Top Infectious Disease News of the Week—April 21, 2019

#5 Laszlo Majoros, MD, PhD: Rezafungin's Activity Against Candida Species

Rezafungin in an echinocandin that is in phase 3 development for the treatment of invasive Candida infections and candidemia. While the novel agent is reported to have excellent activity against Candida, limited data has been available on Candida species.

At the European Clinical Congress of Microbiology and Infectious Disease (ECCMID 2019), Contagion® spoke with László Majoros, MD, PhD, an associate professor of Medical Microbiology, at the University of Debrecen, in Hungary about his poster presentation on rezafungin’s activity against common and rare Candida species in vitro.

Watch the interview with Dr. Majoros here.

#4 Enforced Asymmetric Cell Division Could Boost Memory of CD8+ T Cells

New research suggests a strategy to manipulate T cell division could help CD8+ T cells remember how to fight off pathogens for an extended period of time.

Writing in Science Immunology, investigators from ETH Zurich say the strategy could have implications for cancer treatment and vaccine development.

After successfully fighting off disease, most CD8+ T cells simply die. Some, however, turn into memory T cells—long-lasting, self-renewing cells that are able to recognize and attack pathogens in subsequent infections. Although scientists have yet to fully understand the causes of T cell differentiation, they are beginning to learn more about asymmetric cell division (ACD). In ACD, memory T cells are divided and 2 daughter cells are produced. One daughter cell differentiates into an effector cell, and the other into a cell that shares key characteristics with memory cells. Specifically, this second category of daughter cell maintains “stemness,” the ability to produce diverse progeny.

Read about enforced asymmetric cell division.

#3 World Malaria Day 2019: New Innovations, Same Targets: Public Health Watch

On the eve of World Malaria Day 2019, there is, after several years of relative silence, some good news to report in the battle against the mosquito-borne disease.

As reported by the BBC on April 23, World Health Organization (WHO) officials have announced plans for a pilot study in Malawi of a new vaccine—called RTS,S—to significantly reduce the disease in children. The vaccine candidate contains the QS-21 Stimulon from Agenus, a potent adjuvant. Earlier, phase 3 studiesdemonstrated that the vaccine is up to 40% effective at protecting infants who receive it against the disease, according to the WHO.

The announcement comes at a key time in the fight against malaria globally, as well as in Africa. As experts from around the world gather at the Johns Hopkins Malaria Research Institute (JHMRI) in Baltimore, Maryland, for a scientific symposium entitled “Malaria Elimination in Africa” for the 13^th World Malaria Day on April 25, the challenges surrounding the disease remain significant.

Read about World Malaria Day 2019.

#2 Missed Doctor's Visits Are a Sign of Future PrEP Discontinuation

Retention of HIV pre-exposure prophylaxis (PrEP) is a challenge among diverse patient populations, and a recent study shows that missed doctor’s visits are associated with future discontinuation of treatment.

The study, published in the journal Open Forum Infectious Diseases, followed 364 individuals who were prescribed PrEP at the San Francisco Primary Care Clinics between July 2012 and August 2017. The study found that 16% discontinued PrEP before 90 days, 46% discontinued later, and 38% remained in treatment over 12 months.

“I think the biggest take-aways for my analysis are that only 38% of individuals remain on PrEP over a 1-year median observation time,” study author Matthew Spinelli, MD, of the University of California San Francisco’s Division of HIV, Infectious Diseases & Global Medicine, told Contagion^®. “I was surprised at how few people persisted on PrEP for more than a few months. Missing or no-showing a visit without cancelling in advance portends a 52% higher risk of stopping PrEP in the future in our adjusted model. Other groups, such as younger PrEP users, had higher risks of stopping, which is concerning given rising HIV incidence in younger US [men who have sex with men (MSM)] for instance.”

Read about signs of future PrEP discontinuation.

#1 Ben Berkhout, PhD: CRISPR-Cas Based Therapy for HIV

At the European Clinical Congress of Microbiology and Infectious Disease (ECCMID 2019), Contagion® spoke with Ben Berkhout, PhD, head of the laboratory in the Department of Medical Microbiology at AMC, University of Amsterdam, the Netherlands, about his symposium presentation on CRISPR-Cas9 as a new antiviral strategy for the eradication of HIV.

Interview transcript (modified slightly for readability):

Contagion®: What is the most important message that you tried to convey in your presentation?

Berkhout: Yeah there are I guess 2 messages, 1 of them is that indeed we are were able, after optimization of this CRISPR-Cas technology, to sterilize cell cultures in the laboratory from infectious HIV-1. By doing so, we actually discovered a novel mechanism, how the virus is inactivated, so that's nice for a scientist. But, of course, the main question is can we develop this a therapy. I can show great success in the laboratory, but talking about treating a patient's the first question, is where do we want to deliver this therapy? Where is this virus hiding? Actually, despite many years of research, we don't really know where this so-called HIV vulnerable reservoir is and there was a very prominent paper published 2 years ago in Nature by a group from France (Montpellier) and they published a new potential marker of this reservoir.

Watch the entire interview here.