EACS 2021 – The arrival of long-acting treatments in HIV Rich Hutchings and Bethan Crisp were excited to represent HRW at the European AIDS conference 2021, hearing about the latest HIV treatment advances. Here are HRW’s highlights and what it means for conferences of the future. HIV treatment in the COVID era The theme of the conference this year was ‘crossing borders’ – learning from the experience of physicians and people living with HIV (PLHIV) across Europe and leaving no one behind. The impact of COVID was central to the conference. Firstly, EACS 2021 was both virtual and in-person (see our thoughts on hybrid conferences below) highlighting how COVID continues to force us to adapt our ways of working together, and secondly due to the impact of COVID on treatment of PLHIV. Multiple sponsored symposia covered this second topic, aiming to learn lessons and to assess the extent to which COVID has impacted HIV care. The headlines were positive – control of the virus has remained strong in those treated, and COVID vaccines appear effective in PLHIV based on the latest data. However, HIV testing, referrals, and PrEP usage have declined, meaning the greatest impact may be in those who don’t yet know they are HIV positive. Additionally, low CD4+ counts are correlated with poorer COVID outcomes, meaning maintaining treatment adherence is as important as ever. The arrival of long-acting The hot topic of EACS 2021 was the arrival of long-acting treatments, which represents a paradigm shift for HIV. Up until now, PLHIV have required daily oral therapy to control the virus, whereas long-acting injections will be a more convenient and discreet treatment for many, lowering the impact of HIV on people’s lives. The first approved long-acting treatment (Vocabria + Rekambys injections) is now available in Germany, and soon to be rolled out to the rest of Europe. Perhaps the most impressive data shared at the conference was the preference for the regimen – over 9/10 PLHIV in clinical trials preferred the injections to oral therapy. Additionally, the latest guidance is that the injections can be given without an oral loading stage, increasing convenience and decreasing the complexities of administering the regimen. We look forward to seeing the impact of this new option on improving care for PLHIV in the coming year! As physicians get to grips with this latest treatment option, further long-acting options are coming closer to fruition – with islatravir and lenacapavir expected to diversify this space soon. In the near future we could see monthly oral treatments and even a subdermal implant that could last a year, providing much more diversity of options for patients a few years from now. Hybrid conference – the format of the future? EACS was a hybrid conference, meaning that the in-person experience was back alongside the online format that we’re all familiar with post-COVID. Being there in-person was an interesting experience – we were in the minority, as most delegates joined virtually. This meant that the conference rooms were sparsely populated compared to what we are used to, even for the most popular sessions. Additionally, this year some ever-present companies didn’t have a presence in the exhibition hall of the conference at all – although as the footfall was so low, this likely went unnoticed for the virtual attendees. Seeing the exhibition hall and being in the same room as the speakers certainly added to the experience for us and provided a sense of collaboration and connection to the research. Will the virtual attendees have felt the same impact behind their computer screens? In our research with HIV specialists this year, we’ve heard repeatedly that physicians appreciate the virtual format – it gives them the opportunity to join conference sessions while balancing their job and personal life – even if this means catching up with sessions at lunch and in the evening rather than joining live. As long as the number of virtual attendees vastly outnumbers those in-person, pharmaceutical companies will have to continue to evolve how they approach conferences, possibly focusing on maximizing the experience and impact for those attending virtually over those in-person. By Richard Hutchings and Bethan Crisp Apply Now!