International AIDS Conference | Fauci is optimistic about Montreal

The world can stop the AIDS pandemic, the head of the National Institute of Allergy and Infectious Diseases of the United States, Anthony Fauci, said on Sunday. The great helmsman of the fight against COVID-19 is hopeful that HIV will be transmitted much less thanks to the treatments that are about to emerge.

Mathieu Perreault
The Press

Access and adherence to treatments

“Antiretrovirals are one of the most important biomedical advances of our time,” said Dr.^r Fauci in his video address to the International AIDS Conference at the Palais des Congrès. But only 29 million of the 38 million patients worldwide have access to it, and almost half do not follow their treatment well, skipping more than 20% of days. Worse, in the United States, nearly 80% of people who need pre-exposure prophylaxis (PrEP) stop soon after starting treatment or do not follow PrEP well.

And globally, only 2.8 million people are taking PrEP, while “tens of millions” need it, according to Dr.^r Fauci. PrEP is necessary to prevent people who engage in risky behavior (unprotected sex with multiple partners, for example) from becoming infected. “So not only do we need to improve treatments and find new ones, but we also need to improve treatment and prevention interventions. »

Space the doses

Dose spacing, injections twice a year rather than pills every day, is one of the strongest hopes, according to the D^r Fauci. This applies to both treatment and PrEP. He cited two ongoing studies of PrEP with injections every six months, one with 5,000 African women and the other with 3,000 men and people from gender minorities in the United States and other countries.

Long term remission

About the holy grail of research, the cure for human immunodeficiency virus (HIV), the D^r Fauci thinks it will be more about “long-term remission” rather than clearing the virus from the reservoirs where it hides when it is controlled by antiretrovirals.

Long-term remission aims to mimic the “super-controllers”, whose immune system does not eliminate HIV, but prevents the onset of AIDS, by stepping down various treatments.

COVID-19: the negative…

The pandemic has in many cases interrupted HIV testing as well as treatment and PrEP, laments Dr.^r Fauci. “It must not reverse the significant progress made in reducing mortality due to AIDS. The life expectancy of an HIV-positive person in their twenties is now 56 years if they take their antiretrovirals religiously, compared to one or two years in 1984, he recalled.

… and the positive

But the successes of mRNA vaccines against COVID-19, such as those from Pfizer and Moderna, have renewed hope for an AIDS vaccine. And monoclonal antibodies used to treat COVID-19 could be directed at seven targets identified by Dr.^r Fauci on HIV.

Monkey pox

The US researcher, who was greeted as a star, faced criticism over the US government’s preparedness for monkeypox, which he called a “third pandemic” along with AIDS and COVID-19. 19. “We funded research on smallpox vaccines,” he replied. And we were preparing in a context of bioterrorism. He indicated that 1.1 million doses would be available at the beginning of August while the target population, mainly sexual minorities, is 1.6 million, which means a need for 3.2 million doses.

Demonstration

Between 50 and 70 people also demonstrated at the start of the presentation of the D^r Fauci to support the principle “I = I”, or “undetectable = untransmittable”. He gave them his support, noting that he had been one of the first to promote the concept, which makes it possible to include in prevention efforts patients whose viral load is undetectable to the point of being intransmissible.