New Advances in HIV Research

As Peace Corps in Botswana, our primary mandate is HIV/AIDS, which normally centers around prevention. For us, that is closely tied to gender, since gender-based violence is the leading driver of HIV in Botswana. Hence, we feel that projects that empower young women and girls through literacy or job preparation and encouraging forums to discuss relationships, especially girl's rights within those relationships are really important. Still, occasionally we also get to see the other side of fighting HIV: treatment and care. Sometimes, those are synonymous. An ongoing study by The Botswana-Harvard partnership called "Ya Tsie" includes one of the villages in our reporting district. It is one of the most comprehensive studies to date about treatment as prevention (ARVs both treat and prevent transmission) and combination prevention strategies (like opt-out instead of opt-in testing, and HIV/TB concurrent testing). 

This last week, we got to see some of the results of this year's Conference on Retroviruses and Opportunistic Infections (CROI), where some of the most cutting-edge research on HIV is presented. Here is a short interview from UNAIDS about some conference highlights and a link to the website where you can find abstracts, posters, webcasts and photos for more in-depth information. 

Highlights from the annual Conference on 

Retroviruses and Opportunistic Infections 

New advances in HIV research and development 

The annual Conference on Retroviruses and Opportunistic Infec-tions (CROI) was held in Boston, U.S. from 3-6 March 2014. Every year CROI provides an opportunity for researchers from around the world to come together and share the latest developments in HIV research and development. Several interesting areas of research were presented at this year’s conference (http://www.croi2014.org) and UNAIDS spoke to Professor Salim S. Abdool Karim, Director of the Centre for the AIDS Programme of Research in South Africa and Chair of UNAIDS Scientific Expert Panel, for an overview of the main highlights in HIV prevention, treatment and cure research. 

Q. Professor Karim, we heard of many exciting developments coming out of this year’s conference what did you see as the main advances in HIV prevention research? 

A. The conference hosted a range of great presentations on AIDS treatment, prevention and cure. There was a strong theme on HIV prevention at this year’s CROI, focusing on how to im-prove effectiveness of antiretroviral (ARV) pre-exposure prophylaxis (PrEP). Studies over the last 3 years have provid-ed enough evidence to demonstrate that antiretroviral drugs like tenofovir are effective. However, the ARVs being used for PrEP are not taken as prescribed. At this year’s CROI, we saw a concerted move to find formulations that would have better adherence. To this end, a study of GSK-744LA, a long acting injectable which could transform PrEP from daily pill-taking to 3 monthly injections, showed good protection in monkeys. Another strategy to improve adherence is the development of a new vaginal ring, which has both the contraceptive and anti-HIV properties. 

Q. There was also much talk about cure for HIV—what was your take on that? 

A. The Mississippi baby is now just over 3 years old and has been off ARVs for more than 2 years but re-mains negative on the highly sensitive ELISA and PCR tests, strength-ening the evidence that this child may be cured. The second child presented at the meeting is a 9 month baby who was thought to be cured. Unfortunately, it is not a possible to de-termine whether this child is indeed cured because the child is still on ARVs and it is not possible to determine if negative HIV tests are due to temporary viral suppression or to viral eradication. 

Q. Vaccine development also seems to be advancing—what do you see as the next major step in vaccine research? 

A. In vaccine science, several broadly neutralizing antibodies have been identified and some have even been shown to be effective in preventing, treating or curing infection in mon-keys. The next step is to assess what effect these antibodies would have in the human body. 

Q. Is there anything else in the pipeline we should look out for? 

A. Yes, I am very impressed in the findings of gene modification approaches to treating HIV. I think this new technology has great potential.