22nd International AIDS Conference (AIDS 2018) – first reports

3 August 2018. Related: Conference reports, Conference index, World AIDS 22 Amsterdam 2018.

23 – 27 July 2018, Amsterdam

The 22nd International AIDS Conference (AIDS 2018) was held this year from 23–27 July in Amsterdam.

Several thousand studies were presented as oral lectures or exhibited as posters over four days – so all reports touch on a minority of the research and activity – but much of the conference is also available online.

• Abstracts are online using a searchable database for the conference programme.
  http://programme.aids2018.org
• Clicking on a search result opens a separate window, either for the abstract or the session in which it was presented.
• Slides are available for most oral presentations and plenary lectures. 
• Webcasts are available for many oral presentations (using the “video” link in the session window).
• Posters are available for many abstracts (using a PDF download link at the bottom of the abstract window).
• Oral abstracts are also available online and as a PDF supplement to JIAS.
  https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25148

This was an important conference, with UK researchers involved in many interesting studies. These notably included having sites in both the PARTNER and GEMINI studies and for the RIVER study presenting results of the first randomised kick and kill cure-related study.

The meeting attracted high-profile speakers committed to HIV from fields of science, politics, entertainment, global health and human rights. All these talks and interviews are easy to watch on webcasts, especially for the opening and closing ceremonies or by searching the online programme. 

This enables mainstream media coverage to highlight for a few days the fact that HIV is still an ongoing global crisis. 

So for all the excitement about U=U and PrEP, these advances still only reach a minority of people who need them. Athough 22 million people are now on ART, 15 million are not, with many of these people currently untested. Some regions – including Eastern Europe and Central Asia (EECA) still have increasing HIV incidence and mortality. Viral load testing is still not routinely available to millions of people.

A useful discussion in the IAS pre-conference community cure workshop just before AIDS 2018 linked cure research to global HIV care. Both need a new simple home test for viral load, with a sensitivity threshold of perhaps 1000 copies/mL cut-off. This is essential for cure research if larger numbers of people stop ART as part of a cure strategy, as they will be vulnerable to unpredictable viral rebound, perhaps after weeks, months or years. This would also improve effectiveness of ART and give people the certainty to know if ART completely protects their partners. 

Access to PrEP is improving in some settings, but globally is still struggling.

Reports included in this issue of HTB.

• Zero HIV transmissions in PARTNER study after gay couples had sex 77,000 times without condoms – an undetectable viral load stops HIV

• DTG/3TC dual therapy is non-inferior to triple-ART in GEMINI study

• Once-daily reduced dose darunavir/ritonavir (400 mg/100 mg) is non-inferior to twice-daily lopinavir/ritonavir in South African switch study  

• Superior efficacy with dolutegravir-based ART compared with other regimens at 6 months: real-world data from Brazil 

• WHO recommends dolutegravir widely but women’s access will depend on contraception provision

• No additional neural tube defects among a further 170 preconception dolutegravir exposures in Botswana: Tsepamo study (July 2018)

• Swifter viral load suppression with dolutegravir vs efavirenz in late pregnancy: results from DolPHIN 1

• First randomised kick-and-kill cure study fails to reduce HIV reservoir: RIVER study reports vorinostat and vaccines show activity, but not enough

• Using PrEP with feminising hormone therapy supports daily PrEP dosing for transwomen

• Daily and on-demand PrEP both prevent HIV in Prévenir study: high adherence by gay Parisians

• AIDS 2018 online: links to selected webcasts