{"id":760,"date":"2010-02-28T07:11:59","date_gmt":"2010-02-28T12:11:59","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=760"},"modified":"2015-06-04T15:25:43","modified_gmt":"2015-06-04T19:25:43","slug":"croi-2010-recap-no-obvious-blockbusters-but","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/croi-2010-recap-no-obvious-blockbusters-but\/2010\/02\/28\/","title":{"rendered":"CROI 2010 Recap: No Obvious Blockbusters, But &#8230;"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-761\" title=\"Croi2010\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2010\/02\/Croi201021.jpg\" alt=\"Croi2010\" width=\"120\" height=\"129\" \/>Ok, I&#8217;ll admit it &#8212; I didn&#8217;t see any studies presented at CROI this year that will immediately transform HIV care on a day-to-day basis. \u00a0Nothing that will alter practice\u00a0<em>right now<\/em>.<\/p>\n<p>Nothing like last year&#8217;s\u00a0<a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/360\/18\/1815\" target=\"_blank\">NA-ACCORD<\/a>, or 2008&#8217;s surprising\u00a0<a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(08)60423-7\/abstract\" target=\"_blank\">DAD study<\/a>, or 2007&#8217;s\u00a0<a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/359\/4\/339\" target=\"_blank\">raltegravir studies<\/a>, to name a few recent examples.<\/p>\n<p>(All subsequently published, of course &#8212; links are to the papers.)<\/p>\n<p>Still, as usual, lots to think about:<\/p>\n<ul>\n<li>Does expanded HIV treatment\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/38232.htm\" target=\"_blank\">reduce new infections?<\/a> Maybe &#8230;<\/li>\n<li>Could the rest of the country\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/38192.htm\">expand HIV testing<\/a> and linkage to care the way they have done in Washington, D.C.? \u00a0Wow, those are impressive data.<\/li>\n<li>Can a\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/39864.htm\" target=\"_blank\">4-drug-in-one pill treatment<\/a> compete with what we have, or will have? \u00a0You decide.<\/li>\n<li>Is boosted atazanavir as good as efavirenz? \u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/39789.htm\" target=\"_blank\">Seems so<\/a>.<\/li>\n<li>What are the long-term consequences of these changes in\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/39775.htm\" target=\"_blank\">renal function<\/a> or\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/37582.htm\" target=\"_blank\">bone health?<\/a> The \u00a0extent to which our treatments accelerate aging remains a major open question.<\/li>\n<li>Is there any doubt that letting the CD4 cell count fall\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/37156.htm\" target=\"_blank\">increases the risk of non-AIDS complications?<\/a> I don&#8217;t think so. \u00a0(Multiple other papers with similar findings.)<\/li>\n<li>Is tenofovir the only drug associated with renal dysfunction? \u00a0Not according to\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/39775.htm\" target=\"_blank\">this study.<\/a><\/li>\n<li>Could there be a (broader) role for a CCR5 antagonist? \u00a0Especially one that is\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/37579.htm\" target=\"_blank\">once-daily and does not require boosting?<\/a> This drug looks promising, but\u00a0frankly I don&#8217;t see it unless a better tropism test can be worked out &#8212; or even better, if there&#8217;s some non-antiviral utility to these drugs, or (hope of hopes) they can be\u00a0<a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/360\/7\/692\" target=\"_blank\">part of a &#8220;cure&#8221;<\/a>.<\/li>\n<li>Is &#8220;intensification&#8221; dead? \u00a0Maybe not, but it&#8217;s clearly on life support. \u00a0See studies with\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/39737.htm\" target=\"_blank\">raltegravir<\/a>,\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/39637.htm\" target=\"_blank\">maraviroc<\/a>, and\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/36915.htm\" target=\"_blank\">enfuvirtide<\/a> for the evidence.<\/li>\n<\/ul>\n<p>But just when we think we have it all figured out, there are these two excellent overviews of how we\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/39626.htm\" target=\"_blank\">neither have a cure for HIV (Maldarelli) <\/a> nor can we\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/39627.htm\" target=\"_blank\">treat all our patients successfully (Eron)<\/a>.<\/p>\n<p>These are great summaries of two remaining challenges in the field, and well-worth the web casts &#8212; which are viewable\u00a0<a href=\"http:\/\/www.retroconference.org\/2010\/data\/files\/webcast_2010.htm\" target=\"_blank\">here<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ok, I&#8217;ll admit it &#8212; I didn&#8217;t see any studies presented at CROI this year that will immediately transform HIV care on a day-to-day basis. \u00a0Nothing that will alter practice\u00a0right now. Nothing like last year&#8217;s\u00a0NA-ACCORD, or 2008&#8217;s surprising\u00a0DAD study, or 2007&#8217;s\u00a0raltegravir studies, to name a few recent examples. (All subsequently published, of course &#8212; links [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,5,10],"tags":[87,161,162,244,423,771,805,908],"class_list":["post-760","post","type-post","status-publish","format-standard","hentry","category-hiv","category-infectious-diseases","category-research","tag-atazanavir","tag-ccr5-antagonists","tag-cd4","tag-croi","tag-hiv","tag-quad","tag-retrovirus-conference","tag-tenofovir"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/760","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=760"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/760\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=760"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=760"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=760"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}