Inside This Issue: CROI 2022 news sources, updated COVID-19 guidance for people with HIV, monoclonal antibody treatment for COVID-19, new HIV infections among children, fund opportunities and awards, and more.
Conference News
CROI 2022 Is in Progress: Look for Summary in the Next In Brief
For the third year in a row, the Conference on Retroviruses and Opportunistic Infections (CROI) is now being held virtually and will conclude on February 24. The annual conference, which is in its 29th year features presentations on the latest research about HIV, viral hepatitis, and tuberculosis, as well as updates about SARS-CoV-2 and COVID-19. The opening session on February 13 included presentations on HIV and aging, vaccine strategies for HIV and COVID-19, the public health response to HIV, and the COVID-19 pandemic in the United States. Plenary and oral abstract sessions ran from February 14 through 16, and symposia will be offered from February 22 through 24. Only registered attendees are allowed to access the sessions during the virtual meeting. However, all sessions are expected to become publicly available in late March – 30 days after the conference ends.
If you are interested in following news from CROI 2022, we recommend the following websites:
- Conference on Retroviruses and Opportunistic Infections – the official website for CROI has links to the conference agenda, program guide, and extensive additional resources that are currently limited to registered participants.
- AIDSmap, Healio Infectious Disease News, HIV.gov, NATAP, Poz, and TheBodyPro are all reporting on research and other news developments from CROI.
The New England AIDS Education and Training Center will also host CROI Update 2022 on March 7 from 6 to 8 pm ET. At the event, physicians Rajesh Gandhi, Kenneth Mayer, and Mary Montgomery will discuss important news and key findings from CROI 2022.
We also plan to provide extensive coverage of CROI 2022 in the next issue of In Brief.
COVID-19 Prevention and Treatment
NIH: Updated COVID-19 Guidance for People with HIV
The latest version of the National Institutes of Health (NIH) Coronavirus Disease 2019 Treatment Guidelines includes revisions to the Special Considerations in People with HIV section. This section includes specific guidance on the prevention, diagnosis, and management of COVID-19 in people with HIV, as well as the management of HIV disease when people are infected with SARS-CoV-2 (the virus responsible for COVID-19).
Key changes to guidelines HIV section include the following:
- People with advanced or untreated HIV who are not infected with SARS-CoV-2 and who have not been recently exposed to SARS-CoV-2 are now eligible to receive the long-acting monoclonal antibodies tixagevimab plus cilgavimab as pre-exposure prophylaxis for SARS-CoV-2.
- People with HIV who are taking ritonavir- or cobicistat-based antiretroviral (ARV) regimens and who are prescribed ritonavir-boosted nirmatrelvir (Paxlovid) for the treatment of COVID-19 can continue their ARV regimens without modifying drug doses.
Other recent changes in the COVID-19 guidelines are summarized on NIH’s What’s New in the Guidelines page. For additional information on this COVID-19 and HIV, you may visit NEAETC’s Online HIV Resource Library page focusing on this topic.
FDA Authorizes New Monoclonal Antibody Treatment for COVID-19
On February 11, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for bebtelovimab – a new monoclonal antibody for the treatment of COVID-19 that retains activity against the omicron variant. Under the terms of the EUA, bebtelovimab may be used for the treatment of mild to moderate COVID-19 in adults and pediatric patients 12 years of age and older who weigh at least 40 kilograms (about 88 pounds). In addition, treatment is limited to persons with a positive COVID-19 test, and who are at high risk for progression to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options approved or authorized by the FDA are not accessible or clinically appropriate.
“Today’s action makes available another monoclonal antibody that shows activity against omicron, at a time when we are seeking to further increase supply,” noted Dr. Patrizia Cavazzoni, director of the FDA’s Center for Drug Evaluation and Research. “This authorization is an important step in meeting the need for more tools to treat patients as new variants of the virus continue to emerge.”
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The Global HIV Epidemic
UNAIDS: Most New HIV Infections Among Children in 2020 Could Have Been Prevented
Most of the estimated 150,000 new HIV infections that occurred among children during 2020 could have been prevented, according to a recent analysis from UNAIDS. Nearly 65,000 HIV infections among children occurred because women already living with HIV were not diagnosed during pregnancy and did not start treatment. More than 35,000 additional infections among children occurred because women acquired HIV during pregnancy or breastfeeding, and the associated spike in their viral load during acute infection increased the risk of mother-to-child transmission. Over 38,000 additional infections occurred among children after women with HIV discontinued antiretroviral treatment (ART) during pregnancy and breastfeeding, and nearly 14,000 infections occurred among women who were receiving ART but not virally suppressed.
“Improving the quality of treatment and care – including the use of optimized treatment regimens and peer-assisted retention efforts (such as mentor mothers) – can help close these gaps,” according to UNAIDS. “A strong start would be to better engage women and girls at significant risk of acquiring HIV infection in integrated antenatal care and HIV services, including HIV prevention and testing, delivered at the local level, and to ensure that those who are HIV-positive receive treatment before pregnancy.”
Funding Opportunities and Awards
HRSA Funding Opportunities Focusing on HIV Care
The Health Resources and Services Administration (HRSA) HIV/AIDS Bureau recently issued the following funding opportunities for HIV care:
RWHAP Part F Dental Reimbursement Program (HRSA-22-020) – The Ryan White HIV/AIDS Program (RWHAP) Part F Dental Reimbursement Program (DRP) is providing funding to improve access to oral health care services for low income people with HIV and to support related education and training for the delivery of dental care to people with HIV. The DRP defrays a portion of unreimbursed dental care costs incurred by treating low income people with HIV at accredited dental or dental hygiene education programs recognized by the Commission on Dental Accreditation. HRSA expects to award a total of $9 million to about 50 accredited dental education institutions. The application deadline is March 11.
Using Innovative Intervention Strategies to Improve Health Outcomes Among People with HIV (2iS) – The purpose of the 2iS initiative is to identify and pilot test innovative intervention strategies in four focus areas: 1) improving HIV health outcomes for people with substance use disorder; 2) improving HIV health outcomes for lesbian, gay, bisexual, transgender, or queer youth from 13 to 24 years old; 3) improving HIV health outcomes for people who are or have been justice involved; and 4) improving HIV health outcomes by using telehealth services. The Fenway Institute, in partnership with AIDS United, will solicit, select, issue, and monitor subawards of up to $190,000 per funding year for up to 20 implementation sites. The application deadline was recently extended to March 11.
RWHAP Telehealth Strategies to Maximize HIV Care (HRSA-22-030) – HRSA will fund one cooperative agreement for up to three years to identify and maximize the use of telehealth strategies that are most effective in improving linkage to care, retention in care, and health outcomes, including viral suppression, for people with HIV who receive services through the RWHAP. HRSA expects to award $1.75 million to one government agency, business, or organization. The application deadline is April 8.
HRSA Awards Nearly $55 Million to Increase Virtual Health Care Access and Quality
On February 14, HRSA awarded nearly $55 million to 29 HRSA-funded health centers to increase health care access and quality for underserved populations through virtual care such as telehealth, remote patient monitoring, digital patient tools, and health information technology platforms. These awards build on the more than $7.3 billion in American Rescue Plan Act funding that has been invested in community health centers during the past year to help mitigate the impacts of the COVID-19 pandemic. “Virtual care has been a game-changer for patients, especially during the pandemic,” noted HHS Secretary Xavier Becerra. “This funding will help health centers leverage the latest technology and innovations to expand access to quality primary care for underserved communities.”
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Educational Resources
New and Updated Materials on PrEP from AVAC
The HIV prevention organization AVAC has recently updated its existing resources on HIV pre-exposure prophylaxis (PrEP) and has added several new ones. These include:
- AVAC’s Global PrEP Tracker, which follows global trends in oral PrEP initiations, has been updated to reflect developments in 2021.
- Biomedical HIV Prevention Research in 2022 and Beyond provides a concise update on the full landscape of biomedical interventions, including: PrEP products in the market, next-generation products in the pipeline, including multipurpose products, vaccines, and broadly neutralizing antibodies.
- Advocates’ Primer on Injectable Cabotegravir for PrEP: Trials, Approvals, Rollout and More focuses on injectable cabotegravir for HIV prevention, outlining what’s known and what’s next for this biomedical HIV prevention strategy.
- The HIV Prevention Ambassador Training Package for Adolescent Girls and Young Women was developed to help adolescent girls and young women play a meaningful role in the rollout of PrEP in their communities. The new edition focuses on oral PrEP and the PrEP ring.
- The fact sheet A Collaborative Approach to HIV Prevention Product Introduction describes the Biomedical Prevention Implementation Collaborative’s strategy for introducing new HIV prevention products, including injectable cabotegravir, from research to rollout.
Information about several other recent AVAC resources on PrEP are available on the AVAC website. For additional information on this topic, you may visit NEAETC’s Online HIV Resource Library page focusing on PrEP.
Tools and Guidance Documents from NASTAD
This year, the National Alliance of State and Territorial AIDS Directors (NASTAD) has released several new resources providing information and guidance about funding opportunities for PrEP and harm reduction activities, as well as the sharing of disease data to improve the response to outbreaks of infectious disease. These documents include:
Diversifying PrEP Financing: Strategies to Leverage Funding across the PrEP Care Continuum – “This tool provides an overview of PrEP medication landscape changes, discusses the impacts of these changes, and explores opportunities to meet the funding needs of PrEP ancillary services,” according to NASTAD.
Navigating the Harm Reduction Funding Landscape – “This guidance document was designed to assist a variety of harm reduction programs – ranging from small-scale grassroots organizations to larger harm reduction programs – with navigating the funding landscape and fulfilling the requirements laid out in grant proposals and their application process.”
Cross-Jurisdictional Data Sharing: Legal, Practical, and Ethical Considerations for Improved Infectious Disease Cluster Response – This resource, developed by NASTAD and the Association of State and Territorial Health Officials (ASTHO) “addresses legal, practical, and ethical considerations to support health department decision-making concerning cross-jurisdictional data-sharing practices relating to HIV and viral hepatitis clusters and outbreaks, and offers recommendations for how health departments can improve outbreak preparedness measures through preemptive cross-jurisdictional data-sharing arrangements.”
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Other COVID-19 News
Recent Research Summaries and Reports
CDC’s COVID Data Tracker Weekly Review highlights key data from its COVID Data Tracker, narrative interpretations of the data, and visualizations from the week. Themes of recent Weekly Review issues include: the benefits of getting boosters and the importance of early detection.
The Morbidity and Mortality Weekly Report (MMWR) is also providing continuing coverage of COVID-19-related research. CDC is archiving its MMWR reports on a page devoted to studies about COVID-19. For your convenience, we have compiled links to recent MMWR papers below: