Four Questions with Gilead’s Virology Clinical Research Team: Continuing to Pursue Transformational Innovation in HIV

AIDS 2020 – the first virtual International AIDS Conference – begins today, with HIV researchers and advocates from around the world coming together online to connect and share the latest scientific advancements in HIV/AIDS.

We recently caught up with Hal Martin, Moupali Das and Martin Rhee, executive directors of Virology Clinical Research, who work together and with their teams to advance the company’s HIV treatment and prevention development programs.

Read what they had to say about the science being presented at AIDS 2020, the importance of continuing to innovate and what lessons the AIDS epidemic offers amid the COVID-19 pandemic.

Q: The 23rd International AIDS Conference kicks off today and for the first time will be held in a virtual format. What are you looking forward to about this year’s event?
Hal: Holding the conference, even if only virtually, lends a sense of normalcy during a time that is anything but normal. It is important to see science moving forward and to show the world that science can indeed advance, even – and especially – during a time like this.

Martin: As always, I’m excited to learn about and contribute to the latest science in the field. What I look forward to the most at scientific meetings is the opportunity to meet people who are dedicated to ending the epidemic. I’m interested to see how the new virtual format will enable those interactions. 

Moupali: I would agree – one of my favorite parts of attending is reconnecting with colleagues, scientists, activists and friends from around the world. It will be interesting to see if we can use virtual networking and online chat to replicate those serendipitous hallway conversations that lead to a great idea for a study or a new collaboration with an investigator.

Q: What is Gilead sharing about its HIV development programs at IAS this year, and how have your teams continued to make progress on this work during the COVID-19 pandemic?
Martin: We’re very excited to share updates on both FDA-approved medications and investigational treatments. We will present data on lenacapavir (GS-6207), our investigational long-acting injectable treatment. Lenacapavir is designed to inhibit the capsid protein, which plays an essential role in HIV infection. Phase 1 trial results support further evaluation of a six-month dosing interval – which has the potential to offer people living with HIV the option to receive just two subcutaneous injections per year. We’re pleased with these early but promising results and looking forward to further clinical studies of lenacapavir. We will also share additional data from clinical studies of one of our approved HIV treatments in older adults and those with viral resistance – key populations that are growing as the number of older adults living with HIV increases.

Moupali: Regarding HIV prevention, we will share data about the impact on sexual behavior and the incidence of sexually transmitted infections (STIs) from the Phase 3 DISCOVER HIV pre-exposure prophylaxis (PrEP) trial, the largest PrEP study to date. The data show that there is no evidence of an increase in sexual risk behavior from baseline when individuals at risk take PrEP within the context of a clinical trial with routine counseling and asymptomatic STI testing. Moreover, STI rates actually decreased slightly from baseline, suggesting that engagement in PrEP offers opportunities to further engage individuals at risk for HIV in sexual healthcare.

Hal: Continuing work on these types of studies during the pandemic presents challenges. In most regions, clinical trial enrollment was stopped and is now slowly reopening. Disruption to our studies and access to care can influence engagement in HIV care at the individual, systemic and community level, threatening the progress made against HIV. We’ve looked for opportunities to consider innovative approaches to continue studying and advancing our research and development programs, such as setting up digital networks, using telehealth and leveraging at-home health services.

Q: Since the start of the AIDS epidemic, HIV has been transformed from a death sentence into a manageable chronic condition for most people. Why is it still important to continue pursuing innovative options for people living with or at risk for HIV, in addition to a cure?
Hal: We’ve demonstrated many times in the past that we won’t stop out-innovating ourselves to better address unmet and evolving needs in HIV. That is how we have reached a treatment paradigm in which most people can take one pill, once a day to manage their HIV or minimize their risk of acquiring HIV, and it’s how we will eventually help end the epidemic.

Martin: Our focus on long-acting regimens stems from listening to those who are living with or at risk of acquiring HIV. Many people have told us they want to be free from the burden and potential stigma of taking a daily pill. Long-acting regimens have the potential to help meet this need and provide an important option to help more people stay on treatment. Cure remains the ultimate long-term goal for our research and development efforts, – but science takes time. While we continue to make progress testing investigational curative regimens, it’s important that we keep listening to communities affected by HIV to understand their needs.

Moupali: In addition to our company’s heritage of scientific innovation, I’m proud of the work Gilead has done to make our medicines available in the developing world and address the epidemic in communities where its impact is most severe. We’re pleased to have contributed to tremendous progress in addressing HIV, but there is more work to be done. It’s important that we continue seeking new therapeutic options, but also find innovative ways to support the development and delivery of practical solutions that enhance care for people living with or at risk of acquiring HIV – regardless of where they live or their background.

Q: Some have drawn parallels between the AIDS epidemic and the COVID-19 pandemic. What key learnings can we take from the AIDS epidemic to help inform the response to COVID-19?
Martin: It’s easy to be fearful when facing something we don’t fully understand. We certainly saw that in the early days of AIDS, which colored the global reaction to the epidemic with fear, stigma and misinformation. It’s important to remain calm and patient, strive to understand this pandemic, and follow the science.

Hal: The biggest takeaway for me is that our actions can help end this pandemic. In any epidemic or pandemic, it’s important that we all listen to what our scientists and public health experts discover through research and observation, and act accordingly – especially while the world awaits more effective treatment options and vaccines.

Moupali: Infectious diseases track along the fault lines of social inequality. People living with or at risk of acquiring HIV are often disproportionately impacted by many other structural issues, including racism, stigma, health inequity, and poverty. Many of these issues place the same communities at risk of acquiring COVID-19, and if people in these communities become ill, they are at greater risk for a more severe disease course. The disparate impact of COVID-19 on Black people and other people of color has brought these fault lines in our society into sharp focus. Addressing these structural issues is essential as we seek to help people and communities impacted by COVID-19 – and by HIV.

Photo: Pictured from left to right are Hal Martin, Moupali Das and Martin Rhee.