1. Next Generation Capsid Inhibitor: GS–CA1
Small molecule inhibitor active at nanomolar concentrations
Active against most clades, and viruses resistant to other ART
Resistance can develop, but fitness may be impaired
Tse #38

2. Bictegravir – Investigational INSTI
T ½ ~ 18 hours – QD dosing
Metabolized through CYP3A4 + UGT/A1 – OK to use if CrCL >15 mL/min
Susceptible to cation binding in GI tract – similar to other INSTI
Resistance profile may be similar to DTG
BIC is in clinical development co-formulated with tenofovir alafenamide (TAF) and emtricitabine (FTC)
Custodio #40

3. Virologic Outcomes at Weeks 24 and 48 by FDA Snapshot
BIC + FTC/TAF
DTG + FTC/TAF
% Treatment Difference (95% CI)
-12%
12%
Wk 24
Wk 48
Favors
DTG + FTC/TAF
BIC + FTC/TAF
Week 24
Week 48
Patients, %
Virologic
Success
Virologic
Failure No
Data
Virologic
Success
Virologic
Failure No
Data
No INSTI or NRTI treatment-emergent resistance through Week 48
A/E and changes in CrCl similar between the 2 arms
Sax #41

4. TDF/FTC or ABC/3TC + DOR 100 vs DRV/r 800/100
Drug-related A/E similar
2 pts with NNRTI resistance in DOR arm
Molina 45LB

5. Elsulfavirine – Investigational NNRTI
Phase III, double blind Elsulfavirine 20mg QD vs. EFV 600mg QD both with TDF/FTC
120 pts, HIV RNA 4.81, CD4 360
Drug-related A/E- 37% ESV vs. 78% EFV. Abnormal dreams ¼ in ESV
Murphy 452 LB

6. DTG + 3TC Maintenance
First regimen, no BL resistance, <50 c/mL for >2 years
Open label change 3rd drug to DTG for 8 weeks, then to DTG 50mg + 3TC 300mg
104 pts, 86% male
Joly #458

7. 2 Drug Maintenance with DTG+RPV- SWORD Studies
Screening
Early switch phase
Late switch phase
Continuation phase
VL <50 c/mL on INI, NNRTI, or PI + 2 NRTIs
1:1
DTG + RPV (N=513)
DTG + RPV
DTG + RPV
ART (N=511)
Day 1
Week 52
Week 148
Primary endpoint at 48 weeks: % VL <50 c/mL
Inclusion criteria
On stable ART >6 months
1st or 2nd ART with no change in prior regimen due to VF
Confirmed HIV-1 RNA <50 c/mL during prior 12 months
HBV negative
Llibre #44LB

8. Association Between CVD and Cumulative PI use
Ryom 128LB

9. Should We Focus on Cardiac Risk of Individual Antiretrovirals?
A model of CVD risk developed in a Dutch cohort of 8,791 patients
The model was then used to estimate effectiveness of interventions if implemented in 2017, up to 2030.
Van Zoest 129

10. What Modifiable CVD Factors Should Be Addressed?
¹Dutch Cohort –
HTN & Lipids, Smoking
²North Am. Cohort –
Smoking, HTN, Lipids
1. Van Zoest 129; 2. Althoff 130

11. Prednisone Primary Prophylaxis for TB IRIS
Placebo controlled in pts with TB starting ART. Mean CD4 ~50
Prednisone 40 mg/D x 2 wk, 20mg/D x 2 wk
Pred.
PLA
% IRIS 32 47
# Days to IRIS 10 8
# Hospitalized for IRIS 5 9
# New AIDS 11 18
p=0. 002
RIF decreases Prednisone level by ~50%, may need to give higher dose
Meintjes 81LB

12. High Dose Liposomal AmpB for Cryptococcal Meningitis
For 1st episode CM. All pts get Fluconazole 1200mg/D for 14 days plus varying Liposomal AmpB doses
LPs done at Days 0, 3, 7,14 to measure fungal clearance
Liposomal AmpB Arms:
Control
3mg/kg/D x14
3 Doses
10mg/kg/D1
5mg/kg/D 3&7
2 Doses
10mg/kg/D1
5mg/kg/D3
1 Dose
10mg/kg/D1

13. High Dose Liposomal AmpB - Results
A Phase III trial of Flu 1200 mg/kg + AmpBDC 0.7/mg/kg/14D or Lip AmpB 10mg/kg/1D is planned
Jarvis #82