AS 2025 Kigali, Rwanda

Conference Report – Final Day 3

July 17, 2025

For comprehensive takeaways from the conference, visit:

IAS 2025 Society Takeaways

For other IAS updates, visit:

IAS 2025 Conference Updates

Key Session: Antiretroviral Therapy (ART)

The final day featured the most significant session on HIV medicines, focusing on antiretroviral therapy developments.

Dr. Brenda Crabtree
Senior Researcher, HIV Clinic, Department of Infectious Diseases
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ)
Associate Professor, HIV Program, National Autonomous University of Mexico(UNAM)

Emerging HIV Medications Under Study

Promising Drugs Expected for Approval Next Year

  • Islatravir (ISL) – Available in daily or weekly oral formulations
  • Lenacapavir (LEN) – Available in both oral and injectable forms
  • ULO – Another investigational study drug

Long-Acting Treatment Options

  • Long-acting patches under development
  • Implantable formulations being studied
  • Encouraging results presented for two broadly neutralizing antibodies (bNABs)
  • Various immunologic, non-drug therapies that can complement traditional antiretroviral treatments

Current ART Management Considerations

Challenges in Aging HIV Population

The aging HIV population faces increased risk of drug-drug interactions due to:

  • Multiple comorbidities
  • Polypharmacy (multiple medications)

Treatment Optimization Strategies

Switch to medicines with:

  • Fewer pills required
  • Reduced side effects

Medication Review Protocol

At every medical appointment, review:

  • Complete medicine list
  • Opportunities for regimen simplification (fewer medicines)
  • Potential drug interactions and side effects
  • Mineral and supplement interactions

Important Drug Interactions

  • Integrase inhibitors interact with minerals (magnesium, calcium, iron), potentially impairing absorption
    • Management: Separate HIV medication from supplements by 2-4 hours to allow stomach emptying
  • Metformin levels increase with certain antiretrovirals (common diabetes medication)
    • Action: Patients should consult their provider if taking metformin

Promising ARV Combinations Under Investigation

Oral Combinations for Treatment Switching

For patients already virally suppressed seeking simplified regimens:

Daily Options:

  • Islatravir + doravirine (single pill)

Weekly Options:

  • Islatravir + lenacapavir

Extended-Dosing Formulations

  • Islatravir (pro-drug) being developed for three-month dosing in combination with lenacapavir
  • Patches: Two-month and four-month formulations under study
  • Injectable regimens: Every 2-, 4-, and 6-month dosing schedules being investigated
  • LEN study: Yearly dosing (PURPOSE-365 study)

Broadly Neutralizing Antibodies (bNABs)

Combination therapies featuring:

  • Teropavirmab (TAB)
  • Zinlirvimab (ZAB)

Expected Approvals

  • Islatravir – Look for approval next year
  • Cabenuva© – Extended dosing (every 4 months) expected for approval next yea

Future Directions: Immunologic Treatments

Promising Approaches Under Study

The path to an HIV cure will likely require multiple treatment approaches, including:

  • HIV immunological control
  • Broadly neutralizing antibodies (bNABs)
  • NK cell therapies
  • CAR-T cell therapy for HIV remission

Note: These immunologic treatments represent cutting-edge research with potential for achieving HIV remission through innovative therapeutic strategies.