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Treatment: Cabenuva for Teens

The Food and Drug Administration (FDA) recently extended the indication for Cabenuva (injectable cabotegravir plus rilpivirine) to include adolescents ages 12 and up. Cabenuva was initially approved as a once-monthly regimen, but in February, the FDA authorized every-other-month injections, meaning eligible people can take their antiretroviral therapy just six times per year. The federal agency also recently authorized a new dosing regimen that allows people to start the injections immediately without first taking cabotegravir and rilpivirine pills for a month. Daily HIV prevention pills are highly effective, but studies showed that the long-acting injections work just as well. What’s more, some people find long-acting injections more convenient, which could lead to better adherence. This may be especially important for adolescents, as some research has found that they may struggle with adherence. Other advantages include not having to think about HIV treatment every day and not having pill bottles that could reveal one’s HIV status.
KIDS
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Cure: Antibody Therapy

Broadly neutralizing antibodies (bnAbs) can delay HIV rebound and even lead to long-term remission. People with HIV normally make antibodies against the virus, but HIV can usually escape them. Some people, however, produce more efficient antibodies. One recent study tested a combination of two such bnAbs, 3BNC117 and 10-1074, in people with chronic HIV who had been on antiretroviral therapy for at least a year. Thirteen out of 17 people who stopped their antiretrovirals two days after the first antibody infusion maintained viral suppression for at least 20 weeks, and two participants who received all seven antibody doses remained suppressed after one year. In a second study, people new to HIV treatment received 3BNC117, the latency--reversing agent romidepsin or both along with antiretroviral therapy. After a year on treatment, four out of five participants whose HIV was fully sensitive to 3BNC117 maintained a viral load below 5,000 during a 12-week antiretroviral interruption, and one man still had an undetectable viral load 3.7 years later.
SCIENCE
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My HIV Cure Trial

Editor’s note: Tom Perrault is a consultant, a human resources executive and an attorney. He was board chair of the San Francisco AIDS Foundation (SFAF) and also served as chair of SFAF’s $15 million capital campaign. “Oh, I have a study that you’re going to join,” my doctor,...
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Searching for a Cure

Steven Deeks, MD, was a young resident at the University of California San Francisco (UCSF) in the early 1990s when he saw his first patients with HIV. “I had these young gay men who were so motivated to learn about their health and get involved as activists,” he says. “We developed partnerships and friendships that led to me showing up at ACT UP Golden Gate meetings.” Deeks, now 59, took what was supposed to be a one-year job at UCSF’s Ward 86 HIV clinic; 30 years later, he’s still there.
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Concerns: Lung Cancer

Lung cancer screening, which can detect tumors at an earlier stage, may be even more important for people living with HIV. HIV-positive people are more likely to smoke, and some studies show they have a higher rate of lung cancer than the general population. The U.S. Preventive Services Task Force recommends annual lung cancer screening using low-dose CT scans for people ages 50 to 80 who have at least a 20 pack-year smoking history. A small Spanish study suggests that screening HIV-positive people for lung cancer results in a high diagnosis rate with few unnecessary procedures. Among 141 people seen at a Madrid HIV clinic, 52 (37%) had evidence of lung nodules. Those with suspicious nodules underwent invasive diagnostic procedures, such as biopsies, and five were diagnosed with lung cancer. All five underwent surgery, as did an additional four people who turned out not to have cancer. The diagnosis rate was 3.6%, meaning 28 people would have to be screened to detect one case of lung cancer.
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Speak Up for Menopause Care

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Before war broke out in Ukraine, of the estimated 260,000 people living with HIV in the country, about 152,000 were taking medication to suppress the virus. Not long after Russia invaded on February 21, nearly half the pharmacies were shuttered. That’s a long time to go without refilling a prescription.
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Retire the Word “Risk”

“Women at risk for HIV.” “On the down low.” “Risky behavior.” “High-risk sex.” Such phrases frame conversations about HIV prevention in terms of stigma, fear and judgment, according to Risk to Reasons, a new initiative from ViiV Healthcare spearheaded by and targeting African-American women.
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Everyday – July/August 2022

13 – Timothy DuWhite, a writer, performer and poet living with HIV, premieres his performance piece Neptuneat Dixon Place in New York City. (2018) 16 – The Department of Health and Human Services and the Centers for Disease Control and Prevention launch the national HIV awareness campaign “Let’s Stop HIV Together,” which aims to combat the stigma and complacency fueling the HIV epidemic in the United States. The campaign includes two POZ editors, Regan Hofmann and Oriol R. Gutierrez Jr. (2012)
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A Complex Cure Trial

Experts think achieving a functional cure for HIV will require a combination approach, as is true for antiretroviral treatment. In the trial Tom Perrault has joined, participants will first receive a therapeutic vaccine that contains DNA instructions for making HIV proteins, followed by a booster, to enhance CD8 T cells’ ability to kill virus-infected cells. Next, they will get a TLR9 agonist to coax HIV out of hiding and promote natural killer cell activity. They will also receive broadly neutralizing antibodies that can inactivate diverse strains of HIV. Finally, they will undergo a carefully monitored analytic treatment interruption to see whether HIV remains suppressed after they stop antiretrovirals. The study aims to enroll 20 people living with HIV, 15 of whom—including Perrault—started treatment at an early stage. According to Rowena Johnston, PhD, amfAR’s vice president and director of research, this is “by far the most complex cure trial that anyone has undertaken to date.”
SCIENCE

POZ July/August 2022

Cover: Tom Perrault recounts his journey toward hopefully controlling HIV without medication. Inside: People living with HIV are meeting the accelerating challenges of the opioid epidemic; the basics of clinical trials. Plus: The 2022 HIV Drug Chart.
HEALTH

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