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CROI 2020 Report Back

CROI (Conference on Retroviruses and Opportunistic Infections) was scheduled in Boston from 8-11 March 2020. However, with the growing COVID-19 outbreak in the USA, the conference program was transferred to a virtual/digital format. This report back has been provided by NAPWHA Senior Research Manager, Dr John Rule, who has selected some snippets of information, which he has curated our NAPWHA member organisations and NAPWHA Treatment Officer Network.

Prof. Sharon Lewin of the University of Melbourne was one of the first speakers at CROI 2020 and here is her take home slide from her presentation titled ‘HIV Cure from Bench to Bedside’. It is forward looking with a few question marks. Access the presentation webcast recording via the www.croiwebcasts.org

The ‘London’ Patient

Ravindra Gupta first presenting the case at CROI 2019 in Seattle. Photo by Liz Highleyman.

A London man continues to have no detectable HIV 30 months after stopping antiretroviral therapy, according to a report by Professor Ravindra Gupta of University College London at the Conference on Retroviruses and Opportunistic Infections (CROI 2020). When his case was first presented at CROI 2019, he was known simply as the ‘London patient’, but on Monday he, Adam Castillejo, went public with an interview in The New York Times. The latest findings strongly suggest that Castillejo has joined Timothy Ray Brown, formerly known as the ‘Berlin patient’, as the second person to have been cured of HIV.

Weight Gain on ARV Treatment

Weight gain after starting antiretroviral treatment is likely to raise the risk of diabetes but does not push up cardiovascular disease risk, two large analyses presented to CROI 2020 show.

Several randomised clinical trials carried out in sub-Saharan Africa and cohort studies in North America and Europe have shown substantial weight gain occurs after starting antiretroviral treatment, particularly in black women and people exposed to both dolutegravir and tenofovir alafenamide (TAF).

 

Long Acting Injectables

Long-acting injectables might be administered every two months

A combination of two long-acting injectable drugs administered every two months suppresses HIV viral load as well as monthly injections, according to a report at CROI 2020.

Treatment that can be taken every other month would improve convenience and possibly adherence. However, in this study, those who received the every-other-month regimen were more likely to develop resistance if they did not maintain viral suppression.

Other interesting CROI 2020 links


 

Treatment Outreach Network 2020 meeting held online during COVID-19 restrictions

NAPWHA’s Treatment Outreach Network – a membership of professionals from Australian State and Territory peer-based organisations and AIDS Councils, held their annual formal meeting via video conferencing during this time of COVID-19 restrictions.

Hosted and facilitated by NAPWHA, the network work together to optimise the overall wellbeing of people living with HIV (PLHIV) and those affected by HIV, by providing a high standard of information and care on issues of health and treatments for HIV.

Two video conference calls were held on 8 and 15 April 2020 to hold initial roundtable discussion regarding disruptions to frontline services and responses to the impact of COVID19. A third video call hosted various presenters speaking on themed subjects, including Dr Elizabeth Crock, Vikas Parwani, Dr Darren Russell, and Associate Professor Edwina Wright. Video recordings of these sessions are featured below.

Referral pathways to PLHIV services and Nurse Practitioner community practicing

Dr Liz Crock (HIV Clinical Nurse Consultant) provided members with a question and answer (Q&A) session that allows members to better understand the referral processes and navigating social services for ancillary care arrangements for clients living with HIV.

Government Funded Income Support during COVID-19: Who’s eligible and who’s left behind

Vikas Parwani (Solicitor of The HIV/AIDS Legal Centre – HALC) provided members with a presentation on the delivery of current information on welfare service supports.

Clinical supports for PLHIV during COVID-19 including telehealth and CovidSafe app

Dr Darren Russell (Director of Sexual Health, Cairns Hospital) provided members a presentation and Q&A about clinical supports that are being put into place to enable people living with HIV (PLHIV) to better access services and understand the current situation in relation to COVID-19.

  • Could you give us some of your thinking on the [Australian Government’s] COVID Safe Tracking app launched on 26 April 2020 and people living with HIV – e.g. public health benefits versus privacy concerns?
  • Do you see the COVID Safe Tracking app being used in [workplace setting] as a [mandatory] occupational health and safety tool?
  • Is it possible that those protection laws may change down the line? Who is going to ask permission from you to access your information?
  • Could you tell us a bit about Telehealth from the clinical perspective? What’s working, what’s not? Will we in Australia be seeing it stick around?
  • What privacy and confidentiality measures are put into place for people sending data and information in through Telehealth platforms (e.g. video calls, SMS?)
  • Are numbers of people presenting at clinics and HIV-STI notifications going down or changing during this period?

Current data on COVID-19 and how it applies to PLHIV

Associate Professor Edwina Wright (Head of HIV Prevention Service, Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University) provided members a presentation and Q&A about the most current data on COVID-19 and how it applies to PLHIV, their treatment and long-term health.

Edwina is the Chair of ASHM’s Taskforce on BBVs, Sexual Health and COVID-19 was established on 20 March 2020. It provides a timely opportunity for the BBV and sexual health sectors to discuss the scientific, clinical, BBV and sexual health service delivery and social implications of COVID-19, and provides consistent and evidence-based messaging to the health workforce, sector partners and community.

About the NAPWHA Treatment Outreach Network

The Treatment Outreach Network (TON) is a network of professionals working together to optimise the overall wellbeing of people living with HIV (PLHIV) and those affected by HIV, by providing a high standard of information and care on issues of health and treatments for HIV.

The membership of Treatments Officers throughout Australia and New Zealand, working for their State and Territory peer-based organisations and AIDS Councils are called together by NAPWHA under this program to provide peer support/navigation and to promote the sharing of information. The network meets formally once per year and informal communication occurs throughout the rest of the year to continue the work of the network.

Treatment Outreach Network 2021 meeting held virtually

NAPWHA’s Treatment Outreach Network – a membership of professionals from Australian State and Territory peer-based organisations and AIDS Councils, held their annual formal meeting via video conferencing in April and November 2021. The Treatment Outreach Network 2020 meeting was also held online during COVID-19 restrictions.

Meeting agenda

TimeSession
11 – 11.15amAcknowledgement of Country
Brief introductions
11.15am – 12.00pm

Treatments and update from European AiDS Clinical Meeting – Presentation and Q&A
Damien Fagan – Associate Director, Medical Affairs, HIV (Gilead) NB This is not a Gilead session.

12.00 – 12.15 pmBreak / 15 minutes

12.15 – 12.45pm

 

NAPWHA Research Literacy and Treatment Initiative – Scoping session to identify research literacy needs
Dr Jeanne Ellard – NAPWHA

12.45 – 1.15pm

ARVs and weight gain – Presentation and Q&A
Professor Jennifer Hoy – Director HIV Medicine, Department of Infectious Diseases, The Alfred

1.15 – 1.30pmMeeting review and evaluation
1:30pmMeeting close

ARVs and weight gain

In this presentation to the Treatment Outreach Network,
Professor Jennifer Hoy – Director HIV Medicine at
Department of Infectious Diseases, The Alfred, presents a version of
What is known about weight gain on INSTI-based regimens?

In this presentation, Dr Jennifer Hoy makes references to:

  1. Michael Silverberg et al, “Changes in body mass index over time in persons with and without HIV.” 23rd International AIDS Conference. (2020) Abstract OAB0603.
  2. Myles Helfand, “Body Mass Index Among People With HIV Is Rising Much Faster Than in the General Population.” TheBody/TheBodyPro (2020)
  3. Bourgi K. et al., “Greater weight gain among treatment- naïve persons starting integrase inhibitors: NA-ACCORD.” Conference on Retroviruses and Opportunistic Infections (2019). Abstract #670.
  4. Hill A. et al., “Progressive rises in weight and clinical obesity… ADVANCE and NAMSAL trials.” 22nd International AIDS Conference. (2019) Abstract 4772.
  5. Mallon P. et al., “Weight gain before and after switch from TDF to TAF in a U.S. cohort study.” J Int AIDS Soc. 2021 Apr; 24(4): e25702.
  6. Ramgopal M et al. Pooled analysis of 4 international trials of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in adults aged >65 or older demonstrating safety and efficacy: week 48 results. 23rd International AIDS Conference, abstract OAB0403, 2020.
  7. Liz Highleyman, “Switching to Biktarvy maintains viral suppression in people aged 65 or over.” NAM aidsmap (2020)
  8. European AIDS Clinical Society, “EACS Guidelines – Version 10.1.” (October 2020) – refer to p. 53 on Dietary Counselling and ART

Additional viewing:  Emma Sheldon-Collins, Community Advocate speaking to Dr James McMahon (The Alfred, Victoria) for the HIV ARV Guidelines Session at 2020 Australasian HIV & Sexual Health Conference

About the NAPWHA Treatment Outreach Network

The Treatment Outreach Network (TON) is a formal collaboration of HIV community sector professionals working to optimise the overall wellbeing of People Living with HIV (PLHIV) in Australia, by providing a high standard of information and current research on issues of health and treatments for HIV.

TON’s role is to provide consistent and up-to-date information to HIV sector professionals working at state and territory HIV community organisations as well as PLHIV. NAPWHA maintains a range of partnerships to ensure the aims of the network are met. The network meets formally once per year and informal communication occurs throughout the rest of the year to continue TON’s work.

Treatment Outreach Network 2022 meeting held virtually

NAPWHA’s Treatment Outreach Network – a membership of professionals from Australian State and Territory peer-based organisations and AIDS Councils, held their bi-annual formal meeting via video conferencing on May 25, 2022. The previous Treatment Outreach Network 2021 meeting was also held online, due to COVID-19 travel complications during that period.

Meeting agenda

TimeSession
11 – 11.15amAcknowledgement of Country
Brief introductions
11.15am – 12.00pmInjectable Treatments Availability in Australia – Presentation and Q&A
Jessica Kent – Associate Director, Medical Science Liaison (ViiV Healthcare Australia) NB This is not a ViiV Healthcare session.
12.00 – 12.15 pmBreak / 15 minutes
12.15 – 12.45pm NAPWHA Research Literacy and Treatment Initiative – Update session from last TON Meeting 2021– Dr Jeanne Ellard – NAPWHA
12.45 – 1.15pmNAPWHA’s Cognitive Health initiative – An international collaboration – Presentation and Q&A
Associate Professor Lucette A. Cysique, UNSW and St. Vincent’s Hospital
1.15 – 1.30pmMeeting review and evaluation
1:30pmMeeting close

Long-Acting Injectables in Australia

In this presentation to the Treatment Outreach Network, Ann Maccerrone and Jessica Kent of ViiV Healthcare Australia present an overview of emerging long-acting HIV injectable antiretroviral therapy. Charlie Tredway, Online Moderator of TIM (The Institute of Many) follows with a community perspective. The session concludes with a Q&A.

In this presentation, Jessica Kent overviews:

  1. ViiV treatment pipeline
  2. Unmet need
  3. Cabotegravir (CAB) plus Rilpivirine (RPV)
  4. Patient reported outcomes
  5. Frequently asked questions and Q&A

Other references:  See also CROI 2022: Injectable CAB/RPV-LA results after three years follow-up reported in i-base (1 March 2022)

Cognitive health for people living with HIV

In this presentation to the Treatment Outreach Network, Associate Professor Lucette A. Cysique – Senior Researcher and Neuropsychologist at
St. Vincent’s Hospital Centre for Medical Research (Sydney, NSW) presents an overview of an emerging research area for Cognitive Health for People living with HIV

In this presentation, Associate Professor Lucette A. Cysique overviews:

  1. What is cognitive health and associated guidelines
  2. Cognitive health for people living with HIV; how to talk about it
  3. Cognitive Aging: Is it HIV or simply aging? What is the evidence?
  4. Successful aging in people living with HIV
  5. Risk factors for cognitive decline and PLHIV; and how to talk about it
  6. Acting now or wait?
  7. How to get a shared understanding of issues and what to do about it: A proposed framework
  8. Proposal: Global connections, website and survey
  9. Some resources: I am experiencing cognitive difficulties; what can I do (referral pathways, etc)

Other references:  Lucette references international work stemming from the National AIDS Treatment Project and HIV & Aging Research Project – Palm Springs (HARP-PS); and an emerging project in-development with University of Southern Queensland (USQ).

About the NAPWHA Treatment Outreach Network

The Treatment Outreach Network (TON) is a formal collaboration of HIV community sector professionals working to optimise the overall wellbeing of People Living with HIV (PLHIV) in Australia, by providing a high standard of information and current research on issues of health and treatments for HIV.

TON’s role is to provide consistent and up-to-date information to HIV sector professionals working at state and territory HIV community organisations as well as PLHIV. NAPWHA maintains a range of partnerships to ensure the aims of the network are met. The network meets formally once per year and informal communication occurs throughout the rest of the year to continue TON’s work.