process and will go through testing over the next six months.

Is there a development this week in HIV research that you think we missed? Send us a tip!