New HIV Research Hits and Misses

This spring, 4,000 researchers from 76 countries descended on Boston for the annual Conference on Retroviruses and Opportunistic Infections to share important developments in HIV research. The event is known to deliver new insights, treatment options — and hope — for healthcare professionals and people living with HIV. And this year was no different.

HIV researchers presented the conclusions of their studies — some of which are ongoing, and others that took months or years to compile — and much of the information has potential to lead to further research. Here are some of the key takeaways:

Organ transplants for HIV-positive people are becoming more promising
As we reported last year, surgeons are finally able to transplant organs donated by HIV-positive people into others of the same status (thanks to the 2013 HIV Organ Policy Equity Act). According to a CROI presentation by Dr. Christine Durand of Johns Hopkins University, so far, 286 people with HIV have consented to receive an HIV-positive donor organ, and there have been 77 transplants from 22 donors. Another study at Hopkins also looked at 10 hepatitis C-negative people who received organs from those living with hep C. After a year, those who had received the donated organs remained hep C free. Both studies offer hope for the thousands of people waiting for organ transplants due to the shortage of available donors.

Transgender women are more likely to be included in HIV clusters
A study of HIV cases in Los Angeles found that transgender women are more likely than any other risk group to be in genetically-connected clusters of cases. In other words, they were more likely to share a strain of HIV, due to shared risks; particularly, the study found, a shared pool of sexual partners (out of the 167 transwomen in clusters, 147 had sexual contact as their only risk factor, while the other 20 also used injection drugs). Manon Ragonnet-Cronin of the University of California, San Diego, pointed out that this study shows there is a distinct population of cisgender men who primarily or occasionally have trans women as sexual partners. That’s a group of men who are likely not being reached by traditional HIV prevention efforts.

A longer lasting PrEP pill is in the works
An investigational drug called MK-8591 (or EFdA), is being developed by researchers for Merck & Company, and could become a once-a-week extended release PrEP pill. The drug blocks HIV from making a DNA copy of its genes (which it can then insert into a human cell), while also blocking integrated HIV DNA inside cells from being converted back into viruses. These findings, reported on by Martin Markowitz of the Aaron Diamond AIDS Research Center, could also lead to improvements to current HIV meds.

Pregnant women have a higher risk of contracting HIV
Renee Heffron of the University of Washington presented a study finding women’s risks of contracting HIV through sex with a male partner increases during pregnancy — and peaks at four times as high during the postpartum period. Of course, that increases risks of vertical (or in utero) transmission of HIV. Fortunately, there are steps HIV-positive people can take to avoid transmitting HIV to a partner or child (including using antiretroviral medications).

Antiretrovirals decrease the efficacy of contraceptive rings
The National Institute of Allergy and Infectious Diseases has been funding ongoing studies looking at the use of a two-in-one prophylaxis vaginal ring that prevents both HIV and pregnancy. The need for such a duo-purpose ring (and for using the right combination of drugs) was reiterated in findings presented by Dr. Kimberly Scarsi of University of Nebraska Medical Center, who found that the antiretroviral medication, efavirenz, interfered with the contraceptive hormones in standard birth control rings. Efavirenz reportedly caused an 80 percent decrease in levels of the contraceptive in the blood stream.