On the 22nd of October, in Glasgow, the European AIDS Treatment Groups held the third edition of Steps – a community initiative to design the pathway to a long-term remission of HIV infection. This is a workshop, organised each year the day before the opening of the major European HIV conferences EACS and HIV Therapy Congress, to facilitate a comprehensive and thorough discussion on the latest advances in HIV cure research among the European community of people living with HIV. The first workshop was organised in Glasgow two years ago and was very well participated by about 20 people: it featured presentation about the immune system mechanisms of action by Giulia Marchetti, University of Milan, and about treatment interruption by Cristina Mussini, Policlinico of Modena.
In Barcelona in 2015 the second workshop was a big success: about 30 people attending, presentations from the most innovative and interesting research strategies going on in Europe. A report was released and can be found here: http://www.eatg.org/publications/steps-a-community-initiative-to-design-the-pathway-to-a-long-term-remission-of-hiv-infection-report/
This here in Glasgow the third Steps workshop agenda was focused on treatment interruptions: given that stopping antiretroviral treatment is, at this moment, the only way to assess if a cure strategy is working, how can they be used safely? Are there any alternative biomarker or predictor that could inform scientists on the outcomes of a cure strategy? What are the feelings of people living with HIV towards this kind of interventions?
These questions were all addressed during the workshop: Giulio Maria Corbelli, ECAB chair, introduced the meeting discussing with the audience which measures should be adopted in cure clinical trials design in order to safeguard participants safety when undergoing treatment interruption. The discussion was based on a living document drafted by Simon Collins, Richard Jefferys and David Evans (http://i-base.info/htb/wp-content/uploads/2014/07/Community-TI-draft-for-comment-210714.pdf) containing the main recommendations about inclusion and exclusion criteria, interruptions duration, and guiding factors when managing the interruptions.
Alexander Pasternak, from the University of Amsterdam, explained their work in finding a reliable and easy-to-use tool to measure the size of HIV reservoir. This is a measure that could be very important in identifying those participants who are more likely to experience a successful outcome from cure strategies and that could help in reducing the need for treatment interruptions in cure research trials. Melanie Stecher from University Hospital of Cologne presented their systematic review of treatment interruption studies in the last 20 years: this showed how significantly safer treatment interruption can be when viral load monitoring is very frequent. Stefano Vella from National Institute of Health in Rome, illustrated the EHVA project (European HIV Vaccine Alliance – www.ehv-a.eu) which includes a therapeutic vaccination trial with treatment interruptions to be launched in 2017 in several European countries.
The workshop gave the opportunity to the participants to ask questions and discuss worries and hopes with presenters and among themselves and confirmed how much the European community of people living with HIV needs this kind of opportunities.
The full report from Steps 3 workshop can be found here: STEPS_WORKSHOP-final_report
Slides and more information here: http://www.eatg.org/news/community-cure-workshop-slides-now-online-glasgow-2016/