Infectious Disease Frontier

From July 22-26, 2024, the 25th International AIDS Conference (AIDS 2024) was held in Munich, Germany. As a key player in the global fight against AIDS, China has consistently made significant contributions. At this conference, the China Special Session, titled "Ending AIDS in China: Challenges and Strategies," was jointly organized by the Chinese Association of STD and AIDS Prevention and Control, the Chinese Center for Disease Control and Prevention AIDS Center, and the Chinese Preventive Medicine Association. This session not only highlighted China's achievements in HIV/AIDS prevention and control but also explored the challenges ahead and the future direction of global AIDS prevention, providing new insights and momentum for the worldwide fight against AIDS.

From July 22-26, 2024, the 25th International AIDS Conference took place in Munich, Germany, gathering 15,000 professionals and advocates from around the world to discuss the latest advancements and future challenges in AIDS prevention and treatment. At the conference, Dr. Hanxi Zhang from Dr. Fujie Zhang’s team at Beijing Ditan Hospital presented a multicenter, prospective, longitudinal cohort study conducted in China, which garnered widespread attention. Led by Beijing Ditan Hospital, Capital Medical University, this study aimed to evaluate the impact of antiretroviral therapy (ART) on mortality and virologic response in children and adolescents with HIV. The findings provided valuable insights into the long-term efficacy of ART in Chinese children living with HIV, indicating significant achievements of the ART program in this demographic. We invited Dr. Fujie Zhang to offer an in-depth analysis of the study's findings.

In 2023, the World Health Organization (WHO) recommended that countries with low HIV prevalence adopt a triple testing approach to confirm HIV-positive diagnoses. Specifically, WHO advises countries with an HIV prevalence below 5% to use three consecutive tests to ensure a 99% diagnostic accuracy. The proportion of positive HIV tests in a population can impact diagnostic accuracy, and when the HIV positivity rate is below 5%, at least three consecutive tests are required to guarantee a 99% accuracy rate in diagnosis.

Early detection and treatment of HIV play a crucial role in AIDS prevention and control. A critical battlefield is emerging with increasing importance—the timely detection of acute HIV infection (AHI). AHI refers to the period from the entry of the HIV virus into the body until antibodies become detectable, typically occurring within a few weeks to a few months after infection. During this period, the virus replicates rapidly within the body, leading to a sharp increase in viral load, reaching its peak concentration. Consequently, individuals with AHI are at high risk of transmitting HIV and are a key focus for controlling the spread of the virus. At the 25th International AIDS Conference (AIDS2024), Infectious Diseases Frontier(IIDF) invited Dr. Eduard Sanders from the Aurum Institute in Johannesburg, South Africa, and Dr. Hugo Xi, Senior Medical Director of Scientific and Clinical Affairs at Abbott, to discuss the strategic importance and urgency of AHI detection. They emphasized the immense potential of innovative fourth-generation rapid HIV screening tests in identifying highly infectious individuals. Faced with challenges such as high testing costs, limited data, and false positives, they call for increased public awareness of AHI and advocate for policy adjustments and technological advancements to ensure more people benefit from this crucial testing.

On the global journey to eliminate HIV infections among children, different countries and regions face distinctly different challenges. Recently, at the AIDS2024 conference, Dr. Kira Elsbernd from the University of Munich in Germany delivered a special report on the risk factors involved in HIV vertical transmission and was interviewed by Infectious Diseases Frontier(IIDF). Dr. Elsbernd pointed out that there are significant differences in the rates of HIV vertical transmission between Mozambique and Tanzania. Key factors such as age, duration of antiretroviral therapy, number of antenatal care visits, and viral load at the time of delivery play crucial roles. To effectively reduce the mother-to-child transmission rate of HIV, she emphasized the need for a deep understanding of these risk factors and the design of targeted interventions. Additionally, Dr. Elsbernd expressed optimism about emerging fields and technologies, such as point-of-care diagnostics and broadly neutralizing antibodies, which she believes will play a significant role in the future prevention of pediatric HIV.

Pediatric care and treatment for children with HIV infection have always been a critical component in the global fight against AIDS. Recently, at the AIDS2024 conference, Dr. Anna Turkova from University College London shared her insights with Infectious Diseases Frontier(IIDF) on the breakthrough advancements in pediatric HIV care. She highlighted that the detection and diagnosis of undiagnosed children with HIV remain a major challenge that requires ongoing effort and investment. While the use of dolutegravir-based triple oral therapy has led to significant success in treating pediatric HIV, the development and application of innovative therapies such as long-acting injectables are still in progress. Additionally, psychosocial support is crucial in pediatric HIV care. Looking to the future, Dr. Turkova envisions long-acting injectable preventive treatments, painting a hopeful picture for the global pediatric HIV care landscape.

In the field of AIDS prevention and treatment, tailored immunization strategies for HIV-positive individuals are becoming crucial for improving patients' quality of life and prolonging their lifespan. At the 25th International AIDS Conference (AIDS 2024), Dr. Anna Maria Geretti from the Institute of Infection and Global Health, University of Liverpool presented an insightful report on this topic and subsequently engaged in an extensive interview with " Infectious Disease Frontier"(IIDF). She emphasized the importance of ensuring that HIV-positive individuals receive appropriate vaccination recommendations and pointed out the deficiencies in comprehensiveness and personalization in current guidelines. Dr. Geretti elaborated on the key factors to consider when formulating personalized vaccination strategies, such as immune status, viral load, and CD4+ T-cell count, which directly influence vaccine selection and effectiveness. Furthermore, she shared the latest research findings and vaccination recommendations for vaccines against hepatitis B, shingles, pneumococcal disease, and human papillomavirus (HPV), providing a more scientific and comprehensive protection plan for HIV-positive individuals.

At the 25th International AIDS Conference, a study led by Dr. Troy Grennan from the British Columbia University and the Canadian Centre for Disease Control revealed the astonishing effectiveness of doxycycline pre-exposure prophylaxis (DoxyPrEP) in reducing the incidence of bacterial sexually transmitted infections (STIs) among HIV-positive men who have sex with men. The study found that taking 100 mg of doxycycline daily significantly reduced the incidence of syphilis, chlamydia infection, and gonorrhea, with an overall reduction rate of up to 80%. This breakthrough discovery not only provides a new strategy for STI prevention but also offers important evidence for future public health policy formulation. With the advancement of larger-scale clinical trials, doxycycline is expected to become an important tool in the field of STI prevention, contributing to global public health security. " Infectious Disease Frontier"（IIDF） invited Dr. Troy Grennan for an exclusive interview.

At the just concluded 25th International Conference on AIDS (AIDS2024), as a major clinical research progress of the conference, Dr. Christian Gaebler of Charlotte University in Berlin, Germany, reported the seventh "next Berlin patient" to be cured after the world's first "Berlin patient" cured of HIV. This patient did not follow the traditional path of achieving cure through homozygous CCR5 Δ 32/Δ 32 stem cell transplantation, but miraculously achieved sustained HIV remission without antiretroviral therapy (ART) for over five years after receiving heterozygous CCR5 WT/Δ 32 stem cell transplantation. Infectious Disease Frontier（IIDF） invited Dr. Christian Gaebler for an in-depth interview to elaborate on the significant implications behind this unprecedented successful case.

Broad spectrum neutralizing antibodies (bnAbs) are showing unprecedented potential in the field of HIV prevention and treatment. At the 25th International AIDS Conference (AIDS2024), Professor Hyman Scott, medical director of Bridge HIV clinical research, San Francisco Department of Public Health, introduced the latest progress of bnAbs in HIV prevention and treatment. Infectious Disease Frontier（IIDF） is honored to invite Professor Scott for an in-depth interview, elaborating on the important role of bnAbs in HIV prevention and treatment. Professor Scott pointed out that bnAbs provides a new option for people at high risk of HIV infection due to its convenience and efficient prevention ability of only requiring one injection every six months. By complementing existing antiretroviral therapies, bnAbs not only enriches prevention methods, but also opens up new pathways for the treatment of HIV infection. In the future, with the deepening of clinical development of bnAbs under the framework of HVTN/HPTN/IAVI cooperation, we are expected to witness the widespread application of this innovative therapy worldwide, bringing new hope to end the AIDS epidemic.