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Director, The Peter Doherty Institute for Infection and Immunity
Professor of Infectious Diseases
University of Melbourne
Consultant Infectious Diseases Physician
Alfred Hospital and Royal Melbourne Hospital
Sharon R. Lewin, AO, FRACP, PhD, FAHMS:consultant: Abivax, Aelix, Bionor, Bristol-Myers Squibb, Esfam, Gilead Sciences, Immunocore, InnaVirVax, Merck Sharpe & Dohme, Vaxxinity, ViiV.
AIDS 2022, the 24th International AIDS Conference, brings together a unique mix of more than 10,000 researchers, advocates, policy makers, and key populations to discuss the latest data informing evidence-based interventions represented by more than 2500 abstracts. It will be an exciting moment—the first in-person major HIV meeting since the world was transformed by COVID-19. It also will be our first hybrid conference (held both in person and virtually) and will call on the HIV community to come together to reengage and follow the science.
The COVID-19 pandemic built on the legacy of the global HIV response with an accelerated path to effective COVID-19 vaccines, antibody therapies, antiviral drugs, and diagnostics. AIDS 2022 will leverage this reinvigorated global commitment to public health policy and the widespread heightened understanding of the importance of science and community partnerships in building a successful pandemic response. This meeting will refocus global attention on the HIV pandemic, define future research agendas, and shift the latest evidence to action.
The conference will showcase the latest evidence to inform the global HIV response, which includes new prevention tools, the latest treatments, and advances in the search for an HIV cure. Here’s my take on key new data that will be presented.
AIDS 2022 will feature 2 new case reports of people with HIV who have achieved long-term remission in the absence of antiretroviral therapy (ART). These include the “City of Hope Patient,” the fourth person to experience long-term remission off ART following a stem cell transplant from a CCR5-negative donor. This news comes on the heels of another case report of the “New York Patient,” announced at the 2022 Conference on Retroviruses and Opportunistic Infections in March. Although stem cell transplants are not suitable treatments for people without cancer, the reports on these patients add to our growing understanding of HIV and evidence that, indeed, cure is possible.
One of the most important challenges in HIV cure research is how to recognize a cell that carries a latent virus. We have not yet identified the distinguishing features of these cells, making this a difficult area to study. An exciting study from the US National Institute of Allergy and Infectious Diseases used high-tech microfluidic technology to precisely tag HIV DNA inside cells and then select and interrogate the genes in those cells. These insights may provide many new avenues to better identify the cellular reservoir and ultimately eliminate it. Authors also will present phase I/II results from a study of infants looking at the monoclonal antibody VRC01 with early ART to promote clearance of the HIV reservoir.
Although the availability of pre-exposure prophylaxis (PrEP) has revolutionized HIV prevention, the question remains as to how to prevent other sexually transmitted infections (STIs). New results from a large-scale trial in the United States will shed light on the effectiveness of doxycycline in preventing common STIs among both men who have sex with men and transgender women, and AIDS 2022 will provide a platform to discuss how this approach could be implemented. Concerns such as drug resistance must be thoroughly understood before large-scale implementation is undertaken. In addition, there will be a 48-week update on promising antiretroviral regimens in HIV and hepatitis B coinfection from a randomized, controlled trial of bictegravir/emtricitabine/tenofovir alafenamide vs dolutegravir plus emtricitabine/tenofovir disoproxil fumarate as initial treatment for adults with HIV and hepatitis B.
Exciting research also is looking closely at the efficacy and safety results of long-acting cabotegravir as PrEP from HPTN 084, as well as a comprehensive evaluation of safety and efficacy of gender-affirming hormone therapy interactions with long-acting cabotegravir as PrEP from HPTN 083. These new data on long-acting injectable PrEP reinforce the effectiveness of this prevention tool. In addition, we expect the WHO to release its first-ever guidelines on long-acting PrEP at the conference.
To provide global perspectives on the state of the epidemic, we also will have updates from countries on their efforts to achieve UNAIDS 95-95-95 targets (ie, diagnosing 95% of all people with HIV, providing ART for 95% of those diagnosed, and achieving viral suppression for 95% of those treated by 2030).
Other Important Issues
AIDS 2022 also will be an opportunity to interrogate and amplify the growing global conversation around equity in access to healthcare. Key sessions will spotlight strategies around how to best apply advances in research and policy to meet the needs of people in low- and middle-income countries and key populations, including people with HIV, sex workers, and people with substance use disorders. Implications for equity in access to healthcare also will be addressed through sessions focused on emerging threats, including the crisis in Ukraine, as well as the spread of monkeypox. Finally, this topic will be explored through the lens of research and policy advances around vaccines, including lessons learned from COVID-19 vaccine development and rollout.
As the meeting unfolds, I encourage you to check the Clinical Care Options website often for downloadable slidesets summarizing the data from these and other key studies. Also plan to join us for a series of live webinars hosted by expert faculty providing their take on the clinical implications of the data. After the meeting, look for more ClinicalThought commentaries featuring expert perspectives on integrating new data into practice.
What data from AIDS 2022 are you most anticipating? Take part in our poll or share your comments in the discussion section.