The International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention Concludes

The 6th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention was held in Rome, Italy, from July 17 to July 20, 2011. Scientists, clinicians, public health experts, and community leaders convened to discuss the latest in HIV/AIDS-related research and to increase public awareness of how new scientific advances will impact the global response to HIV. The entire IAS program is available online through Programme-at-a-Glance, a searchable database that includes all sessions, abstracts, slide sets with audio, reports, and e-posters.

---

CDC Updates “Pediatric HIV Surveillance” and “HIV Surveillance in Urban and Nonurban Areas” Slide Sets

The Centers for Disease Control and Prevention (CDC) recently updated two slide sets with information from the 2009 HIV Surveillance Report. The “Pediatric HIV Surveillance” slide set provides information on diagnoses of HIV infection and AIDS in children younger than 13 years old in the United States and dependent areas, including breakdowns of diagnoses by race/ethnicity, age group, and geographic region. The “HIV Surveillance in Urban and Nonurban Areas” slide set provides information on diagnoses of HIV infection and AIDS in urban and nonurban areas in the United States, including breakdowns of diagnoses by race/ethnicity, age group, and transmission category.

---

Study Evaluates Rilpivirine Versus Efavirenz in Combination with Tenofovir and Emtricitabine in Treatment-Naive HIV-Infected Adults

“Efavirenz with tenofovir-disoproxil-fumarate and emtricitabine is a preferred antiretroviral regimen for treatment-naive patients infected with HIV-1. Rilpivirine, a new non-nucleoside reverse transcriptase inhibitor, has shown similar antiviral efficacy to efavirenz in a phase 2b trial with two nucleoside/nucleotide reverse transcriptase inhibitors. We aimed to assess the efficacy, safety, and tolerability of rilpivirine versus efavirenz, each combined with tenofovir-disoproxil-fumarate and emtricitabine. …

“We did a phase 3, randomised, double-blind, double-dummy, active-controlled trial, in patients infected with HIV-1 who were treatment-naive. The patients were aged 18 years or older with … viral sensitivity to all study drugs. … Patients were randomly assigned … to receive either once-daily 25 mg rilpivirine or once-daily 600 mg efavirenz, each with tenofovir-disoproxil-fumarate and emtricitabine. Our primary objective was to show non-inferiority (12% margin) of rilpivirine to efavirenz in terms of the percentage of patients with confirmed response (viral load <50 copies per mL intention-to-treat time-to-loss-of-virological-response [ITT-TLOVR] algorithm) at week 48. Our primary analysis was by intention-to-treat. …

“346 patients were randomly assigned to receive rilpivirine and 344 to receive efavirenz and received at least one dose of study drug, with 287 (83%) and 285 (83%) in the respective groups having a confirmed response at week 48. The point estimate from a logistic regression model for the percentage difference in response was -0.4 (95% CI -5.9 to 5.2), confirming non-inferiority with a 12% margin (primary endpoint). The incidence of virological failures was 13% (rilpivirine) versus 6% (efavirenz; 11%vs 4% by ITT-TLOVR). Grade 2-4 adverse events (55 [16%] on rilpivirine vs 108 [31%] on efavirenz, p<0.0001), discontinuations due to adverse events (eight [2%] on rilpivirine vs 27 [8%] on efavirenz), rash, dizziness, and abnormal dreams or nightmares were more common with efavirenz. Increases in plasma lipids were significantly lower with rilpivirine. …

“Rilpivirine showed non-inferior efficacy compared with efavirenz, with a higher virological-failure rate, but a more favourable safety and tolerability profile.”

More information is available:

• PubMed: Study abstract
• ClinicalTrials.gov: Study summary
• AIDSinfo: Drug database

---