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  IAS 2019: Conference on HIV Pathogenesis
Treatment and Prevention
Mexico City
July 21-24 2019
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HPTN 078: Primary results of a randomized study to engage men who have sex with men (MSM) living with HIV who are virally unsuppressed in the USA
  IAS: Out-of-Care HIV+ US MSM Will Resume Treatment, But Only Half Control HIV in 12 Months - (07/26/19)
More than 90% US men who have sex with men (MSM) with HIV and out of care with a detectable viral load returned to care in the HPTN 078 trial [1]. But only half who resumed treatment had a viral load below 200 copies after 12 months, regardless of whether randomized to enhanced case management or standard of care. Most enrolled people (81%) had some form of health coverage, yet 35% had syphilis and 15% had a positive HCV antibody test. Most participants (84%) were black, and most (90%) had more than a high-school education. Two thirds had an annual income below $20,000.
Toward those ends, HPTN 078 used deep-chain respondent-driven sampling and direct recruitment to identify MSM living with detectable HIV in four US cities-- Atlanta, Birmingham, Baltimore, and Boston. Researchers randomized them to enhanced case management for linkage and treatment or to standard care.
After 12 months, 42% in the enhanced case-management arm and 54% in the standard-of-care arm had a viral load below 200 copies, a nonsignificant difference (odds ratio 0.615, 95% confidence interval 0.315 to 1.197, P = 0.1526). The proportion of people with a sub-200-copy load did improve slowly throughout follow-up: overall 28% at 3 months, 36% at 6 months, 39% at 9 months, and 48% at 12 months.
Reported by Jules Levin
10th IAS Conference on HIV Science (IAS 2019), July 21-24, 2019, Mexico City Chris Beyrer, Chair
Robert H. Remien, Co-Chair