HIV 2019: ADVANCES AND EMERGING TRENDS
Summary: The 7th Annual Global Health & Infectious Disease Conference at Washington University in St. Louis
Emerging trends in HIV indicate that rural areas of Missouri are among the most “vulnerable counties experiencing, or most at-risk of, outbreaks” according to the CDC. This was just one of the topics concerning HIV heard by an audience of nearly 200 at the Spring Global Health & Infectious Disease Conference, “HIV 2019: Recent Advances and Emerging Trends.”
In its seventh year at Washington University, the conference featured presentations by the St. Louis AIDS Clinical Trials Group; physicians from WashU, Columbia University, and the University of California, San Diego; and, was moderated by the Larry J. Shapiro Director of the Institute for Public Health and Director of its Global Health Center, William Powderly, MD.
Discussed among presentations concerning the latest HIV research, development and implementation were: HIV vaccines and preventatives, oral PrEP usage, new trends in antiretroviral therapies, health disparities in the ability to treat patients, global pediatrics and HIV, and teen education.
The featured keynote address was by Robert Schooley, MD, who serves as Professor of Medicine in the Division of Infectious Diseases, Vice-Chair for the Department of Medicine, and Senior Director – International Initiatives at University of California, San Diego. Listen to his keynote: “Ending AIDS: No Vaccine – No Problem”.
“The virus is incredibly genetically diverse…the virus keeps changing…we should not count on vaccines as a mechanism to stop this epidemic. We need to figure out how to get the things that we know work…to places where they are most needed — where the infection is happening…figure out how to use science in the most appropriate way…and get the drugs to the right place.” – Dr. Robert Schooley
Associate Professor Ericka Hayes, MD, from the university’s Department of Pediatrics discussed the current epidemiology of pediatric HIV infection and global approaches surrounding mother-to-child transmission.
St. Louis Public Radio (KWMU-FM, NPR) interviewed Dr. Hayes regarding the trend of rising HIV cases in rural Missouri. Hayes noted that “those most at risk of contracting HIV are racial minorities and men who have sex with men.” Rural populations are at great risk due lack of access to care, according to the Larry J. Shapiro Director of the Institute for Public Health, William Powderly, MD, who was also interviewed. Read the STLPR story.
Proscovia Nabunya, PhD, and co-director of the university’s new Africa Initiative, gave a revealing presentation concerning her work in HIV-impacted communities in sub-Saharan Africa, where 50% of children living in poverty currently reside. 36 million people in the region are living with HIV/AIDS, with women ages 15-24 accounting for 74% of new HIV cases. Dr. Nabunya pointed out that poverty plays a huge role in undermining a family’s ability to support and care for children with HIV. “Children are more likely to stay on their medication if they aren’t struggling for food and simple necessities,” she said.
Dr. Nabunya discussed the benefits of using asset-based interventions and programs that provide scholastic materials, workshops on financial management and training on income-generating activities. Health-focused interventions such as facilitating better social networks for children and families, are shown to help students stay in school and stay on their HIV medication. Dr. Nabunya’s research also indicates that better health outcomes can result from the involvement of surrounding civil society, government and private bank entities working in community partnership.
Rupa Patel, MD, assistant professor and director of the HIV Prevention Program known as PrEP (Pre- Exposure Prophylaxis), discussed usage of the pill which is helping stem the global tide of new HIV infections. Dr. Patel noted that for every 13 people who take PrEP consistently for a year, the spread of one case of HIV infection can be prevented.
Among patients using PrEP consistently for a year in South Wales, there was a 32% reduction in new HIV infections and a 55% percent reduction among patients in the UK.
Conference panelists agreed that President Trump’s recent call to eliminate AIDS by the year 2030 will be a huge challenge for the U.S. medical and global communities. Panelists’ predictions concluded that the current suggested redistribution of HIV-related funding could essentially “flatten” Medicaid. By reducing the caliber of drug therapies to save costs, drug prices to consumers who rely on antiretroviral medications will inevitably skyrocket.
Other presenters included: Liang Shan, PhD, Washington University assistant professor of medicine, Division of Infectious Diseases regarding immunological approaches to treating HIV; John Santelli, MD, MPH, professor of Population and Family Health and Pediatrics at Columbia University on HIV incidences among teens in rural Uganda; and, Sebla Kutluay, PhD, Washington University assistant professor of molecular microbiology concerning the unexpected role of HIV-1 proteins in virion maturation.
George Kyei, PhD, MBChB, assistant professor in the Washington University Division of Infectious Disease, and O. Dan Smith from the AIDS Clinical Trials Group Community Advisory Board, St. Louis were among the panelists.
Students presenting at the Global Health Infectious Disease Trainee Oral Symposium were reviewed on their talks and poster presentations.
• Nicole Howard, BS, Graduate Student, Department of Molecular Microbiology (Shabaana Khader Lab), on “Rifampicin Resistance Conferring Mutations in Mycobacterium tuberculosis Modulate host Macrophage Metabolism Through cell wall Lipid Changes”
• Marla Hertz, PhD, Postdoc, Department of Molecular Microbiology (Philip Budge Lab), on “The Molecular Signature of False-Positive Rapid Diagnostic test Results for Lymphatic Filariasis (LF): Implications for Renewing LF Elimination Efforts in Central Africa”
• Ninecia Scott, BS, Graduate Student, Department of Molecular Microbiology (Shabaana Khader Lab) on “S100A8/A9 During Chronic Tuberculosis Promotes Pathogenesis by Regulating Neutrophil Accumulation”
• Sumit Kumar, PhD, Postdoc, Department of Molecular Microbiology (David Sibley Lab), on “Toxoplasma gondii Effector TgIST blocks type I Interferon Signaling to Promote Infection”
The seventh annual Global Health Infectious Disease Conference and Trainee Oral Symposium was co-sponsored by the Center for Global Health and Infectious Disease at the Institute for Public Health and the departments of Medicine, Molecular Microbiology, and Pediatrics at the School of Medicine.