PD Dr. Martin Hartmann reports from the International AIDS Congress (IAC) in Montreal. HIV therapy is so good today that the survival time has increased from one to 50 years.
Transcript of the video by PD Dr. Martin Hartmann, Heidelberg
Beautiful good day,
here is Martin Hartmann from the Department of Dermatology at the University of Heidelberg.
I want today from 24th International AIDS Congress report that from 28.7. until 2.8. took place in Montreal (Canada). Around 13,000 doctors and activists took part, 2,000 from home. It was the first on-site AIDS congress since the beginning of the SARS-CoV2 pandemic.
There is always new progress in HIV infection, even if it is happening a little more slowly now.
Past and future
Dr. A.S. Anthony Fauci gave an overview of the past and future of HIV infection. Since the last International AIDS Congress in Montreal in 1989, ie 33 years ago, there have been tremendous advances in the treatment of HIV infection.
Life expectancy has increased from over 1 year to over 50 years. Mortality has decreased significantly due to the therapies now available. The introduction of treatment as prevention, i.e. treating as many people as possible with HIV, and also PrEP (pre-exposure prophylaxis), i.e. giving medication before infection as a preventive measure so that unsafe sex does not cause infection, have led to a significantly reduced infection rate.
In the future, PrEP will also be possible with long-acting substances, and monoclonal antibodies are on the rise in therapy and prevention of HIV infection.
Cabotegravir for PrEP
There was also data on this at the AIDS Congress. the HPTN-084 Study shows that the long-acting substance cabotegravir as PrEP is clearly superior to oral PrEP with tenofovir/emtricitabine in women. There were no abnormalities in the pregnancies that did occur. The problem is the price, which is significantly higher than oral PrEP. At the moment there are considerations, also from the industry, that cheaper access can be found for the poorer people.
This was also underlined by a contribution from the WHO, which urged that such effective PrEP drugs must be made available to all people.
Doxycycline for PEP
Another highlight at the congress was the proof of the effectiveness of PEP, i.e. post-exposure prophylaxis, in the DoxyPEP Study. People with PrEP and unsafe sex often suffer from bacterial infections, chlamydia, syphilis or neisseria. They took doxycycline right after the unsafe sex. This significantly reduced the rate of chlamydia and syphilis, with the Neisseria the effect was not as pronounced due to resistance.
Long-term data on bictegravir
With the 1-tablet regimen for HIV infection, efficacy has not decreased over 5 years when patients take the therapies. The side effect is an increase in weight of about 1 kg per year, but this decreases over the years.
Weight gain may also be greater in certain predisposed patients, particularly women of African descent.
Fourth patient cured
Another case of a cure was presented at the congress. The 66-year-old patient had been suffering from HIV infection for decades. Because of leukemia, he received a stem cell transplant from a CCR5-negative donor. The HI virus needs this receptor to get into the cell.
The patient recovered and the HIV medication was discontinued during the follow-up care. He is currently virus and symptom free.
That’s it from Montreal.
Thanks for listening.