The "2021 HIV G Summit" is grandly held in Nanjing. What kind of sparks will the experts collide with?

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On May 29, 2021, Gilead Sciences successfully held the "2021 HIV G Summit" in Nanjing.
The conference aims to promote the exchange of the latest AIDS scientific research progress between different regions, broaden the clinicians' diagnosis and treatment ideas, and ultimately benefit the majority of patients
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This conference invited a number of experts in the industry to gather together to participate in academic seminars
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It can be said that there is a gathering of big coffee, and it is wonderful! Figure 1.
At the beginning of the on-site conference of the "2021 HIV G Summit", Mr.
Jin Fangqian, Global Vice President and General Manager of Gilead Sciences, gave a welcome speech.
He said that Gilead Sciences has brought innovative treatment solutions to people living with HIV ——From the first compound single-tablet therapy to HIV prevention drugs, these groundbreaking inventions have broken the once impossible
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Gilead Sciences provides innovative and simplified treatment programs that benefit Chinese patients; it works with all parties to help improve public health
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Figure 2.
Mr.
Fangqian Jin’s speeches.
Chairman of the conference, Professor Wang Fusheng, Academician of the Chinese Academy of Sciences, Professor Li Taisheng of Peking Union Medical College Hospital, and Dean Yi Yongxiang of Nanjing Second Hospital, successively delivered speeches.
All three experts said that Gilead Sciences is a Chinese AIDS patient The prevention and treatment has given a lot of help.
Thank you Gilead Sciences for providing support and a platform for this conference.
This conference has a wide coverage and novel content.
I believe that through the intense discussion of experts and professors, it can bring help to frontline doctors.
I wish the conference a success.
A complete success
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1.
Frontiers of the field, keeping pace with the times Professor Wang Ning from the Chinese Center for Disease Control and Prevention talked about his views on AIDS epidemiology and control strategies.
As of the end of 2019, there are 38 million people living with HIV/AIDS in the world and new infections in 2019 The number is 1.
7 million
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Control strategies include: public health and preventive medicine + social management, clinical medicine + clinical intervention
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Professor Wang Fusheng briefly described the countermeasures and recommendations of China's AIDS prevention and clinical translation research, such as allogeneic adoptive immunotherapy (AAIT) and chimeric antigen receptor T cell (CAR-T) technology applied to HIV-infected people to accelerate immunity Resume
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Professor Wang Fusheng proposed to formulate and promote the standardized and standardized "Chinese Plan" for the diagnosis and treatment of infectious diseases
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Professor Li Taisheng explained the success and challenges of AIDS treatment in China.
He believes that antiretroviral treatment has made AIDS a chronic infectious disease, and the annual mortality rate of AIDS has been reduced by 86% in 10 years.
At present, AIDS complications have become the main cause of death and require full course management.
And comprehensive treatment
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2.
New Era, New Goal Professor Zhang Fujie: From the road to simplicity, to help 3T Era Bicampinox tablets are a powerful combination of powerful backbone drugs (F/TAF) and innovative integrase inhibitors (BIC)
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A 4-year follow-up study of naive adults who were initially randomized to receive bicampano tablets treatment showed that bicampano tablets can achieve and maintain a high virological inhibition rate
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In studies on women, elderly, children, and adolescents, it was also found that Bikampinol tablets can achieve a very high viral suppression rate
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In addition, bicampano tablets have a very high genetic barrier, and complex mutations are not prone to drug resistance
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In particular, it is worth mentioning that compared to Kempinol tablets, the treatment is simpler.
The guidelines recommend rapid antiretroviral therapy (ART) treatment within 7 days after diagnosis, when the estimated glomerular filtration rate (eGFR) When ≥30 mL/min, FTC/TAF does not need to adjust the dose
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At the same time, there are very few drug interactions with Enpino Tablets
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In 192 weeks, there was no proximal renal tubular disease or renal function-related discontinuation of Bikampinol tablets, and the bone safety was good, and the fasting blood lipid changes were minimal
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In addition, studies have shown that after switching from other treatment options to Bicampano tablets treatment, the patient's mental symptoms and sleep quality have been significantly improved
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Bikampinol tablets can also make the detection of anti-"AIDS" easier, without waiting for other laboratory test results to start the treatment of Bikampinol tablets, its potent antiviral effect is not affected by the baseline viral load.
And CD4 levels
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During treatment, patients do not need frequent monitoring of liver, kidney, bone, cardiovascular and other functions
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Figure 3.
The clinical treatment advantages of Bik En Pino Tablets Professor Yongtao Sun: New era, new goals-new HIV treatment targets.
The renewal and iteration of antiviral drugs promotes the renewal of HIV treatment targets and the emergence of Integrase Inhibitors (INSTI).
While improving the efficacy of virus suppression, the advantages of integrase monolithic inhibitors in terms of safety, drug resistance, drug interactions and dosage forms make it possible to improve patient tolerance and improve the quality of life of patients
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In the context of different times, the goals of HIV antiviral treatment are also changing.
Unlike the previous treatment goals that focused on virus suppression, the new HIV treatment goals put forward higher requirements such as improving the quality of life of patients
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Figure 4.
New targets for HIV treatment.
New targets for HIV treatment can be achieved through rapid and powerful suppression of the virus and reduction of adverse drug reactions
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Compared with previous nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and protease inhibitors (PI) drugs, INSTI drugs have a rapid and potent antiviral and low resistance It has advantages such as medicine, effective restoration of immune function and reduction of adverse reactions, and the triple scheme is better than the two-part scheme in these aspects
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At present, integrase inhibitors have advanced to the era of monolithic preparations with F/TAF as the backbone.
The monolithic preparations with F/TAF as the backbone are suitable for rapid initiation of antiviral treatment, and the virus inhibition rate has increased to 92%.
144 weeks of use are 0 resistant.
The drug withdrawal rate due to adverse reactions does not exceed 1%, and the increase in the ratio of CD4/CD8 is more significant, which further helps to achieve the new goal of HIV treatment
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Professor Wei Hongxia: The clinical significance of HIV rapid start-up treatment In the era of high-efficiency antiretroviral therapy (HARRT), although China has made significant progress in HIV prevention and treatment, the challenges remain arduous
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At present, the World Health Organization (WHO) advocates the principle of accepting ART as soon as HIV is diagnosed.
However, there are still differences between reality and guidelines.
Delaying treatment is a shackle in China's AIDS prevention and control process
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In the past, due to limited resources and complicated "patient screening" procedures, delays in ART treatment were unavoidable
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The clinical significance of rapid initiation of treatment includes: increasing the rate of virus inhibition, improving treatment compliance, increasing the acceptance rate of antiviral treatment, and reducing the HIV-related mortality rate
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Numerous clinical research results support that the rapid ART program is significantly better than the non-rapid start program in terms of improving the patient's turn-on ART treatment rate, virus inhibition rate, treatment, retention rate, and mortality rate
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Many authoritative guidelines emphasize that HIV patients should receive rapid-start treatment once they are diagnosed, including ART on the day of diagnosis.
The implementation of rapid-start ART programs should use drugs with strong effects, small dosages and small side effects as fast programs as possible
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Figure 5.
The clinical significance of rapid initiation of treatment for HIV-infected patients.
A monolithic integrase solution with F/TAF as the backbone-Bikampinol tablets can be quickly started, potent and long-term inhibition of the virus, and the incidence of drug resistance at 144 weeks is 0 , Few adverse reactions, the smallest monolithic preparation, high patient compliance with treatment, and a wide range of applications.
It is the preferred plan for rapid start of treatment
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3.
Go beyond virus suppression and focus on treatment experience Professor Liu Shuiqing: Inhibit the virus strongly, the lower the better.
HIV virus has the characteristics of high replication and high specificity.
The short-term and long-term prognosis of late detection is poor, and it is fast and powerful.
Viral therapy can improve the clinical prognosis of HIV-infected patients
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Therefore, the initial antiviral treatment requires rapid, strong, and continuous inhibition, and the viral load is the gold standard for measuring the effect of virus inhibition
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The high standard of HIV viral load in the past easily leads to low-level viremia and Blips, which increases the risk of treatment resistance and treatment failure
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In addition, for every log10 increase in viral load, the risk of sexual transmission increases by 2.
9 times
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Current guidelines recommend that antiviral treatments reach a lower viral load threshold.
Low viral levels can reduce the risk of virological rebound, treatment failure, and all-cause death, help improve immune function, block HIV sexual transmission, and reduce drug resistance The production of strains reduces the risk of Blips and has a wide range of benefits
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The optimization of the antiviral treatment plan promotes the realization of a lower viral load level.
The monolithic integrase inhibitor with F/TAF as the backbone has a high viral inhibition rate, which is not affected by the baseline disease load or CD4 level, and is safe to tolerate Good, patient compliance is good, medication is convenient, and it is the best choice for a strong virus suppression program
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Figure 6.
The treatment is simpler than Kempinol tablets, which can greatly improve treatment compliance.
Professor Zhang Renfang: Focus on the treatment of HIV-infected patients.
The patient report outcome (PRO) is not subject to the intervention of any clinician or others, and the main complaint of the patient PRO is a unique reporting channel different from doctors and physiological reports, as shown in the figure below
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PRO data can improve patient care and prognosis from the individual, institutional, and population levels
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It has been recognized by the U.
S.
Food and Drug Administration (FDA) as important data for new indication applications, clinical research and drug approval, and drug safety monitoring
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Figure 7.
Reporting channels for treatment outcomes of HIC-infected patients.
Studies 1489 and 1844 have confirmed that PRO can be used to study the health level and quality of life of patients in HIV treatment.
In newly-treated and treated HIV patients, Biquenpronol tablets are effective The curative effect of multiple HIV-related symptoms is significantly better than DTG/ABC/3TC
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However, after switching from TDF/FTC/EFV to icoenbanti tablets, EFV-related central nervous system (CNS) symptoms were relieved and improved
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At the same time, more research related to PRO is underway
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In 2019, the U.
S.
Department of Health and Human Services (DHHS) clearly proposed improving the quality of life of patients as one of the new goals of HIV treatment, and the management of comorbidities has now become an important part of the daily care of HIV patients
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The latest quality of life survey results show that: 1.
Doctors have an ideal assessment of the quality of life of patients, and at the same time underestimate the actual CNS comorbidities of patients in daily diagnosis and treatment; 2.
Among newly diagnosed patients, patients who use non-free drugs are anxious and depressive.
Even lighter, the proportion of sleep disorders in patients who use free medicine is higher than that of other types of patients; among the follow-up patients, free medicine is changed to non-free medicine, and the proportion of patients with depression and anxiety is the lowest
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Professor Lv Wei: Optimal management strategies for HIV patients with CKD The prevalence of HIV with chronic kidney disease cannot be underestimated.
The probability of progression to chronic kidney disease is positively correlated with the length of antiviral treatment.
Exposure to drugs such as TDF and PI increases the incidence of chronic kidney disease.

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The combined chronic kidney disease reduces the antiviral efficacy of HIV in patients, increases the mortality of patients, and affects the mental health of patients
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Renal function should be screened and monitored regularly during ART treatment.
eGFR and urine protein have always been the main indicators of chronic kidney disease (CKD) screening.
The use of eGFR for HIV combined with CKD screening lacks early accuracy, and eGFR cannot be used to judge HIV.
The only indicator that merges CKD
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Urine albumin/creatinine ratio (UACR), urine protein/creatinine ratio (UPCR), morning urine retinol binding/creatinine ratio (RBP/Cr), β2 microglobulin index and other indicators are more conducive to the early screening of chronic kidney disease The investigation has yet to be further evaluated
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The innovative backbone drug propofol tenofovir (TAF) greatly reduces nephrotoxicity.
Icoen Propiti Tablets uses FTC/TAF as the backbone component, and there is no need for dose adjustment in patients with renal impairment.
When adverse renal reactions occur, Consider switching to a TAF-containing solution or a non-TDF solution
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Icoen-Binti Tablets are powerful, safe and convenient, and can significantly improve patient compliance with treatment.
It is the preferred dressing change program for patients with chronic kidney disease after treatment
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Figure 8.
The single-tablet regimen of Ecoen Bingti tablets can significantly improve patient compliance with academic controversy.
Experts discussed Professor Yun Chi shared a case report titled "The present is not what it used to be, and the future is achieved".
Three HIV patients received ART Benefit from treatment
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Zhang Renfang, Sun Lijun, and Professor Chen Yahong had a heated discussion on "New era, new goals, and new concepts for the management of HIV patients".
As a result, everyone agreed that INSTI-based monolithic preparations can quickly and strongly inhibit the virus and effectively recover.
Immune function and can be used for quick start to meet the treatment needs of multiple infections (or other complicated cases) under the background of the new era and new targets
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With F/TAF as the backbone of the integrase monolithic preparation, CNS and digestive tract symptoms are significantly better than DTG/ABC/3TC regimen.
It has excellent comprehensive efficacy, adverse reactions and drug resistance, which can meet a variety of complicated outpatient cases.
Demand
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Dr.
Li Jin shared a case report entitled "Choose Carefully, Long-term Outcomes Are Unpredictable".
One HIV patient benefited from HAART treatment
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Cai Lin, Ma Ping, and Professor Liu Jun had a heated discussion about "triple therapy, the best choice for HIV antiviral therapy", and they all agreed that the dual regimen is more prone to virological failure and drug resistance than the triple regimen.
The current guidelines It is recommended that the dual scheme can only be considered when ABC, TAF and TDF are out of reach, and close monitoring is required during use
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Conference summary The conference shared the status quo of China's AIDS epidemiology, treatment strategies, successful experiences and challenges from a national and strategic perspective
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The renewal iteration of antiviral drugs promotes the renewal of HIV treatment goals, and the advent of integrase inhibitors makes it possible to improve patient tolerance and improve the quality of life of patients
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The monolithic integrase inhibitor with F/TAF as the backbone has a high virus inhibition rate, and is the preferred solution for strong virus inhibition
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"This article is only used to provide scientific information to medical and health professionals, and does not represent the platform's position"