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HVTN at the 24th International AIDS Conference in Montreal – Newswise

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Newswise — SEATTLE (EMBARGOED UNTIL 10 A.M. EDT ON JULY 28, 2002) — Scientists, doctors and other health professionals from the HIV Vaccine Trials Network (HVTN) will present research findings and other HIV-related news at AIDS 2022, the International AIDS Conference taking place virtually and in person in Montreal, Canada, July 29 to Aug. 2.

HVTN, based at the Fred Hutchinson Cancer Center in Seattle with an international network of AIDS and HIV experts, will be involved in more than a dozen oral, poster and other presentations. Abstracts and information are embargoed until 10 a.m. EDT on Thursday, July 28. To arrange an interview, please contact Sandy Van, [email protected].  

Here are summaries of several representative sessions.

High prevalence of asymptomatic omicron carriage and correlation with CD4+ T cell count among adults with HIV enrolling in COVPN 3008 Ubuntu clinical trial in sub-Saharan Africa

Dr. Jessica Andriesen, a senior staff scientist in vaccine and infectious disease who will make this presentation, said the Ubuntu study (CoVPN 3008) provides the opportunity to further understand the COVID-19 pandemic in people living with HIV. People living with HIV make up approximately 80% of the about 11,300 individuals enrolled as of July 1, 2022. The planned analyses include the effectiveness of COVID-19 mRNA vaccines against symptomatic and severe COVID-19 illness caused by variants of concern, and the immune response to mRNA vaccination in people living with HIV.  As Ubuntu began enrollment, a high percentage of participants who were joining the study were found to be living with asymptomatic SARS-CoV-2 infections at their first vaccination visits. Participants living with HIV who had low CD4 counts were more likely to also be living with SARS-CoV-2 infections, whether or not they already had antibodies from an infection in the past. “These findings highlight the urgent need to better characterize how being immunocompromised due to HIV impacts a person’s chances of becoming infected with SARS-CoV-2, and their ability to clear the infection and fully recover,” Andriesen said.

Session type: Oral presentation. Late Breaker Track C.

Date, time, location: Tuesday, Aug. 2, 11:45 a.m. to 12:45 p.m., Room 517d/Channel 2.

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Administration of the broadly neutralizing, CD4-binding site targeting antibody VRC07-523LS in dual- and triple-antibody combinations with 10-1074, PGT121, and/or PGDM1400: impact on pharmacokinetics compared to VRC07-523LS administration alone

“We found in the antibody-mediated prevention (AMP) studies that a broadly neutralizing antibody could prevent HIV infection, but only if the infecting strain was very susceptible to the antibody,” said first author and presenter Dr. Stephen R. Walsh, an infectious diseases specialist at Brigham and Women’s Hospital. “To improve on this, we are testing newer antibodies that cover more strains of HIV, and we are testing combinations of these antibodies to try to get broader coverage of global HIV diversity. One antibody we are testing is called VRC07-523LS, and it covers more strains of HIV than the AMP antibody. The VRC07-523LS antibody has a half-life in the human body of about 55 days which means we wouldn’t have to give it to people as often as the AMP antibody. When we combined VRC07-523LS with other anti-HIV antibodies, the half-life in the human body was about 52 days, which really isn’t any different. This is important because it shows that the level of VRC07-523LS in the body is unchanged if it’s given alone or in combination with other anti-HIV antibodies.”

Session type: E-poster.

Date, time, location: Sunday, July 31, beginning at 3:30 p.m., on the conference website and in the Palais des Congrès, second floor.

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Analysis of the HVTN 702 Phase 2b-3 HIV-1 vaccine trial in South Africa assessing RV144 antibody and T cell correlates of HIV-1 acquisition risk

First author and presenter Dr. Zoe Moodie, a senior staff scientist in the vaccine and infectious disease division at Fred Hutch, said this study addresses the critical question of whether the immune responses that correlated with HIV in the RV144 Thai trial also apply to other vulnerable populations. “Although the related vaccine regimen studied in HVTN 702 in South Africa did not prevent participants from getting HIV, the trial gives us a unique opportunity to answer this important question and hints about why the vaccine regimen did not work,” she said. The study showed that among vaccinees with a certain type of high binding antibody response, vaccine-specific CD4+ T-cell responses were associated with 51%-60% lower vulnerability to HIV. On the other hand, among those with low binding antibody responses, CD4+ T-cell responses were associated with a 2.2- to 3.6-fold higher vulnerability to HIV. “Our findings are in line with the correlates results from RV144, raising the possibility that vaccination needs to induce high binding antibody responses, along with strong CD4+ T-cell responses, to achieve protection from HIV,” Moodie said.

Session type: Poster. Late Breaker Track A.

Date, time, location: Saturday, July 30, 9 a.m.

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Immune correlates analysis of the Imbokodo HIV-1 vaccine efficacy trial

First author and presenter Avi Kenny, a PhD student in biostatistics at the University of Washington, said this presentation is on the Imbokodo clinical trial (HVTN 705) that enrolled 2,600 women in sub-Saharan Africa and was designed to evaluate the safety and effectiveness of a novel Ad26 vector-based HIV vaccine. “Although the vaccine did not show significant efficacy to prevent HIV-1 acquisition, a secondary analysis assessed whether any of a prespecified set of antibody and T-cell biomarkers were associated with risk of HIV acquisition or vaccine efficacy.  While there were no statistically significant associations, the subgroup of vaccine recipients with highest levels of a specific biomarker measuring antibodies that bind to the surface of an HIV envelope protein had the lowest rate of HIV-1 acquisition,” Kenny said. “This hypothesis-generating finding provides a useful direction for future vaccine research, indicating a goal post to favor candidate vaccines that generate more frequent and higher levels of the specific biomarker.”

Session type: Oral presentation. Late Breaker Track A.

Date, time, location: Saturday, July 30, 11:47 a.m., Room 511/Channel 7.

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COVID-19 and HIV: Community engagement lessons learned and applied from two pandemics

Lessons learned about community engagement from the past 20 years of HVTN trials informed the success of similar efforts in support of COVID-19 vaccine research. Now that the COVID-19 vaccine studies are reaching their conclusions, what lessons can be applied back to HIV vaccine research as those studies resume? The presenters will share how the COVID-19 Prevention Network (CoVPN) built on prior community engagement successes in the HVTN, the success of these efforts in COVID-19 vaccine studies, including enrollment of BIPOC communities, engagement of faith-based organizations and Native American or Indigenous communities, the use of a participant screening registry, and the use of infographics and video for social media and marketing campaigns. As HIV vaccine studies begin to resume, the presenters will also share how these COVID-19 successes are being applied back to HIV research, addressing pre-pandemic challenges with slow study enrollment. This Global Village session will be presented and moderated by Gail Broder, associate director of HVTN’s Social Behavioral Science & Community Engagement Unit, and Dr. Stephaun Wallace, director of External Relations at HVTN. Additional participants and panelists will include HTVN community engagement project managers Rafael Gonzalez, U.S. and Puerto Rico; Kagisho Baepanye, eastern and sub-Saharan Africa; Luciana Kamel, Argentina and Brazil; and Patricia Segura, Mexico and Peru.

Session type: Global Village Session.

Date, time, location: Sunday, July 31, 5 p.m. to 6 p.m., Global Village Channel/Room 2.

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Interfaith Preconference: Taking Action to Overcome HIV Stigma and Discrimination

Ahead of AIDS 2022, Dr. Ulysses W. Burley III, founder of UBtheCURE LLC, will co-facilitate a two-day event featuring workshops, networking opportunities and presentations by and for faith leaders targeting HIV-related stigma and discrimination. Among session topics are:

  • Recommendations of persons and communities affected, in dialogue with faith leaders.
  • Theological principles that guide faith groups to overcome stigma and discrimination.
  • Leveraging trust and access to sustain epidemic control and advance prevention.
  • Innovations to tackle HIV stigma and discrimination.
  • The impact of new testing tools and methodologies.
  • How optimal HIV pediatric treatment is paving the way to end stigma among children.
  • Long-acting injection to treat HIV.
  • PREP and PEP: essential tools to end stigma.
  • Monitoring and evaluation frameworks that can be adapted to faith interventions to address stigma and discrimination.

UBtheCURE is a Chicago-based consulting company at the intersection of faith, health, and human rights, with expertise in HIV/AIDS and COVID-19. Although Burley’s formal training is in immunology and cancer epidemiology, his primary work has been in HIV and AIDS education, awareness, advocacy, and capacity-building in the context of faith.

Session type: Preconference event.

Date, time, location: Wednesday, July 27, and Thursday, July 28, from 8 a.m. to 5:45 p.m. both days, Montreal’s La Plaza Centre-Ville-EVO.

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Documentary Film Screening: ‘My Faith, My Story: HIV in the U.S. South’

Dr. Ulysses W. Burley, also will host a screening of the documentary “My Faith, My Story: HIV in the U.S. South” on behalf of the U.S. HIV/AIDS Faith Coalition and National Faith HIV/AIDS Awareness Day. Burley is a co-founder of both the organization and the recognition event. He and Khadijah Abdullah, executive director of Reaching All HIV+ Muslims in America (RAHMA), co-produced the film, and W. Imara Canady, national director of Communications & Community Engagement for AIDS Healthcare Foundation, is featured. All three are HVTN faith ambassadors. The Global Village screening will begin at 3:25 p.m. on Sunday, July 31.

 ==

HVTN experts will discuss a variety of other subjects at AIDS 2022

Among other subjects covered by HVTN professionals: recruitment strategies in a global preventive HIV vaccine study, broadly neutralizing monoclonal antibody studies, mRNA technology, strengthening industry engagement in vaccine research, ethical and community considerations in experimental medicine trials in Africa, and COVID-19’s impact on vaccine research and development. HVTN will also host an exhibition booth – HIV Vaccine Trials Network: Help End HIV – in the Global Village.

About Fred Hutchinson Cancer Center

At Fred Hutchinson Cancer Center, home to three Nobel laureates, interdisciplinary teams of world-renowned scientists seek new and innovative ways to prevent, diagnose and treat cancer, HIV/AIDS and other life-threatening diseases. Fred Hutch’s pioneering work in bone marrow transplantation led to the development of immunotherapy, which harnesses the power of the immune system to treat cancer. An independent, nonprofit research institute based in Seattle, Fred Hutch houses the nation’s first National Cancer Institute-funded cancer prevention research program, as well as the clinical coordinating center of the Women’s Health Initiative and the international headquarters of the NIAID-funded HIV Vaccine Trials Network (HVTN) and COVID-19 Prevention Network (CoVPN).

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COVID Outbreak at Meno-Ya-Win in Sioux Lookout – ckdr.net

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Sioux Lookout’s Meno Ya Win Health Centre has declared a Covid-19 Outbreak after two patients were diagnosed with the virus.

Both patients have been in-patients for a long period of time, which indicates they contracted COVID-19 while at the hospital.

Effective immediately, visitation will be limited at SLMHC to two (2) designated visitors per patient.

Contact tracing is also underway at SLMHC. Anyone who is identified as a risk has been contacted.

“We have processes in place to provide the safest possible environment for our patients, staff and physicians. Our priority is to see this outbreak contained quickly,” says Douglas Semple, SLMHC President and CEO.

In addition to continuing daily screening and adherence to personal protective equipment standards, such as masks and eye protection,

SLMHC’s housekeeping department is following policies relating to increased cleaning and proper handling of an outbreak.

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Every 22 minutes a Canadian woman dies of a heart attack. Most of those deaths are preventable – CBC News

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Every 22 minutes, a woman in Canada dies of a heart attack. 

But the majority don’t have to, experts say, warning that more women will die unnecessarily if the medical community doesn’t tailor care to their needs.

“We have one of the best health-care systems in the world, and we’re not serving women,” said Dr. Paula Harvey, a cardiologist and head of the department of medicine at Women’s College Hospital in Toronto. “We have to do better.” 

Heart disease is a top killer of women in Canada, and the push to change that is more urgent than ever. Harvey says more younger women are presenting with classic high risk factors for heart disease: high blood pressure, diabetes and obesity.

“There’s this trend to cardiovascular risk factors starting to be a problem at an earlier age, and I find that disturbing,” said Harvey. “I never used to see a woman in her 40s with high blood pressure. I’m starting to see that, and that’s going to mean that we’ll have more premature heart disease.”

Dr. Paula Harvey, a cardiologist and head of the department of medicine at Women’s College Hospital, said women are often not counselled about how menopause and declining estrogen can affect their heart health. (Ousama Farag/CBC)

How hormone levels affect heart health

Some studies have already found the heart attack rate among women aged 35-54 has gone up.

Lifestyle factors play a role in the trend, but the threat itself is broader — the majority of Canadian women have at least one risk factor for cardiovascular disease. Women with diabetes and those who come from certain racial or ethnic backgrounds are at higher risk, but fluctuating hormones can wreak havoc with any woman’s heart health, especially as they enter menopause and levels of the heart-protecting hormone, estrogen, start to drop.

That transition starts when women are in their 40s and can catch many off guard, Harvey said.

“I do think that a lot of that comes from the fact that women are still not being educated, they’re not being counselled, they don’t understand the impact of our changing biology with age that puts them at cardiovascular risk.”

Heart disease kills 5 times more women than breast cancer

According to the Canadian Women’s Heart Health Centre, at the University of Ottawa Heart Institute, 24,000 Canadian women die of heart disease every year. That’s nearly five times more deaths than from breast cancer. 

Yet when it comes to heart health, experts say it’s still largely a man’s world: Women remain underdiagnosed, undertreated and unaware.

Karin Humphries, an associate professor at UBC, studies the ways in which gender and sex differences can affect the diagnosis, treatment and outcomes of people with cardiovascular disease. (Submitted by Jessica Weingarten)

“It is a glass ceiling. It’s a glass ceiling for awareness, it’s a glass ceiling for research and for how we provide care,” said Karin Humphries, an associate professor at the University of British Columbia whose has researched gender and sex differences in the diagnosis, treatment and outcomes of patients with cardiovascular disease.

The basic medical model is still male-dominated and contributes to a general lack of awareness among women and health-care providers, Humphries said. And while awareness is growing, it’s not growing fast enough, she said.

“Everything in our culture emphasizes that cardiovascular disease is a man’s disease. I mean, think of Hollywood. Every time you see a heart attack, it’s on the male, right? You’re not watching a woman in a Hollywood movie having a heart attack.”

Heart attack symptoms more subtle in women

Part of the problem is that women’s symptoms can be different than those of men and can be attributed by both doctors and women themselves to stress and busy lives. For example, months before a heart attack, women may experience unusual fatigue, trouble sleeping, indigestion and anxiety. 

Even during a heart attack, the symptoms can be subtle. Women are more likely to have chest discomfort, shortness of breath and even neck, jaw or back pain.

Risa Mallory had subtle symptoms in the days preceding her heart attack four years ago. Then suddenly, the pain in her chest became severe. Cardiac research has found that women often present with different symptoms than men when having a heart attack. (Brenda Witmer/CBC)

“I was still, you know, two months after my event, still reeling from that shock,” said Risa Mallory, who had a heart attack four years ago at age 61.

Mallory had been experiencing discomfort in her chest for several days, she said, but it came and went and didn’t seem so bad — until it suddenly was.

“On the fourth day, I experienced chest pain. It had changed. It was much more severe. I was feeling nauseous and I had this sense of fight or flight,” she recalled. “I remember sitting in the car, rocking, and saying, ‘We gotta go, we gotta go, we gotta go.'”

Mallory ended up in the emergency room and got help in time. But it was a close call. Heart disease runs in her family, she was aware of her own risk, but she still almost missed the warning signs.

WATCH | Why heart disease is often missed in women: 

What women need to know about heart disease

3 days ago

Duration 8:37

A woman in Canada dies of heart disease every 22 minutes, and most don’t have to. CBC’s Ioanna Roumeliotis explores why so many women are underdiagnosed and what they can do to protect themselves.

That’s something that happens often, according to a 2018 Heart and Stroke Foundation report. The report found that early signs of a heart attack were missed in 78 per cent of women. 

“What it tells us is that there are still a lot of inequalities and biases at the community level and the health-care provider level,” said Dr. Thais Coutinho, a cardiologist and chair of the Canadian Women’s Heart Health Centre at the University of Ottawa Heart Institute. 

Many women are in the dark, Coutinho said, in large part because much of the medical community is too. 

Most cardiac research done with male patients

Even now, the majority of heart disease research is conducted on men — despite important physiological differences, she said. Women’s hearts and arteries are smaller, and plaque builds in different ways. Standard diagnostic tests like angiograms and stress tests are often not sensitive enough to detect heart disease in women. 

“That assumption still permeates through the cardiovascular research community that women are small men,” Coutinho said. “I do a lot of sex- and gender-based research, or women-specific cardiovascular research, and it’s amazing the differences that you find if you look. All of the gaps that we know exist from awareness, diagnosis, treatment, care, rehabilitation, education, everything — it starts with knowledge. 

“So if we don’t even know what the differences are, we don’t know how to manage them.”

‘There’s something wrong with my heart’

Samia Janna was 48 when she first went to her doctor in 2018 because of shortness of breath. The Ottawa-area woman was prescribed anti-anxiety medication and told to take it easy. But the symptoms persisted.

Janna went back to her doctor twice more, only to be given the same advice

“At that time, I said, ‘No, I know it’s not anxiety,'” Janna says. “I know myself. There’s something wrong with my heart.”

At 48, Samia Janna found herself experiencing shortness of breath. Her doctor dismissed it as anxiety, but when symptoms continued Janna advocated for herself. In fact, an ultrasound revealed that her heart was enlarged. (Brenda Witmer/CBC)

Blood tests didn’t flag anything, but Janna insisted on an ultrasound to check her heart. It revealed Janna’s heart was enlarged and causing damage to her heart valves. She ended up having two open heart surgeries.

Janna says it was hard to let go of her anger about the fact that her concerns were initially dismissed. She joined a cardiac rehabilitation program and says it helped her regain her physical and emotional strength. “If it wasn’t for them. I would have been in a different place now, in a very dark place.”

Female patients less likely to get cardiac rehab

Cardiac rehabilitation can be critical for physical and emotional recovery, studies show — but gaps exist there too.

Research finds women are up to 50 per cent less likely than men to attend cardiac rehab programs, often because they don’t get referred to one or face other barriers to follow-up care, including a tendency to minimize their own needs.

It helps explain why women who have a heart attack are more likely to die or experience a second heart attack compared to men. 

Diagnostic tests for heart disease were designed for men, which means angiograms and stress tests are not always sensitive enough to pick up heart disease when it presents in women. (Goodluz/Shutterstock)

Harvey says research is beginning to uncover the biological, medical, and social reasons for this — and the hope is that new knowledge will lead to advances in tailoring prevention and treatment to women’s needs. 

But she points out, 80 per cent of heart attacks can be prevented and women can decrease major risk factors by managing high blood pressure, not smoking and sticking to a healthy weight. Harvey says women should also urge their doctors to check their hearts.

“We need to be empowered,” she says. “Knowledge is power. Advocacy is power. And do what you can so that you are aware of cardiovascular risk.”

And though prevention is key, Humphries says women should not hesitate to get help if they feel something is wrong. 

“Call 911 and ask for help. Don’t worry about, you know, taking up time for health-care providers. They’re there to help you. And if you find out there’s nothing wrong with you, that’s wonderful. But absolutely do not hesitate and call 911.”

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COVID-19 lockdown linked to HIV spike among some drug users, study says – Global News

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A new study says reduced access to HIV services during early COVID-19 lockdowns in British Columbia was associated with a “sharp increase” in HIV transmission among some drug users.

The study by University of British Columbia researchers says that while reduced social interaction during the March-May 2020 lockdown worked to reduce HIV transmission, that may not have “outweighed” the increase caused by reduced access to services.

Read more:

Are COVID-19 sniffer dogs more accurate than rapid tests? A new study says yes

The study, published in Lancet Regional Health, found that fewer people started HIV antiretroviral therapy or undertook viral load testing under lockdown, while visits to overdose prevention services and safe consumption sites also decreased.

The overall number of new HIV diagnoses in B.C. continues a decades-long decline. But Dr. Jeffrey Joy, lead author of the report published on Friday, said he found a “surprising” spike in transmission among some drug users during lockdown.

Joy said transmission rates for such people had previously been fairly stable for about a decade.

“That’s because there’s been really good penetration of treatment and prevention services into those populations,” he said in an interview.

Read more:

Kelowna General Hospital embraces innovations in stroke care

B.C. was a global leader in epidemic monitoring, which means the results are likely applicable elsewhere, Joy said.

“We are uniquely positioned to find these things,” he said. “The reason that I thought it was important to do this study and get it out there is (because) it’s probably happening everywhere, but other places don’t monitor their HIV epidemic in the same way that we do.”

Rachel Miller, a co-author of the report, said health authorities need to consider innovative solutions so the measures “put in place to address one health crisis don’t inadvertently exacerbate another.”

“These services are the front-line defence in the fight against HIV/AIDS. Many of them faced disruptions, closures, capacity limits and other challenges,” Miller said in a news release.

“Maintaining access and engagement with HIV services is absolutely essential to preventing regression in epidemic control and unnecessary harm.”

The Health Ministry did not immediately respond to requests for comment.

Read more:

Long COVID-19 linked with autoimmune diseases, Canadian study shows

Researchers said the spike among “select groups” could be attributed to a combination of factors, including housing instability and diminished trust, increasing barriers for many people who normally receive HIV services.

British Columbia is set to become the first province in Canada to decriminalize the possession of small amounts of hard drugs in January, after receiving a temporary federal exemption in May.

Joy said this decision, alongside measures like safe supply and safe needle exchanges, will make a difference preventing similar issues in the future.

“The take-home message here is, in times of crisis and public health emergency or other crises, we need to support those really vulnerable populations more, not less,” he said.

“Minimally, we need to give them continuity and the access to their services that they depend on. Otherwise, it just leads to problems that can have long, long-term consequences.”

This report by The Canadian Press was first published Sept. 24, 2022.

© 2022 The Canadian Press

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