HTB September 2022 (1 September 2022)

This issue of HTB includes further reports from the 24th International AIDS Conference (AIDS 2022) held in Montreal from 29 July to 2 August 2022.

This includes further data to support the use of dolutegravir during pregnancy, a move already supported by WHO.

We also report that longer follow-up in the ADVANCE studies continues to report weight gain associated with dolutegravir and tenofovir alafenamide, especially in Black women.

And this caution might also exend to long-acting injectable ART which shows a similar weight and lipid profile to dolutegravir-based ART.

Other studies report that oral PrEP during pregnancy does not have any negative impact on exposed children.

Other reports from AIDS 2022 include a presentation on monkeypox cases diagosed at the three London clinics and a talk about the public health response in Montreal.

And our reporting on this outbreak in the UK continues with another dozen reports.

These are outlined in the special report on monkeypox that leads this issue of HTB.

The good news is that cases are starting to fall, but this might mainly be due to behavioural changes by gay and bisexual men who now believe that monkeypox is real and they know they want to avoid it.

But the range of reports includes a BHIVA update on vaccine efficacy, the potential for asymptomatic transmission, heterosexual transmission in Nigeria, a case of transmission to pets and several severe and difficult cases.

We cover the vaccine shortage in the UK and the potential to extend doses by using intradermal delivery. Also that a tecovirimat study has opened in the UK.

These have been particularly difficult months, especially coming after (and during) covid, which is still ongoing.

The response from sexual health clinics to manage this crisis has been remarkable.