Between 27 and 30 November, the GeSIDA National Congress 2022, was held in Sitges and brought together experts who research in the field of the fight against AIDS. On this occasion, Dr. María José Buzón, co-head of the Infectious Diseases group at Vall d'Hebron Research Institute (VHIR), has been the co-chair for the organization of the sessions that incorporate the advances and knowledge generated in the area of HIV infection.

Throughout the week, numerous basic and clinical research projects have been presented, including researchers from Infectious Diseases group at VHIR.

In the field of basic research, Ana Gallego has presented an oral poster focused on the development of an intestinal explant model to study strategies targeting HIV reservoirs. The creation of these models is important due to the lack of samples from people with HIV and for this purpose explants from uninfected donors have been used. This system will be useful to evaluate the impact of infection on the immune system, the identification of the cellular reservoir of HIV and the action of agents to reactivate latent HIV and promote the elimination of the virus by drugs or the immune system itself. The study has been funded by La Caixa Foundation and directed by Dr. Buzón.

In an oral poster, David Perea, predoctoral student in Dr. Buzón's group, presented the results of his work on the characterization of Natural Killer (NK) cells resident in tissues usually involved in the persistence of HIV, such as the tonsils or the intestine. The research, funded by the Ministry of Science and Innovation, shows that each tissue has different subtypes and distributions of these cells and that, in addition, they may play an important role in the control of HIV in lymphoid tissue. Therefore, strategies related to NK expansion could be useful for the development of targeted therapies in the main tissues of HIV persistence.

The thematic poster by Nerea Sánchez, a predoctoral student in Dr. Buzón's group, summarizes the work carried out in relation to the loss of control of elite controllers, i.e. people who spontaneously control the infection, but lose this ability. Specifically, the researchers have identified changes in NK cells that could be related to this loss of control. Understanding the mechanisms by which this happens may be relevant for the development of new therapies.

Cristina Mancebo's project, presented as a poster, has studied immunological biomarkers associated with anal dysplasia in people living with HIV. Early detection of anal lesions is essential to prevent the development of anal cancer. The work has shown that there is a complex immunological environment in these lesions and that neutrophil infiltration could be a biomarker associated with the degree of dysplasia. This study has been led by Dr. Joaquín Burgos and Dr. Meritxell Genescà.

Dr. Daan Pieren has presented an oral poster with the study of the mechanisms by which a primary sexually transmitted infection increases the risk of subsequent HIV infection. The work shows that a type of immature myeloid cells can have a suppressive effect on the immune system in the face of a primary infection. For this work, led by Dr. Genescà thanks to a grant from the Marató de TV3, the collaboration with medical staff at Drassanes-Vall d'Hebron has been essential to obtain patient samples.

On the clinical research side, the work presented by Dr. Patricia Álvarez analyzed the number of new HIV diagnoses, the stage of infection at diagnosis and the time to specialized care and initiation of treatment. It was noted that centers specializing in care for sexually transmitted infections such as Drassanes-Vall d'Hebron are essential for the diagnosis of HIV as they allow a greater number of patients to be detected and earlier compared to other centers.

Dr. Alvarez also presented the results of a study that analyzed the characteristics of patients with urethritis caused by Mycoplasma genitalium and the cure rates with azithromycin and moxifloxacin. Through the study of more than 500 patients treated at Drassanes-Vall d'Hebron, a high failure rate was found when azithromycin was administered to men who had sex with men because they had an infection resistant to this treatment. Therefore, they recommend moxifloxacin as the first line of treatment.
On the other hand, Dr. Paula Suanzes described in her presentation the characteristics of a cohort of patients with acute HIV infection and the evaluation of immunological recovery and suppression of the virus after starting antiretroviral treatment. The work confirmed that immune recovery is better the earlier therapy is initiated.

In a second paper, Dr. Suanzes also showed the results of a clinical trial on cytomegalovirus (CMV) disease in patients with advanced HIV infection. It was found that, although the incidence of CMV disease in HIV patients is low, the level of CMV in the blood is associated with a higher degree of immunosuppression.

Finally, in a project presented by Dr. Vicente Descalzo, the clinical and epidemiological characteristics of patients with a first HIV infection in Drassanes-Vall d'Hebron after the implementation of pre-exposure prophylaxis (PrEP) were described. It was seen that one in three new diagnoses was a first infection and almost half of them occurred at a PrEP visit and allowed rapid initiation of antiretroviral therapy.