6 MARCH 2020 VOLUME 22 ISSUE 9

Media Coverage

• Top Coronavirus Official for US Has Fought an Epidemic Before

  In the spring of 1983, even before the virus that causes AIDS had a name, a young Army doctor named Deborah L. Birx suffered excessive bleeding while giving birth. Moments before she passed out from pain, she screamed an order at her husband: “Do not let them give me blood!”

  March 6, 2020

  General

  New York Times

• Monthly Long-Acting Injectable HIV Meds Just as Good as Daily Pill for Those New to Treatment and Those Already Undetectable, New Studies Find

  Two studies published on Wednesday in the New England Journal of Medicine showed the effects of the monthly, long-acting injectable forms of cabotegravir and rilpivirine (Edurant). One study compared the injectable combination to standard oral therapy in people with HIV who were already virally suppressed. The other study compared the efficacy of the two drugs in injectable form to that of oral therapy for patients who were treatment-naive at the start of the study.

  March 4, 2020

  Treatment

  The BodyPro

• New TB Drug Regimen Controls Resistant Disease in 9 of 10 Cases: Study

  The new anti-tuberculosis drug combination of bedaquiline, pretomanid and linezolid cures 90 percent of people with deadly drug-resistant TB if given for six months, researchers report in The New England Journal of Medicine.

  March 4, 2020

  General

  Reuters

• Truvada Monopolization Claims Get Green Light Against Gilead

  Gilead Sciences Inc. and several other pharmaceutical companies must face claims they schemed to cement its “stranglehold” on the HIV prevention market by delaying generic competition for the blockbuster drug Truvada, a San Francisco federal judge ruled.

  March 4, 2020

  PrEP

  Bloomberg Law

• What Would It Take to End HIV Forever?

  During his State of the Union address in February, President Donald Trump reiterated a promise he had made a year earlier: By 2030, the United States would bring an end to the HIV/AIDS epidemic that first took root nearly 40 years ago. It’s the sort of sweeping assurance that seems too good to be true, given Trump’s track record of broken pledges and his administration’s attempts to slash HIV-related programs and public health priorities.

  March 3, 2020

  General

  Gizmodo

• Uganda Finalizes Research On Injectible HIV Drug

  The Uganda AIDS Commission is finalizing clinical trials on a new injectable treatment for human immunodeficiency virus (HIV), the Director General of Uganda AIDS Commission, Dr Nelson Musoba, announced this week. The government is planning to unveil the treatment 2021.

  March 3, 2020

  Treatment

  All Africa

• HIV Drug Giveaway Effort Gets Fresh Boost From Pharmacies

  A franchise of over 3,300 independent pharmacies will dispense the HIV prevention drug donated by Gilead Sciences Inc. at no cost to the federal government, the Health and Human Services Department said Tuesday.

  March 3, 2020

  PrEP

  Bloomberg Law

• Misleading Ads Turn People Away From HIV-Prevention Meds

  Targeted advertisements on Facebook and television that overstate side effects of HIV-prevention pills might be the greatest threat to protecting people at high risk of infection with the virus, experts say.

  March 2, 2020

  PrEP

  Reuters

• USPSTF Recommends HCV Screening for All US Adults Ages 18-79

  The US Preventive Services Task Force (USPSTF) today expanded its recommendation for one-time hepatitis C virus (HCV) screening to include all asymptomatic US adults ages 18-79 years, including pregnant women, who do not have known liver disease.

  March 2, 2020

  General

  Medscape

• A $100 Million HIV Vaccine Project Failed. But All Hope Is Not Lost

  Infectious disease specialist Glenda Gray spent the last 10 years of her life organizing a clinical trial on HVTN 702, a vaccine she and her team hoped could protect people from becoming infected with HIV.

  March 2, 2020

  HIV Vaccine

  NPR

• US Funding Agency Upbeat About HIV Research Despite SA Vaccine Failure

  A senior scientist from the biggest external funder of SA HIV research says he remains optimistic about the prospects of an effective vaccine, despite the failure of the HVTN 702 trial.

  March 1, 2020

  HIV Vaccine

  Business Day

• US to Give Zambia $389 Million Grant for AIDS Relief

  The United States will give Zambia a new one year bilateral grant of $389 million for AIDS relief starting in October after Congressional approval, Zambia’s ministry of health said in a statement.

  March 1, 2020

  Treatment, Voluntary Medical Male Circumcision

  Reuters

• Study Raises Alarm Over Low Uptake of HIV Drugs

  One of the largest campaigns to recruit Kenyans for the HIV prevention pill has reported low uptake, poor adherence and serious drug related side effects.

  March 1, 2020

  PrEP

  Standard Digital

• Same-Day Viral Load Testing Linked to Significant Improvements in HIV Treatment

  South African trial finds 90 percent of people receiving rapid viral load testing were virally suppressed and in care after 12 months, compared to 76 percent who waited for tests.

  February 28, 2020

  Treatment

  Avert

Published Research

• Is PrEP Necessary During Natural Conception in HIV-1-Serodiscordant Couples on Art With Suppressed Viral Load? A Retrospective Cohort Analysis

  Our results show that PrEP had minimal influence in reducing the risk of HIV transmission during natural conception in HIV-1-serodiscordant couples with a stably suppressed viral load. Thus, it may be an acceptable option for HIV-negative partners to not use PrEP during the process of natural conception if the HIV-positive partner has achieved viral suppression for more than half a year.

  March 6, 2020

  PrEP

  BMC Infectious Diseases

• Mapping and Characterising Areas With High Levels of HIV Transmission in Sub-Saharan Africa: A Geospatial Analysis of National Survey Data

  We found that, among young adults, micro-epidemics of relatively high HIV prevalence alternate with areas of very low prevalence, clearly illustrating the existence of areas with high levels of transmission. These areas are partially characterised by high economic activity, relatively high socioeconomic status, and risky sexual behaviour. Localised HIV prevention interventions specifically tailored to the populations at risk will be essential to curb transmission.

  March 6, 2020

  General

  PLOS Medicine

• Cabotegravir Long-acting Protects Macaques Against Repeated Penile SHIV Exposures

  We used a novel penile simian HIV (SHIV) transmission model to investigate if cabotegravir long-acting (CAB LA) prevents penile SHIV acquisition in macaques. Twenty-two macaques were exposed to SHIV via the foreskin and urethra once-weekly for 12 weeks. Of these, six received human-equivalent doses of CAB LA, six received oral FTC/TDF, and 10 were untreated. The efficacy of CAB LA was high and similar to that seen with oral FTC/TDF. The high efficacy of CAB LA in the penile transmission model supports extending the clinical advancement of CAB LA PrEP to heterosexual men.

  March 6, 2020

  PrEP

  Journal of Infectious Diseases

• Ending the HIV Epidemic in the USA: An Economic Modelling Study in Six Cities

  Evidence-based interventions can deliver substantial public health and economic value; however, complementary strategies to overcome social and structural barriers to HIV care will be required to reach national targets of the ending the HIV epidemic initiative by 2030.

  March 5, 2020

  General

  Lancet HIV

• Treatment of Highly Drug-Resistant Pulmonary Tuberculosis

  The combination of bedaquiline, pretomanid, and linezolid led to a favorable outcome at 6 months after the end of therapy in a high percentage of patients with highly drug-resistant forms of tuberculosis; some associated toxic effects were observed.

  March 5, 2020

  General

  NEJM

• Triumph and Tragedy of 21st Century Tuberculosis Drug Development

  Since the discovery of the first antituberculosis drugs 75 years ago, the pursuit of a short, effective, and affordable regimen that has acceptable side effects and is capable of curing most patients most of the time has been a major public health priority. Such a “pan-tuberculosis” regimen is seen by many as essential in reducing the global tuberculosis burden. The successful development of two new antituberculosis drugs — bedaquiline and pretomanid — represents an important step forward in the pursuit of pan-tuberculosis regimens fit for the 21st century.

  March 5, 2020

  General

  NEJM

• Zulu Men’s Conceptions, Understanding, and Experiences of Voluntary Medical Male Circumcision in KwaZulu-Natal, South Africa

  The understanding of males regarding VMMC was mainly attributed to HIV prevention; however, knowledge on the degree of partial protection appeared to be limited. An array of negative accounted in the form of complications such as poor wound healing and postoperative pain undergone by peers and other close influencers’ accounted for participants’ experiences of VMMC. Poor knowledge and negative experiences relating to VMMC could account for reasons why men choose not to undergo VMMC.

  March 5, 2020

  Voluntary Medical Male Circumcision

  American Journal of Men's Health

• Changes in Key Vaginal Bacteria Among Postpartum African Women Initiating Intramuscular Depot-Medroxyprogesterone Acetate

  Our findings suggest that postpartum use of DMPA-IM and non-HC may have differential impacts on the vaginal concentrations of some bacteria that have previously been associated with HIV acquisition.

  March 5, 2020

  Hormonal Contraceptives and HIV

  PLOS One

• Long-Acting Cabotegravir and Rilpivirine After Oral Induction for HIV-1 Infection

  Therapy with long-acting cabotegravir plus rilpivirine was noninferior to oral therapy with dolutegravir–abacavir–lamivudine with regard to maintaining HIV-1 suppression. Injection-site reactions were common.

  March 4, 2020

  Treatment

  NEJM

• Long-Acting Cabotegravir and Rilpivirine for Maintenance of HIV-1 Suppression

  Monthly injections of long-acting cabotegravir and rilpivirine were noninferior to standard oral therapy for maintaining HIV-1 suppression. Injection-related adverse events were common but only infrequently led to medication withdrawal.

  March 4, 2020

  Treatment

  NEJM

• Monthly Injectable Antiretroviral Therapy — Version 1.0 of a New Treatment Approach

  Combination antiretroviral therapy (ART) for the treatment of human immunodeficiency virus (HIV) infection is one of the most important advances in medicine in the past quarter century. The availability of several single-tablet multidrug treatment regimens that effectively control the replication of HIV type 1 (HIV-1) has dramatically improved the prognosis of people living with HIV who are able to adhere to daily oral therapy.

  March 4, 2020

  Treatment

  NEJM

• Abundant HIV-Infected Cells in Blood and Tissues Are Rapidly Cleared Upon Art Initiation During Acute HIV Infection

  Our results indicate that although a large pool of cells is infected during acute HIV infection, most of these early targets are rapidly cleared upon ART initiation. Therefore, infected cells present after peak viremia have a greater ability to persist.

  March 4, 2020

  Treatment

  Science Translational Medicine

• The Significance and Expectations of HIV Cure Research Among People Living With HIV in Australia

  There is an ethical need to consider the expectations of PLHIV in design of, and recruitment for, HIV cure-related research. The language used to describe HIV cure research should differentiate the long-term aspiration of achieving complete elimination of HIV from the body and possible shorter-term therapeutic advances, such as achieving medication free viral suppression.

  March 4, 2020

  Cure

  PLOS One

• Disclosure of PrEP Use by Young Women in South Africa and Tanzania: Qualitative Findings From a Demonstration Project

  Partner disclosure was common in Johannesburg but less so in Mwanza, where many partners were feared as judgemental and potentially violent. In both sites, participants commonly disclosed to family to secure support, and to friends and work colleagues to advocate about PrEP and encourage uptake among at-risk peers. Adherence clubs appeared helpful in building participants’ skills and confidence to disclose, particularly in gender-inequitable sexual relationships.

  March 4, 2020

  PrEP

  Culture, Health & Sexuality

• Immunotherapy With DNA Vaccine and Live Attenuated Rubella/Siv Gag Vectors Plus Early Art Can Prevent SIVmac251 Viral Rebound in Acutely Infected Rhesus Macaques

  There was only one viral rebound in the vaccine group. Three out of four vaccinees had no viral rebound, even after CD8 depletion, and they remain in drug-free viral remission more than 2.5 years later. The strategy of early ART combined with immunotherapy can produce a sustained SIV remission in macaques and may be relevant for immunotherapy of HIV in humans.

  March 4, 2020

  Therapeutic Vaccines, Treatment

  PLOS One

• VRC34-Antibody Lineage Development Reveals How a Required Rare Mutation Shapes the Maturation of a Broad HIV-Neutralizing Lineage

  The broadly neutralizing VRC34.01 branch required the rare heavy-chain mutation Y33P to bind FP, whereas the early bifurcated VRC34.05 branch did not require this rare mutation and evolved less breadth. Our results demonstrate how a required rare mutation can restrict development and shape the maturation of a broad HIV-1-neutralizing antibody lineage.

  March 3, 2020

  Antibody Related Research

  Cell & Host Microbe

• HIV Programmatic Outcomes Following Implementation of the ‘Treat-All’ Policy in a Public Sector Setting in Eswatini: A Prospective Cohort Study

  Compared to standard of care (SOC), Treat‐All resulted in comparable retention, improved viral suppression and comparable composite outcomes of retention without viral failure.

  March 3, 2020

  Treatment

  JIAS

• HIV Testing Among Black and Hispanic/Latino Men Who Have Sex with Men in New York City: A Mixed-Methods Study

  Qualitative analyses revealed three major themes: (1) perceptions on the NY State HIV opt-out HIV testing law; (2) HIV testing experiences; and (3) HIV testing and its role in the MSM community. These findings provide insight into HIV testing approaches and can be used to help strengthen HIV testing strategies for BLMSM in NYC.

  March 3, 2020

  General

  Archives of Sexual Behavior

• PMTCT Adherence in Pregnant South African Women: The Role of Depression, Social Support, Stigma, and Structural Barriers to Care

  Depression and social support may play an important role in adherence to PMTCT care. Pregnant women living with HIV with elevated depressive symptoms and high levels of stigma may suffer from low social support. In PMTCT programs, maximizing adherence may require effective identification and treatment of depression and stigma, as well as enhancing social support.

  March 3, 2020

  Treatment

  Annals of Behavioral Medicine

• Tenofovir Alafenamide Use in Pregnant and Lactating Women Living With HIV

  Initial pregnancy data suggest that TAF-based FDCs have high efficacy and low risk of adverse effects during pregnancy. TAF is likely to become part of first-line regimens for use in pregnant women living with HIV once additional pregnancy data from phase III trials are available.

  March 3, 2020

  Treatment

  Expert Opinion on Drug Metabolism & Toxicology

• Expanding Access and Reducing Prices for Drugs to Prevent HIV: Should Government Enforce Its Patent Rights Against the Pharmaceutical Industry?

  On November 6, 2019, the Department of Health and Human Services (HHS) filed a lawsuit against Gilead Sciences, claiming Gilead’s highly profitable sale of antiretroviral drugs (estimated at US $4 billion annually) infringes on patents held by the Centers for Disease Control and Prevention (CDC). The government rarely enforces its intellectual property rights, instead preferring collaborative relationships with industry.

  March 3, 2020

  PrEP

  JAMA

Announcements