Progress in fight against HIV with the emergence of injectable treatments and the challenge of personalised therapies

On the occasion of World AIDS Day, the HIV and Sexually Transmitted Infections Unit of the Infectious Diseases Service at Bellvitge Hospital - one of the pioneers and most prestigious in Catalonia - recalls that many of the current healthcare efforts are aimed at optimising and personalising treatments as well as improving the patients’ quality of life.

“Currently, HIV infection remains stable in the vast majority of patients," says Dr Arkaitz Imaz, a specialist in the HIV-STI Unit, "but these still suffer from many associated chronic comorbidities that have a major impact on their health and quality of life”. For this reason, he adds, it is important to keep making progress in treatment and deploying new strategies such as individualising care according to each patient’s needs.

A remarkable new development in therapies is the first injectable treatment for HIV, available today in Spain. The HIV and STI Unit at Bellvitge has participated in the clinical trials that have led to the development of this treatment, which combines the antiretroviral drugs cabotegravir and rilpivirine. Although it will only be available to a limited number of patients, Dr Imaz stresses it will be a significant improvement, as they will only have to come to the centre once every two months for treatment and will no longer have to worry about pills. This will allow them "to enjoy more flexibility, intimacy and ease of adherence, and will save them some stigmatisation problems". On the latter issue, Imaz regrets that, "forty years after the onset of the disease, people with HIV continue to suffer from stigma; this is a serious problem that needs to be addressed and solved at once”.

Other areas where progress needs to be made include the fact that there are still around 15% of patients who do not know they have the infection, and that 30-40% of patients arrive at the first visit at an advanced stage of the disease. “The challenge is to diagnose more and to diagnose earlier,” concludes Imaz. The HIV and STI Unit at Bellvitge also plays an important role in the field of research. In addition to participating in a large number of clinical trials of antiretroviral drugs, it develops its own lines of research, such as the pharmacokinetics of antiretroviral treatment in different anatomical compartments, the comorbidities of HIV with diseases such as cardiovascular pathology or cognitive impairment, or research into sexually transmitted infections and anal cancer associated with human papillomavirus. With the support of the Marató de TV3, it is also working on characterising the profile of patients who do not adhere to treatment and developing recovery strategies for patients who have stopped therapy.