HTB: no. 10 – HIV and COVID-19: issue 7 (28 August 2020)

We continue to report from the virtual AIDS 2020 conference: mainly focused on the continued data linking second-generation integrase inhibitors (dolutegravir and bictegravir) with weight gain, especially when combined with tenofovir alafenamide (TAF). This disproportionally affects women compared to men, is higher in African women, and global role-out of dolutegravir-based ART is now using fixed-dose combinations that use TDF rather than TAF.

AIDS 2020 also included data on 6-monthly dosing for the investigational capsid inhibitor lenacapavir, paediatric dosing of dolutegravir and two larger US studies on COVID-19 in HIV positive people.

Regulatory news includes that long-acting cabotegravir and rilpivirine injections (Cabenuva) have now been resubmitted to the US FDA and that the EMA has given a positive opinion on the efficacy and safety of the dapivirine vaginal ring as an HIV prevention option in high-incidence countries.

In the UK, the proposal to abolish Public Health England during the current COVID-19 crisis, with little notice or concern for its broad remit for other aspects of health, drew immediate response from HIV organisations and is included here. As we went to press, wider community responses were also being organised that will be publicised next week.

Our coverage of COVID-19 includes two large cohorts that took different approaches to looking at risk of mortality in HIV positive people. While these studies need further analyses for potential confounding it is notable that they both report higher risks compared to HIV negative people.

The monthly review of COVID-19 studies from BHIVA, EACS and other European HIV groups still minimises the impact of HIV on COVID-19 outcomes, calling for more data.

Other COVID-19 news includes positive reports from use of tocilizumab and famotidine, with news of an upcoming study using monoclonal antibodies led by the INSIGHT research network.

An update on vaccine news includes the role of HIV activists in ensuring HIV positive people can enrol in vaccine studies and in cautioning against ethics of participants receiving challenge with active SARS-CoV-2, however altruistic this might seem.

Plus plenty to watch online: we highlight the ART in Africa video that i-Base was involved with and a range of webinars from AVAC including an interview on vaccine advances.

Finally, two more HIV medical conferences have been reorganised as virtual meetings, including both BHIVA and R4P, both of which were rescheduled from earlier in the year in the hope that an effective response to coronavirus might have allowed a return to face-to-face meetings. Please continue to support these important events as for all the focus on COVID-19, developments in HIV still depend on these essential platforms.