Biological, clinical and ethical imperatives for involving diverse women in HIV clinical trials

Clinical trials have historically under-enrolled women, and research has too often ignored that females and males are biologically different, although women are disproportionately affected by HIV in sub-Saharan Africa. Women’s exclusion from trials is often motivated by a desire to protect them and their children from potential harm caused by a medication, but this results in inequity for women: unknown safety, efficacy and tolerance of most new medications. This is how Dr Catherine Orrell, from the Desmond Tutu Health Foundation, University of Cape Town, opened a session on the involvement of women in clinical trials at the virtual HIV Glasgow 2020 congress earlier this month.

New once-a-week drug could be part of weekly oral treatment

The conference heard about two human studies of a new drug being developed by Merck & Co in the non-nucleoside reverse transcriptase inhibitor (NNRTI) class. This drug, MK-8507, could be given just once a week, according to these studies.

High blood pressure less common in people with HIV in Africa

High blood pressure is less common among people with HIV in sub-Saharan Africa compared to the rest of the population, a systematic review presented at the conference shows.

European AIDS Treatment Group documents the impact of COVID on HIV services throughout Europe

A series of rapid-response surveys by the European AIDS Treatment Group (EATG) has uncovered significant changes in access to HIV testing, PrEP and HIV treatment during the course of the COVID-19 epidemic, the conference heard.

Long-acting injectables work without oral lead-in period

A combination of two long-acting injectable antiretrovirals taken once monthly maintained viral suppression with a very low rate of virologic failure, according to results from two phase III trials presented at HIV Glasgow.

Islatravir plus doravirine remains effective at 96 weeks

Islatravir, the first of a new class of antiretrovirals, continued to demonstrate high potency and good tolerability at 96 weeks when combined with doravirine (Pifeltro), researchers reported at the conference.

Promising results for programme to reduce sleep disturbance in people with HIV

A poster at the conference has concluded that a questionnaire on sleep quality, validated in other disease areas, appears to be reliable, simple and convenient for assessing sleep disturbance in people with HIV. The study also concludes that providing information on sleep hygiene and switching antiretrovirals when necessary can significantly improve sleep disturbance in people with HIV, including among those going through mental health issues.

Weight gain after switch to an integrase inhibitor does not boost 'bad fat'

People with HIV who gain weight after switching to an integrase inhibitor are not gaining a disproportionate amount of body fat linked to increased risk of metabolic disorders or heart disease, Dr Giovanni Guaraldi of the University of Modena, Italy, told the conference.

Injectable HIV therapy should save money if adherence is better than to oral therapies

A presentation at the conference on the cost-effectiveness of the new injectable formulation of the antiretroviral drugs cabotegravir and rilpivirine finds that, if it improves adherence relative to oral drugs, it should save the UK NHS money, at least over a patient's lifetime. It would also add from 2-15 weeks to the time people with HIV who take it can expect to live in good health, and would avert some HIV transmissions.

Weight gain on HIV treatment: what is normal, and what is harmful?

Weight gain in people with HIV on antiretroviral treatment – especially integrase inhibitors – may reflect a return towards a weight that's normal in the wider society, but physicians should be watching out for the most extreme cases, as these people are most likely to suffer weight-related complications in the future, Professor Andrew Carr of St Vincent’s Hospital, Sydney, told HIV Glasgow.

Two-thirds of people living with HIV would like to try injectable treatment, according to European survey

Two-thirds of people on HIV treatment would like to switch to a long-acting injectable regimen, according to a four-country survey presented to the conference. Healthcare professionals answering the same survey thought fewer people – a quarter – would end up switching.

PrEP does not protect against COVID-19 or make the disease less severe

Tenofovir-based HIV pre-exposure prophylaxis (PrEP) does not provide protection against infection with the new coronavirus, nor does it ameliorate the course of COVID-19 disease, Spanish research published in Open Forum Infectious Diseases suggests. Indeed, prevalence of SARS-CoV-2 (the scientific name for the virus that causes COVID-19) was actually higher among people taking PrEP compared to individuals who were not.

Fatty liver disease common in people living with HIV and hepatitis B

Around one in three people with HIV and hepatitis B had fatty liver disease and one in ten had liver damage, US researchers from the Hepatitis B Research Network report in Clinical Infectious Diseases.

Genetics may contribute to weight gain after switching from efavirenz to an integrase inhibitor

Genetic variations in a liver enzyme could explain why some people put on unwanted weight after switching from efavirenz to an integrase inhibitor, Dr Michael Leonard of Vanderbilt University Medical Center in Nashville and colleagues report in Clinical Infectious Diseases. Slow metabolism of efavirenz due to the CYP2B6 gene – leading to higher blood concentrations of the drug – was associated with greater weight gain after switching from efavirenz to some integrase inhibitors.

Self-sampling for STIs in the rectum and throat as diagnostically accurate as sampling by a clinician

Self-sampling for sexually transmitted infections in the rectum and throat is just as accurate as testing performed by a healthcare worker, investigators from Leeds report in the online edition of Clinical Infectious Diseases. This is based on a study that involved women and gay men. They found that rectal and throat self-sampling was equal in accuracy to sampling by healthcare workers. Self-sampling also had cost-saving potential, especially when performed at home.

US study shows an increased risk of dementia in men ageing with HIV

Do men who age with HIV have a higher risk of dementia than their HIV-negative counterparts? It may well be the case, according to a recent study conducted in the US by Dr Kirsten Bobrow, University of California San Francisco.

COVID-19’s impact on HIV treatment less severe than feared | UNAIDS

While recent data collection has shown that the COVID-19 pandemic has had a significant impact on HIV testing services, the impact on HIV treatment is less than originally feared.

ViiV Healthcare receives positive CHMP opinion for long-acting regimen for the treatment of HIV | ViiV Healthcare press release

ViiV Healthcare’s Vocabria (cabotegravir injection) used in combination with Janssen Pharmaceutical Companies of Johnson & Johnson’s Rekambys (rilpivirine injection) reduces treatment dosing days from 365 to 12 or 6 per year. The long-acting regimen is based on co-administration of cabotegravir and rilpivirine injections once-monthly or once every two months to treat HIV-1.

GSK's ViiV, armed with long-term Dovato data, eyes 'tipping point' for 2-drug HIV regimen | FiercePharma

Changing over two decades of treatment practice can be laborious. For ViiV Healthcare, the process involves delivering long-term data to prove its two-drug HIV regimens work just well as traditional triplets over time. Now, the GlaxoSmithKline subsidiary believes it has the results to boost confidence among doctors and move closer to a major growth boost.

Equitable access to PrEP now | Terrence Higgins Trust

Read our PrEP4All community statement of 50-plus HIV, health and equalities organisations calling for equal access for all who need PrEP and sign your name below.

What happened with PEPFAR's faith-based initiative? | Devex

On World AIDS Day in 2018, Vice President Mike Pence announced a new US President’s Emergency Plan for AIDS Relief initiative that would provide an additional $100 million to faith-based organisations. It was a flashy announcement that raised concerns over where the funding would come from and whether it would be politics or evidence that determined the initiative’s direction.