DGHT Team Presents Innovative Research at CROI in Boston

Division leadership and researchers are in Boston this week (February 22-25) at the annual Conference on Retroviruses and Opportunistic Infections (CROI) to share the latest studies and developments around HIV/AIDS, TB and related infectious diseases. Fifteen abstracts were accepted from DGHT staff on topics ranging from Malawi’s Option B+ program to household transmission of extensively drug-resistant TB (XDR TB) in South Africa. Here are just a few of the highlights:

National HIV transmission in 4-12 week olds in Malawi:
A study from Malawi is proof that developing countries can dramatically reduce HIV among newborns. The CDC-led study analyzed the impact of implementing Option B+ – a policy of offering treatment to all HIV-infected pregnant and breastfeeding women – in the country. Malawi was able to provide HIV treatment to nearly 94% of all HIV-positive pregnant women nationwide. As a result, just 2.8% of these women passed the virus on to their babies – compared to 20% for those who never started treatment or chose to stop it. The study also showed that the sooner HIV-positive women begin treatment, the less likely they are to transmit HIV to their children. A low-income country with one of the highest HIV rates in the world, Malawi can be a model for other developing countries that are working to eliminate pediatric HIV.

HIV/ XDR TB transmission occurs across households and hospitals in South Africa:
In this study, authors looked at what is causing an epidemic of extensively drug-resistant TB (XDR TB) in eastern South Africa. The primary cause of drug-resistant TB is failure to identify and effectively treat TB before it has the chance to develop resistance. However, this study found that in South Africa, XDR TB is being transmitted person-to-person in hospitals and in communities. The study shows that nearly eight in 10 XDR TB patients had a traceable linkage to other people with XDR TB through their hospitals, homes, churches, and other settings in the community. The authors also conclude that analyzing people’s social interactions can provide valuable insight into how TB is transmitted, and should be taken into account when designing programs to slow the spread of the disease.

Gains in ART not reflected in fewer deaths: HIV mortality surveillance in Nairobi:
This study indicates that a large-scale increase in treatment in Nairobi, Kenya – 73% coverage of people living with HIV – has led to significant reductions in HIV prevalence but, surprisingly, not HIV-related deaths. The finding is troubling: despite successes in reaching more people with treatment, people living with HIV in Nairobi still have four-fold higher risk of death than the general population. The study suggests those who died did not have access to treatment or their treatments failed. However, further research is needed to understand why HIV-related deaths in Nairobi have not declined despite the tremendous progress made in providing treatment to those in need.

Symposium and plenary lectures, workshops, themed discussions, and oral presentations are available online as webcasts. Electronic posters will be accessible to download next week. You can also follow CDC highlights from CROI on Twitter @CDC_HIVAIDS or #CROI2016 to see conversations from this year’s conference.