September/October 2014: Volume 15 Number 9/10
This edition of HTB includes conference reports from the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) and a few final ones from the 20th International AIDS Conference (IAS 2014).
Updates from ICAAC include: news on tenofovir alafenamide, suggesting potential bone and renal benefits with this compared to the current formulation of tenofovir; non-inferiority of cobicistat for boosting atazanavir compared to ritonavir; an update on the pipeline NNRTI doravirine; a post-hoc analysis of Stribild in black participants; and tenofovir gel for prevention.
We are grateful to NATAP and include their ICAAC reports on switching from Atripla to Eviplera, which significantly reduced central nervous system toxicity; on the detection of HIV in lung alveolar macrophages; and low US uptake of HCV treatment in a 2008-2013 analysis of the VA cohort in Washington.
Reports from AIDS 2014 cover the PROUD study of oral PrEP – with discussion about access to Truvada for PrEP in the UK and Europe; high baseline rates of COPD in a substudy of the START trial; the risk of cardiovascular disease or type-2 diabetes according to change in BMI after starting ART; and loss to follow up in the Malawi Option B+ programme – which needs some improvement.
Recent new ARV approvals are: the new FDC of dolutegravir plus abacavir and 3TC; cobicistat and elvitegravir as single agents in the US and a positive opinion for co-formulated darunavir/cobicistat in Europe. For hepatitis C treatment, daclatasvir was approved in Europe for genotypes 1-4 and the CHMP gave a positive opinion to approve co-formulated sofosbuvir/ledipasvir.
Other antiretroviral news includes data on raltegravir in pregnancy and for infants; efavirenz PK in pregnancy and in the presence of rifampicin for TB treatment and a report showing kidney signal trouble worsens over 5 years in a Japanese cohort receiving tenofovir.
Gareth Hardy reviews two important journal papers: one reporting little clinical impact from HIV reinfection (so long as drug resistance is not an issue) and a second reporting an experimental approach to treating PML that may be applicable for HIV positive people.
And Richard Jefferys once again updates us on basic science and cure research.