Significant Studies From CROI 2015

The International Conference on Retroviruses and Opportunistic Infections (CROI) wrapped up in Seattle last Friday. The HIV related conference made headlines with results of several studies. Here's a wrap up of the most significant ones:
PROUD (UK) — This British study was conducted on the efficacy of pre-exposure prophylaxis (PrEP). This study was going so well that in October, those in the deferred arm were called and offered the drug immediately — effectively ending the comparative study. Why? Because in the PrEP arm of the study, there were zero infections among men who took the drug daily. Three men in that arm did seroconvert, two of them because they had stopped going to the clinic to get their prescriptions filled. A third tested positive one month into the test, and researchers believe he was infected prior to starting the drug. Overall efficacy, which includes the three positive cases, is 86 percent. But again, no one who took the drug daily, as prescribed, seroconverted, placing intent to treat at nearly 100 percent. (AIDSMap)
IPERGAY (France) — This French study explored whether a less than daily pill dosing of PrEP would be effective. They called this model "PrEP on Demand." Participants were to take two PrEP pills 2-12 hours prior to having sex, then one pill a day for three days after sex. If that person had sex again during that follow-up period, they would add one more day of PrEP. This study also found that PrEP, even in this less than daily dosing schedule, was 86 percent in overall efficacy. However, as the CDC points out, with study participants having an average of eight to 10 sexual partners every two months, it is conceivable the participants were protected by near daily use of PrEP rather than on-demand scheduling. The study had two seroconversions in the PrEP arm of the study. Both participants had stopped taking the drug prior to infection, researchers said. (AIDSMap)
New Treatment Drug Shows Promise — Researchers from Bristol Myers Squibb reported a study of their new drug, 955176, was successful. The drug represents a new class of anti-HIV medications and targets the end stage of viral replication, POZ Magazine reports. In the study, researchers saw that the drug reduced the viral load of participants by 97.7 percent. (POZ Magazine)
OPPOSITES ATTRACT (Australia) — This study — which is ongoing — is reviewing transmissions of HIV in sero-discordant male-male relationships (where one partner is HIV-positive and the other HIV-negative.) The study began enrolling in 2012 and released data through December 2014. It is funded until 2016, but researchers are looking for more funding to extend the study time. In this study, researchers found no HIV transmissions linked to the HIV-positive partner — including in eight couples that reported over 5,000 episodes of condom-less anal sex. There were seroconversions during the study, but researchers verified the new infections were not genetically linked to a partner's HIV. Forty-three percent of the couples reported being in non-exclusive relationships. (AIDSMap)
Cancer Rates — Cancer rates in HIV-positive Americans are 50 percent higher than HIV-negative Americans, a new study has found.
"In 2010, an estimated 7,760 cancers occurred among the nearly 900,000 HIV-diagnosed Americans," POZ Magazine reported. "Out of those cancers, 3,920, or 50 percent, exceeded the figure expected of them if they did not have HIV. The most common cancers occurring at disproportionate rates among people with HIV were non-Hodgkin's lymphoma (with 1,440 more cancers than what is expected in an HIV-negative group, for an excess rate of 88 percent), Kaposi's sarcoma (910 more cancers, 100 percent excess), anal cancer (740 more cancers, 97 percent excess) and lung cancer (440 more cancers, 52 percent excess)." (POZ Magazine)
AFRICAa — Abstinence-only HIV prevention funding in Africa doesn't work. A second year medical student at Stanford has published a study reviewing data on efficacy of the President's Emergency Plan for AIDS Relief's abstinence and fidelity messaging focuses. Nathan Lo found the policies were failing, reports the New York Times. Lo reviewed state department data looking at age of onset of sexual activity, teen pregnancy rates and number of annual partners in 22 African nations. Fourteen of those nations received PEPFAR funding while eight did not. He reviewed data from 1998 to the present. His results were that PEPFAR had "no detectable effect" in addressing sexual risk behaviors for HIV in the 14 African nations that received the money. (NYTimes.com)