May/June 2015: Volume 16 Number 5/6

The issue of HTB is led by the news of the unexpected death of Professor Martin Fisher. His extraordinary contribution to HIV care and the enthusiasm and buoyancy that he brought to all aspects of the field will be greatly missed.

Thoughts about Martin dominated the BHIVA conference where most people first heard the news, but the meeting still went ahead and several reports are included here.

Together with BHIVA, we include news from two other meetings. These are the 5th Workshop on HIV & Women and continued news from CROI 2015 – covering paediatric and maternal care and, thanks to natap.org, an excellent overview of cardiovascular studies by Priscilla Hsue (who give a leading plenary talk at BHIVA on vasculitis and HIV).

The news that the DSMB for the international START study found that benefits of earlier ART significantly outweighed the risks – and reporting at least 18 months earlier than expected – is leading news not just for HTB but for media globally. i-Base reports technical results in this issue of HTB with additional non-technical community articles and a Q&A resource on the i-Base website.

The investigators and participants should be acknowledged for providing the evidence gap that everyone wanted – but that no-one quite predicted. Finding that early ART reduced AIDS events at very high CD4 counts will change guidelines nationally and globally.

Other news in this issue includes the FDA submission for tentative approval for the integrase inhibitor dolutegravir – less than two years after US approval for the originator formulation. This also has the potential to change treatment prescribing globally. The rapid route for a new generic is thanks to a collaboration between originator and generic manufacturers with support from the Clinton Health Access Initiative (CHAI).

Basic science articles related to cure research cover new data from a Thai study looking at the impact on mucosal dysfunction of ART started during very early Fiebig stages, plus reviews of research on broad CD4 responses and neutralising antibodies.

We report a new study for extremly drug resistant TB is just starting in South Africa – and the urgency for broader access to recently approved TB drugs is highlighted in a report from MSF.

We include news of legal actions that are challenging Gilead’s patent on sofosbuvir – driven by the unaffordably high cost – and note that UK access is both extremely slow and extremely limited.

The WHO have strengthend their call for tranparency in publishing trial results – now supported with maximum timelines for publications.

And finally, we include a resource for health workers – drafted by 56 Dean Street and i-Base – to clarify that ChemSex does not refer just to using recreational drugs for sex, but is specific to three drugs: meth, meph and G.