HIV update

September 4, 2020 - 9:30-13:00

ART stragegy

Treatment is universally recommended for all persons living with HIV regardless of CD4 count. In the absence of any definitive cure/remission strategies, this treatment will be life-long. Currently HIV infection can be controlled long term with potent, safe and convenient antiretroviral therapy that leads to prolonged healthy survival in our patients. With earlier initiation of antiretroviral therapy and considering the potential for several decades of suppressive antiretroviral therapy, management of patients is evolving. This session will review current treatment guidelines and explore strategies to individualise and optimise antiretroviral therapy taking into account our ageing population, comorbidities and polypharmacy.

Speaker: Dr Nicola Mackie (United Kingdom)

New drugs

Antiretroviral therapy has constantly evolved from several daily intakes to once daily , from more potent regimens on resistant HIV strains , better tolerated drugs . Development of new drug classes represent a major challenge to provide long term therapies overall several decades . The latest development of long acting drugs is a key issue in a context of the mandatory maximal viral suppression for HIV infected individuals and maximal ARV concentrations for prevention of HIV transmission in PREP strategies . The session will provide an overview of the latest drugs in clinical development , their potential use in clinical management and their position in new strategies .

Speaker: Prof. Christine Katlama (France)

Bodyweight, HIV and ART

The topic of on-treatment weight gain among PLWH has become an issue garnering considerable attention. In this session, we will review some of the recent data on the subject. We will discuss various aspects related to this topic including: how to differentiate between desirable and undesirable weight gains; patient-, HIV disease- and ARV-related factors associated with excessive weight gain; the impact of study design/statistical methodology on the reliability of findings; potential mechanisms for this phenomenon; health consequences of weight gain; and available interventions for the management of ART-related weight gain in PLWH.

Speakers: Prof. Stéphane De Wit (Belgium)/ Prof. Caroline Sabin (United Kingdom)

Co-morbidities

This session will provide a summary and critical review of some of the recent data on major comorbidities in HIV, including cardiovascular disease, renal dysfunction and osteoporosis. Although observed more commonly in people with HIV, the mechanisms underlying these co-morbidities are complex and interlinked. We will discuss factors associated with these conditions, including relevant contributions from patient, disease and treatment factors, and will comment on the robustness of studies that attempt to quantify the effects of these factors. We will also discuss relevant data gaps and treatment options, particularly in relation to the development of EACS guidelines.

Speakers: Prof. Patrick Mallon (Ireland)/ Prof. Caroline Sabin (United Kingdom)

PrEP and prevention strategies

HIV Prevention strategies have evolved over the last 30 years to include prevention of vertical transmission from mother to child, pre-exposure prophylaxis (PrEP) with antiretroviral therapy taken daily or around the time of unprotected sex and post-exposure prophylaxis (PEP) for sexual or occupational exposure. Assessment of HIV risk must also include assessment for sexually transmitted infections and Hepatitis ABC. PrEP and PEP form part of a risk reduction strategy but the treatment of those diagnosed with HIV as Prevention (TasP) remains key. Recent data on current treatments and updates on novel and/or better-tolerated prevention modalities including vaccines will be discussed.

Speakers: Prof. Dominique Costagliola (France)/ Dr Yvonne Gilleece (United Kingdom)

Clinical cases

This session will highlight current issues and dilemmas in the management of patients with HIV with clinical cases.

Speakers: Dr Sanjay Bhagani (United Kingdom)/ Dr Juan Ambriosioni (Spain)