HIV Activist Raises Hope and Warnings in New Attachment Inhibitor Trial.

Video: HIV Activist Raises Hope and Warnings in New Attachment Inhibitor Trial.

Leading HIV activist Nelson Vergel raises hopes but also warns HIV salvage patients and their physicians about functional monotherapy risks in the Bristol-Meyers Squibb (BMS) new attachment inhibitor study (Fostemsavir, BMS-663068) currently enrolling (2015-2016). This innovative drug, along with Taimed’s ibalizumab, can be the last hope for HIV+ patients who have no remaining treatment options. However, like any HIV drug, you have to combine with at least one more medication that can control your virus. If your doctor has told you that you have no more HIV medications left to bring your HIV viral load to undetectable, please email
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BMS attachment inhibitor:…

Starting HIV Medications Within First Weeks of Infection Decreases Hidden Virus

  1. Clin Infect Dis. (2015) doi: 10.1093/cid/civ171First published online: March 3, 2015
Impact of the Earliness of Antiretroviral Therapy Initiation During Primary HIV-1 Infection on the Decay of Cell-Associated HIV-DNA
Moussa Laanani1,2,
1Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Paris-Sud University, Le Kremlin-Bicêtre, France
2APHP, Department of Epidemiology and Public Health, Bicêtre Hospital, Le Kremlin-Bicêtre, France
Background. Combined antiretroviral therapy (cART) initiation during primary HIV infection (PHI) yields larger decrease in cell-associated HIV-DNA (CA-HIV-DNA) than initiation during the chronic phase. Our objective was to model the short and long-term decay of CA-HIV-DNA blood reservoir in patients initiating cART during PHI and to assess the impact of the earliness of cART initiation on CA-HIV-DNA decay.
Methods. We included patients enrolled during PHI in the ANRS PRIMO cohort, treated within the month following enrollment and achieving sustained virological response. The decay of CA-HIV-DNA over time while on successful cART was modeled with a 3-slope linear mixed-effects model according to the delay between estimated date of infection and cART initiation.
Results. 327 patients were included, accounting for 1,305 CA-HIV-DNA quantifications. Median time between infection and cART initiation was 41 days (IQR: 33-54). Median follow-up under cART was 2.3 years (range: 0.4-16.6). The earliness of cART initiation had significant impact on the first slope of decrease: the earlier cART was initiated after HIV infection, the faster CA-HIV-DNA level decreased during the first 8 months of cART: -0.171, -0.131, and -0.068 log10 copies/106 PBMC/month when cART was initiated 15 days, 1 month and 3 months after infection, respectively.
Conclusions. This study provides strong arguments in favor of cART initiation at the earliest possible time point after HIV infection.

Most Important HIV Research Reports from CROI 2015

From Jules Levin: perhaps the biggest stories out of CROI from my perspective are the development of 2 new HIV therapies – the new attachment inhibitor & the new maturation inhibitors, as well as the safety & efficacy of TAF, and an important message out of CROI is that TAF can also be used in HCV coinfected patients as a replacement for TDF in their ART regimen which will likely provide key safety improvements. Equally important are the HCV coinfection study results from Harvoni, daclatasvir+sofosbuvir, and Abbvie’s 3D Viekira Pak, and at CROI are a number of presentations on use of simeprevir+sofosbuvir as this therapy was the most potent HCV therapy available in 2014. Merck is in phase 3 with their 2 HCV drug regimen and developing a triple drug regimen with the study of the 2-drug regimen in combination with the nuke they acquired from Idenix. J&J is studying the nukes they acquired from Alios, they have GSK’s NS5A inhibitor, and they have a non-nuke polymerase in-house as well as simeprevir. Abbvie & Merck reported 2nd/3rd generation drugs at AASLD in pre & early clinical – protease, NS5A. Achillion reported high SVR rates in their early clinical studies with their potent nuke, potent NS5A & they have 2 protease inhibitors. Aging & comorbidities were a focus at CROI as well, particularly noteworthy is the research from the Mass General group reported again that subclinical heart disease is ever present in HIV+, that it can results in plaque buildup, particularly of note in HIV+ it results in non calcified plaque buildup which can rupture; they reported Atorvastatin reduced coronary artery noncalcified plaque and that plaque buildup is associated with a leaky gut, microbial translocation. Statins got quite a bit of attention with several reports including one from Grace McComsey that Rosuvaststin arrests progression of carotid intima media thickness in HIV+. Ken Lichtenstein reported the 4 heart disease algorithms underestimate risk for heart disease in HIV+ based on the SUN cohort. Bone disease is highlighted as well with Michael Yin reported modified FRAX underestimates risk for fractures among HIV+, and from HIV+ WIHS women experienced increased risk for fracture. Bigger font titles below indicate key reports, more NATAP reports coming including 9 specialized topical reports by expert researchers. Gilead has introduced a new HIV “cure” drug that appears to induce HIV reservoirs, TLR7, this immune based drug has been in ongoing research for several years at Gilead to treat HBV.

22nd Conference on Retroviruses and Opportunistic InfectionsSeattle WashingtonFeb 23 – 26, 2015

 Preventing one HIV infection in US saves $229,800 in modeling analysis – written by Mark Mascolini – (03/02/15) 

 Linkage to HIV care and viral suppression climb steadily in New York City – improvements to 76%, 73% – written by Mark Mascolini – (03/02/15) 

TAF noninferior to TDF through 48 weeks in elvitegravir combination – written by Mark Mascolini – (03/02/15) 

 Atorvastatin for 1 year trims coronary artery plaque volume and number in placebo trial – written by Mark Mascolini – (03/02/15) 

TAF easier on kidney and bone signals than TDF in 48-week trials – written by Mark Mascolini – (03/02/15) 

Do gut flora play key role in cardiovascular disease with HIV? – written by Mark Mascolini – (02/27/15) 

Lower CD4 count, higher viral load tied to primary MIs in NA-ACCORD – written by Mark Mascolini – (02/27/15) T

AF easier on kidney and bone signals than TDF in 48-week trials – written by Mark Mascolini – (02/27/15) 

Earlier ART in primary infection leads to bigger drop in cellular HIV DNA – written by Mark Mascolini – (02/27/15) 

Viral load above 1500 copies 23% of time in CDC study of 6 clinics – written by Mark Mascolini – (02/26/15) 

Levonorgestrel contraception fails in 15% of women taking efavirenz – written by Mark Mascolini – (02/26/15) 

NCI sees “sizeable absolute risk” of cancer in elderly with HIV – written by Mark Mascolini – (02/26/15) 

Lower CD4 count, higher viral load tied to primary MIs in NA-ACCORD – written by Mark Mascolini – (02/26/15) 

Almost half of US women with HIV not in regular care in CDC analysis – written by Mark Mascolini – (02/26/15) 

As-Needed PrEP Cuts HIV Rate 86% in French-Canadian Ipergay Trial – written by Mark Mascolini – (02/23/15) 

Wider PrEP Use in San Francisco Could Cut New HIV Rate by 70% – written by Mark Mascolini – (02/23/15)