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CROI 2014: Long-acting GSK744 Protects Monkeys against HIV-like Virus [VIDEO]

A long-acting injectable formulation of the next-generation integrase inhibitor GSK1265744 protected monkeys from infection via vaginal or anal exposure to a hybrid human-simian virus, according to 2 studies presented at the 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014) this week in Boston. These promising findings suggest this may be a future approach to pre-exposure prophylaxis (PrEP).

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CROI 2014: No One with Undetectable Viral Load Transmits HIV in PARTNER Study

The second large study to look at whether people with HIV become non-infectious if they are on antiretroviral therapy (ART) has found no cases where someone with a viral load under 200 copies/mL transmitted HIV, either by anal or vaginal sex, researchers reported at the 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014) this week in Boston.

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CROI 2014: Treatment as Prevention Dramatically Lowers HIV Sexual Transmission [VIDEO]

A large study of heterosexual and gay couples saw no cases of linked HIV transmission during 44,500 condomless sex acts when the positive partner was on combination antiretroviral therapy (ART) with suppressed viral load, according to a presentation at the 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014) this week in Boston. Based on these findings, there is no reason for legal action against people not using condoms while on effective ART.

[Jens Lundgrenspeaks at CROI 2014 press conference, Boston, March 4, 2014]

Jens Lundgren from the University of Copenhagen reported the first findings from the PARTNER study, looking at HIV transmission within more than 750 serodiscordant couples -- together contributing nearly 900 years of follow-up -- who reported not using condoms.

While this much condomless vaginal and anal sex would be expected to lead to 50 to 100 transmissions, based on historical data, the researchers did not see any cases of linked transmission in which newly acquired HIV matched a partner's strain.

While the risk of transmission per sex act while on ART fell to nearly zero, the cumulative risk over time must still be considered. Lundgren said. Estimates of risk over 10 years may reach as high as 1 in 25 overall, or up to 1 in 10 for anal sex. Whether this level of risk is acceptable "is not for us to say, but for people to decide," he said.

Lundgren emphasized, however, that there is "no reasonable legal action you can take against people for not using condoms" if they are on effective ART, and no indication for post-exposure prophylaxis (PEP) in this situation.

These findings support the recent decision by the Centers for Disease Control and Prevention (CDC) -- at the urging of activists -- to refer to "condomless sex" rather than "unprotected sex," recognizing that there are other effective prevention approaches besides condom use.

See also:

• CROI 2014: No One with Undetectable Viral Load Transmits HIV in PARTNER Study [STUDY SUMMARY]

• CROI 2014: HIV Transmission through Condomless Sex -- Interview with Jens Lundgren [VIDEO]

3/5/14

Sources

A Rodger, T Bruun, V Cambiano, J Lundgren, et al. HIV Transmission Risk Through Condomless Sex If HIV+ Partner On Suppressive ART: PARTNER Study. Conference on Retroviruses and Opportunistic Infections (CROI 2014). Boston, March 3-6. Abstract 153LB.

Press conference. 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014). Boston. March 4, 2014.

CROI 2014: Retrovirus Conference Now Underway in Boston

The 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014) kicked off in Boston this week with a program for young investigators, a press conference on new hepatitis C treatments, and opening lectures on HIV immune response and cross-species transmission and an update on the epidemic in West Africa.

HIVandHepatitis.com will be on site all week bringing you the latest news.

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