Most Important HIV Research Reports from CROI 2015

From Jules Levin: perhaps the biggest stories out of CROI from my perspective are the development of 2 new HIV therapies – the new attachment inhibitor & the new maturation inhibitors, as well as the safety & efficacy of TAF, and an important message out of CROI is that TAF can also be used in HCV coinfected patients as a replacement for TDF in their ART regimen which will likely provide key safety improvements. Equally important are the HCV coinfection study results from Harvoni, daclatasvir+sofosbuvir, and Abbvie’s 3D Viekira Pak, and at CROI are a number of presentations on use of simeprevir+sofosbuvir as this therapy was the most potent HCV therapy available in 2014. Merck is in phase 3 with their 2 HCV drug regimen and developing a triple drug regimen with the study of the 2-drug regimen in combination with the nuke they acquired from Idenix. J&J is studying the nukes they acquired from Alios, they have GSK’s NS5A inhibitor, and they have a non-nuke polymerase in-house as well as simeprevir. Abbvie & Merck reported 2nd/3rd generation drugs at AASLD in pre & early clinical – protease, NS5A. Achillion reported high SVR rates in their early clinical studies with their potent nuke, potent NS5A & they have 2 protease inhibitors. Aging & comorbidities were a focus at CROI as well, particularly noteworthy is the research from the Mass General group reported again that subclinical heart disease is ever present in HIV+, that it can results in plaque buildup, particularly of note in HIV+ it results in non calcified plaque buildup which can rupture; they reported Atorvastatin reduced coronary artery noncalcified plaque and that plaque buildup is associated with a leaky gut, microbial translocation. Statins got quite a bit of attention with several reports including one from Grace McComsey that Rosuvaststin arrests progression of carotid intima media thickness in HIV+. Ken Lichtenstein reported the 4 heart disease algorithms underestimate risk for heart disease in HIV+ based on the SUN cohort. Bone disease is highlighted as well with Michael Yin reported modified FRAX underestimates risk for fractures among HIV+, and from HIV+ WIHS women experienced increased risk for fracture. Bigger font titles below indicate key reports, more NATAP reports coming including 9 specialized topical reports by expert researchers. Gilead has introduced a new HIV “cure” drug that appears to induce HIV reservoirs, TLR7, this immune based drug has been in ongoing research for several years at Gilead to treat HBV.

22nd Conference on Retroviruses and Opportunistic InfectionsSeattle WashingtonFeb 23 – 26, 2015

 Preventing one HIV infection in US saves $229,800 in modeling analysis – written by Mark Mascolini – (03/02/15) 

 Linkage to HIV care and viral suppression climb steadily in New York City – improvements to 76%, 73% – written by Mark Mascolini – (03/02/15) 

TAF noninferior to TDF through 48 weeks in elvitegravir combination – written by Mark Mascolini – (03/02/15) 

 Atorvastatin for 1 year trims coronary artery plaque volume and number in placebo trial – written by Mark Mascolini – (03/02/15) 

TAF easier on kidney and bone signals than TDF in 48-week trials – written by Mark Mascolini – (03/02/15) 

Do gut flora play key role in cardiovascular disease with HIV? – written by Mark Mascolini – (02/27/15) 

Lower CD4 count, higher viral load tied to primary MIs in NA-ACCORD – written by Mark Mascolini – (02/27/15) T

AF easier on kidney and bone signals than TDF in 48-week trials – written by Mark Mascolini – (02/27/15) 

Earlier ART in primary infection leads to bigger drop in cellular HIV DNA – written by Mark Mascolini – (02/27/15) 

Viral load above 1500 copies 23% of time in CDC study of 6 clinics – written by Mark Mascolini – (02/26/15) 

Levonorgestrel contraception fails in 15% of women taking efavirenz – written by Mark Mascolini – (02/26/15) 

NCI sees “sizeable absolute risk” of cancer in elderly with HIV – written by Mark Mascolini – (02/26/15) 

Lower CD4 count, higher viral load tied to primary MIs in NA-ACCORD – written by Mark Mascolini – (02/26/15) 

Almost half of US women with HIV not in regular care in CDC analysis – written by Mark Mascolini – (02/26/15) 

As-Needed PrEP Cuts HIV Rate 86% in French-Canadian Ipergay Trial – written by Mark Mascolini – (02/23/15) 

Wider PrEP Use in San Francisco Could Cut New HIV Rate by 70% – written by Mark Mascolini – (02/23/15) 

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