Episode 197: IAS Brazil 2026 Highlights

Let's start with HIV prevention.

What were some of the most important PrEP-related updates presented at IAS, and what should HIV care providers take away from those findings?

Yeah.

So thanks, Marianna.

You know, again, you know, this is the IAS meeting, so this is, this was in, in, in Brazil, um, in, in July.

But, uh, you know, hopefully this will be helpful for people.

I, I'm not covering everything.

There was a lot of information that was covered, but I'll, I'll top line some of the major things.

But, but there was a couple, I think, important, uh, updates for, for PrEP.

So, uh, obviously PrEP, HIV prevention, right, the pre-exposure prophylaxis.

Um, the, there was some data from the Purpose 1 and Purpose 2.

So for those of you who don't know, the Purpose 1 and Purpose 2, these were the, the, the data sets that looked at the approval of, uh, that led to the approval of lenacapavir.

And some of these have been published and, and they've had, you know, the f- the, the 52-week data, and now there's actually an open-label extension.

This, this is where people basically are allowed to kinda pick at the end of the study, like after the randomized blinded phase, they can say, you know, "What do you wanna go on? Do you wanna stay on your, your tablets, or do you wanna go on, on injections?" And the vast majority of people actually went on injections in both the Purpose 1 and the Purpose 2 studies.

So the vast majority of those people stayed on injections and switched to injections in that open-label extension.

And the open-label extension period was f- 52 weeks after the end of the randomization period.

So after they, after they'd been randomized and they completed their 52 weeks there, they had another 52 weeks of the open-label extension.

All right? So that's kinda how they do it.

In the Purpose 1, there was no new infections in the open-label extension.

And remember, Purpose 1, that was all the, a- all done outside of the United States, all done in women, um, and many of whom were actually young adolescent women as well.

Uh, in the Purpose 2 study, those, that was the kinda the more, more diverse population.

Um, and there was one additional study, uh, study patient who developed, uh, acquired HIV at 39 weeks into the open-label extension.

So this is into the open-label extension at week 39, this person acquired HIV.

Their viral load at diagnosis to, was 243,000, uh, copies.

Uh, um, however, the antigen antibody test was not reactive, but the viral load was.