News from EACS 2021
People with HIV with CD4 counts below 200 show weaker responses to COVID-19 vaccines
People with CD4 counts below 200 were significantly less likely to generate strong antibody and cellular immune responses to the Pfizer or Moderna mRNA COVID-19 vaccines compared to people with better immune function, Italian researchers reported at the 18th European AIDS Conference (EACS 2021) in London.
HIV testing and prevention services affected badly by COVID in Europe, HIV treatment less so
Two sessions at the conference concentrated on the way the COVID pandemic has impacted on HIV diagnosis, treatment and prevention, especially in Europe and central Asia. Both keynote presenters said that the services most badly affected were HIV testing and surveillance.
Clinics will need new systems to administer injectable HIV therapies, says Canadian early adopter
Dr Jonathan Angel, an HIV physician and researcher at the University Hospital of Ottawa in Canada, is one of the first doctors in the world to prescribe the injectable formulation of the drugs cabotegravir and rilpivirine, not as part of a clinical trial, but in standard medical practice. Dr Angel told the conference about his practical experience of prescribing the new injectable antiretrovirals.
For long-term PrEP, we need better definitions of adherence, conference hears
No one is in any doubt as to the efficacy of HIV pre-exposure prophylaxis, at least for gay men, EACS 2021 was told. However, the conference heard, we need better tools to monitor its long-term use by individuals and whether they are using it optimally. And PrEP is still nowhere nearly available enough in the parts of Europe that need it most.
Europe far from achieving hepatitis C elimination targets
European Union states are far from reaching the global targets towards hepatitis C elimination, especially on harm reduction, testing and treatment, Dr Erika Duffell of the European Centre for Disease Prevention and Control told the conference.
Most people with HIV accept COVID-19 vaccination; more safety information would help those who are hesitant
Surveys from diverse settings do not suggest unusual levels of COVID-19 vaccine hesitancy among people living with HIV, the conference heard. Data were presented from Argentina, Greece, Turkey, the Middle East and the United Kingdom.
Woman with HIV with low CD4 count remained positive on SARS-CoV-2 tests for over 5 months
People with HIV who are severely immunosuppressed may have prolonged periods of shedding SARS-CoV-2 without clinical symptoms, a case report presented at the conference suggests.
Levels of COVID-19 vaccination in people with HIV in central and eastern Europe vary widely
People with HIV are not being prioritised for COVID-19 vaccination in all countries in central and eastern Europe and vaccination rates in this vulnerable population remain low in some countries, Dr David Jilich of Charles University, Prague, told the conference.
Half of Swiss mothers with HIV decide to breastfeed their baby when given the choice
For new mothers with HIV, whether to breastfeed their baby has been a difficult choice. Unlike transmission through sex, viral suppression through antiretroviral therapy may not completely remove the risk of transmission. At the conference, Dr Pierre-Alex Crisinel of Lausanne University Hospital reported findings from an observational study in the Swiss Mother and Child HIV Cohort.
Lung function declines faster in people living with HIV
A study at the conference showed that people living with HIV who receive effective antiretroviral therapy have a faster rate of lung function decline than HIV-negative people.
Half of trans people attending English sexual health clinics took part in PrEP IMPACT study
A study comparing HIV risk factors in trans and non-binary people who did, and did not, take part in the PrEP IMPACT study has found that just over half the people who attended sexual health services in England during the period of the IMPACT trial ended up participating in it.
People living with HIV should be routinely asked about domestic abuse
Dr Nadia Ahmed from the Mortimer Market Centre in London reported on the importance of routine domestic abuse screening following a project that she and her colleagues ran from March 2020 to March 2021.
Large international study finds 40% higher risk of serious cardiovascular problems in people taking abacavir since 2012
People taking abacavir as part of their antiretroviral regimen were 40% more likely to experience a heart attack, stroke or other serious cardiovascular event than people not taking the drug, and this risk was not affected by pre-existing cardiovascular problems, a large international study of people with HIV in Europe and Australia has found.
New cases of multi-drug resistant HIV becoming rarer in Europe
Resistance to all four main classes of antiretrovirals is becoming rarer among people with HIV in western Europe, a seven-country study presented at the conference shows.
First efficacy results from England's PrEP IMPACT Trial
Attendees at the conference in London heard the first efficacy data from probably the largest PrEP demonstration study ever conducted – the PrEP IMPACT implementation trial in England. Gay and bisexual men enrolled in IMPACT had 87% fewer HIV infections than a comparable group of sexual health clinic attendees who did not take PrEP.
Half of speciality guidelines for medical conditions suggesting HIV don’t recommend HIV testing
More widespread HIV testing in Europe is being hampered by medical guidelines which do not recommend testing people who have AIDS-defining conditions or other illnesses that could be linked to HIV, the conference heard.
aidsmapLIVE: HIV prevention special
On Monday 8 November, we broadcast an aidsmapLIVE HIV prevention special.
NAM aidsmap’s Susan Cole was joined by guests Professor Sheena McCormack from the Medical Research Council Clinical Trials Unit; Dr Vanessa Apea from Barts Health NHS Trust; Winifred Ikilai from the National Forum of People Living with HIV/AIDS Networks in Uganda; and Gus Cairns from NAM aidsmap.
You can watch the broadcast on our Facebook and Twitter pages and on YouTube.
Other news from aidsmap
A double whammy: the impact of HIV and menopause on bone mineral density
A study of women in the United States has found that HIV and menopause stage are each independent risk factors for lower bone mineral density, with each having an additive effect.
High mortality of people living with HIV in Thailand highlights the need for early diagnosis and treatment
The probability that people living with HIV in Thailand survive five years after starting antiretroviral therapy was just 75%, according to a recent study published in AIDS Research and Therapy.
Seasons of risk: the PrEP journey of adolescent girls and young women in Kenya and South Africa
A qualitative study in South Africa and Kenya looked at barriers and facilitators along the PrEP journey of adolescent girls and young women. Intentional PrEP pauses and restarts, corresponding to changing circumstances and seasons of risk, were common among participants in this study.
Beta variant of COVID-19 may cause more severe illness in people with HIV
People with HIV who developed COVID-19 during the second wave of South Africa’s pandemic in 2021 were more likely to experience a severe illness than HIV-negative people and more likely than people with HIV in the first wave to show low CD4 counts and other immune disturbances, South African researchers report in the journal eLife.
New cases of hepatitis C have fallen among gay and bisexual men with HIV in France
The rate of new hepatitis C infections halved among gay and bisexual men with HIV in France between 2014 and 2017 following the introduction of direct-acting antivirals, a French cohort study has reported.
CDC PrEP guidelines should include specific criteria for trans women
Data from a large American cohort of transgender women highlights the need for new PrEP prescription criteria for this group. Current Centers for Disease Control and Prevention (CDC) guidelines for PrEP do not include any specific criteria for trans women. However, they have criteria for gay and bisexual men, which are often applied to trans women as well. The researchers suggest more trans women will be eligible for PrEP if trans women specific criteria are introduced into the current CDC guidelines.
Stark disparities seen all along the US PrEP continuum
Among a large US sample, women, Black, Latinx, younger and poorer people were less likely to receive PrEP prescriptions and start taking it, but were more likely to stop when compared to White, older men from higher socioeconomic backgrounds.
“Why are we being used like guinea pigs?” Transgender women’s mistrust of PrEP research
Peruvian trans women participating in PrEP studies expressed feelings of mistrust towards researchers, questioning who PrEP is really for and stating that PrEP is rarely provided once a study is over, leaving them feeling like guinea pigs.
Anal warts increase the risk of developing pre-cancerous lesions and cancer, especially in people living with HIV
A new analysis published in AIDS and conducted by Dr Andreia Albuquerque at the University of Porto, Portugal shows that having a history of anal warts increases the risk of developing pre-cancerous lesions and anal cancer, especially in people living with HIV.
World AIDS Day Red Run
The World AIDS Day Red Run is taking place in Victoria Park, London on Saturday 27 November.
Want to take part in this year’s event in support of NAM aidsmap? There's still time to sign up (registration closes on Saturday 20 November at 11am) and you’ll be helping to raise vital funds so we can continue to provide information to people living with HIV.
Editors' picks from other sources
Researchers test two gene therapy approaches for curing HIV | POZ
Clinical trials exploring novel gene therapy approaches could pave the way for a functional cure, or long-term HIV remission. American Gene Technologies is testing genetically modified HIV-specific CD4 T cells that are resistant to viral entry, while Excision BioTherapeutics is developing a method to remove HIV DNA from the chromosomes of infected cells.
HIV patient ‘denied life-saving medication’ in UK detention centre | The Independent
The 42-year-old man relies on daily medication to manage his HIV, and says the dosages for his other ailments, schizophrenia and depression, have been reduced by staff at Colnbrook Immigration Centre.
Advocates challenge the CDC’s new effort to track HIV spread | Undark
Molecular surveillance can slow outbreaks. But with states still criminalising HIV, people with the virus see risks.
Pregnancy and birth
We have updated our information page on pregnancy and birth on aidsmap.
Find out about health care and HIV treatment during pregnancy, childbirth, testing and post-exposure prophylaxis for your baby, and emotional wellbeing.
We have also published a new page on getting pregnant when you have HIV.