HTB April 2023 (6 April 2023)

This issue of HTB includes reports from CROI 2023 on the safety of the dapivirine ring during pregnancy and on the impact of recent US legislation on the reproductive health of women in the US.

Also that several generic companies have signed licenses to be able to manufacture cabotegravir-LA for use as PrEP in selected low- and middle-income countries, though the timeline for this has not been announced.

Although cases of mpox have almost disappeared in the UK and many other countries, we include three reports that caution against reliance on current vaccine coverage to prevent new outbreaks. One looks at efficacy data based on observational studies, another summarises latest US research, including plans for a new mRNA-based vaccine, and the third reports cases of mpox reinfection, including after receiving a course of the current MVA-BN vaccine, also noting other currently approved drugs that might have mpox activity.

Although many UK clinics are still providing vaccine services, this will apparently only be for a short period. Anyone who has not yet had a first dose will have to do this by 16 June 2023. The last day to complete the second dose is 31 July 2023. It is unclear whether this will provide sufficient cover on a population level to prevent a future outbreak. [1]

The large international REPRIEVE study looking at statin use in people living with HIV at low-to-moderate cardiovascular risk has reported a significant and early benefit in reducing heart attacks and stroke, with all participants now offered open-label pitavastatin for the remaining follow-up.

And a small study reports that penile Botox injections might overcome erectile dysfunction in people who are unresponsive to other treatments. 

Richard Jefferys reports a consensus on the order of HIV cure cases and a new documentary about the artist David Wojnarowicz is now streaming free online. Recommended watching.

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