IAS 2009 – Cape Town 19-22 July 2009 - International AIDS Society

Late Breaker C

WELBC1

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Type:

Oral Abstract Session

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Venue:

Session Room 2

Time:

16:30 - 17:30, 22.07.2009

Code:

WELBC1

Chairs:

Tim Farley, Switzerland
Papa Salif Sow, Senegal

Presentations in this session:

16:30
WELBC101
Abstract Twice-daily acyclovir to reduce HIV-1 transmission from HIV-1 / HSV-2 co-infected persons within HIV-1 serodiscordant couples: a randomized, double-blind, placebo-controlled trial
Presented by Connie Celum, United States
C. Celum^1,2,3, A. Wald^2,3,4,5, J. Lingappa^1,2,6, A. Magaret^4,5, R. Wang¹, N. Mugo^1,7, A. Mujugira¹, J. Baeten^1,2, J. Mullins², J. Hughes², E. Bukusi^1,7,8, C. Cohen⁹, E. Katabira¹⁰, A. Ronald¹¹, J. Kiarie⁷, C. Farquhar^2,3, G. John Stewart², J. Makhema¹², M. Essex¹³, E. Were¹⁴, K. Fife¹⁵, G. deBruyn¹⁶, G. Gray¹⁶, J. McIntyre¹⁶, R. Monongi¹⁷, S. Kapiga^17,18, D. Coetzee¹⁹, S. Allen²⁰, M. Inambao²¹, K. Kayitenkore²², E. Karita²², W. Kanweka²³, S. Delany²⁴, H. Rees²⁴, B. Vwalika²⁵, W. Stevens²⁶, M. Campbell², K. Thomas², R. Coombs^2,5, R. Morrow⁵, W. Whittington², M.J. McElrath^1,2, L. Barnes¹, R. Ridzon²⁷, L. Corey^2,4,5, Partners in Prevention HSV-HIV Transmission Team
¹University of Washington, Department of Global Health, Seattle, United States, ²University of Washington, Department of Medicine, Seattle, United States, ³University of Washington, Department of Epidemiology, Seattle, United States, ⁴Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Institute, Seattle, United States, ⁵University of Washington, Department of Laboratory Medicine, Seattle, United States, ⁶University of Washington, Department of Pediatrics, Seattle, United States, ⁷University of Nairobi and Kenyatta National Hospital, Department of Obstetrics & Ginecology, Nairobi, Kenya, ⁸Kenya Medical Research Institute, Center for Microbiology Research, Nairobi, Kenya, ⁹University of California San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, United States, ¹⁰Makerere University, Infectious Disease Institute, Kampala, Uganda,
16:40
WELBC102
Abstract Daily acyclovir delays HIV-1 disease progression among HIV-1/HSV-2 dually-infected persons: a randomized trial
Presented by Jairam R Lingappa, United States
J.R. Lingappa¹, J.M. Baeten¹, A. Wald^1,2, J. Hughes¹, K.K. Thomas¹, A. Mujugira¹, N. Mugo^1,3, E.A. Bukusi^1,3,4, C.R. Cohen⁵, E. Katabira⁶, A. Ronald⁷, J. Kiarie³, C. Farquhar¹, G. John-Stewart¹, J. Makhema⁸, M. Essex⁹, E. Were¹⁰, K. Fife¹¹, G. deBruyn¹², G. Gray¹², J. McIntyre¹², R. Manongi¹³, S. Kapiga¹⁴, D. Coetzee¹⁵, S. Allen^16,17,18, M. Inambao¹⁹, K. Kayitenkore¹⁸, E. Karita¹⁸, W. Kanweka²⁰, S. Delany-Moretlwe¹², H. Rees¹², B. Vwalika²¹, A. Magaret^1,2, R. Wang¹, L. Kidoguchi¹, L. Barnes¹, R. Ridzon²², L. Corey^1,2, C. Celum¹, Partners in Prevention HSV/HIV Transmission Study Team
¹University of Washington, Seattle, United States, ²Fred Hutchinson Cancer Research Center, Seattle, United States, ³University of Nairobi and Kenyatta National Hospital, Nairobi, Kenya, ⁴Kenya Medical Research Institute, Nairobi, Kenya, ⁵University of California, San Francisco, United States, ⁶Makerere University, Kampala, Uganda, ⁷University of Manitoba, Winnipeg, Canada, ⁸Botswana-Harvard Partnership, Gaborone, Botswana, ⁹Harvard University, Cambridge, United States, ¹⁰Moi University, Eldoret, Kenya, ¹¹Indiana University, Indianapolis, United States, ¹²University of Witwatersrand, Johannesburg, South Africa, ¹³Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of, ¹⁴London School of Hygiene & Tropical Medicine, London, United Kingdom, ¹⁵University of Cape Town, Cape Town, South Africa, ¹⁶Emory University, Atlanta, United States, ¹⁷Rwanda Zambia HIV Research Group, Ndola, Kitwe, and Lusaka, Zambia, ¹⁸Rwanda Zambia HIV Research Group, Kigali, Rwanda, ¹⁹Rwanda Zambia HIV Research Group, Ndola, Zambia, ²⁰Rwanda Zambia HIV Research Group, Kitwe, Zambia, ²¹Rwanda Zambia HIV Research Group, Lusaka, Zambia, ²²Bill and Melinda Gates Foundation, Seatlte, United States

16:50
WELBC103
Abstract
Powerpoint Both maternal HAART and daily infant nevirapine (NVP) are effective in reducing HIV-1 transmission during breastfeeding in a randomized trial in Malawi: 28 week results of the Breastfeeding, Antiretroviral and Nutrition (BAN) Study
Presented by Charles Chasela, Malawi
C. Chasela¹, M. Hudgens², D. Jamieson³, D. Kayira¹, M. Hosseinipour¹, Y. Ahmed³, G. Tegha¹, R. Knight⁴, A.P. Kourtis³, D. Kamwendo¹, I. Hoffman⁵, S. Ellington³, Z. Kacheche¹, J. Wiener³, F. Martinson¹, P. Kazembe⁶, I. Mofolo¹, D. Long², A. Soko¹, S.B. Smith², C. van der Horst⁷
¹UNC Project, Lilongwe, Malawi, ²University of North Carolina, Department of Biostatistics, Chapel Hill, United States, ³U.S. Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, United States, ⁴Principia International, Chapel Hill, United States, ⁵University of North Carolina, Chapel Hill, United States, ⁶Kamuzu Central Hospital, Lilongwe, Malawi, ⁷University of North Carolina, Division of Infectious Diseases, Chapel Hill, United States

17:00
WELBC104
Abstract Risk of HIV acquisition among men with and without human papillomavirus infection in Kisumu, Kenya
Presented by Jennifer S. Smith, United States
J.S. Smith¹, S. Moses², M. Hudgens¹, C.B. Parker³, K. Agot⁴, I. Maclean², J.O. Ndinya-Achola⁵, P.J.F. Snijders⁶, C.J.L.M. Meijer⁶, R.C. Bailey⁷
¹University of North Carolina, Chapel Hill, United States, ²University of Manitoba, Winnipeg, Canada, ³Research Triangle Institute, Research Triangle Park, United States, ⁴UNIM Project, Kisumu, Kenya, ⁵University of Nairobi, Nairobi, Kenya, ⁶VU University Medical Center, Amsterdam, Netherlands, ⁷University of Illinois at Chicago, Chicago, United States

17:10
WELBC105
Abstract
Powerpoint Pregnancy and HIV transmission among HIV discordant couples in a clinical trial in Kisumu, Kenya
Presented by Sara Brubaker, United States
S. Brubaker¹, E.A. Bukusi², J. Odoyo³, J. Achando³, A. Okumu³, C. Cohen¹
¹University of California San Francisco (UCSF), Obstetrics, Gynecology and Reproductive Sciences, San Francisco, United States, ²Kenya Medical Research Institute (KEMRI), Center for Microbiology Research, Nairobi, Kenya, ³Kenya Medical Research Institute (KEMRI), Center for Microbiology Research, Kisumu, Kenya

Powerpoints presentations

Both maternal HAART and daily infant nevirapine (NVP) are effective in reducing HIV-1 transmission during breastfeeding in a randomized trial in Malawi: 28 week results of the Breastfeeding, Antiretroviral and Nutrition (BAN) Study - Chasela

Powerpoint (358 KB)

Pregnancy and HIV transmission among HIV discordant couples in a clinical trial in Kisumu, Kenya - Brubaker

Powerpoint (2.37 MB)

Rapporteur report

Track C report by Drs Guy De Bruyn

The last session in Track C provided an exciting conclusion to the conference.

Connie Celum presented the much-awaited results of the Partners in Prevention trial. This trial was the largest study of serodiscordant couples yet conducted, and investigated the impact of herpes suppression with acyclovir on HIV transmission. Investigators from 14 sites in 8 Sub Saharan African countries enrolled 3408 couples, who were followed for 12 to 24 months. The HIV-infected partners were not receiving antiretroviral therapy at study entry, were co-infected with HSV-2 by serology, and had CD4 counts above 250 cells / mm3. Retention of the study participants was excellent, and adherence to the study drug, by pill count, was high. The intervention did not reduce HIV transmission between partners (HR 0.92) but reduced genital ulcers by 73%. Jai Lingappa then presented an analysis of the impacts of the study intervention on HIV disease progression in the HIV-infected study participants. The intervention reduced the frequency of initiation of antiretroviral therapy, CD4 decline below 200 cells, or death. In aggregate, the intervention group had a 17% improvement in HIV disease progression. Lingappa however cautioned that these results should be carefully considered prior to possible implementation.

Charles Chasela presented results from the Breastfeeding Antiretroviral and Nutrition (BAN) study. 2367 mother-infant pairs randomized to one of the three antiretroviral viral intervention groups – infant extended nevirapine prophylaxis, maternal HAART, or ‘enhanced control’. The primary endpoint was HIV transmission to the infant at 28 weeks, which was significantly reduced by both of the antiretroviral interventions, compared to control (infant NVP 1.8%, maternal HAART 3.0% vs. control 6.4%).

A presentation by Jennifer Smith described an analysis of the effect of infection with human papillomavirus on acquisition of HIV among men participating in the Kenyan male circumcision trial. Among men who had HPV detectable at entry to the trial, the risk of HIV acquisition was 1.8, with no interaction by circumcision status.

The last presentation by Dr Brubaker described an analysis of HIV acquisition in relation to pregnancy among serodiscordant couples participating in the Partners trial in Kisumu, Kenya. They found an unadjusted relative risk of 1.8 for HIV acquisition for those who became pregnant.

The organizers reserve the right to amend the programme.