EACS 2025 – European AIDS Clinical Society Conference

Special ANRS MIE session with TRT-5 CHV

An ANRS MIE session, co-organised with the TRT-5 CHV, will be held on 17 October from 4.15pm to 5.15pm on the theme of ‘Global public health funding cuts: a new challenge for HIV in Africa’. TRT-5 CHV is a group of associations working to combat HIV, hepatitis and STIs, focusing on clinical research and therapeutic advances to defend the interests of those affected.

Focus on a few research projects

The use of lenacapavir in real life

Charlotte Charpentier, et al : A French national real-world survey of people initiating a lenacapavir-based treatment during the post-approval period

Lenacapavir, which is used in people living with HIV (PLHIV) harboring multidrug-resistant viruses, is the only capsid inhibitor on the market to date. Until now, no data were available on its use in real-world settings, with the exception of the early access programme in France.

Charlotte Charpentier’s team, in collaboration with other French research teams, conducted a real-world study. Its objective was to describe immunovirological characteristics and virological outcome in PLHIV initiating a lenacapavir-based treatment.

Findings from the survey show specificities compared to clinical trials. Unexpectedly, half of the 94 participants were virologically-suppressed at treatment initiation. In cases of failure, emergence of resistance was also lower.

Systematic molecular screening for Mpox

Jade Ghosn, et al : Systematic molecular screening for mpox in anal/pharyngeal swabs in high-risk MSM on PrEP: a substudy of the ANRS-DOXYVAC trial

Mpox, a zoonotic disease related to human smallpox, emerged in non-endemic countries in 2022, disproportionately affecting men who have sex with men (MSM). Recent data suggest that asymptomatic viral shedding may contribute to transmission dynamics. As shown by the ANRS-DOXYVAC cohort, the incidence rate is high (49.3 per 1,000 person-months) among MSM on pre-exposure prophylaxis (PrEP) with a history of sexually transmitted infections (STIs).

The aim of the ANRS-DOXYVAC trial sub-study, conducted by Jade Ghosn and hir fellow researchers, was to quantify the proportion of participants with asymptomatic Mpox shedding in anal or pharyngeal swabs, and to identify viral subtypes and transmission clusters.

Retrospective PCR tests for Mpox were conducted on 2,980 samples (1,451 anal and 1,529 pharyngeal swabs) collected quarterly between March 2022 and January 2023. The findings revealed the existence of asymptomatic carriage among high-risk MSM, with a prevalence of 8.4%. Asymptomatic carriers were significantly more likely to have been vaccinated against smallpox during childhood than symptomatic participants, highlighting that vaccine-induced immunity, while protecting against symptomatic forms, does not prevent asymptomatic viral shedding. Furthermore, the discovery of a large transmission cluster (13 cases) including 9 asymptomatic cases suggests that asymptomatic carriers play a crucial role in virus transmission chains. The next step in this project will be to study correlates of cellular immune response and Mpox virus-specific antibody kinetics.

Factors associated with loss to follow-up among PWH

Charlène Mafuta, et al : Factors associated with loss to follow-up among PWH-1: Analysis through linkage of the ANRS PRIMO, CODEX, and COPANA to the ANRS CO4 FHDH: the PDVCOH study

People living with HIV (PWH) who interrupt their medical follow-up are at increased risk of viral rebound. Identifying them is a major challenge, even in high-income countries.

The authors of the PDVCOH study linked three cohorts (ANRS PRIMO [HIV-1 primary infection], ANRS CODEX [HIV-1 controllers], and ANRS COPANA [recent HIV-1 diagnosis], to the national hospital cohort ANRS-CO4 FHDH (French Hospital Database on HIV Infection) in order to combine data from 2,935 PWH.

Their findings showed that migration background, unemployment and poor mental health were associated with an increased risk of loss to follow-up. This highlights the need for targeted support for vulnerable groups to promote long-term engagement in care.

 Sustainability of post-exposure prophylaxis with doxycycline

Jean-Michel Molina : Doxycycline prophylaxis to prevent bacterial STIs: Results of the open-label extension phase of the ANRS 174 DOXYVAC trial

Three randomised trials have demonstrated the effectiveness of post-exposure prophylaxis with doxycycline (DoxyPEP) on the incidence of bacterial sexually transmitted infections (STIs) in men who have sex with men (MSM) and transgender people using pre-exposure prophylaxis (PrEP) or living with HIV.

Jean-Michel Molina and the ANRS 174 DOXYVAC study group conducted an open-label extension study of the ANRS 174 DOXYVAC trial to evaluate the sustainability of this strategy in the post-randomisation phase, where all participants had access to DoxyPEP. The other objective was to study the effect of this approach on antimicrobial resistance (AMR) for Neisseria gonorrhoeae between the randomised and the open-label extension phase.

The results confirmed the sustained efficacy and excellent tolerability profile of DoxyPEP in reducing the incidence of STIs. In the initial DoxyPEP group, the incidence of STIs remained stable and low between the randomised and post-randomised phases. In the initial control group, the incidence of chlamydia, syphilis, and gonorrhoea decreased significantly after the introduction of DoxyPEP following the post-randomisation follow-up period. However, DoxyPEP was associated with the selection of Neisseria gonorrhoeae strains carrying tetM and PenA 34007 resistance markers (genes conferring resistance to tetracycline and to penicillin, respectively). Monitoring antimicrobial resistance is therefore essential during widespread use of DoxyPEP in people frequently exposed to STIs, both for gonorrhoea and other species of bacteria.

In addition, based on these results, the team plans to contribute to the development of recommendations aimed at influencing national and international guidelines on the use of DoxyPEP. They also prepared to explore ways of integrating this strategy into healthcare, which will require research into long-term patient adherence and the cost-effectiveness of the DoxyPEP approach.

Other events

Professor Yazdan Yazdanpanah, Director of the ANRS Emerging infectious diseases, will be taking part in a conference for the general public on HIV on 14 October from 4.30pm to 6.30pm at the Université Paris Cité. You can download the flyer below.

The EACS 2025 conference will close with a 5km run entitled ‘Living Free with HIV’ on 18 October, with the aim of combating HIV-related stigma and discrimination. More information below.

ANRS MIE Award for the best basic/translational research article on HIV

As part of the conference, the ANRS MIE prize honoring the best basic or translational research article on HIV was awarded on Thursday, 16 October 2025. This peer-reviewed award, worth €20,000, was given this year to Dr Philippe Schommers for his article entitled: ‘Dynamics and durability of HIV-1 neutralisation are determined by viral replication.’