HIV

Despite major advances in medical knowledge of the infection and in disease management, HIV still remains a big challenge worldwide, with its greatest burden in Africa.

Europe is sole global region with infection increases.

Fixed-dose triple-combination drug and doravirine get the nod.

In Europe, millions are unaware of their status.

Time from infection to diagnosis remains unchanged over 2 decades.

Results offer an opening to improving screening for both.

Option B ART use is high in this population.

GEMINI 1 and 2 results suggest noninferiority.

Outcomes are still poor in this population.

DEXA screening should be part of routine care.

Monitor lipids when switching patients from tenofovir disoproxil to tenofovir alafenamide.

Dr Peter Ackerman presented the recent results of the BRIGHTE study – an analysis of the prodrug fostemsavir as an attachment inhibitor against HIV. Metabolism to the active moiety temsavir is via the gastrointestinal tract and it has been designed specifically for HIV-1 infected heavily treatment-experienced patients (HTP) who are failing their current therapy. In the BRIGHTE study, 86% of patients coming into the trial had a prior history of AIDS.

Dr Graeme Meintjes presents an overview of diagnostic and prevention issues in adult patients with HIV-associated tuberculosis. Estimates for 2017 showed that approximately 10% of global TB cases occurred in HIV infected people. This group also displays a disproportionately high TB mortality rate. However, incidence rates of HIV-associated TB have declined over the last decade.

Dr Zvi Cohen presents the phase 3 trial results of ibalizumab in heavily treatment experienced adults with multidrug-resistant HIV-1 infection failing their current ARV regimen; ibalizumab was approved by the FDA in March 2018 for this patient population. Results from the Week 25 study (TMB-301) along with the Week 48 expanded access (completer) study (TMB-311) are discussed.