25 February 2016 VOLUME 17 ISSUE 8

The new ring is far from fail-safe, but it did reduce HIV infection by 27 percent in one study and 31 percent in the other... Research now moves to a ring that would be effective for three months and to one that would also release contraceptive drugs - a potential incentive to get young women to use the device consistently. That research cannot proceed fast enough.

Researchers have for the first time documented a case of an individual contracting a multi-drug resistant strain of HIV, while apparently adhering well to the daily regimen of Truvada as PrEP. The scientists concluded that it is indeed possible for individuals who are adherent to PrEP to contract HIV when exposed to a virus resistant to both drugs included in Truvada. While this case is concerning, experts suggest that such failures will likely remain rare.

A programme of home visits, partner education and HIV testing for couples in Kenya was able to double the proportion of men who tested during their partner’s pregnancy, Carey Farquhar of the University of Washington told the Conference on Retroviruses and Opportunistic Infections in Boston yesterday. Partners became aware of each other’s HIV status without this being linked to an increase in intimate partner violence.

Over a 16-year period, life expectancy of HIV patients with good access to medical care rose "dramatically." In 1996, a 20-year-old patient with HIV...could expect an additional 19 years of life, according to Julia Marcus, Kaiser Permanente Research in Oakland, CA, and colleagues. By end 2011 that had risen to 53 years. But despite that improvement, HIV-positive people still lived almost 14 years fewer on average than those without the virus, although some subgroups of patients did better.

A reduced glycerin formulation of tenofovir gel was found safe when used daily and around the time of sex, according to the first extended safety study of a rectal microbicide for HIV prevention from anal sex. Presented today at [CROI], the MTN-017 study, led by the NIH-funded Microbicide Trials Network, also indicated that participants were as likely to follow through using the gel with sex as they were to using daily oral pre-exposure prophylaxis.

For years, the fixed-dose single-pill combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) -- sold as Truvada -- has been a favored backbone for many three-drug anti-HIV regimens, noted Joel Gallant, MD, of the Southwest Care Center in Santa Fe, NM. But a new prodrug of TDF -- tenofovir alafenamide, or TAF -- appears to have similar efficacy with fewer side effects, Gallant reported at the Conference on Retroviruses and Opportunistic Infections (CROI).

ViiV Healthcare and Johnson & Johnson are pressing into late-stage development with a combination HIV treatment that can be dosed every 8 weeks, building on clinical results in which their cocktail measured up to daily pills....The results, presented at the Conference on Retroviruses and Opportunistic Infections this week, have convinced ViiV to map out a Phase III effort, and the company said it expects to start late-stage studies later this year.

In the fight against HIV, women have been severely limited in what they can do to protect themselves against the virus and it typically involves asking an infected partner to wear a condom....There's finally hope that a convenient and inexpensive option that puts more power in women's hands may be available in the not-so-distant future. Scientists reported this week that two large-scale studies in Africa have shown that a flexible vaginal ring that women can insert themselves may be able to provide limited protection against the virus.

Based on an estimate of lifetime risk of an HIV diagnosis, half of all US black men who have sex with men [MSM] will contract infection. Latino MSM also face a relatively high...risk (one in four), according to Kristen Hess of the CDC. Lifetime risk for white MSM is one in 11, her group reported at the Conference on Retroviruses and Opportunistic Infections....Risk of HIV infection is one in 48 among African-American women compared with one in 880 for white women.

A single dose of the drug zoledronic acid was found to inhibit the bone loss that is common in HIV-infected patients is increased during the first two years of treatment with ART, [and] also leads to a higher rate of fracture. Results of the Phase II clinical trial were presented Feb. 23 at the 2016 Conference on Retroviruses and Opportunistic Infections in Boston.

New research out Tuesday from the Centers for Disease Control shows the nation losing ground in the fight against HIV/AID in minority communities....Some North Texans working to prevent new infections–and support those living with the disease–say the arrival of anti-viral medications helped ease the panic of a generation ago: but, now in many cases apathy has replaced panic.

A program to accelerate HIV diagnosis, preparation, and starting antiretroviral therapy in South Africa led to a higher proportion of people initiating treatment and better health outcomes, according to results from the RapIT trial....The RapIT protocol condenses the steps of the testing, counseling and medication dispensing process, making it faster and easier for people to start ART...and to have all steps completed during a single clinic visit, ideally on the same day a person tests HIV-positive.

A combination of two long-acting injectable antiretrovirals, cabotegravir and rilpivirine, given once every 4 or 8 weeks, maintained viral suppression as well as a standard oral antiretroviral therapy regimen and appeared safe and well-tolerated, according to results from the LATTE 2 trial presented at the Conference on Retroviruses and Opportunistic Infections this week in Boston, USA.

For the first time, the Health Ministry has approved a pre-exposure prophylaxis (PrEP) program to prevent HIV transmission, making Israel one of the first countries outside the US to use it....The drugs will be handed out at the various AIDS centers in hospitals and clinics that serve homosexuals, as well in health fund clinics. The ministry will soon decide whether to give the drug “cocktails” also to those who inject hard drugs and women at high risk.

Within 6 years of human papillomavirus vaccine introduction, there was a dramatic decline among teen-age girls and young women in the four types of HPV in the 4-valent HPV vaccine (4vHPV). Among females ages 14-19, 4vHPV-type prevalence was down 64%, and declined 34% among women ages 20-24, compared to comparable data from the "pre-vaccine era."... However, no statistically significant differences were observed among women ages 25-29 and ages 30-34 from the pre-vaccine era to the "vaccine era" (2009-2012).

A flexible and inexpensive ring inserted into the vagina, where it slowly releases an antiviral drug, helped protect African women against contracting HIV from their sexual partners, researchers said Monday in reports on two major studies that included more than 4,500 women. The protection was not complete [but] researchers said the device was still a major advance and that...they would press ahead to get the ring approved and widely distributed as quickly as possible.

Researchers have succeeded in developing a designer recombinase (Brec1) that is capable of specifically removing the provirus from infected cells of most primary HIV-1 isolates....Importantly, the antiviral effects were accomplished without measurable cytotoxic or genotoxic side effects. Based on these findings, Brec1 represents a promising candidate for possible applications in improved HIV therapies.

Now that the trial has been completed, the National Institute of Allergy and Infectious Diseases — the US institute that funded the trial — plans to convene experts in March to decide the future of dapivirine ring research. Depending on the outcome, two other government-funded trials could take place. Those would involve providing the ring to former participants of today’s study and trying to better understand the HIV prevention needs and desires of adolescent girls and young women.

Researchers at University of California, San Diego School of Medicine have discovered that HIV infection of human immune cells triggers a massive increase in methylation, a chemical modification to both human and viral RNA, aiding replication of the virus. The study, published February 22 in Nature Microbiology, identifies a new mechanism for controlling HIV replication and its interaction with the host immune system.

When a field is besieged by failures, small steps forward seem great triumphs. That’s the case with the latest effort to protect women at high risk of being infected with HIV. Two large trials of a vaginal ring that secretes an antiretroviral drug into the vagina found it reduced infections by about 30%....“It’s a bold step in the right direction, and gives the field something to build on,” says Robin Shattock, Imperial College London.

Two groups of scientists presented results at an HIV conference on Monday suggesting that a vaginal ring could prevent HIV transmission in women....“A prevention tool like a ring could be used discreetly, a woman would have control over it, and it could allow her to keep herself safe from HIV without having to ask a male partner to take on prevention strategies,” lead author Jared Baeten said. “That individual control of prevention is so powerful.”

Researchers who studied a large cluster of new HIV infections in Cambodia...have recommended that national prevention strategies be expanded to monitor the risk for HIV transmission via unsafe injections....Preliminary results [showed] that cases were nearly five times as likely as controls to have received an IV or intramuscular injection, and four times as likely to have received an IV infusion during the previous 6 months.

It would seem that we have the tools we need to end the epidemic. Yet more than 1.5 million people around the globe become infected with HIV each year and another one million die of AIDS....We are going to learn more about two emerging tools to control the HIV/AIDS epidemic: prevention medicines that are easy to use and protect those who are HIV negative from infection, and advances in vaccine research.

Only 7% of clinicians recommended to patients that the HPV and hepatitis B vaccines specifically can reduce cancer, according to a recent survey. “The majority of physicians and other health care providers surveyed reported that discussing cancer prevention with their patients is an effective compliance strategy for HPV and hepatitis B vaccination, yet few are acting on that knowledge,” [said] Carolyn Aldigé, president of the Prevent Cancer Foundation.

Pope Francis said the use of contraception can be acceptable in regions hit by the Zika virus, a stance that could reignite a debate over the church’s prohibition on using condoms to stop the spread of the AIDS virus.

There's been a male tilt to biomedical research for a long time. The National Institutes of Health is trying to change that and is looking to bring gender balance all the way down to the earliest stages of research. As a condition of NIH funding, researchers will now have to include female and male animals in their biomedical studies.

Between April 2013 and March 2014, we enrolled 369 eligible women similar across groups for marital status, duration of HIV diagnosis, and distance to facility. Of the 369 women, 98% had WHO clinical stage 1 disease, 99% had high functional status, and 96% delivered vaginally. Mothers in the intervention group were more likely to initiate ART (97%) [and] mother and infant pairs in the intervention group were more likely to be retained in care at 6 weeks (83%) and 12 weeks (75%) post partum.

S- and N-dihydro-alkyloxy-benzyl-oxopyrimidines (S-DABOs/N-DABOs) are interesting compounds active at nanomolar concentration against wild type of reverse transcriptase (RT) and with a very interesting activity against RT mutations. Herein, novel N-DABOs were synthesized and tested as anti-HIV agents. Furthermore, their mode of binding was studied by molecular modeling. At the same time, a vaginal microbicide gel formulation was developed and tested for one of the most promising candidates.