13th Interest Conference was held in Accra, Ghana May 14th – 17th 2019.
Known as the “African CROI” the INTEREST Conference brings together scientists involved in HIV treatment, pathogenesis, and prevention research in Africa to share pivotal findings, promote collaboration, and transfer experiences across several fields and many continents. The conference showcases cutting-edge knowledge in the diagnosis and treatment of HIV and the prevention of the HIV-1 infection. Additionally, it continues to foster building a community of African physicians and scientists to facilitate the implementation of local solutions for the management of patients living with HIV-1 infection and for the prevention of HIV transmission. AFROCAB members were present and were able to highlight the issues they felt are relevant in their work in-country:
Undetectable = Untransmitable:
U=U is a message meant to encourage those who are currently on treatment and those who will be started on treatment to adhere on their taking of treatment.
There needs to be a way of making the community understand on what is meant when we say undetectable viral load and this can only be done through treatment literacy on those currently taking treatment and to the community.
This message shows positivity and clear understanding with the ones who understand English language but for our community it will be difficult to translate the words and not loose meaning and biggest danger will be the misunderstanding of the U+U and have people who think they are cured and decide to quit their treatment.
Luckyboy Mkhondanwe – South Africa
Laboratory viral load error:
The pre analytical phase of testing is associated with the majority of laboratory errors and thus makes it more important that for country for the ongoing scale up of viral load uptake in the country manage this stage process. In one of the counties in Kenya according to the oral abstract, this was critical in big initiatives such as in the five counties in Rift valley Kenya were significant errors may have been compounded with high rejection rates, making a persistent barrier to timely clinical interventions. Potential barriers to viral load scale up in the 5 counties in Kenya were described and potential interventions were offered.
This was made possible after a retrospective cross-sectional review of the National Aids and Sexual Transmitted Infections control program Kenya (NASCOP) data base viral load for 5 counties in the Rift Valley one of the eight regions of Kenya and this was done between the months of October 2015 to December 2017.The target population was of people living with HIV and eligible for viral load monitoring under the USAID funded programs in the above region in Rift Valley Kenya. The data was reviewed for rates of rejection and categorized by County, gender, age, reasons and the regimen. All the data were analyzing by use of STATA package and were presented in proportions and frequencies.
Conclusion –Missing samples and improper packaged sample was the main cause for VL sample rejection at almost all the testing laboratories and it resulted to call for in built trainings on the pre-analytical phase of VL testing process as it is being scaled up.
Salim Kibet- Kenya
Scientific debate: 2DR is next Frontier in HIV treatment
We have randomized control trial studies showing evidence of efficacy of 2DR, why the hesitation? It has the advantages of Lower toxicity, less monitoring, less hassle, smaller packages, and smaller tablets and less cost. The promise of an injectable is exciting.
Not all 2DR are created equal and there’s no improvement it efficacy over triple regimen. Even in countries where 2DR are used they are not recommended for patients with high viral load. In most studies done patients are later switched. Most studies are done for 98 weeks, treatment is usually for life. When we do research, we don’t consider the reality on ground. With the data available 2DR is not suitable for all situation and population. During research, TB and other co infections are not considered and there are usually no data for pregnancy and infants and children not cared for.
Buki Ayinde- Nigeria
Optimizing treatment for lifelong management of HIV
This session was very educative, informative and explored the roles of PIs in antiretroviral treatment in Africa, the second- and third-line treatment case studies and how they related to clinical practice and the newer HIV care initiating advancing in pediatrics HIV treatment management. The session was chaired by Kwesi Torpey and presenters from Zambia, South Africa and Cote D Ivoire presented on their studies and researches around understanding the role of PIs in antiretroviral treatment in Africa including best practice with PIs around second and their line treatment in Africa as part of long-term strategic anti –HIV therapy in children and adults. With the following presenters Serge Paul Eholie from Ivory coast, Dr. Michalle Moorehouse (South Africa) and Lloyd Mulenga (Zambia).
Stephen K Mc Gill