Groundbreaking HIV studies unveiled at the International AIDS Society Conference on HIV Science in Kigali, Rwanda, are bringing new hope for safer and more tailored treatment for older adults living with HIV in Africa.
The three studies B/F/TAF, Sungura, and Twiga highlight critical gaps in HIV research involving adults aged 60 and above, a group often excluded from clinical studies despite their vulnerability to age-related illnesses such as kidney disease, diabetes, and osteoporosis.
The B/F/TAF study involved 520 older adults who had been on antiretroviral therapy for more than a decade. Participants either remained on the standard national regimen (TLD – Tenofovir disoproxil fumarate, Lamivudine, and Dolutegravir) or switched to a newer regimen (Bictegravir/Emtricitabine/Tenofovir alafenamide). Over 96 weeks, those on B/F/TAF showed improved kidney and bone health, with sustained viral suppression marking it as a safer option for older patients. However, because B/F/TAF is not yet included in Kenya’s national treatment program, researchers faced an ethical challenge in reverting patients to potentially harmful regimens.
To address this, the Sungura study followed 197 of these participants on a dual-drug regimen Dolutegravir and Lamivudine (DTG/3TC). Early results showed strong viral control and zero treatment failures, suggesting simplified dual therapy may be effective for older patients. However, it also revealed many participants had prior exposure to Hepatitis B (HBV), raising concerns about the regimen’s HBV coverage and highlighting the need for expanded HBV testing and vaccination.
The third study, Twiga, is tracking comorbidities among older HIV-positive and HIV-negative adults over five years. Early findings show that older people living with HIV face higher risks of kidney impairment, medication burden, and osteoporosis than their HIV-negative peers.
Run in collaboration with Kenya’s Ministry of Health, Kenyatta National Hospital, and other institutions, and supported by Gilead Sciences and ViiV Healthcare, the studies call for age-sensitive HIV care, revised treatment guidelines, and urgent investment in HBV screening and adult vaccination.
These findings are pivotal in reshaping HIV treatment for Africa’s ageing population, promoting care that is both effective and safe.
