ISSN 1472-4863 HTB no. 11 – HIV and COVID-19 no.hiv 8 treatmen hiv bulletin+(e) treatmen bulletin+(e) HIV Glasgow; HIV and COVID-19 (14 October 2020) C O N T E N T S EDITORIAL: HIV and COVID-19 issue 7 3 i-BASE APPEAL 2 • Please support i-Base with £5 or £10 a month.. IN MEMORY 4 • Timothy Ray Brown: the Berlin patient, the first person to be cured of HIV CONFERENCE REPORTS 5 HIV Therapy Glasgow 2020, 5-8 October 2020, virtual conference • Introduction • Single doses of MK-8507 reduce viral load by mean –1.5 log and support once-weekly dosing above 80 mg • Capsid inhibitor lenacapavir, dosed six-monthly, has high barrier to drug resistance and no cross-resistance to other classes • COVID-19: pathogenesis and treatment • EACS guidelines updated (v.10.1) for Glasgow conference CONFERENCE REPORTS 10 International Workshop on Clinical Pharmacology of HIV, Hepatitis, and Other Antiviral Drugs, 28-30 September 2020, virtual meeting • Introduction • FTC exposure higher in young transgender men than cisgender controls • Levels of long-acting anti-HIV bNAb high in infants after 1 or 2 doses – but not high enough HIV GUIDELINES 12 • BASHH 2020 PEP guidelines: online for comment CURE RESEARCH 1 3 • New insights into elite control of HIV and a possible case of virus clearance HIV and COVID-19 SUPPLEMENT issue 7 COVID-19: HIV & COVID-19 COINFECTION 14 • US study of HIV positive people with COVID-19 reports worse outcomes with comorbidities and having a CD4 <200 • Outcomes from COVID-19 in French cohort of 54 HIV positive people on ART COVID-19: INVESTIGATIONAL TREATMENTS 16 • Tocilizumab fails to meet clinical endpoints in randomised COVACTA study: other studies continu7 COVID-19: TRANSMISSION 17 • COVID-19 reinfection can occur after varying times and with more severe disease • Transmission from children to family members in US childcare setting Contents continued inside... Published by HIV i-Base HTB 11 (COVID supplement 8) 14 October 2020 HTB no.10 – HIV and COVID-19 supplement ISSUE 7 Contents continued. COVID-19: GUIDELINES 19 • BHIVA update guidance for HIV care during second wave of COVID-19 COVID-19: PAEDIATRICS 20 • COVID-19 deaths in children and people <21 years old in the US COVID-10: DIAGNOSTICS 20 • IDSA guidelines on serologic testing for SARS-CoV-2 COVID-10: OTHER NEWS 21 • Long COVID: Mild infection with sustained complications • Review paper highlights substandard COVID-19 research in both peer-review journals and pre-review websites FUTURE MEETINGS 22 • Conference listing 2020/21 - including new meeting changes PUBLICATIONS & SERVICES FROM I-Base 23 HTB CREDITS 24 ORDER FORM 25 i-Base 2020 appeal Please support i-Base with £5 or £10 a month... This year we are continuing a funding appeal to help i-Base continue to provide free publications and services during 2020. i-Base now recieve more than 12,000 questions each year and the website has more than 500,000 view each month. We also distribute more than 80,000 booklets and leaflets free to UK clinics every year. If 1000 people support us with £5 a month we will be on course to meet our funding shortfall. All help is appreciated. http://i-base.info/i-base-appeal-we-need-your-help Plus a BIG thank you all all supporters over the years including in the recent Solidarity2020 campaign. More than 70 people bought one or more posters curated by Wolfgang Tillmans and the Between Bridges Foundation, to who we are also really grateful :) 2 HIV i-Base publication HTB 11 (COVID supplement 8) 14 October 2020 EDITORIAL This double issue of HTB (covering September and October 2020) is again combined with a supplement on COVID-19. All readers are unfortunately already likely to know about our first news. This issue leads with a tribute to Timothy Ray Brown - an inspiring activist and the first person to be cured of HIV. Timothy will always have a unique place in the history of HIV and his story brought hope to millions of people globally. But he took this further in working for a cure for the rest of us. He will be missed and our thoughts are with his partner, family and friends. We then include reports from two conferences, both held as virtual meetings: the biennial HIV Glasgow and the annual PK Workshop. As the UK is already being pulled into a second lockdown, virtual meetings are likely to be with us for some time. And Glasgow did particularly well in developing a web format that retained the tension of a real-time meeting. Prerecorded videos enabled webcasts to be posted at the end of each day, but speakers and panelists were also available to answer questions in real time after each session in the programme. Posters were similarly already loaded as PDF files and were easy to download. The programme was current and topical, with many lectures and sessions covering COVID-19, women’s health, side effects (notably weight gain) as well as presentations sessions on PrEP and pipeline compounds for treatment. First reports from this meeting are included in this issue and more will continue in the next. Other HIV news included that BASHH PEP guidelines are now online for comment and an article on elite controllers and cure research by Richard Jefferys. STOP PRESS news also includes that the EMA have given a positive opinion on approving long-active cabotegravir/rilpivirine injections for treatment. Also that this is for both monthly or two-monthly dosing. And as the UK is on the brink of a second lockdown, the supplement on HIV and COVID-19 - now in its eight edition - also has extensive news. This covers HIV coinfection, potential treatment, transmission news (including cases of reinfection) and more. As always, we extend our appreciation to all health workers during this difficult 3 HIV i-Base publication HTB 11 (COVID supplement 8) 14 October 2020 time - and hope all readers stay as safe as possible. IN MEMORY: Timothy Ray Brown: the Berlin patient, the first person to be cured of HIV It is with great sadness that we report that on 29 September 2020, Timothy Ray Brown, the first person to be cured of HIV, died age 54, following a five-month battle with leukemia. The news was announced by his partner Tim Hoeffgen on Timothy’s Facebook page. [1] Over the next few days, before this reached mainstream media, hundreds of people paid tributes online to the inspiration he had given them and many thousands more, connected in community networks internationally, shared this loss, remembering the unique impact he had on our lives. For most, this news was unexpected, even though during the previous week he had released a few interviews reporting how he was again seriously ill, though it was nothing Timothy Ray Brown, filmed to do with HIV. [2, 3] at IAS 2015 for ‘Is a cure for HIV possible’. [6] Timothy was first known as the Berlin Patient. In 2007, while living in Germany, he had received an allogeneic stem cell transplant as a last treatment for refractory leukemia and he repeated this traumatic therapy in 2008 after the cancer returned. The second time, his doctors made the remarkable decision to use a donor with the CCR5 genetic deletion which blocks the most common form of HIV from establishing infection. This was the first time this had been tried in HIV and also involved stopping HIV treatment. Not only did this send the leukemia into remission, but HIV viral load also failed to rebound. Establishing this as a definitive HIV cure however involved months of working closely with his doctors and providing countless tissue samples including lymph and gut biopsies. He also continued to do this to help answer research questions ever since. This first case of an HIV cure was an astonishing achievement. Even though the procedure was so traumatic that Timothy was vocal about not wishing anyone else should have to go through it, his case inspired hope globally. But Timothy then took it further, talking publicly about his experience and devoting most of the next decade to HIV activism. He was not content to just be cured for himself, he was determined to use his profile to raise the importance of finding an easier HIV cure for everyone else. Everyone who met Timothy in this new role - likely many thousands - were immediately struck by his dedication and modesty. Or they could read about his story in any of the hundreds of interviews he gave to both mainstream and community press. [4, 5] He was always happy to talk about his experience, no matter how many times he must have had to answer similar questions and he did this carefully because he could see how his story reached HIV positive people in all countries. Whether the meetings he spoke at were international conferences or smaller community meetings, he had time to talk to everyone, always smiling and always with humour and style. He was an activist that led by a personal example that most of us never come close to and he leaves a wonderful legacy that challenges us to continue to find a cure. As he said many times “I don’t want to be the man who says I am cured, I want to be the man who says we are cured.” [6] He will be remembered with kindness and our thoughts are with his partner, family and many many friends. References 1. Timothy Ray Brown. Facebook. https://www.facebook.com/TimothyRayBrown 2. King MS. As Timothy Ray Brown faces death, a great love endures.