The scenario of HIV infection has dramatically changed in the last two decades. Since HIV became a treatable and “chronic” disease, people living with HIV (PLHIV) require lifelong care and treatment. This is thanks to the progress of antiretroviral therapy (ART), which is increasingly effective, potent, tolerable and with a high genetic barrier. Concomitantly, the strategy for treating/preventing HIV infection has also changed over time: possibility of starting ART immediately upon diagnosis (test-and-treat), likely (virtually) increasing the chance of detect acute infection; opportunity to simplify the regimen in virosuppressed ART-experienced PLWH or prevent infection (pre-exposure prophylaxis, PrEP), using effective regimens with just two active components and/or based on long-acting injectable formulation. Both oral and injectable PREP have been shown to greatly reduce the risk (incidence) of HIV infection. In both ART-naive and -experienced PLWH, these strategies can promote retention in care, treatment adherence and drug tolerability, ultimately improving the overall quality of life of PLWH. Despite increasing evidence of the efficacy, safety and tolerability of these new strategies in both ART-naive and -experienced PLWH, it is mandatory to evaluate them in clinical practice settings. In this regard, it is crucial to strictly monitor and follow PLWH from the time of diagnosis, via: I) standard surrogate markers (CD4 and HIV-RNA); II) markers of inflammation/immune-activation panels; III) total HIV-DNA, as a marker of the reservoir; and IV) genotypic tests for detecting primary and secondary drug resistance. To date, microfluidic technologies (microfluidic ELISA, digital droplet PCR and “next generation sequencing), which have enhanced laboratory performances (higher sensitivity, higher throughput) could fulfil the needs of a routine practice in clinical virology improving, in turn, the management of “present-day” ART-naive and virologically suppressed PLWH.
15.00 - 15.30
Proviral DNA/transcription-competent reservoir as a marker for monitoring the efficacy of novel antiretroviral strategies
(simplification/LA) in virosuppressed PLWH:
- clinical implication/interpretation of the results
F. Saladini, Siena
15.30 - 16.00
Diagnosis and Management of Acute HIV
- Diagnostic algorithm
- Clinical relevance of early detection
V. Micheli, Milano
16.00 - 16.30
NGS in HIV: present and future challenges:
- Understand the cut-off for detection of the minority variants (clinical interpretation)
- Whole genome sequencing (WGS) in the light of new strategies based on antiretrovirals acting on several different targets
D. Armenia, Roma
16.30 - 17.00
A new paradigm for antiretroviral delivery: long-acting new antivirals and strategies for the treatment and prevention of HIV:
- Clinical and virological perspectives
R. Rossotti, Milano