NIAID Now | March 09, 2021
In an HIV.gov video conversation yesterday, NIH’s Dr. Carl Dieffenbach shared highlights from HIV research presented at the 2021 virtual Conference on Retroviruses and Opportunistic Infections (CROI). This year’s conference also features research on COVID-19, given the roles that many HIV and other infectious disease researchers and clinicians are playing in the global coronavirus response.
Dr. Dieffenbach, Director of the Division of AIDS at NIH’s National Institute of Allergy and Infectious Diseases (NIAID), began his conversation with his colleague Hillary Hoffman discussing some of the intersections between HIV and COVID-19. He also discussed research on potential new HIV prevention options and highlighted an analysis that found that some disparities remain despite overall progress in delivering timely antiretroviral treatment in the United States. Watch the conversation with Dr. Dieffenbach:
Some highlights of Dr. Dieffenbach’s conversation follow.
Vaccine Development: Intersections Between HIV and COVID-19 Efforts
Dr. Dieffenbach addressed a question that he and his colleagues frequently hear: If safe and highly effective COVID-19 vaccines could be developed in less than a year, why after more than 30 years of research is there still no HIV vaccine? He noted differences between the viruses, discussed features of HIV that make it a uniquely challenging target for vaccine development, and explained how efforts to develop HIV and COVID-19 vaccines complement each other. Vaccine technologies first explored for HIV helped advance the development of COVID-19 vaccines, Dr. Dieffenbach explained. Lessons learned from COVID-19 vaccine development now are being used to inform continued research into an HIV vaccine.
Dr. Fauci’s Plenary Lecture on the HIV and COVID-19 Pandemics
Dr. Dieffenbach shared highlights from the CROI 2021 opening plenary lecture delivered by NIAID Director Dr. Anthony S. Fauci, who discussed how lessons from the concurrent HIV/AIDS and COVID-19 pandemics are a two-way street. Dr. Fauci’s talk explored some of the parallels between the two pandemics, including asymptomatic transmission, exacerbation of health disparities, and the importance of community engagement in pandemic response. He also underscored that both pandemics require a large-scale, collaborative global response and observed that tools, technologies, and research expertise from the HIV response have been leveraged to support a swift response to the COVID-19 pandemic.
Disparities in Timely Receipt of HIV Treatment
Dr. Dieffenbach next discussed a study focused on disparities in how soon people received antiretroviral therapy (ART) after entering HIV care in the United States between 2012 and 2018. Using data from the NIH-funded North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), CDC researchers and colleagues studied trends in the timely receipt of ART prescriptions, defined as receipt of prescription within 30 days of entering HIV care. The researchers found that timely ART has substantially improved in the United States since 2012, when the Department of Health and Human Services HIV treatment guidelines began recommending ART for all people with HIV regardless of CD4 count. While racial/ethnic and some geographic disparities in timely ART lessened over time, people with substance use disorders still experienced delays, suggesting the need for additional support services for this population. Discussing this study, Dr. Dieffenbach reviewed why starting ART as soon as possible after HIV diagnosis is important both to benefit individual health and to prevent onward sexual transmission of HIV.
Potential Implants and Other New HIV Prevention Options
Finally, Dr. Dieffenbach highlighted an early-stage study of the investigational HIV drug islatravir delivered as an implant for HIV prevention. Researchers reported that the islatravir-containing implants were generally well-tolerated and provided drug release projected to be sufficient for HIV prevention for at least one year. Dr. Dieffenbach briefly discussed this potential new HIV prevention tool in the context of HIV prevention options now available and others being studied that may offer individuals more choices for HIV prevention tools that best suit their needs and circumstances.
CROI is an annual scientific meeting that brings together top researchers from around the world to present and discuss the latest studies and other developments that can help accelerate global progress in the response to HIV/AIDS and other infectious diseases, including COVID-19. Thousands of HIV and infectious disease researchers are gathering virtually this year for this four-day forum for translating laboratory and clinical research into progress against these diseases. Among the studies that are being presented are many that have been conducted or supported by NIH and CDC.