{"id":9596,"date":"2020-03-16T07:42:30","date_gmt":"2020-03-16T11:42:30","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=9596"},"modified":"2020-10-27T16:37:17","modified_gmt":"2020-10-27T20:37:17","slug":"difficult-times-meaning-no-croi-really-rapid-review-2020","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/difficult-times-meaning-no-croi-really-rapid-review-2020\/2020\/03\/16\/","title":{"rendered":"Difficult Times &#8212; Meaning No CROI Really Rapid Review 2020"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2020\/03\/Screen-Shot-2020-03-15-at-10.35.15-PM.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-9598\" src=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2020\/03\/Screen-Shot-2020-03-15-at-10.35.15-PM.png\" alt=\"\" width=\"361\" height=\"160\" srcset=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2020\/03\/Screen-Shot-2020-03-15-at-10.35.15-PM.png 361w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2020\/03\/Screen-Shot-2020-03-15-at-10.35.15-PM-300x133.png 300w\" sizes=\"auto, (max-width: 361px) 100vw, 361px\" \/><\/a>In a usual year, right about now, I&#8217;d be obsessed with two things:<\/p>\n<ul>\n<li><strong>What were the most practice-changing studies presented at the <a href=\"https:\/\/www.croiconference.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">Conference on Retroviruses and Opportunistic Infections<\/a>, or CROI?<\/strong> I&#8217;d want to summarize those for a patented, copyright-protected, check-with-my-lawyer-before-copying, <a href=\"https:\/\/blogs.nejm.org\/hiv-id-observations?s=really+rapid+review&amp;fulltext=really+rapid+review&amp;searchPointer=This+Blog\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>Really Rapid Review\u00a9\u00ae.<\/strong><\/a><\/li>\n<li><strong>How will the upcoming baseball season play out?<\/strong> Most readers here don&#8217;t care, I concede. Oh well, we all have our enthusiasms.<\/li>\n<\/ul>\n<p>But this isn&#8217;t a usual year, especially not for us specialists in Infectious Diseases.<\/p>\n<p>Baseball is on hold for now, thank you coronavirus &#8212; they say two weeks, but everyone knows it will be longer. Who knows.<\/p>\n<p>As for CROI? Due to some remarkable sleight of hand, at the last minute it became a virtual meeting, with <a href=\"https:\/\/www.croiconference.org\/electronic-materials-and-evaluations\" target=\"_blank\" rel=\"noopener noreferrer\">research and plenaries presented online<\/a>. The\u00a0 planners moderated the sessions in place right here in Boston &#8212; but no one attended live.<\/p>\n<p>I thought about writing a Really Rapid Review\u00a9\u00ae on this electronic CROI.<\/p>\n<p>But I was so distracted by COVID-19 activities that it was tricky. (Ok. Impossible.) Today I concluded that the product wouldn&#8217;t meet the high standards of those who read this site regularly, for which you have my sincere gratitude.<\/p>\n<p>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 &#8212; how often do we see randomized clinical trials in pregnant women with HIV?<\/p>\n<p>(HARDLY EVER. There, I answered.)<\/p>\n<p>It&#8217;s called <a href=\"http:\/\/www.croiconference.org\/sessions\/safety-and-efficacy-dtg-vs-efv-and-tdf-vs-taf-pregnancy-impaact-2010-trial\" target=\"_blank\" rel=\"noopener noreferrer\">IMPAACT 2010.<\/a> And with the disclosure that I&#8217;m a (relatively unimportant) co-investigator on the study, and obviously some disappointment that it didn&#8217;t get the attention it deserved, here&#8217;s a take-home message &#8212; DTG + TAF\/FTC may well be the best regimen for treatment-naive pregnant women.<\/p>\n<blockquote class=\"twitter-tweet\" data-width=\"500\" data-dnt=\"true\">\n<p lang=\"en\" dir=\"ltr\">Important, practice-changing RCT presented a <a href=\"https:\/\/twitter.com\/hashtag\/CROI2020?src=hash&amp;ref_src=twsrc%5Etfw\">#CROI2020<\/a> on Rx of HIV in pregnancy. Take-homes:<br \/>&#8211; DTG superior to EFV in viral suppression<br \/>&#8211; TAF\/FTC+DTG best for adverse pregnancy outcomes<br \/>&#8211; Weight gain most with TAF\/FTC+DTG; closest to rec wt changes <a href=\"https:\/\/twitter.com\/IMPAACTNetwork?ref_src=twsrc%5Etfw\">@IMPAACTNetwork<\/a> <a href=\"https:\/\/t.co\/6mNWstFbVX\">pic.twitter.com\/6mNWstFbVX<\/a><\/p>\n<p>&mdash; Paul Sax (@PaulSaxMD) <a href=\"https:\/\/twitter.com\/PaulSaxMD\/status\/1237746008542461952?ref_src=twsrc%5Etfw\">March 11, 2020<\/a><\/p><\/blockquote>\n<p><script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script><\/p>\n<p>Meanwhile, if you want to know how your fellow ID doc feels right now, take it away Adi:<\/p>\n<blockquote class=\"twitter-tweet\" data-width=\"500\" data-dnt=\"true\">\n<p lang=\"en\" dir=\"ltr\">Medical professionals internally right now <a href=\"https:\/\/t.co\/vYlABMUycv\">pic.twitter.com\/vYlABMUycv<\/a><\/p>\n<p>&mdash; Adi (@IDdocAdi) <a href=\"https:\/\/twitter.com\/IDdocAdi\/status\/1239357085705539584?ref_src=twsrc%5Etfw\">March 16, 2020<\/a><\/p><\/blockquote>\n<p><script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script><\/p>\n<p>Thank you for your patience. And take care of yourself during this difficult time.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In a usual year, right about now, I&#8217;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&#8217;d want to summarize those for a patented, copyright-protected, check-with-my-lawyer-before-copying, Really Rapid Review\u00a9\u00ae. How will the upcoming baseball season play out? Most readers here don&#8217;t [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,4,5],"tags":[244,783],"class_list":["post-9596","post","type-post","status-publish","format-standard","hentry","category-health-care","category-hiv","category-infectious-diseases","tag-croi","tag-really-rapid-review"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/9596","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=9596"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/9596\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=9596"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=9596"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=9596"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}