houseofjoehiv

The photo I’ve chosen represents what we used to call the “pipeline”: the HIV drugs being developed. I’m afraid it’s slowed to a trickle. There’s nothing huge coming out in the next few years, and we won’t see anything resembling what’s happened with hepatitis C for a while.

Probably the most important new drug will be tenofovir alafenamide (TAF), a new prodrug of tenofovir that we expect to have less bone and kidney toxicity than TDF (Viread), the current prodrug of tenofovir. Because it achieves higher intracellular tenofovir levels than TDF, it is also expected to have greater activity against nucleoside analog-resistant virus.

TAF will be available in new versions of what are today known as Complera, Stribild, and Truvada. We also expect to see the first single-tablet protease inhibitor regimen: a combination of darunavir (Prezista), cobicistat (Tybost), emtricitabine (FTC, Emtriva) and TAF.

For greater convenience, we’ll soon have coformulated versions of darunavir plus cobicistat and atazanavir (Reyataz) plus cobicistat (“D/C/F/TAF”).  People taking protease inhibitors will no longer have to take a separate tablet of ritonavir (Norvir).

Focus Point: STIs and HIV Are on the Rise in London Gay Men

Although men who have sex with men (MSM) are less than 2% of London’s adult population, they account for 24% of STI diagnoses.

65% of London’s gonorrhea cases and 84% of syphilis diagnoses were among MSM.

HIV diagnoses rose by 28% among London MSM 2003-2012.

In London, the ratio of MSM with the virus is now 1 in 12.

There is a study showing that high dose flu vaccine is safe and gives better antibody responses than standard flu vaccine in HIV-positive patients (McKittrick N, et al. Improved immunogenicity with high-dose seasonal influenza vaccine in HIV-infected persons: a single-center, parallel, randomized trial. Ann Intern Med. 2013;158:19-26.)  However, they didn’t look at clinical outcomes, so we don’t know whether the better immune repsonse made a difference.