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At the 10th International AIDS Society Conference on HIV Science (IAS) from July 21-24, 2019, in Mexico City, Mexico, researchers from around the globe gathered to share new science on the treatment and prevention of HIV infection.
Among the most anticipated presentations, updated findings from a large birth surveillance study in Botswana alleviated earlier concerns about the safety of a preferred first-line antiretroviral agent during pregnancy. Initial analyses from the study revealed a higher incidence of neural tube defects in babies born to mothers who were receiving the drug at the time of conception. As a result, several guidance bodies, including the World Health Organization (WHO), issued warnings about the drug in women of childbearing age. However, updated analyses and similar smaller studies presented at IAS showed the incidence of birth defects was much smaller than initially signaled, leading the WHO to reaffirm preferred status for the drug.
Regarding efforts to prevent the spread of HIV infection, pre-exposure prophylaxis (PrEP) with antiretroviral drugs has been an integral strategy to protect at-risk individuals from contracting the virus. New data from IAS has reinforced the validity of an on-demand dosing strategy, in which at-risk men who have sex with men (MSM) receive PrEP immediately preceding and following risky behaviors. On-demand dosing was shown to be noninferior to daily dosing, the only strategy currently approved by the FDA, in preventing new HIV infections. As a result, the WHO issued a technical brief endorsing on-demand PrEP dosing for preventing HIV infection among MSM. Further studies are needed to assess the efficacy of on-demand PrEP in other populations, including heterosexual men and women and transgender women.
Many other advances were reported at IAS, including research on new antiretroviral agents, the use of 2-drug vs 3-drug regimens to suppress HIV replication, and optimal drug regimens for persons coinfected with HIV and tuberculosis. Detailed reporting of key data from the conference is available from multiple educational sources, such as Clinical Care Options’ Conference Coverage.