HPTN researchers virtually presented 14 abstracts showcasing HPTN 052, HPTN 071, HPTN 075, HPTN 078, and the HPTN Modelling Centre and HPTN Laboratory Center's ongoing work at the 27th annual Conference on Retroviruses and Opportunistic Infections (CROI).
HPTN 052 was a Phase III, two-arm, randomized, controlled, multi-center trial that determined antiretroviral therapy (ART) can prevent the sexual transmission of HIV-1 in HIV-1 serodiscordant couples.
- HPTN Scholar Dr. Maganizo Chagomerana’s poster Sexually Transmitted Infections Among HIV Serodiscordant Sexual Partners: HPTN 052 showed sexually transmitted infection (STI) prevalence at enrollment was slightly higher among study participants living with HIV compared to their HIV-uninfected partners. In addition, STI prevalence at enrollment was higher among females and unmarried participants.
- HPTN Laboratory Center’s Dr. Yinfeng Zhang presented Use of Phylogenetic Analysis to Infer the Direction of HIV Transmission. The poster showed accurate predictions of transmission direction were obtained using whole-genome and pol next-generation sequencing data. Further research is needed to evaluate the performance of these methods in other settings and cohorts and in cases where both individuals (source and recipient) have a long-term infection.
HPTN 071 (PopART) examined the impact of a package of HIV prevention interventions on community-level HIV incidence. Results showed delivery of an HIV prevention strategy that includes offering in-home HIV testing to everyone, with immediate referral to HIV care, and treatment for people living with HIV based on prevailing in-country guidelines, can substantially reduce new HIV infections.
- Dr. Tim Skalland’s poster HIV Incidence and Viral Burden at the Community Level in HPTN 071 (PopART) demonstrated an association between higher HIV incidence and higher viral burden.
- Dr. William Probert’s poster HIV-1 Dynamics Following Universal Testing-and-Treatment Within HPTN 071 (PopART) showed how continuation of Universal Testing and Treatment (UTT) as delivered in the study through 2030 could dramatically reduce new HIV infections in sub-Saharan Africa, but that targeting of high-risk individuals might be necessary.
- In a third study-related poster from the HPTN Laboratory Center, Evaluation of Cross-Sectional HIV Incidence Testing In the HPTN 071 (PopART) Trial, Ethan Klock showed that a widely-used cross-sectional incidence algorithm that included the limiting antigen avidity assay and HIV viral load yielded accurate point estimates of incidence, despite high rates of viral suppression among those with both prevalent and incident infection.
HPTN 075 evaluated the feasibility of HIV prevention research among men who have sex with men (MSM) and transgender women (TGW) in three countries in sub-Saharan Africa. Findings showed participants were at an alarming risk for getting HIV.
- HPTN Laboratory Center’s Philip Palumbo presented HIV Superinfection Among MSM and TGW in Sub-Saharan Africa: HPTN 075. The poster demonstrated the incidence of HIV superinfection among seroconverters was significantly higher than the rate of primary HIV infection. This finding contrasts with previous studies reporting superinfection rates were equal to or lower than the rate of primary HIV infection.
HPTN 078 was a U.S.-based research study designed to evaluate the effectiveness of a combined HIV prevention strategy, including a peer-to-peer referral method to recruit men who have sex with men (MSM) living with unsuppressed HIV and an intervention to help them achieve and maintain viral suppression.
- Dr. Ken Mayer’s poster Cascade to Trickle: Reasons for Suboptimal PrEP Use Among at Risk U.S. MSM (HPTN 078) suggests that strategies to increase effective PrEP uptake in U.S. MSM will need to address socio-economic issues and misinformation about side effects, and should assist MSM in assessing their true HIV acquisition risk.
Two other posters from the HPTN Laboratory Center presented additional findings from this study.
- Dr. Jessica Fogel’s poster Resistance to Integrase Strand Transfer Inhibitors Among MSM in the U.S.: HPTN 078 documents significant levels of INSTI resistance and highlights the importance of including baseline integrase resistance testing when selecting antiretroviral therapy regimens for MSM in the U.S.
- Dr. Risha Irvin’s poster HPTN 078: High Incidence of Hepatitis C Virus Infections Among MSM suggests HCV risk counseling should be considered in both people living with HIV and HIV-negative MSM, particularly in those with a high number of lifetime sexual partners and substance use.
HPTN Modelling Centre
- Dr. Kate Mitchell’s poster Using Surveillance Data to Measure Trial HIV Incidence Outcomes: A Modelling Study showed surveillance diagnoses data can only rarely be used to estimate HIV incidence reductions in cluster-randomized controlled trials of HIV interventions.
- Dr. Dobromir Dimitrov’s poster Achieving 95-95-95 May Not Be Enough to End AIDS Epidemic in South Africa suggests that without HIV prevention, scale-up practically all high-risk people living with HIV may need to be virally suppressed for HIV incidence to fall below AIDS elimination threshold.
Additional posters from the HPTN Laboratory Center
- George Mwinnyaa’s poster Indeterminate HIV Rapid Test Results: Outcomes and Risk Factors suggests HIV surveillance programs should develop a protocol for reporting individuals with mixed or persistently indeterminate HIV results in multiple follow-up visits.
- Wendy Greenawalt’s poster HIV Drug Resistance in Female Sex Workers from the Dominican Republic and Tanzania demonstrated high rates of HIV drug resistance among female sex workers in the Dominican Republic and Tanzania, including high rates of multi-class resistance.
- Athena Chen’s poster Improving Classification for Recent HIV Infection Using Top Scoring Pairs found the approach can be easily applied to other populations and viral subtypes to identify novel peptide signatures for cross-sectional incidence estimation.