Rapporteur summaries: track B clinical science

Simon Collins, HIV i-Base

The webcast of the rapporteur summaries at the end of the conference is a good way to appreciate the breadth of research presented.

These talks are thanks to small groups of people who spend their conference chasing and reporting in real time on presentations and then compressing the most important studies into a short 10-minute summary.

The work involved is often under-appreciated and the conference hall is under-attended as delegates often need to leave early. These summaries deserve a higher profile and should be included in the material made available to non-delegates immediately when the conference ends.

The following report is based on the Track B talk and credit should go to the rapporteurs. Other tracks will be posted shortly online for the next issue of HTB.

Rapporteur summary: Track B clinical science

The track B summary was given by Vidya Mave, co-director of the Johns Hopkins Centre for Infectious Diseases in India, who included 20 oral presentations in seven key themes. [1]

Long-acting formulations

Long-acting drugs were noted as a game-changing development. Although the current focus is on injectables (cabotegravir-LA, rilpivirine-LA and lenacapavir), other technologies include implants, rings and other formulations.

One study using long-acting cabotegravir/rilpivirine (CAB-LA/RPV-LA) reported high efficacy in adolescents. [2]

Another included off-label use in San Francisco in people with detectable viral load who didn’t want to use oral meds or when daily adherence was complicated by living on the street or injecting drug use. Currently, CAB-LA/RPV-LA is only indicated as a switch option for people who have had a sustained undetectable viral load for six months on oral ART. [3]

Although lenacapavir is being developed as a six-monthly injection, the potential for oral weekly dosing was shown after study participants needed to switch to oral meds for six months due to supply difficulties. All participants maintained undetectable viral load using the weekly oral version. [4]

ADVANCE study and DTG rebound

An oral presentation from the ADVANCE study reported that providing additional adherence support was able to bring viral load to undetectable in 95% of participants who remained detectable on first-line dolutegravir-based ART. Drug resistance did not develop during this period. [5]

Delayed switching was less successful with efavirenz-based ART with only 66% of participants becoming undetectable after adherence support. Drug resistance was also likely to be higher.

REPRIEVE study and statin use

This large international RCT in people at low-moderate risk of major adverse cardiovascular events (MACE) showed significant benefits from using a daily statin. The study was important enough for the conference to devote a symposium to cover the findings. The discussion noted that the results could chance management guidelines but that there might be regional differences in the results. [6, 7, 8, 9]

ART and hypertension, diabetes and weight changes

Several studies, including NAMSAL and ADVANCE provided data on risks of hypertension and diabetes with ART. [10]

Weight gain on INSTI-containing ART was not reversed after switching to doravirine/islatravir. [11]

Although not highlighted by the rapporteurs, a similar study switching to boosted darunavir was also unsuccessful, but the design of these studies was also not ideal. [12]


High completion rates (>90%) of short-course rifapentine-based TB preventative treatment were reported in a retrospective analysis from Taiwan. This study reported on one-monthly use of daily rifapentine/isoniazid or three-monthly use of weekly rifapentine/isoniazid in people on dolutegravir or bictegravir-based ART. The daily regimen had slightly higher rates of skin and liver side effects. [13]

Although high rates of HCV reinfection were reported in HIV positive gay men in Thailand, sustained virological response rates (SVR) to subsequent retreatment with DAAs was also high (>95%). [14]

Women and children

Two studies reported the benefits of integrase-based ART, including as second-line therapy and another study reported lower drug levels of bictegravir during the third trimester of pregnancy, but that viral suppression was still maintained. [15, 16, 17]

COVID-19 and mpox

Finally, the review recommended two studies in the importance of COVID-19, including research into Long COVID, which more frequently occurs in people living with HIV. [18, 19]

Also, the higher risk of severe mpox in people living with HIV who have severe immunosuppression and that although now greatly reduced, mpox infections are still being reported in some countries. [20, 21]


Some of the studies highlighted in the excellent rapporteur summary, including REPRIEVE, are already reported by i-Base in detail and others will be reported shortly. [22]

It is also important to hear the results from CAB-LA/RPV-LA being used as first-line ART – and that it is also being used off-label with lenacapavir. [23]


  1. Mave V. Track B Rapporteur summary. IAS 2023, plenary session PL08.
  2. Moore C et al Implementation of LA-ART in low-middle-income countries in adults and adolescents: Possibilities and expectations of populations. IAS 2023 Symposium SY19.
  3. Ghandi M et al. Injectable therapies for treatment and prevention. IAS 2023, symposium SY08.
  4. Ogbugo O et al. Lenacapavir oral bridging maintains efficacy with a similar safety profile when SC LEN cannot be administered. IAS 2023, oral abstract OAB0205.
  5. Hill A et al. High rates of long-term HIV RNA re-suppression after virological failure on dolutegravir in the ADVANCE trial. IAS 2023, oral abstract OAB0204.
  6. The REPRIEVE trial: Developing a cardiovascular disease prevention strategy for people living with HIV. IAS 2023, symposium SY06. (symposium) (webcast)
  7. Grinspoon SK et al. Key REPRIEVE results and the utility of statins among people living with HIV: What have we learned? IAS 2023, symposium SY06, see reference 6.
  8. Bloomfield G et al. Cardiovascular disease among people living with HIV in high- and low-income countries: Can one strategy fit all? IAS 2023, symposium SY06, see reference 6.
  9. Zanni M et al. Unique aspects of cardiovascular disease among women with HIV: Lessons from REPRIEVE. IAS 2023, symposium SY06, see reference 6.
  10. Venter F et al. Risks of hypertension with first-line dolutegravir (DTG) and tenofovir alafenamide (TAF) in the NAMSAL and ADVANCE trials. IAS 2023, oral abstract OALBB0504.
  11. McComsey G et al. Weight and body composition after switch to doravirine/islatravir (DOR/ISL) 100/0.75mg once daily: week 48 results from 2 randomized active-controlled phase 3 trials, MK8591A-017 (P017) and MK8591A-018 (P018). IAS 2023, oral abstract OAB0203.
  12. Blick G et al. Prior M184V/I and multiple prior virological failures have no impact on the efficacy of switching HIV+ adults to DTG/3TC through 96Wks in SOLAR-3D. IAS 2023, oral abstract OAB0202.
  13. Lin K.-Y. et al. Short-course rifapentine-based regimens for latent tuberculosis infection among people living with HIV who received integrase inhibitor-based antiretroviral therapy. IAS 2023, oral abstract OAB0304.
  14. Promsena P et al. High rate of hepatitis C and reinfection after direct-acting antiviral treatment among men-who-have-sex-with-men living with HIV in Bangkok, Thailand. IAS 2023, oral abstract OAB0303.
  15. Musiime V et al. Increasing second-line antiretroviral therapy options for children with HIV in Africa: week-96 efficacy and safety results of the CHAPAS-4 randomised trial. IAS 2023, oral abstract OALBB0503.
  16. Ani I et al. Virological dynamics among children living with HIV transitioned to a dolutegravir-based regimen in Nigeria. IAS 2023, oral abstract OAB0105.
  17. Zhang H et al. Pharmacokinetics, safety, and efficacy of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in virologically suppressed pregnant women with HIV. IAS 2023, oral abstract OAB0104.
  18. Matthews G. Lessons from COVID and mpox: Preparing for future pandemics and improving outcomes for people living with and affected by HIV. IAS 2023, symposium SY10.
  19. Corral Herrera E.A. et al. Post-acute sequelae of COVID-19 (PASC) and Quality of Life in people with HIV. IAS 2023, E-poster EPB0282.
  20. Orkin C et al. Lessons from COVID and mpox: Preparing for future pandemics and improving outcomes for people living with and affected by HIV. IAS 2023, symposium SY10.
  21. Hoxha A et al. HIV among mpox cases: clinical characteristics and outcomes in the WHO global surveillance 2022. IAS 2023, oral abstract OAB0302.
  22. Collins S. REPRIEVE study: statin benefits people living with HIV at low CVD risk. HTB 26 July 2023.
  23. HIV, New Drugs & Restoring Trust. Interview with Monica Gandhi.

Links to other websites are current at date of posting but not maintained.