Looking back through 2024 and forward to 2025…

1 January 2025. Related: Special reports.


Simon Collins, HIV i-Base

Thank you to everyone who has worked for and supported i-Base since April 2000 and everyone who is continuing to help us during 2025 and beyond.

Wishing you happiness for the upcoming year.

Review of 2024

The key themes in this review of the past year highlight the importance of responding to political changes as much as tracking incredible advances in HIV science. These issues will continue into 2025.

  • The impact of political change on HIV care included LGBT+ hate laws in Uganda and extended to questioning the stability of PEPFAR after the US elections.
  • Continued investment in new drugs in the exciting ART pipeline were reported at CROI, IAS, R4P and Glasgow — shifting to multiple long-acting combinations.
  • Remarkable research into oral PrEP led to exciting changes that includes easier dosing options for everyone.
  • Lenacapavir PrEP gets a special category for generating astonishing results — but who will get access and when depends on civil society generating global demand.
  • The promise of GLP-1 agonists such as semaglutide have potential in HIV and perhaps addiction management, and possible new indications are suggested every month — but people with HIV have been excluded from research studies.
  • Mpox continued throughout 2024 in key endemic countries, largely ignored until WHO recognised the implications of clade 1b in the Democratic Republic of Congo. We reported research throughout the year though including the disappointing results in December from tecovirimat studies.
  • Guidelines for HIV treatment and prevention were produced in the UK, Europe and US by some of our most experienced and committed doctors and researchers —and we refresh a list of 14 we covered during the year — which did you miss?
  • A few special reports and reviews include the chance to recognise the work of a few friends and colleagues.
  • Finally, news about i-Base changes during the year, archives at Bishopsgate Institute and the Wellcome Collection and your chance to help in 2025.

1. Anti-LGBT+ hate laws in Uganda

Politics undercut HIV news throughout 2024 and started with reports on the anti-LGBT+ hate laws in Uganda.

We reported on international campaigns to challenge the new law. We also included links to financially support some of those who are now without homes and incomes.

CROI also recognised the significance and urgency by inviting Frank Mugisha to give one of the opening plenary talks.

This appeal is also still ongoing to help some of the individuals most affected.

2. HIV pipeline: Exciting research for new and better meds

Throughout 2024 we reported breakthrough news on the continued research into new treatments for HIV treatment and prevention.

A comprehensive report from CROI covered more than 30 studies presenting new data, many in novel combinations and including more than a dozen involving the potential for bNAbs. This continued at IAS 2024 in Munich, notably with the first formal presentation of lenacapavir for PrEP.

We also featured an impressive overview from Tracy Swan and ITPC on the HIV pipeline for low- and middle-income countries.

Finally, a new summary of the pipeline for 2025 based on a comprehensive review by José Arribas at the 2024 Glasgow Congress.

3. New PrEP research: easier and more effective dosing options

A series of research papers included a new modelling study that effectively explained the results from PrEP RCTs in both men and women.

Together with previously published pharmacokinetic studies and a meta-analysis of observational data reporting high levels of protection in women taking at least four daily doses a week, this lead to dramatic changes in the PrEP guidelines from BASHH, European (EACS) and IAS-USA.

Working with BASHH researchers and other UK community groups, i-Base included these recommendations in February 2024, distributing 20,000 booklets to UK clinics between February and August 2024.

4. Lenacapavir PrEP: outstanding efficacy but global challenges of access and equitable access

Six-monthly injectable PrEP produced astonishing results and delivered new challenges for access.

The potential annual generic price of US $41 depends as much on activist demands from civil society to generate pre-order commitments as it does pharmaceutical pricing.

5. Semaglutide and other GLP-1 agonists in HIV care and potential use in addiction

i-Base was one of the community organisations to highlight the urgent need for data to inform the management of GLP-1 agonists such as semaglutide in people living with HIV.

Every month during the year, potential new indications in addition to the FDA-approved use for managing diabetes and weight loss. These include alcohol use disorder, liver complications, asthma, lung complications, heart and kidney disease, osteoarthritis,  mental health, Alzheimer’s, increased fertility and late onset epilepsy. Important possible safety cautions have also been reported including the loss of muscle mass and perhaps higher rates of arthritis and pancreatitis..

The surge in demand also raised many other issues including drug pricing, moving to telemedicine in the US, aggressive strategies to extend and evergreen patents beyond the intended lives, lack of global access and manufacturing monopolies.

6. Mpox continues to challenge global health: continued epidemic in central Africa, emergence of more pathogenic clade1b, tecovirimat failure, unanswered questions on vaccine durability…

The mpox crisis in DRC emphasised how mpox had been ignored globally since 2023 until a new more pathogenic clade 1b strain emerged with new cases expanding to neighbouring countries.

Professor Chloe Orkin eloquently predicted that cases in Europe would inevitably be reported but that close management would limit any general risk.

The UK announced including the mpox vaccine within routine sexual health, although this planned programme is now at a time of global vaccine scarcity.

Looking forward, despite WHO declaring this an emergency, the limited access to vaccines is likely to continue this epidemic well into 2025.

Research updates continued to report on the efficacy of the MVA-BN vaccine and likely duration of protection, especially with breakthrough infections still reported in people who received two vaccine shots.
https://i-base.info/htb/47082

Despite having antiviral potency against mpox in vitro, tecovirimat fails to show efficacy against mpox in two RCTs.

7. Guidelines: treatment and prevention

Many guidelines were updated or newly published.

All required the tireless work from many of our most respected HIV experts. Here are 14 guidelines from 2024 – are there any here you might have missed?

8. Special reports

Several of the reports during 2024 were published as special reports.

This included not only the unexpected increase in new diagnoses in the UK, but also the chance to recognise the work of friends and colleagues.

9. Change at i-Base: looking to the future

Finally, 2024 was a year of significant changes for i-Base.

https://i-base.info/htb/48024

We hope these changes will sustain the i-Base information services and the website for at least the next two years.

i-Base was also proud to donate our own accumulated library to the Bishopsgate Institute and the Wellcome Trust. Both organisations allow access to all resources.

Please consider supporting i-Base to help us continue this work into 2025. 
https://i-base.info/htb/49913

i-Base appeal

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