New research was presented at AIDS 2016, the International AIDS Conference, from July 18 to 22 in Durban, South Africa. The features below highlight some of the studies that emerged from the conference.
Comparing TB Treatment Approaches in HIV Patients
Research has yet to determine whether an intensified daily regimen or intermittent therapy delivering less medicine for tuberculosis (TB) is more effective for patients diagnosed with TB and HIV. For a study, patients with HIV and TB were assigned to anti-TB drugs daily for 6 months, daily for 2 months followed by three times a week for 4 months, or three times a week for 6 months. All participants also received anti-HIV medication. At 6 months, 98% of patients in daily regimen group had negative TB cultures, compared with a rate of 92% observed in the thrice-weekly group. In the daily regimen group, 98% of patients achieved negative TB cultures at 2 months, compared with a rate of 87% observed in the thrice-weekly group. Patients on the partial daily schedule did better than those on the intermittent schedule overall. Adverse reactions were experienced by 24% of patients on the daily regimen, 19% for those on the partial daily regimen, and 15% for those on the intermittent regimen.
PrEP Use Among Teens
Use of oral pre-exposure prophylaxis (PrEP) has increased substantially among patients at high risk for contracting HIV since being approved by the FDA in 2012. However, use among teens is not FDA approved. As a result, little is known regarding PrEP use in this population. For a study, researchers in Chicago provided PrEP to boys aged 15 to 17 who reported having sex with other males. Adherence rates to the daily regimen of pills were high when participants were seen by clinicians on a monthly basis, but adherence decreased when visits were scheduled on a quarterly basis. Sero-conversion was experienced at a rate of 6.41 infections per 100 person-years. This high rate suggests that clinicians were treating a high-risk population. The authors noted that 12.3% of participants were being treated for sexually transmitted infections (STIs) at baseline, and 10.3% were diagnosed with an STI at the end of the study.
Continued ART Reduces Postpartum Complications
Few studies have assessed the optimal treatment of HIV-positive women during pregnancy, breastfeeding, and thereafter. For a study, UCLA researchers randomized pregnant, HIV-positive women with high CD4 cell counts to stop antiretroviral therapy (ART) after delivering their baby or to continue receiving ART after pregnancy. During 18 months of follow-up, rates of AIDS-defining illnesses and non-AIDS deaths were similarly low among both groups. However, rates of WHO 2 events—including other infections like pulmonary tuberculosis—occurred at a rate of 2.02 per 100 person-years among women who stayed on ART, compared with a rate of 4.36 events per 100 person-years observed among those who discontinued ART.
Suppressing HIV Limits Transmission
Data are lacking on the long-term effect of HIV treatment on transmission of the virus. For a study, more than 1,700 heterosexual couples—in which only one partner was HIV-positive—were assigned to a group in which the HIV-positive partner received immediate treatment or to a group in which the HIV-positive partner waited for treatment until evidence existed of increasing immune system damage or an illness that was suggestive of AIDS. During the 5-year study, 46 HIV-negative partners acquired the virus from their infected partners. However, none of these cases occurred when the infected partner’s virus was suppressed. Of the 46 cases examined in the study, only three occurred in the early-treatment group.
HIV Self-Testing Among High-Risk Men
Current guidelines recommend that individuals who are at high risk for HIV have their status tested every 3 to 6 months. Studies have yet to determine if self-testing helps those who are at high risk adhere to these recommendations. For a study, researchers randomly assigned HIV-negative men who had more than five male partners in the previous 3 months or who engaged in unprotected sex with men to self-testing with a test that has nearly 100% specificity or standard care that included HIV testing at a clinic. Participants in the self-test group were given four self-test kits for the 12-month study. Men in the self-test group completed an average of 3.9 tests during the study, compared with a rate of 1.6 tests that was observed among men in the standard care group.
NEWS FROM AIDS 2016
MORE FROM AIDS 2016