February 19th, 2017

Really Rapid Review — CROI 2017, Seattle

The Conference on Retroviruses and Opportunistic Infections (CROI) returned to Seattle this past week for its 24th meeting. It’s the 4th time CROI has been held in Seattle, an excellent city for a meeting of this size, which includes “only” 4200 people. The convention center is pleasant and user-friendly — big but not cavernous, actually encourages interactions with colleagues — and there are numerous hotels and restaurants within walking distance, plus more Starbucks per square foot than any place on the planet.

From a content perspective, the big change for CROI 2017 was the return of numerous studies on antiretroviral therapy, studies involving both approved and investigational agents. The last several years, by contrast, had relative dominance of pre-exposure prophylaxis and hepatitis C studies. With PrEP, one had the sense at the meeting that we’re now waiting for the next strategies (long-acting injectables, for example).

As for hepatitis C, well that’s been all but solved (except for the implementation part). How do you improve on 97%-plus cured. Hooray!

On to the summary, a Really Rapid Review™ of the most interesting studies at the conference (at least from one perspective, ahem). Links are to the conference website (as usual excellent), abstract #’s are in brackets, and be sure to check out some of the oral presentations here. The list is roughly organized into epidemiology/prevention, treatment, cure, and opportunistic infections. Please tell me what I missed in the comments section.

And, because I was involved in a few of the studies listed below, for full disclosure I’ve inserted a special Puppy text emoticon to draw attention to that fact. ੯ੁૂ‧̀͡u  (Make sure you click on them. Woof.)

If you’re interested in watching webcasts of interesting plenary or symposium talks, I can strongly recommend Demetre Daskalakis on ending the HIV epidemic in NYC (he has more energy than the rest of the 4199 CROI attendees combined), Charlie Flexner on long-acting ART (he dispelled several “myths”), and Carl June on how cellular treatments of cancer might apply to the HIV cure effort.

One caveat to this last talk is that Dr. June neglected to mention that there’s huge difference in acceptable risk between someone with refractory metastatic cancer versus stable HIV infection. So I’m mentioning it for him.

You’re welcome.

See you at next year’s CROI in Boston!

8 Responses to “Really Rapid Review — CROI 2017, Seattle”

  1. susan Larrabee says:

    Thanks for confirming my recommendation to our HIV psychiatrist, John Grimaldi, MD We need to be prescribing way more puppies to people with depression, regardless of ART regimen. 🙂

  2. Nicolás Merchante says:

    Thanks for an excelent review !

    I missed a comment of our study [abstract 139] assessing the possible associations between DAA use and the risk of hepatocellular carcinoma in HIV/HCV-coinfected patients. We found that the frequency of HCC after SVR has not increased with widespread use (in contrast to previous alarming reports). On the other hand, the proportion of HCC cases after SVR (among the total cases of HCC) has increased in recent years, probably due to the fact that DAA have allowed treating patients at advances stages of liver disease in which the protective effect of SVR may be less marked. Of note, currently 1 out of 3 new diagnosis of HCC in coinfected patients is performed in patients with previous SVR.

    So, two main messages: 1) DAA does not seem to increase HCC risk (good news!) and 2) HCC surveillance should be maintained in cirrhotics after SVR, which are an emerging at-risk population for HCC.

  3. Loretta S says:

    Thanks, as always, Paul, for these great rapid reviews. Loved the puppies. Where’s Louie?

    One tiny correction: The American Ginseng study didn’t use a homeopathic preparation. They used standardized powdered AG root, an herbal remedy.

  4. Lenny Berkowitz says:

    Are they really going to make DOR/TDF/3TC? I think using TDF in any new product will make it far less popular.

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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