HIV and ID Observations

In a usual year, right about now, I’d be obsessed with two things:

• What were the most practice-changing studies presented at the Conference on Retroviruses and Opportunistic Infections, or CROI? I’d want to summarize those for a patented, copyright-protected, check-with-my-lawyer-before-copying, Really Rapid Review©®.
• How will the upcoming baseball season play out? Most readers here don’t care, I concede. Oh well, we all have our enthusiasms.

But this isn’t a usual year, especially not for us specialists in Infectious Diseases.

Baseball is on hold for now, thank you coronavirus — they say two weeks, but everyone knows it will be longer. Who knows.

As for CROI? Due to some remarkable sleight of hand, at the last minute it became a virtual meeting, with research and plenaries presented online. The  planners moderated the sessions in place right here in Boston — but no one attended live.

I thought about writing a Really Rapid Review©® on this electronic CROI.

But I was so distracted by COVID-19 activities that it was tricky. (Ok. Impossible.) Today I concluded that the product wouldn’t meet the high standards of those who read this site regularly, for which you have my sincere gratitude.

Meanwhile, you can take a look at this isolated citation from the conference. I do think it is the most important practice-changing study from CROI 2020 — how often do we see randomized clinical trials in pregnant women with HIV?

(HARDLY EVER. There, I answered.)

It’s called IMPAACT 2010. And with the disclosure that I’m a (relatively unimportant) co-investigator on the study, and obviously some disappointment that it didn’t get the attention it deserved, here’s a take-home message — DTG + TAF/FTC may well be the best regimen for treatment-naive pregnant women.

Important, practice-changing RCT presented a #CROI2020 on Rx of HIV in pregnancy. Take-homes:
– DTG superior to EFV in viral suppression
– TAF/FTC+DTG best for adverse pregnancy outcomes
– Weight gain most with TAF/FTC+DTG; closest to rec wt changes @IMPAACTNetwork pic.twitter.com/6mNWstFbVX

— Paul Sax (@PaulSaxMD) March 11, 2020

Meanwhile, if you want to know how your fellow ID doc feels right now, take it away Adi:

Medical professionals internally right now pic.twitter.com/vYlABMUycv

— Adi (@IDdocAdi) March 16, 2020

Thank you for your patience. And take care of yourself during this difficult time.