Topical delivery of long-acting antiretrovirals to prevent HIV acquisition
Purpose of review
Although tremendous successes in HIV treatment and prevention have occurred in the past decade, existing HIV prevention options are inadequate, unacceptable or inaccessible to many. Topical antiretroviral-based preexposure prophylaxis (PrEP) options may offer effective, long-acting prevention to those who do not desire systemic exposure to anti-HIV drugs or who want greater control over their own prevention.
Recent findings
Among long-acting topical PrEP agents, the dapivirine vaginal ring has advanced the furthest in product development; recent studies have shown high adherence and persistence and e...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research
Long-acting implants to treat and prevent HIV infection
Purpose of review
Subcutaneous implants are a promising technology to enable long-acting parenteral delivery of antiretroviral drugs (ARV) because they may be able to provide protective drugs concentrations for a year or longer following a single implant. The present review covers the current status of preclinical and clinical development of antiretroviral implants.
Recent findings
Over the past three decades, subcutaneous implants have been widely used for long-acting hormonal contraception and the treatment of hormonally-driven malignancies. They are economical and scalable to manufacture, but require special proced...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research
Islatravir for the treatment and prevention of infection with the human immunodeficiency virus type 1
Purpose of review
To discuss the potential role of islatravir (ISL), a novel reverse transcriptase translocation inhibitor, in the treatment and prevention of human immunodeficiency virus type 1 (HIV-1) infection.
Recent findings
Islatravir (4′-ethynyl-2-fluoro-2′-deoxyadenosine, MK-8591) is a long-acting first-in-class nucleoside reverse transcriptase translocation inhibitor with the potential for versatile dosing routes and dosing intervals. It demonstrated robust antiviral activity when dosed once daily and once weekly in HIV-1-infected individuals and SIV-infected rhesus macaques. In clinical trials of ISL in ...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research
Long-acting injectable cabotegravir for the prevention of HIV infection
Purpose of review
This review highlights the development of long-acting injectable cabotegravir (CAB LA) for HIV preexposure prophylaxis (PrEP), with a focus on phase 2 studies and later development.
Recent findings
Early studies of CAB LA for HIV prevention offered promising pharmacokinetic data and paved the way for phase 2 studies, which have now been completed. On the basis of phase 2 data, dosing of CAB LA at 8-week intervals consistently delivers target trough concentrations in both men and women. Recent studies have shown no required dose adjustments for hepatic or renal disease and minimal drug--drug interacti...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research
Long-acting injectable therapy: an emerging paradigm for the treatment of HIV infection
Purpose of review
Long-acting formulations of antiretrovirals have the potential to reshape the treatment paradigm for HIV infection. Emerging evidence demonstrates efficacy and safety of two drug regimens for the treatment of HIV infection. This review focuses on recent advances with long-acting cabotegravir and rilpivirine administered intramuscularly every 4 weeks for the treatment of HIV infection in virologically suppressed patients.
Recent findings
Despite the development of complete, orally administered single tablet regimens with improved efficacy, side effects, tolerability, with an improved drug interaction ...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research
HIV treatment and prevention 2019: current standards of care
Purpose of review
The purpose of this review is to summarize the current standards of care for both HIV treatment and HIV prevention in 2019.
Recent findings
Current HIV treatment is started as soon as feasible in a person with HIV infection and consists of a three-drug oral daily antiretroviral regimen, consisting of two nucleoside analogue reverse transcriptase inhibitors combined with a third drug, either an integrase inhibitor, a non-nucleoside reverse transcriptase inhibitor, or a protease inhibitor. Present treatment regimens are potent, convenient, generally well tolerated and durable, and lead to a normal life...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research
Introduction: long-acting antiretrovirals for the treatment and prevention of HIV-1 infection: the future is now
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research
Treatment as prevention trials and ending AIDS: what do we know, when did we know it, and what do we do now?
Purpose of review
HIV remains a significant global public health problem. Treatment as prevention of HIV and TB illness, death and transmission was proposed in 2006 as a means to end the HIV epidemic. We review the results of the treatment as prevention trials.
Recent findings
Some of the trials struggled with delivering services, however, most demonstrate that it is feasible to achieve at least the 90–90–90 target by scaling access to test-and-treat at the community level and by extension at the district or national level. Patients, if offered, will start and stay on immediate treatment even without symptoms. Com...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
The cost of reaching the 90–90–90 targets: are current investments enough?
Purpose of review
The 90–90–90 targets were launched with the aim of reaching specific milestones by 2020. To support these targets, modeling has shown that additional resources are needed. This review examines what is known about current investments for HIV in low and middle-income countries, resource needs, and the potential for additional investment.
Recent findings
Reaching the 90–90–90 targets would place the global community on track to end the AIDS epidemic by 2030, significantly improving health outcomes and reducing future spending needs. Recent analyses indicate, however, that funding has slowed and ...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
Fast-Track Cities: striving to end urban HIV epidemics by 2030
Purpose of review
To provide a summary of progress achieved, lessons learned, and best practices employed in select Fast-Track Cities striving to attain and surpass the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90–90–90 targets.
Recent findings
The 90–90–90 targets have served as a catalyst to galvanize political, programmatic, and funding support for urban HIV responses, while prompting increased community engagement. More than 300 cities and municipalities have joined the Fast-Track Cities network, pledging to attain and surpass the UNAIDS 90–90–90 targets. One city has officially surpassed the...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
Reaching the second 90: the strategies for linkage to care and antiretroviral therapy initiation
We present recent literature describing interventions for linkage to HIV care in the era of Universal Test and Treat (UTT) policies. We also provide information for ongoing studies of linkage to care strategies registered with ClinicalTrials.gov.
Recent findings
Differentiated service delivery for linkage to care involves implementing strategies that simplify and adapt HIV services to better serve individual needs and reduce unnecessary burdens on the health system. Recent strategies have focused not only on clinic-based populations testing for HIV but also emphasize community-based services and HIV self-testing, which ...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
The first 90: the gateway to prevention and care: opening slowly, but not for all
Purpose of review
Knowledge of HIV status is the gateway to HIV treatment and prevention, and optimizing this pillar is essential to bend the curve of the HIV epidemic toward zero new infections. This review will discuss the epidemiology of serostatus awareness, including disparities among key populations, and explore interventions and societal barriers.
Recent findings
Rates of serostatus awareness have improved overall; however, progress is lagging in many regions, nations and populations, with substantial disparities seen among key populations. These populations and their partners now contribute the majority of new...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
Harnessing digital data and data science to achieve 90–90–90 goals to end the HIV epidemic
Purpose of review
Effective public health interventions depend on timely, accurate surveillance. Harnessing digital data (including internet searches, social media, and online media) and data science is an emerging approach to complement traditional surveillance in public health but has been underutilized in HIV prevention and treatment.
Recent findings
We highlight recent examples that illustrate how social media data can be applied to HIV surveillance and prevention interventions.
Summary
To achieve 90–90–90 goals to end the HIV epidemic, we encourage traditional public health researchers to partner with data...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
Challenges of reaching 90–90–90 in the Southern United States
Purpose of review
More than half of new HIV diagnoses occur in the Southern United States where the epidemic disproportionately affects persons of color. Although other areas of the country are seeing dramatic declines in the number of new cases, the progress in the South lags behind. This review will examine the reasons for that disparity. Many are unique to the South.
Recent findings
Despite advances in antiretroviral therapy for HIV, many in the South are not benefiting from these medications, at either a personal or public health level. The reasons are complex and include lack of access to healthcare, lower levels...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
