THE TREATMENT OFHIV HAS MADE SIGNIFICANT PROGRESS IN RECENT YEARS, BUT PEOPLE AFFECTED BYAIDSOR ACQUIRED IMMUNODEFICIENCY SYNDROMEI AM STILL AT RISK OF DEVELOPING OTHER DISEASES. THANKS TO NEW TREATMENTS, THE INFECTION CAN BE MADE CHRONIC, IMPROVING PEOPLE’S QUALITY OF LIFE AND INCREASING THEIR SURVIVAL. THIS IS WHAT EMERGES FROM THE STUDIES PRESENTED AT THE XXIII CONGRESS OF THE ITALIAN SOCIETY OF INFECTIOUS AND TROPICAL DISEASES
The success of antiretroviral therapy and the improvement of the immune system
The extraordinary progress achieved with antiretroviral therapy allows us to consider different therapeutic options, adapting them to the specific needs of each patient. «In recent years, the possibility has opened up of personalizing treatment by opting for a two-drug therapy instead of three, evaluating the advantages of both strategies on a case-by-case basis“, explains Giovanni Di Perrifull professor of Infectious Diseases of the University of Turin.
The three-drug therapy consists of Bictegravir, Emtricitabine and Tenofovir Alafenamide represents an advanced evolution of each therapeutic category, thanks to characteristics such as long half-life, high intrinsic potency and greater tolerance to adherence errors (forgiveness). «This combination offers levels of efficacy and tolerability that can manage even poor adherence to treatment. For example, a 20% non-adherence rate, which in the past would have compromised the success of the therapy, is now sustainable with this regimen», underlines Di Perri.
These results highlight the importance of triple therapy in outlining personalized and accurate treatments for people with HIV, offering a balance between effectiveness, safety and flexibility in the management of the therapeutic path.
HIV prevention: expanding screening and therapies to combat the epidemic
According to the data UNAidsapproximately 76% of the 39 million people living with HIV receive antiretroviral therapy, and 71% of these have the virus suppressed. However, to contain the epidemic it is essential to increase these percentages.
«It is a priority to intensify screening to identify hidden cases, encourage early diagnosis and initiate treatment for infected people», he states Massimo Andreoniscientific director of Simit, Italian Society of Infectious and Tropical Diseases. «Effective treatment not only protects the patient but prevents the transmission of the infection».
For those who are not infected but are at high risk, the Pre-Exposure Prophylaxis (PrEP) has proven to be highly effective. Recent scientific developments have introduced a drug administered every two months and an option with protection for up to six months will soon be available. These advances represent a crucial turning point in the fight against HIV.
Antiretroviral therapy to reduce inflammatory markers and improve the immune system
Although antiretroviral therapy effectively controls the viral load, it is not always able to guarantee a full recovery of the immune system, exposing patients to risks of pathologies cardiovascular, bone and renal diseases which can negatively affect the quality and duration of life.
«Among the most used therapies, the BIC/FTC/TAF regimen has demonstrated in clinical trials a significant ability to reduce inflammatory markers and improve the function of the immune system“, explains Giulia Marchettifull professor of Infectious Diseases of the University of Milan and San Paolo Hospital. «This progress is fundamental, as it allows people with HIV, especially if they start therapy early, to maintain a good quality of life and survival comparable to that of the general population».
The XXIII SIMIT Congress in Naples
The XXIII Congress SIMIT, which took place in Naples in recent days, highlighted the most recent ones innovations in the treatment of HIV.
The event, which saw the participation of over a thousand infectious disease specialists, addressed crucial issues such as antibiotic resistance, healthcare-related infections, vaccinations in adults and fragile subjects, the management of Covid-19 in patients immunosuppressed and the fight against chronic hepatitis. The congress also explored the role of climate change in arboviruses and other infections.
The Organizing Committee includes leading experts such as Nicola Coppola, Vincenzo Esposito, Ivan Gentile and Roberto Parrellawho contributed to the success of the initiative.