As the final symposium of the Conference on Retroviruses and Opportunistic Infections (CROI) begins, and after hearing about all of the new research predominantly in HIV over the last 4 days, it’s hard not to wonder where it’s all pointing. Fortunately, one of the final symposia sought to provide an answer - ART: The Next 25 Years.
The general themes discussed at the conference would be to say that in general, we are doing quite well with controlling incidence of HIV in MSM in the developed world, the caveat being hot-spots of predominantly Black and Latinx men, or White guys who inject drugs. We’re not doing so well with women in general, particularly in the African setting, and the pregnancy/post-partum complex is perhaps more ominous that we’d initially thought. All of this is constructive, however, and allows us to check the temperature, so to speak, and re-evaluate our approaches to HIV management.
There is continuing controversy about the clinical effect of HIV in the brain. This session sought to examine the effects of cART, started early or not, on both the physical health of the brain and mental health of the patients.
The changes in management of Hepatitis C virus (HCV) has been an interesting and rewarding time for those of us who have treated patients that ultimately achieve sustained virological response (SVR) or ‘cure’, but there are still some tricky clinical situations that can cause some consternation, including infants and teenagers as the new face of HCV, how to manage an acute infection and what to do with resistant strains.
"Research without community is not good research": Dr Sharon L Hillier of the University of Pittsburgh says if we are to continue to make strides in the management of HIV and toward eradication then the research is going to have to include the communities affected by what she refers to not only as a chronic but a social disease.