Keynote Lecture

Chairs: M. Farinella, C. Mussini

Symposium

Virus persistence and host interactions

Antiretroviral therapy (ART) has gained a great deal of success in recent years and succeeded in suppressing viral replication in people infected with HIV. Nevertheless, infected cells persist for decades on ART and HIV-RNA comes back if ART is stopped. Persistence has been attributed to viral replication in cellular/anatomical reservoirs and long-lived and/or proliferating latently infected cells. This symposium aims at shedding light on the fine mechanisms of persistence of retroviruses and their cross-talk with the host immune system.

Chairs: G. Antonelli, P. Bagnarelli, S. Rusconi

Satellite Symposium

Fighting multi drug resistance - the right moment, the right drugs

Patients with Multi Drug Resistant (MDR) HIV infection and few residual antiretroviral options are very likely to experience progression of the disease and death. To address this important unmet need, new antiretroviral agents are needed with novel mechanisms of action, good safety profile, no drug-drug interactions and no cross-resistance to other HIV drugs. The Symposium will focus on new modes of action currently in development and share latest clinical data conducted so far with ibalizumab, a new humanized IgG4 monoclonal antibody which blocks the entry of HIV by non-competitive binding to CD4. The Italian experience with the use of ibalizumab will also be presented.

Chairs: C. Mussini, M. Zazzi

Keynote Lecture

Chairs: F. Ceccherini - Silberstein, A. De Rossi

Symposium

New metabolic challenges in comorbidities

HIV ad cART comorbidities are continuously changing their presentations, in parallel with the evolving spectrum of antiretroviral treatment regimens and the demographic and clinical features of people with HIV (PWH). At present, the current scenario of metabolic comorbidities seems to reflect, on one hand, the extended use of potent antiretroviral drugs with a very high safety profile, and, on another hand, the increasing age of PWH and the persisting immune activation. This symposium discusses emerging issues in the field, including prevalence and impact of these complications and explore the potential of old and new tools for their definition and management.

Chairs: A. Bandera, P. Bonfanti, F. Castelli

Sponsored Symposium

Streamline ART from the start: the novel approach of 2DR single pill regimen dolutegravir/lamivudine

Remarkable advances in drug development for the treatment of HIV-1 infection have been achieved in recent years. From the co-formulation of combination antiretroviral therapy (cART) into single-tablet regimens to the development new antiretroviral drugs, the treatment of HIV has and will become much more tolerable and less complicated for people living with HIV (PLWH). Moreover, there is a focus on reducing short- and long-term toxicities of treatment while maintaining robust efficacy and good tolerability. In this scenario, one of the most recently options considered is 2-drug regimen (2DR) containing highly effective ARV compounds while excluding components that have relatively unfavorable toxicity profiles, with the potential additional advantage to minimize antiretroviral medication burden for improving effectiveness. In this novel therapeutic context, the 2DR consisting of the INSTI dolutegravir (DTG) and the NRTI lamivudine (3TC), represents today the unique regimen extensively studied versus standard 3- or 4-drug regimens both in naïve and virologically suppressed patients. Aim of the symposium is to highlight important considerations for the use of 2DR single tablet DTG/3TC in the context of existing and emerging ARV options.

Chair: G. Rizzardini

Expert Meeting

Hepatitis C Elimination: the winning challenge of the 8-weeks treatment

Thanks to the DAAs, the WHO's goal of HCV elimination by 2030 could be achieved more easily. The high efficacy of these antiviral drugs, characterized by great power, few DDIs and short treatment make the patient's journey less onerous and heavy. Clinical trials and RWE data demonstrate not only the high SVR rate of the short therapies but also the improvement of adherence to the treatment. This last aspect is fundamental for the special populations (PWIDs and patients from SERD) because the briefer the therapy, the less burdensome it is for them. The Expert Meeting will focus precisely of the opportunity of the short therapy in the challenge against HCV. In this context, it represents an important step towards the efforts for eliminating the hepatitis C because it evaluates a brief antiviral regimen in untreated patients without cirrhosis and with compensated cirrhosis, across HCV genotypes 1-6. Through a talk show session, the two Professors will explain and convey the main data and results of this HCV turning point to the audience. The latter will be able to intervene in the session thanks to an interactive platform that will allow the physicians to answer the questions formulated by the speakers.

Oral Communications

Social Science

Chairs: G. Liuzzi, A. Matteelli, L.A.R. Rancilio

Oral Communications

Antiretroviral Therapy

Chairs: M. Malena, C. Torti

Oral Communications

HIV Prevention

Chairs: A. Bignardi, T.S. Prestileo, B. Suligoi

Meet the Expert

During these Sessions, participants will have the opportunity to informally discuss with top ICAR Experts and exchange with them personal views, receive practical insights about specific topics. Guided by Facilitators, these sessions represent an important opportunity for all delegates to sit down and converse on a more one-to-one level.

Chairs: M. Cascio, S. Mattioli

Keynote Lecture

Chairs: S. Di Giambenedetto, F. von Schloesser

Sponsored Symposium

POP ART (population on ART): from patient to personas A new approach to fulfill PLHIV expectations

The advent of the new antiretroviral drugs has permitted to obtain virological success in the majority of treated patients. This achievement has allowed the clinicians to focus on HRQoL (4th 90) to guarantee a long-term well-being. In this new context, populations defined by clinical conditions are now obsolete:  to achieve the 4th 90 goal we need to consider PLHIV lifestyles by moving from patient profile to personas concept. Each personas is different and has different expectations, therefore is crucial to contemplate all the key factors that contribute to obtain a better quality of life. In this evolving scenario, therapy still has a critical role in controlling the virus, but how can it fulfill doctors' and patients' needs to reach the HRQoL (4th 90)?

Chairs: A. d'Arminio Monforte, C.F. Perno

Symposium

Reaching out: same models for different infections

The first of the United Nations' 90-90-90 targets to end the HIV epidemic is for 90% of people living with HIV to learn their HIV status. HIV testing is therefore essential to achieving the first 90. The only way to determine a person's HIV status is for them to have an HIV test. What is the best way? HIV testing in healthcare services is the traditional approach. Good results have been accomplished through it but there are some obstacles as  limited access and usability of the healthcare structures and the difficulty of people to undergo the test in the hospital. In recent years, the Point of Care (POC) have been successful to overcome some difficulties and to make easier the access to the test especially for populations who showed reluctance to go to the hospital. The European POC has also created a network to facilitate access to the hospital and to make access to care simpler and faster. It already has the result to accelerate the United Nations' 90-90-90 campaign . Discussing and finding further solutions requires reflection on the experiences that have been carried out by NGOs. Looking for concrete collaborations and new intervention strategies between POC and hospital can bring us closer to the WHO objectives and reinforce the equation Undetectable = Untransmittable (U=U) message. There is an opportunity to improve prevention, testing services and ensure high-quality well-adhered treatment and care for all.

Chairs: B. Marchini, V. Puro, E. Vaccher

Keynote Lecture

Chairs: M. Galli, E. Girardi

Satellite Symposium

Committed globally to fight HIV and other severe infections

Since the introduction of cART there has been increased survival in HIV-infected persons, so nowadays it is important to answer to individual HIV patients needs, going beyond viral suppression, as antiretroviral therapy is a life-long commitment. Furthermore, with the availability of two or three drugs combinations is becoming more crucial the physician's role in choosing and adapting the ART to treat population living with HIV (PLWH) avoiding issues about adherence, potential drug-drug interactions, long-term toxicities given that the PLWH is ageing with increasing comorbidities such as osteoporosis, renal, cardiovascular, metabolic and liver diseases, which need additional drugs. The aim of the symposium is to examine how current antiretroviral agents may be better incorporated into management strategies in daily practice to benefit patient's individuality now and to preserve the future. In this changing scenario, is interesting to show how the well-known NNRTI rilpivirine (RPV) has remained central to several key therapeutic innovations due to its proven durable efficacy & tolerability that delivers multiple benefits for HIV patients. Furthermore, while the global genetic diversity of HIV poses a considerable scientific challenge, the symposium will be an opportunity to discuss on the lnfectivologists & pharma company's commitment to HIV and other infections vaccine research, aiming to address these problems.

Chair: C. Mussini

Symposium

Lights and shadows in HIV clinical research

Evidence based medicine relies on well conducted clinical trials and comprehensive cohort data to draw its indications. However, no experimental design is completely free of drawbacks and limitations. Therefore, the results of different clinical experiences must be read in a critical way understanding which is the right field of application. The problem is further complicated in a constantly expanding field as HIV/AIDS by the need to adequate outcomes and measures to newly defined goals. The symposium will offer a comprehensive discussion about all these critical aspects of clinical management of HIV/AIDS.

Chairs: P.M. Cinque, N. Gianotti, A. Gori

Oral Communications

Virology

Chairs: S. Menzo, M.C. Re

Satellite Symposium

Recent advances in the management of Gram positive infections: the evolving role of long acting therapy

Gram positive infections are a continuing challenge for clinicians: while classic pathogens still persist and evolve acquiring new mechanisms of resistance, new pathogens emerge with intrinsic multiple antibiotics resistance profiles, causing life-threatening infections as nosocomial pneumonia and intravascular device associated bloodstream infections. Not less important, the population at risk, i.e. elderly with multiple comorbidities or recipients of various foreign bodies, is increasing. New therapy options are required, with increased bactericidal activity and antibacterial spectrum that includes multiple resistant pathogens. Recently, the antimicrobial armamentarium has been enriched by a lipoglycopeptide with a very prolonged half-life (dalbavancin) enabling treatment with a single intravenous administration.  Pharmacokinetic profile and convenient single dosing make dalbavancin an interesting option for other serious Gram positive infections requiring prolonged treatment courses, for example bone infections, endocarditis and intravascular line associated infections. The aim of this workshop is to focus on new pharmacological, clinical and pharmacoeconomical data with dalbavancin in order to provide an up-to-date of the actual and potential future role of this options for serious Gram positive infections.

Chair: M. Tavio

Oral Communications

Comorbidities

Chairs: D. Francisci, G. Parruti

Oral Communications

Clinical Hepatitis and Coinfections

Chairs: G. Mazzola, T.A. Santantonio

Meet the Expert

During these Sessions, participants will have the opportunity to informally discuss with top ICAR Experts and exchange with them personal views, receive practical insights about specific topics. Guided by Facilitators, these sessions represent an important opportunity for all delegates to sit down and converse on a more one-to-one level.

Chairs: M. Breveglieri, S. Mattioli

Round Table

HIV in COVID-19 era: how to ensure quality of care and outpatient management

2020 has been so far very challenging for infectious disease specialists around the world especially for new coronavirus. The aim of the round table is to discuss how this emergency impacted on the outpatient management of HIV infected patients and, more generally, on their quality of care. Clinicians will talk about clinic experiences, recommendations and organizational models on management and security, diagnosis, screening, telemedicine while patients will relate about their perception on the quality of care with a focus on PrEP and STI management.

Chairs: M. Andreoni, A.M. Cattelan

Satellite Symposium

HIV: understanding the real burdens of the disease

The today new standards of highly virologically effective antiretroviral regimens fully authorize clinicians to move the attention from pursuing viro-immunological outcomes, namely efficacy, to also considering in the clinical practice concrete strategies for preserving both quality of life and long-term well-being, namely effectiveness. Reducing all kind of medication burdens, both pharmacological and taking medicine ones, suggest a patient-centered approach.

Chair: C. Mussini

Symposium

Immune control over HIV reservoir

Despite full control over HIV replication by cART, HIV has been shown to persist in lymphoid tissues, and represent a major obstacle to HIV eradication. The symposium will review the major immunologic pathways behind immune control over HIV, alongside the distinguishing features of patients with progressive versus non-progressive disease.

Chairs: A. Caruso, M.S. Clerici, L. Sarmati

Symposium

Challenges in PrEP implementation and TasP confidence

Pre-exposure prophylaxis (PreP) for HIV has proven effective in reducing the number of new infections in several trials and in different settings, while treatment as prevention (TasP) is one of the major advancements in the HIV field, becoming a major argument for supporting both the universal treatment and test and treatment strategies. However, issues are arising in PreP implementation in clinical practice, while the trust in TasP may be challenging when it comes to the real world, as both patients and clinicians may have different interpretations, expectations and confidence.

Chairs: S. Maugeri, D. Ripamonti, L. Sighinolfi

Symposium

HIV and Coinfections: new challenges for 2020

In the last years the control of HIV replication  obtained excellent results with more than 90% of patients being undetectable. However, clinical challenges in the management of HIV infected patients still remain, such as the presence of co-infections with viruses such as HBV and HPV, both involved in cancer development, as well as with tuberculosis. The symposium will focus on such pathogens, discussing the challenges in terms of clinical history, diagnosis and treatment.

Chairs: R. Bruno, M. Stagnitta, G. Taliani

Oral Communications

Basic Science and Immunology

Chairs: C. Agrati, C.M. Mastroianni

Expert Meeting

Enhancing care for people living with HIV: current and future of monitoring approaches

The most significant advance in the medical management of HIV-1 infection has been the treatment of patients with antiretroviral (ART) drugs, which can suppress HIV-1 replication to undetectable levels. Despite this HIV cannot currently be eradicated from the body, and antiretroviral treatment thus has to be indefinitely maintained. People living with HIV will have to go a long way and only CD4+ lymphocytes count and HIV-RNA load will not be able to adequately inform the doctor and the researcher about the real benefit of the ART. New approaches need to be defined for monitoring people with HIV infection, including clinical, virological, immunological parameters and also the point of view of people living with HIV. The purpose of this Expert Meeting is to highlight the evidence on different biomarkers or innovative approach use in research and clinical settings, to better define the management of HIV infection.

Chairs: A. Di Biagio, F. Maggiolo

Oral Communications

Clinical HIV

Chairs: A. Calcagno, M.C. Moioli

Expert Meeting

Urgent global challenges in infectious diseases: fight together against HIV and AMR

The objective of this expert meeting is to give an update on the current global health challenges in infectious diseases, giving a clear picture on how HIV and AMR are impacting our country and patients' life. Prevention and protection of future generations is becoming increasingly important in HIV: awareness, innovative drugs and quality of life are essential to ensure the achievement of Global UNAIDS objectives. Together with HIV, the fight against drug resistance is a priority at worldwide level with Antimicrobial resistance (AMR) as the most important infectious disease threat of our time. The impact of AMR on patients' life creates the need to accelerate the fight in hospital setting and to ensure the dissemination of strategies and tools for an appropriate management.

Chair: G. Di Perri

Meet the Expert

During these Sessions, participants will have the opportunity to informally discuss with top ICAR Experts and exchange with them personal views, receive practical insights about specific topics. Guided by Facilitators, these sessions represent an important opportunity for all delegates to sit down and converse on a more one-to-one level.

Chairs: D. Calzavara, S. Mattioli

Symposium

The Fast-Track Cities initiative and the Italian state of the art

The Fast-Track Cities initiative is a global partnership between cities and municipalities around the world and four core partners - the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Human Settlements Programme (UN-Habitat), and the City of Paris. Launched on World AIDS Day 2014, the network has grown to include more than 300 cities and municipalities that are committed to attain the UNAIDS 90-90-90 targets by 2020. The aim of the symposium is to discuss the global initiatives and to focus on the Italian Fast-Track Cities state of the art, in a round table involving the different Italian Fast-Track Cities' stakeholders.

Chair: B. Audoin

Discussants: A. d'Arminio Monforte, M.R. Iardino

Special event

Special Session on HIV and COVID in Italy

Chairs: G. Angarano, E. Vicenzi

Symposium

ART treatment: when the patient's journey becomes difficult

The high efficacy and tolerability of antiretroviral drugs nowadays available might give the impression that treating HIV infection is today an easy task. That could even be true in a fairly large proportion of patients but, as in every population, ties exist and these extremes of the Gaussian curve are the challenging patients. The symposium will offer a comprehensive overlook on different difficult to treat patients offering hints to an optimized clinical management in these specific situations. When the play gets tough, tough guys start to play.

Chairs: T. Bini, L. Calza, M. Cernuschi

Symposium

Proud to be women, proud to fight HIV

The efforts made so far in terms of controlling the HIV epidemic on a global level have left women behind compared to the achievement of the objectives set by the WHO. This is because a tailored approach specifically aimed at the female population is far from being applied both in terms of implementation of prevention tools and of clinical and psychological management of women. The objective of this symposium is to focus attention and reflect on peculiar aspects of women's health to ensure that this gap is quickly bridged.

Chairs: G. Lapadula, A. Moznich, G. Scarlatti

ICAR 2020 Special Awards

Chairs: M. Clementi, S. Mattioli, C. Mussini, G. Silvestri, M. Tavio

Closing remarks

Chairs: M. Clementi, S. Mattioli, C. Mussini, G. Silvestri, M. Tavio

Oral Communications

Immunopathogenesis

Chairs: M. Nasi, G. Nunnari

Oral Communications

Hepatitis and Clinical Virology

Chairs: N. Coppola, G. Verucchi

Oral Communications

Social Science and Epidemiology

Chairs: A. Franco, M. Manfredini, G. Orofino

Oral Communications

Pharmacology

Chairs: S. Bonora, C. Gervasoni