Asia-Pacific HIV Clinical Forum: Integrase inhibitors

HIV Forum—31 May 2017 (11am to 6pm)

I would like to present my interpretation of a session at the HIV Clinical Forum (for integrate inhibitors) held on the 31st May 2017. I believe this sessions was not as widely attended as the first day of the Asia Pacific AIDS and Confections Conference (APACC). Specifically, I will focus on an ‘HIV prevention 2.0’ talk by Dr Charles Boucher, who is a virology professor in Rotterdam and the scientific director (and owner) of Virology Education, Utrecht, Netherlands. Virology Education is the organisation that put together the APACC event in Hong Kong right now and have at least 8 other conferences throughout the year in a number of international locations.

Please note that the information presented here is not exhaustive and is limited by the speed at which I was able to take notes and my individual interpretation.

Dr Boucher began his talk speaking about the HIV prevention methods of circumcision, condoms, PrEP, PEP and ART. I was quite interested in the addition of circumcision to this list, because in my experience it is not often included in such lists. The evidence that male circumcision reduces HIV infections is quite strong.

The cost of prevention methods is a very significant problem across the world and very specifically in developing countries. Dr Boucher commented that governments struggle to understand the medication PrEP and do not see its effectiveness in reducing the cost of HIV ART and associated health care costs. I believe that some of the attendees and presenters have mentioned that PrEP comes at a cost of approximately $1US per day, which is completely unattainable to many persons around the world. Among these people are severely disadvantaged groups such as sex workers, transgender individuals and PWID.

Targeting strategies for each at risk population was a point made repeatedly by this speaker. It is interesting to note that the percentages of specific population transmission routes varied considerably between countries attending this conference. The sexual transmission groups in Australia are dominated by the MSM community whereas in China the most common group transmitting the virus are heterosexuals (66%).

The doctor concluded by saying that increasing annual testing and the uptake of PrEP in the high risk population of MSM is very important. Lack of substantial reductions in transmission is not due to ineffective ART provision or inadequate retention, rather, it is due to frequent early transmission. Dr Boucher seemed dubious as to achieving the goal of zero new HIV infections in 2030 and recommended closer collaboration between public health professionals and HIV health care providers. He also repeated his recommendation of targeted strategies and intervention approaches with specific reference to sexual/virological networks.

NB. I would like to say that the doctor also spoke about flyogenetics, analysis of sequences, resistance genotyping and viraemia but I am unable to accurately represent this information. I am very much looking forward to all of these presentations being accessible online and organisers of this even have informed me that 80% or more of the presentations should be available within 2-3 weeks.