Ernest Tee

Following tributes to Professor David Cooper, the speakers highlighted the MK8591A-020 trial results; the social network-based intervention’s impacts on HIV self-testing rates and healthcare linkages among Kenyan fishermen; sustained aviraemia in male infants off ARTl; and socioeconomic measures to facilitate the completion of latent tuberculosis therapy among Tanzanians with HIV.

Jürgen Rockstroh presented the 48-week results of MK8591A-020, a double-blind phase 3 clinical trial of once-daily Doravirine/Islatravir 100mg/0.75mg (DOR/ISL) compared to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) as initial HIV-1 treatment. DOR/ISL was non-inferior to B/F/TAF in achieving plasma HIV-1 RNA below 50 copies/mL at 48 weeks. 1 participant in DOR/ISL group developed treatment-emergent resistance secondary to non-adherence. DOR/ISL was generally well-tolerated, but with a lower degree of CD4+ T cells and total lymphocytes rise at week 48. Carol Camlin highlighted the impact of social-network based interventions in elevating the HIV self-testing rates and linkages to health facilities among highly-mobile Kenyan fishermen in Siaya County. This was achieved by harnessing the social influences of male ‘promoters’ within this vulnerable population group. Gabriela Cromhout presented five children who remained aviraemic in the setting of cART non-adherence. All five children were male, and possessed HIV viruses with low replicative capacity and heightened sensitivity to interferon. These virological characteristics may account for their virological control off cART. Carolyn Fahey described the power of financial incentives incorporated within mobile health technology in augmenting the rates of isoniazid dispensation to treat latent tuberculosis among Tanzanians with HIV who are at high risk of loss to follow-up.

The MK8591A-020 trial showed a higher rate of lymphocyte count drop in the DOR/ISL group but no statistical analysis of this trend was performed. Ongoing trials involving DOR/ISL are progressing with a lower dose of islatravir at 0.25mg. Social network-based interventions can demystify and normalize health-seeking behaviours among highly-mobile population groups with poor health literacy. The sustained aviraemia among 5 male children off cART highlights the potential role of immune-related sex differences in achieving long-term cure among children with HIV. Lastly, combination socioeconomic strategies can bolster retention and adherence to TB treatment among individuals co-infected with TB and HIV.