Updates from the International AIDS Conference in Paris 2017

The International AIDS Society (IAS) Conference is the premier, global scientific conference on AIDS.

Here are some key advances that were discussed at IAS 2017 in Paris.

Abstracted from IAS 2017 - http://www.ias2017.org

1. The future is injectable, as treatment for HIV continues to improve
The quest for better, easier-to-take treatments for HIV continues its advance. Results from the 96-week LATTE-2 study on a long-acting, injectable HIV treatment regimen showed that monthly or bimonthly injections of antiretroviral therapy (ART) could soon replace daily pills for people living with HIV.

Another study, HPTN 077, tested long-acting injectable pre-exposure prophylaxis (PrEP).

My take: Great news. A huge advance in treatment. 30 years ago, this was beyond my comprehension.


2. Stopping HIV Transmission

Vaccine
A vaccine study called APPROACH evaluated 7 different HIV vaccine regimens and identified the most promising candidate for an upcoming study.

PrEP 

New data from the IPERGAY study supports the on-demand use of PrEP for men who have sex with men (MSM), even if they have sex less frequently.

My take: More good news. Some people may be able to take PrEP on demand just before and after sex. Stay tuned on this one.

Another study showed that HIV self-testing can play a vital role in supporting rapid linkage to care for key populations, including female sex workers.

And a large study in serodiscordant MSM couples (men who have sex with men; one partner HIV positive, the other HIV negative) supports the growing body of evidence that “Undetectable = Untransmittable" (U=U). In other words, people with HIV on treatment who have undetectable viral loads do not transmit HIV to their sexual partners.

My take: Again, this is significant progress, especially with U=U. The fact that people with HIV on medication who have undetectable viral loads do not transmit virus sexually is important prevention news.

3. Good news – treatment saves lives

On the eve of IAS 2017, UNAIDS announced that a record-setting 53% of adults living with HIV worldwide were accessing therapy in 2016, and AIDS-related deaths have dropped by nearly 50% since 2005.

As a growing number of countries reach or approach the 90-90-90 targets, however, numerous studies in Paris highlighted regions, countries and populations that are not receiving the benefits of advances in HIV prevention and treatment.

A breakthrough study featured from Swaziland demonstrating the remarkable nationwide impact of expanded HIV prevention and treatment in the nation with the highest HIV incidence in the world. The incidence of HIV in that country has almost halved in the past five years.

My take: I am reminded of my friend, the late Dr. Joep Lange (Netherlands) who once said, "If we can bring Coca-Cola to every corner of Africa, we can also bring them antiretroviral drugs.

4. Exploring the links between HIV cure and cancer
Identifying new strategies for the long-term remission or cure of HIV infection, courtesy of collaborations between HIV and cancer research, was the focus of a standing-room-only conference session, the IAS HIV Cure & Cancer Forum. Sponsored by the IAS Towards an HIV Cure initiative, the Forum was the first major scientific gathering to address the connections in the treatment of HIV and cancer.

5. Science matters… and so does money.
IAS set the tone for the week with the launch of the Paris Statement, which reiterated that “scientific knowledge is the backbone of the HIV response” and called for “an unfaltering commitment to research.” “

A golden age in HIV science” was the catchphrase heard repeatedly throughout the week. But IAS President Linda-Gail Bekker warned in her speech at the opening ceremony that if the proposed funding cuts by the US administration to HIV programs and research become a reality, the impact on current and future scientific advances would be “devastating” for the global response to the epidemic.

A new Kaiser Family Foundation/United Nations (UNAIDS) report showed that donor government funding for HIV fell 7% last year to the lowest level since 2010, while the Resource Tracking Working Group found the lowest annual investment in HIV prevention Research & Development in more than a decade. Advocates and policy makers called for concerted efforts to reverse the cuts and promote the tremendous impact, seen in hundreds of presentations at IAS 2017, of investing in HIV R&D, treatment and prevention.

My take: It takes money to make these advances. Why worry about the rest of the world when we have so much to do here at home? Answer: HIV is not only a health issue, it is an economic matter as well. We live in a global society.