Interview with NCHIV speaker, Chloe Orkin

NCHIV speaker, Chloe Orkin is a professor of HIV medicine at Queen Mary University of London and consultant physician at the Royal London Hospital. She is also chair of the British HIV Association and vice-president of the Medical Women's Federation (UK). We recently spoke to Professor Orkin to find out a little more about her background, interests, and what she plans to talk about at NCHIV.

Chloe Orkin originally trained as a doctor in South Africa, where she first became interested in HIV. “The HIV prevalence on the medical wards was close to 40%, so I gained a lot of experience in looking after people with opportunistic infections, and I also had some friends who were HIV-positive”, she says. She subsequently moved to the UK to train and specialise in the field of HIV and now runs the busy HIV & HIV/ HCV clinical trials unit in London that she first set up 16 years ago.

At NCHIV, Prof. Orkin will deliver a plenary talk entitled ART: a changing landscape. According to Orkin, the key focus for antiretroviral therapy (ART) in the immediate future is to reduce the overall cumulative drug exposure over the course of a person’s life: “It’s something that both patients and clinicians are very interested in, either by reducing the number of drugs or the frequency of dosing, for example through injectables, implantables, or long-acting oral preparations. These are the key factors, along with the use of different non-oral technologies to deliver the antiretroviral therapy”.

But does reducing the number of drugs carry risks? Orkin believes not, saying that the results so far look very promising: “The studies with two-drug regimens are now well-known and have had very good outcomes.” 

We also asked Chloe Orkin what challenges she foresees with the implementation of long-acting ART. “The challenges are what to do if people miss injections, how to deal with the potential development of resistance, how to manage the cold-chain in resource-deprived settings, and working out who the ideal patient is for these regimens,” she says.

So who is the ideal person to receive long-acting ART? According to Orkin, there are not enough data available yet to recommend long-acting ART for anyone other than the trial population of people who adhere well to treatment. However, she believes it would be very interesting to look at the use of these formulations in adolescents and people who have poor adherence and who may not want to take oral therapy. “There are study plans to investigate this, but currently there are no data,” explains Orkin.

With the many different therapeutic modalities in development, Orkin believes we should be working to achieve the same situation for HIV treatment as we have today for contraception, where there’s an option for every person at different points of their life course. “People may want one option at one point and a different option at another,” she says.

We round off the interview by asking what it is about her work that she enjoys most. “What I enjoy most is continually pushing myself to deliver the newest and best therapy. It is important not to become complacent and accept that what we have is enough. I am always trying to find ways of improving quality of life and enjoy responding to what our patients want and need,” she answers with enthusiasm.