Biomedical prevention against HIV-1

Question 1

How many people were living with HIV globally at the end of 2017?

Answer 1

> 36.9 million

Question 2

How have new HIV infections reduced since 1996?

Answer 2

reduced by 47%

Question 3

How have AIDs-related deaths been reduced since its peak in 2004?

Answer 3

by more than 51%

Question 4

What is the risk of acquiring HIV if MSM?

Answer 4

27 times higher than general population

Question 5

What should initial HAART therapy consist of?

Answer 5

2NRTIs + PI/NNRTI

Question 6

What is the risk of mother-child transmission without therapy?

Answer 6

1 in 4

Question 7

How adherent to therapy do you need to be to prevent resistance?

Answer 7

95%

Question 8

How many countiries criminalised same-sex sexual relationships in 2016 June?

Answer 8

74

Question 9

What is the MOA of gp41 inhibitors?

Answer 9

prevent HIV from fusing with the cell

Question 10

Waht is the MOA of gp120 and CCR5 antagonists?

Answer 10

prevent HIV from attaching to the cell

Question 11

What is the function of PIs?

Answer 11

prevent processing of HIV proteins and the development into a mature virion

Question 12

What is the source of the virus during effective ART?

Answer 12

primarly defined by the half-life of hte cells that were infected before therapy was initiated - after several years, long-lived populations of resting central memory cells become dominant source of HIV persistance

Question 13

What percentage of all people living with HIV are unaware of their HIV status?

Answer 13

aroudn half

Question 14

What is the UNAIDs targets for 2020?

Answer 14

90% of people living with HIV know diagnosis; 90% of those are on ART and 90% of those are virologically suppressed by 2020

Question 15

What are hte challenges to meeting the UNAID targets?

Answer 15

money; drug supply chains; trained staff; capacity; stigma; gender based violence

Question 16

What are the 4 pillars of HIV prevention?

Answer 16

behavioural change; treatment(ARTs; STIs) ; social justice and human rights; biomedial strategies

Question 17

What are the behvarioural changes needed for HIV prevention?

Answer 17

partner reduction; condom use; clean IDU equipment

Question 18

What are the 2 forms of Prep?

Answer 18

oral and topical microbicides eg gels or intravaginal rings

Question 19

What is the one off the greatest risk factors for HIV globally?

Answer 19

being in a stable relationship (won’t use condoms)

Question 20

What effect does male circumcision have on HIV transmission?

Answer 20

> 57% reduction- but doesn’t reduce risk of transmitting HIV to women

Question 21

How does on demand PrEP work?

Answer 21

2 tablets of truvada before sex (2-24h); 1 tablet 24 hours after and 48 hours after

Question 22

What are some of current issues regarding PrEP?

Answer 22

who will pay for it; who will be eligible; long-term safety; adherence; will it change risk behaviour; if get HIV whilst on PrEP, will have impact on treatment- eg resistnace?

Question 23

What are the possibilities of sustained release of PrEP?

Answer 23

long acting injectables; implantables; intra-vaginal rings

Question 24

What was the effect of the PrEP vaginal ring in women >21 years?

Answer 24

protection was 56%

Question 25

What was the effect of the Thai vaccination RV-144 trial?

Answer 25

protective efficacy at around 31%

Question 26

What was the vaccination schedule of RV-144

Answer 26

vaccination injections at 4 times over 6 months with gp120 boosters at 12 and 24 weeks

Question 27

When was the highest protection with RV-144?

Answer 27

first 6-12 months

Question 28

What was the significant about RV-144 despite not great efficacy?

Answer 28

showed that protection from infection of HIV is possible

Question 29

Aside from eliciting antibodies through vaccination, what is the other use for broadly neutralising antibodies?

Answer 29

passive immunisation by injecting antibodies or gene transfer through a vector that produces the antibodies for prevention and therapy

Question 30

What is the kick and kill strategy for getting rid of the reservoir?

Answer 30

activate latently infected cells then kill the cells through immunologic therpay; gene therapy; stem cells transplants (both getting rid of CCR5) and continuing ART to prevent new cells being infected