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PARIS -- The world's premier conference focusing on the science of HIV returns this year to the City of Light, where the virus was first discovered 34 years ago.
But the comes as U.S. leaders are proposing to slash support for research in health and science, cuts that would affect how HIV studies are supported.
At the meeting, "we will again call out any reluctance on the part of leadership ... to continue to prioritize HIV science," said IAS president Linda-Gail Bekker, MBChB, PhD, of the Desmond Tutu HIV Centre in Cape Town, South Africa.
"We will unite to tell the world that research cuts would not only stall our progress, but would put us at great risk of stepping back and losing a lot of the ground that has been gained," Bekker told reporters in a telephone briefing in advance of the meeting.
The biennial meeting focuses on understanding HIV's pathogenesis and treatment, while the International AIDS Conferences, held on odd-numbered years, have a greater emphasis on the political and social aspects of the pandemic.
The Paris meeting is expected to attract 6,000 delegates to hear details of some 1,700 abstracts, Bekker said. As with all AIDS meetings sponsored by the IAS since 2012, it will be preceded by a symposium focusing on research aimed at a cure for the infection.
That symposium this year has a new twist -- research looking at re-purposing some of the immunotherapeutic approaches now under study in oncology, according to co-chair Steven Deeks, MD, of the University of California San Francisco.
HIV treatment, Deeks said, appears unlikely alone to cure HIV, even when therapy starts very early in the infection. What's needed, he said, are "stronger T cells" that can more effectively seek out and destroy HIV-infected cells.
That, Deeks told reporters, is the promise of cancer immunotherapies now under study. The symposium and the larger IAS meeting will learn of research on the safety of such approaches in HIV patients, their effect on HIV-associated cancers, and their ability to enhance the immune response to the virus.
A key element in the overall research agenda remains the search for a vaccine against HIV, Bekker said, adding, "It's the only way we will really see complete control of the HIV epidemic."
Only one vaccine study has ever had a positive result -- the RV-144 trial found a small preventive effect -- but research has recently intensified. Here, investigators will present early results from the phase I APPROACH trial, which is examining 7 different "prime-boost" regimens and laying the groundwork for efficacy trials, Bekker said.
In the absence of a vaccine or a cure, treatment remains a central element in the fight against HIV, she said.
While effective triple-drug therapy is well known to control HIV, other approaches have been under study. Attendees here will get the 96-week results of the LATTE-2 trial, which is comparing different ways of using the long-lasting injectable anti-HIV drugs cabotegravir and rilpivirine to control already suppressed HIV.
Importantly, clinical trials have demonstrated that treatment itself can be prevention and delegates will hear real-world data from Swaziland about what happened when that hard-hit nation sharply scaled up its testing and treatment programs.
And since HIV attacks the immune system, the meeting will feature several studies that look at how to prevent or treat opportunistic infections, including one trial that examined how to treat HIV-associated cryptococcal meningitis and another looking -- for the first time -- at the use of direct-acting agents against hepatitis C in an African setting, where many patients also have HIV.
Research has shown that male circumcision cuts the risk of HIV acquisition in men, and the clinical trials have shown hints that women might benefit as well. But there has been a "lack of population-level data outside of the experimental setting" on the benefits for women, commented Jean-François Delfraissy, MD, PhD, the former head of the French AIDS research agency and a conference co-chair.
In Paris, investigators from South Africa will present real-world data showing the effects of male circumcision on the risk of women acquiring a range of sexually transmitted diseases, including HIV, he told reporters.
Finally, Delfraissy said a study conducted in Australia, Thailand, and Brazil will shed light on how well HIV treatment in serodiscordant male couples -- where one partner is infected and the other is not -- prevents transmission of the virus. In serodiscordant heterosexual couples, such a benefit for effective HIV therapy has long been established, but it has been unclear how well treatment as prevention works in gay men.
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