Tuesday, 06 December 2011 18:11

Highlights of Science Sessions: ART Resistance and HIV-Vaccines

science_sessionAddis Ababa, December 06, 2011 - In the second day of Science Sessions at the ICASA 2011 conference, the audience was treated to presentations covering issues dealing with ART resistance, HIV-vaccine research and using mathematical modelling to test HIV-prevention and treatment.

The highlight of the day came when the young investigator Dr. Nafissatou Leye was awarded for her Track B oral presentation entitled "Echec virologique et resistance du VIH-1 aux ARVs apr├Ęs 12 et 24 mois de traitement de 1ere ligne au Senegal (Projet ANRS 12186)" which outlines the rates of failure of certain ART after 12 and 24 months..

Furthermore, several presentations dealt with the recent experience with ART initiation in Africa. Two presentations compared the efficacy and tolerability of simplified ART regimens. Other presentations addressed mortality and compared the risk factors and causes of death among PLHIV who are on ART versus pre-ART.

Several sessions were presented in the area of Basic Science. Speakers from Burkina Faso, Ethiopia and the USA all described advances in the use of HIV-monitoring assays and new technologies. The presentations stressed the need for the development of new approaches and tools to assist in the monitoring of immunological status and viral status of patients in Africa benefiting from the successful roll-out of ARV treatment.

Two presentations in particular - one from Ethiopia (Assefa) reviewed in house HIV drug resistance - and - one from the USA (Ulenga) reviewed the multiplex ligation amplification PCR assay for HIV drug resistance. Both presentations stressed the need for reduced cost, reduced assay times and applicability in the periphery.

In another session, speakers from Kenya, Nigeria and Uganda addressed the topic of defining the African HIV-Vaccine Agenda. The session focused on advocacy and promotion of HIV vaccine research and development. All speakers emphasised the need for African countries to recognise that in order to develop a successful HIV vaccine, more priority should be placed on support.

Several innovative approaches were proposed, including the use of Adaptive Trial Designs for clinical trials, which obtains results in real time and allows for several endpoints to be assessed in the same clinical trial, thus obtaining results more rapidly and at a reduced cost. Another alternative is the African AIDS Vaccine Partnership (AAVP), which emphasizes African ownership and contribution to all phases of the development of an effective HIV vaccine.

The two Track E sessions on Policy, Program and Health Economics focused on HIV cost efficiency and effectiveness as well as innovations and best practices. In the session on HIV cost efficiency and effectiveness, Patricia Doughty from UNICEF, as well as Dramane Kania from Burkina Faso spoke on the costs of PMTCT in low and middle income countries. In some countries, the range of indicates the potential for efficiency gains and assists future planning exercises for PMTCT. While in countries like Burkina Faso PMTCT services remain too expensive for the majority of the population.

Finally, the team from DREAM program conducted a mathematical modelling exercise to assess the impact of universal HIV testing of all adults and treatment to all HIV+ patients on a hypothetical sub-Saharan African population of about 300,000 persons where the HIV prevalence is 12%.

Results from this model show the HIV infection incidence will drop from 0.7% to 0.2% within the 5 years of initiation of a universal testing and treatment approach, with a dramatic reduction of the new cases by nearly 75%. The data demonstrates through mathematical modelling that prevention through testing and treatment can impact progression, transmission, and death rates of HIV.

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