IAS conference opens with push for treatment as prevention

The 6th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention taking place in Rome this week "started optimistically as the hype surrounding the use of antiretroviral treatment to prevent HIV infection gained momentum. But the focus of much discussion … will undoubtedly be on how to transform the recent promising research findings into workable policy," PlusNews reports (7/18).

On Monday, Myron Cohen of the University of North Carolina presented detailed findings of HPTN 052, which showed "more than 96 percent reduction in transmission risk for discordant couples where the HIV-infected partner was randomized to early antiretroviral therapy (ART) at CD4 counts of 350-550 compared to couples where ART was delayed for the infected partners until CD4 counts dropped to 250 or less, mak[ing] ART the most effective prevention intervention identified to date," the Center for Global Health Policy's "ScienceSpeaks" blog writes (Lubinski, 7/19). The study's findings, which were released early in May, were published on Monday in the New England Journal of Medicine (7/18).

In an accompanying NEJM editorial, Scott Hammer of Columbia University Medical Center writes, "Aggressive programs to diagnose and treat HIV infection as part of a comprehensive care package and multiple approaches to the prevention of transmission that have been tested in well-designed clinical trials have the potential to preserve health and control the epidemic until a safe and effective HIV vaccine is a reality" (7/18).

Another study released on Monday at the conference showed that "[p]atients taking HIV drugs in Africa can expect to have a near-normal lifespan, although men are likelier to die far sooner than women, according to the biggest study of its kind," Agence France-Presse notes (7/18). "Actuarial analysis (the kind life insurance companies do to gauge the remaining lifespan of someone at a given age and gender in a given society) reveals that more than 22,000 Ugandans on HIV treatment can expect to live almost as long as those who don't carry the virus. The average life expectancy at birth in Uganda is 55 years," according to NPR's health blog "Shots" (Knox, 7/18).

Experts at the conference said "[c]ountries that have been quick to incorporate medical male circumcision into their HIV prevention programs are already seeing good results compared with those that have been slower to embrace the procedure," PlusNews reports in an article examining how leadership has played an important role in the scale-up of the practice in Africa (7/18).

Several other reports and announcements were made at the conference on Monday:

• Under the auspices of IAS, a group of internationally respected scientists and stakeholders is guiding the development of a global scientific strategy called "Towards an HIV Cure," and on Monday the strategy's Advisory Board launched the Rome Statement for an HIV Cure, calling for an acceleration of research into cures for HIV, according to an IAS press release (7/18).
• Some pharmaceutical companies have stopped their HIV drug discount programs in middle-income countries, according to a report released by Medecins Sans Frontieres (MSF), according to an MSF press release. "The report, Untangling the Web of ARV Price Reductions - which analyzes the prices of 23 antiretrovirals with information provided by 19 manufacturers - also shows continued trends of price reductions for drugs not blocked by patents," the release states (7/18).
• The HIV Vaccines and Microbicides Resource Tracking Working Group, comprising AVAC, the International AIDS Vaccine Initiative (IAVI), the International Partnership for Microbicides (IPM) and UNAIDS, released its seventh annual report "documenting investments in biomedical HIV prevention research from public, philanthropic and commercial sectors," according to an AVAC press release. The report "argues that capitalizing on recent promising scientific breakthroughs will require substantial additional and sustained investment from a broader set of donors," the release states (7/18).
• The Drugs for Neglected Diseases initiative (DNDi) announced the launch of a new drug development program to address the unmet treatment needs of children with HIV/AIDS, according to a press release from the organization. "There is consensus around the need to develop an improved first-line protease inhibitor-based regimen for children under three years of age, irrespective of prior exposure to ARVs, and this will be DNDi's first priority," the release states (7/18).