Associate Professor Thanyawee Puthanakit’s talk on “HIV Co-morbidities in children and adolescents” addressed what kind of co-morbidities we are encountering in the era of antiretroviral therapy (ART). She gently urged the pharmaceutical companies to address the lack of potent pediatric antiretroviral formulated drugs (i.e., integrase inhibitors, tenofovir alafenamide fumarate (TAF), and lipid-friendly HIV drugs) with low toxicities. She pointed out that research organizations need to do more operational research studies in resource-limited settings using the public health approach. For example, can urine dipstick detect renal abnormalities (i.e., glycosuria or proteinuria) if the children and adolescents are on TDF? Or, can we use other risk factors to detect renal abnormalities such as having AIDS, being malnourished or on boosted protease inhibitors and tenofovir disoproxil fumarate (TDF)?. Early ART and switching antiretroviral drugs can prevent and manage HIV co-morbidities (i.e., poor growth, delayed puberty, and impaired neurocognitive development) in the HIV-infected children and adolescents.
Dr. Torsak Bunupuradah’s oral presentation entitled, “Atazanavir/ritonavir 200/100 mg is non-inferior to atazanavir/ritonavir 300/100 mg in virologic suppressed HIV-infected Thai adults: a multicentre, randomized, open-label trial: LASA” showed that switching to low-dose atazanavir (ATV) was not inferior and had lower discontinuation rate compared to the standard dose of ATV in Thai HIV-infected patients with plasma HIV-RNA less than 50 copies/ml. Low-dose ATV is cost-effective, especially in resource-limited settings. These findings suggested that lower dose of ATV can be used in patients with lower body weight in resource-limited setting. However, the results cannot be generalized to other patient population such as those who have not started treatment (i.e., treatment-naïve) or those who have drug resistance (i.e., treatment-experienced).
Dr. Anchalee Avihingsanon participated in the official press briefing entitled, “HCV: The good news continues”. The briefing provided the public with the latest results from HIV-HCV co-infection clinical trials. New drugs (i.e., fixed-dose combination tablet of protease inhibitor grazoprevir and NS5A inhibitor elbasvir) and DAA (direct acting agents) were efficacious and well-tolerated among hard-to-treat HIV-HCV co-infected patients. Duration of treatment or status of cirrhosis and genotype did not affect the rate of suppressed virological response (i.e., having undetectable HCV RNA). Overall, diagnosis, treatment and prevention of HBV – and HCV-co-infected patients should not be overlooked in our fight to reduce HIV globally because viral hepatitis often appears with HIV. Therefore, serious co-infections are extremely important factors that need to be addressed to achieve a successful scale-up of the UNAIDS’s 90-90-90 (90% will know their HIV status, 90% will be on HIV treatment, and 90% will have undetectable HIV RNA) vision.
Additional information can be found at LASA: In HIV-Infected, Virologically Suppressed Thai Adults, Efficacy of Atazanavir/Ritonavir 200/100 mg Is Noninferior to Atazanavir/Ritonavir Dosed at 300/100 mg
